Below average — CMS composite of the measures below.
Past the typical resurvey interval — a standard survey could occur at any time
Estimate from public CMS data, current as of July 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Wedgemere Healthcare during CMS and state inspections, most recent first.
A resident with Alzheimer's disease, major depression, and a history of falling did not have a person-centered Activities Care Plan in place for months after admission. The IDT reviewed the resident's interests, including music, games, TV, family visits, outdoors, horses, and hot cocoa, but the comprehensive care plan did not document an activities plan until the day of survey. The interim AD said the prior AD had left and she created the plan after finding none in the record, while the DON said she was unaware the plan was missing and expected care plans to be completed within 21 days of admission.
A resident with a Stage 3 necrotic sacral pressure injury had a physician order for a sacrum/pelvis x-ray to evaluate for osteomyelitis, but the x-ray was never completed. An RN entered the order into the radiology provider’s portal, but the test was not done before the end of the shift, and there was no documented nursing follow-up to confirm completion or obtain and report results to the practitioner. The DON later learned from the radiology provider that the x-ray had been cancelled due to lack of a credentialed radiologist to read it, and the facility had not been notified of this cancellation, resulting in the ordered diagnostic test not being provided.
A resident who was dependent on staff for most ADLs and had multiple documented pressure injuries to the sacrum and buttocks was inaccurately charted by nursing staff as having intact skin and no pressure injuries on numerous dates, despite pressure ulcer evaluations showing Stage 2 and Stage 3 wounds. Weekly skin assessments also conflicted with wound documentation. Additionally, CNA ADL flow sheets for this resident contained multiple days and shifts with blank entries for all ADL care areas, even though CNAs and the DON stated that ADL care must be documented in the EMR by the end of each shift.
The facility failed to maintain accurate documentation for four residents, leading to deficiencies in MAR and TAR. A resident's MAR showed unsigned entries for medications prescribed for hypertension and diabetes, while another resident's MAR had similar issues for dementia and depression medications. A third resident's TAR lacked documentation for catheter care, and a fourth resident's MAR showed unsigned entries for diabetes medications. Interviews revealed a lack of awareness and understanding of documentation requirements among staff.
A facility failed to maintain an effective infection prevention and control program, leading to deficiencies in the care of three residents. Staff did not adhere to Contact Precautions or Enhanced Barrier Precautions, as evidenced by a nurse entering rooms without PPE and failing to perform hand hygiene. Additionally, a resident's gastrostomy tube equipment was improperly stored, exposing it to potential contaminants. These actions compromised infection control measures and increased the risk of transmission of infections.
The facility failed to maintain a clean and safe smoking area, with cigarette butts scattered in bushes and planters, and improperly maintained ashtrays. A resident noted that wind often blew over ashtrays, while the Maintenance Director reported that residents did not follow disposal instructions. The Administrator was unaware of the issues despite staff supervision.
A facility failed to create a comprehensive care plan for a resident with Diabetes Mellitus, despite the resident's severe cognitive impairment and recent hypoglycemia. The care plan did not address diabetic management, and staff interviews confirmed the absence of necessary monitoring orders and diabetic protocols.
The facility failed to implement physician orders for two residents, leading to deficiencies in care. One resident did not receive recommended eye drops, while another did not have physician-recommended treatments entered into the electronic medical record. The lack of communication and follow-through on physician orders highlights systemic issues in the facility's process for managing medical recommendations.
A resident with hemiplegia following a stroke did not receive necessary adaptive equipment, including an AFO brace and a left arm sling, essential for mobility and shoulder support. Despite physician orders, the resident was observed without these aids, and staff acknowledged the need for a custom AFO but did not arrange for one. The resident reported discomfort with the provided AFOs, and the treatment record inaccurately indicated daily application, highlighting a failure in meeting the resident's equipment needs.
A resident with a G-tube did not receive appropriate care due to errors in enteral feeding management. The facility failed to administer the correct formula, Jevity 1.5, and instead provided Osmolite 1.5, with inconsistent labeling and documentation. Nursing staff admitted to confusion and errors in following physician's orders, and the Director of Nursing confirmed the deficiencies.
