Above average — CMS composite of the measures below.
The next survey window likely opens around January 2027
Estimate from public CMS data, current as of August 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Maine Veterans Home - Caribou during CMS and state inspections, most recent first.
Failure to notify the provider of a significant change in condition: A resident with CHF, pulmonary fibrosis, pulmonary HTN, and chronic respiratory failure developed worsening SOB, anxiety, and restlessness with O2 needs increasing above the ordered level. Staff documented the resident’s request to go to the hospital and use of 8 L O2 via NRB, but the provider was not notified until later, when the resident was found in respiratory distress and required morphine for comfort.
The facility failed to follow its infection control policies by not ensuring staff wore gown and gloves in rooms under EBP and Contact Precautions and by not discarding a pill that fell onto the medication cart. Staff were observed providing direct care and medication administration to residents with foley-related EBP and shingles-related Contact Precautions without the required PPE, and a CNA-M attempted to reuse a pill that had fallen onto the cart before it was ultimately placed for disposal.
Failure to Follow Abuse Reporting and Protection Procedures: A resident reported feeling unsafe around an RN and described the RN being rough with a roommate and forcefully pushing the roommate back into bed. CNAs emailed the DON about the allegation, but the report was delayed, CNAs did not have access to on-call contact information to report immediately, and the RN was allowed to continue working the rest of the shift after the allegation was reported.
Failure to provide ordered respiratory care for two residents. One resident was observed in the dining room wearing nasal cannula tubing connected to an empty O2 tank, and an RN confirmed the tank was empty even though the resident was ordered continuous O2. Another resident had orders for continuous O2 up to 5 LPM and PRN albuterol for dyspnea, but the record showed O2 was given at 8 LPM without evidence of new orders, PRN neb treatments, or provider notification.
Inaccurate clinical record documentation was found for three residents. One resident’s chart incorrectly stated that a Foley catheter was not in place despite admission with an indwelling catheter, another resident’s wound records and care plan identified the wrong heel for a pressure injury, and a third resident’s activity record documented participation after the resident had already died. The DON, RN2, and Staff Development Coordinator confirmed the inaccuracies.
A facility failed to maintain the dignity of a resident by not properly covering their Foley catheter bag, as specified in the care plan. On multiple occasions, surveyors observed the catheter bag's covering riding up, exposing urine while the resident was in public areas, such as the dining room and hallway. This deficiency was confirmed by surveyors and the Staff Development Coordinator.
A facility failed to follow a resident's preferred bathing schedule, providing showers only once a month instead of weekly as requested. The resident reported this issue, and CNA documentation confirmed the infrequency of showers. The DON acknowledged the discrepancy, noting two instances of documented refusal.
The facility failed to maintain resident-centered care plans for two residents. One resident's care plan was not followed, as fluids were not within reach and a Hoyer sling was left under them, contrary to instructions. Another resident experienced significant weight loss, but their care plan lacked updates to address nutritional needs and weight monitoring. The care plans were not effectively updated or implemented to meet the residents' needs.
A resident experienced significant weight loss despite being prescribed a nutritional supplement. The facility failed to implement effective interventions or update the care plan to address the resident's nutritional needs and preferences. The dietary manager did not communicate food preferences to