Two residents in the facility had unsecured medications in their rooms, contrary to professional principles. One resident, with end-stage renal disease, had a bottle of Tylenol brought in by a friend, while another resident with glaucoma had unsecured eye drops. Neither resident had a Self-Administration of Medications Assessment completed, and staff were unaware of the presence of these medications.
The Facility did not follow its Abuse Policy by failing to conduct a Massachusetts Nurse Aide Registry (NAR) check for a nurse before her employment. The policy requires an NAR check prior to hiring, but documentation for Nurse #1, who started employment, was missing. The Administrator confirmed the requirement but could not provide evidence of compliance.
Missing Person-Centered Activities Care Plan
Penalty
Summary
The Facility failed to ensure Resident #1 had a comprehensive, person-centered care plan with interventions, treatment goals, and outcomes that addressed individual recreational activity needs. Resident #1 was admitted in October 2025 with diagnoses including Alzheimer's disease, major depression, and a history of falling. Review of the medical record from 10/21/25 through 05/11/26 showed no documentation that an Activities Care Plan had been developed and implemented to meet the resident's individual recreational activities of choice and interest during that seven-month period. The resident's care plan meeting form dated 04/29/26 showed that the interdisciplinary team reviewed activities of interest including music, games, television, family visits, outdoors, horses, and hot cocoa. However, the comprehensive care plan did not contain documentation that an activities care plan had been developed and implemented until 05/12/26, seven months after admission. During interview, the interim Activity Director stated the previous Activity Director had left at the end of April 2026, reviewed the resident's assessments and care plans, and found no Activity Care Plan in place; she created the plan on 05/12/26. The DON stated she was not aware the resident did not have an Activities Care Plan and said it was her expectation that comprehensive care plans are created by all disciplines, including activities, within 21 days of admission.
Failure to Ensure Completion and Follow-Up of Ordered X-Ray
Penalty
Summary
The facility failed to ensure that a resident received radiology services as ordered by the physician. A physician progress note dated 12/07/25 documented that the resident had a Stage 3 sacral pressure injury that appeared necrotic, and the physician ordered an x-ray of the sacrum and pelvis to evaluate for osteomyelitis. A corresponding physician order dated 12/07/25 directed staff to obtain an x-ray of the pelvis and sacrum. Review of the medical record from 12/07/25 through 12/15/25, when the resident was transferred to the hospital for evaluation, showed no documentation that the ordered x-ray had been completed. Nurse #2 reported that the physician saw the resident late in the evening on 12/07/25 and ordered the sacrum and pelvis x-ray, and that she entered the x-ray order into the radiology provider’s computer portal that same day. She stated the x-ray was not completed before the end of her shift and she was unaware it had not been done. The medical record contained no evidence that nursing staff followed up on the x-ray to determine if or when it was conducted or to obtain and report results to the physician. The DON stated that non-STAT x-rays may take a few days to be completed and reported that the radiology provider later indicated they had cancelled the x-ray because they did not have a credentialed radiologist to read the results, and that the provider did not inform facility staff of this cancellation. The DON stated it was her expectation that x-rays be obtained as ordered by the physician.
Inaccurate Wound Documentation and Incomplete ADL Charting
Penalty
Summary
The deficiency involves the facility’s failure to maintain a complete and accurate medical record for a dependent resident with multiple pressure injuries. The facility’s charting and documentation policy required that services provided, progress toward care plan goals, and any changes in a resident’s condition be documented in the medical record, and that objective observations and treatments be recorded. The resident, admitted with multiple diagnoses including dementia, depression, muscle wasting, anxiety, and dysphagia, had a care plan and MDS indicating dependence on staff for most ADLs, including transfers, bathing, dressing, and personal hygiene. Despite this, nursing documentation in progress notes and at least one weekly skin evaluation repeatedly indicated that the resident’s skin was intact and that there were no pressure injuries over multiple dates in October, November, and December. A weekly skin evaluation on 11/14 also documented clean, intact skin. These entries conflicted with the resident’s pressure ulcer evaluations, which consistently documented a Stage 3 pressure injury to the sacrum on multiple dates, as well as additional Stage 2 and Stage 3 pressure injuries on the right sacrum, left sacrum, and left buttock. During interviews, the SDC and DON acknowledged ongoing issues with nurses documenting skin as intact when residents had open areas or pressure injuries, and a nurse who authored many of the notes admitted she had inaccurately documented the resident’s skin as intact and without pressure injuries. The facility also failed to ensure complete CNA documentation of ADLs for this resident. Review of CNA ADL flow sheets for October and November showed multiple days and shifts where all ADL care areas were left blank, including several day, evening, and night shifts each month. CNAs reported that ADL documentation is done in Point of Care in the EMR and must be completed by the end of each shift, and the DON stated that CNA documentation should not be incomplete and that all care provided should be documented by the end of every shift. Nonetheless, the records showed repeated omissions, resulting in incomplete daily documentation of the resident’s ADL care.
Documentation Deficiencies in Medication and Treatment Administration
Penalty
Summary
The facility failed to maintain accurate documentation of medication and treatment administration for four residents, leading to deficiencies in the Medication Administration Records (MAR) and Treatment Administration Records (TAR). For Resident #37, the MAR from November 2024 through January 2025 showed multiple instances where medications were not signed off as administered, despite physician orders. This included medications for conditions such as hypertension, diabetes, and depression. Similarly, Resident #50's MAR for December 2024 and January 2025 also had numerous unsigned entries for medications prescribed for dementia, diabetes, and depression, among other conditions. Resident #32, who has a suprapubic catheter due to traumatic spinal cord dysfunction, had missing documentation in the TAR for catheter care and cleaning from November 2024 through January 2025. The facility's failure to document these treatments as ordered by the physician indicates a lack of adherence to the facility's policy on charting and documentation. Additionally, Resident #23's MAR from November 2024 through January 2025 showed numerous unsigned entries for medications prescribed for diabetes and other conditions, further highlighting the facility's documentation issues. Interviews with nursing staff and the Director of Nursing (DON) revealed a lack of awareness and understanding of the documentation requirements. Nurse #3 was unaware of the documentation issues and mentioned that internet outages were not communicated effectively, leading to gaps in documentation. The DON acknowledged the problem but could not determine the cause, whether it was due to internet issues or residents being out of the facility. The expectation was for nurses to document medication and treatment administration before the end of their shifts, but this was not consistently followed, resulting in significant documentation deficiencies.
Infection Control Deficiencies in Resident Care
Penalty
Summary
The facility failed to maintain an effective infection prevention and control program, resulting in deficiencies in the care of three residents. For one resident, staff did not adhere to Contact Precautions, as evidenced by a nurse entering the resident's room without personal protective equipment (PPE) and failing to perform hand hygiene before and after administering medications and checking the resident's blood pressure. The nurse also did not sanitize the blood pressure cuff before using it on another resident. Additionally, a certified nursing assistant and a housekeeper entered the resident's room without PPE and did not perform hand hygiene, further compromising infection control measures. Another resident was under Enhanced Barrier Precautions (EBP) due to a surgical wound, yet the same nurse failed to perform hand hygiene and did not wear PPE when administering medications and checking the resident's blood pressure. The nurse also did not clean the blood pressure cuff between uses on different residents. This lack of adherence to EBP and hand hygiene protocols increased the risk of transmission of multidrug-resistant organisms (MDROs) among residents. A third resident, who had a gastrostomy tube, was observed with a piston syringe lying uncovered and undated on the bedside table, exposing it to potential environmental contaminants. The facility's policy required that such equipment be stored in a sanitary manner with a protective barrier and labeled with the resident's name and date. The nurse responsible for this resident acknowledged the lack of proper storage and labeling, indicating a failure to follow infection control guidelines for maintaining gastrostomy tube equipment.
Improper Disposal of Cigarette Butts in Smoking Area
Penalty
Summary
The facility failed to maintain a safe and clean environment in the designated smoking area by not properly disposing of cigarette butts in designated safe ashtrays. Observations revealed hundreds of cigarette butts scattered along the border of the smoking area, in bushes, and in planters by the door to the facility. Additionally, white glass bowls stained with a black substance and ashes were found in the bushes, and plastic outdoor self-extinguishing ashtrays were improperly maintained, with one having its neck disconnected from the bucket, leaving cigarette butts exposed. Cigarette butts were also found in trash cans lined with plastic bags containing empty cigarette boxes. Interviews with residents and staff highlighted issues contributing to the deficiency. A resident mentioned that the ashtrays often blew over in the wind, scattering cigarette butts. The Maintenance Director (MD) stated that he cleans the smoking area twice a week, but residents often do not dispose of cigarettes in the ashtrays despite being instructed to do so. The MD also noted that the outdoor ashtray was missing a screw, causing the top to come off, and he had removed all open ashtrays from the tables. The Administrator was unaware of the cigarette litter and the missing screw, despite a staff member being assigned to supervise all smoking sessions.
Failure to Develop Comprehensive Diabetic Care Plan
Penalty
Summary
The facility failed to develop and implement an individualized, person-centered care plan for a resident with Diabetes Mellitus, resulting in a deficiency. The resident, admitted in October 2024, had diagnoses including Diabetes Mellitus with complications and diabetic neuropathy. Despite these conditions, the facility did not create a comprehensive care plan addressing the resident's diabetic management. The Minimum Data Set (MDS) assessment indicated the resident had diabetes and recent falls, but it did not include a Brief Interview for Mental Status (BIMS) to assess cognitive status. A later BIMS assessment revealed severe cognitive impairment, yet the care plan still lacked diabetic management. The hospital discharge summary noted the resident had experienced hypoglycemia due to poor intake, and their diabetic medication regimen was adjusted before discharge to the facility. Physician's orders included medications to manage blood sugar levels, but the comprehensive care plan did not reflect these needs. Interviews with facility staff, including a nurse and the Director of Nurses (DON), confirmed that a care plan for diabetes should have been in place, including monitoring blood sugars and having a diabetic order set. The absence of such a care plan and monitoring orders constituted a failure to meet the resident's needs.
Failure to Implement Physician Orders for Two Residents
Penalty
Summary
The facility failed to adhere to professional standards of practice for two residents, resulting in deficiencies in care. For Resident #54, the facility did not implement the eye doctor's recommendation for eye drops. Despite the resident being cognitively intact and aware of the recommendation, the eye drops were not ordered or administered. Interviews revealed that the Director of Nursing expected new orders from a consultant physician to be communicated and implemented, but this process was not followed, and there was no policy in place for consultant physician appointments. For Resident #23, the facility did not enter or implement physician-recommended treatments into the electronic medical record. The resident, who had severe cognitive impairment, was admitted with diabetes and a history of falls. The physician's progress notes included orders for glucose monitoring, lab work, and a chest x-ray, but these were not carried out. Interviews indicated that the physician's notes were uploaded into the electronic medical record, but nurses did not routinely read them, and there was no unit manager to oversee this process. The physician expected the orders to be entered and implemented, but this did not occur. The lack of communication and follow-through on physician orders for both residents highlights a systemic issue in the facility's process for managing and implementing medical recommendations. The absence of a policy for consultant physician appointments and the failure to ensure that physician orders are read and acted upon contributed to the deficiencies observed in the care of these residents.
Failure to Provide Necessary Adaptive Equipment for Resident
Penalty
Summary
The facility failed to provide necessary adaptive equipment for a resident with hemiplegia following a stroke, specifically an ankle foot orthosis (AFO) brace and a left arm sling, which were essential for the resident's mobility and shoulder support. The resident, who had moderate cognitive impairment and a history of falls, was observed multiple times without the AFO brace and sling, despite physician orders indicating their necessity. The resident expressed discomfort with the AFOs provided, and the facility staff acknowledged the need for a custom AFO but did not follow through with obtaining one. Interviews with the rehabilitation staff and the Director of Nurses revealed a lack of communication and follow-up regarding the resident's need for a custom AFO. The rehabilitation staff trialed various AFOs, but they were uncomfortable for the resident, and the custom AFO was never arranged. Additionally, the resident's treatment administration record inaccurately indicated that the AFO was applied daily, despite its absence. The resident also reported that the sling was not regularly applied, and the AFO was removed by therapy staff due to discomfort, highlighting a failure in ensuring the resident's adaptive equipment needs were met.
Inadequate Enteral Feeding Management for Resident with G-tube
Penalty
Summary
The facility failed to provide appropriate care and services for a resident with a Gastrostomy tube (G-tube), specifically in the administration of enteral feeding. The resident, who was admitted with diagnoses including dysphagia and intracranial hemorrhage, was observed to have discrepancies in the labeling and administration of their enteral nutrition. The feeding pump was set at 45 ml/hr with a flush of 150 ml every 6 hours, but the formula labels were inconsistent and sometimes incorrect, with one instance showing a different resident's name and room number. The facility's policy required that enteral formulas be labeled with specific information, including the resident's identifiers, formula name, date, and time of preparation, and administration details. However, observations revealed that the labels on the formula and water flush bags were incomplete or incorrect, leading to the administration of the wrong formula, Osmolite 1.5, instead of the prescribed Jevity 1.5. Additionally, the water flush bag was not changed as required, and the tubing set was not documented as changed every 24 hours, as per the physician's orders. Interviews with nursing staff revealed confusion and errors in following the physician's orders and facility policies. Nurse #4 admitted to changing the formula upon noticing the error but did not change the water flush bag or tubing. Nurse #2 acknowledged the labeling errors and confusion between different residents' formulas. The Director of Nursing confirmed that the physician's orders were not followed and that the labeling should have been completed accurately to prevent such errors.
Unsecured Medications Found in Residents' Rooms
Penalty
Summary
The facility failed to ensure that medications were stored securely in accordance with professional principles for two residents. Resident #31, who was cognitively intact and admitted with end-stage renal disease, had a bottle of Tylenol left unsecured in their room. The resident admitted to having a friend bring the medication into the facility, unaware that it was against policy to have unsecured medications in their room. There was no documentation of a Self-Administration of Medications Assessment for Resident #31, and Nurse #1 confirmed that the resident was not authorized to self-administer medications. Resident #67, who had moderate cognitive impairment and was admitted with glaucoma, had unsecured bottles of Timolol and Latanoprost eye drops in their room. These medications were found in a clear plastic bag on top of the resident's bureau. Nurse #1, who administered the eye drops daily, was unaware of their presence in the room and suggested they might have come from the hospital. The Director of Nursing confirmed that medications should not be kept in residents' rooms unless they are locked and secure, and a proper assessment and physician's order are in place for self-administration.
Failure to Conduct NAR Check Before Employment
Penalty
Summary
The Facility failed to adhere to its Abuse Policy by not conducting a Massachusetts Nurse Aide Registry (NAR) check for a nurse prior to her employment. The Facility's policy, revised in February 2024, mandates that an NAR check is performed before hiring any employee. However, upon reviewing the employee file of Nurse #1, it was found that her employment began on March 4, 2024, without any documentation of an NAR check being conducted beforehand. During an interview, the Administrator confirmed that all employees are required to have an NAR check before starting employment, but the Facility could not provide evidence that this was done for Nurse #1.
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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Nursing homes near Taunton
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Marian Manor Of Taunton | 0.9 mi | ★★★★★ | 1 | 0 |
| Regalcare At Taunton | 1.8 mi | ★★★★★ | 0 | 0 |
| Life Care Center Of Raynham | 1.9 mi | ★★★★★ | 0 | 0 |
| Life Care Center Of West Bridgewater | 7.4 mi | ★★★★★ | 0 | 0 |
| Oakhill Healthcare | 8.2 mi | ★★★★★ | 13 | 0 |
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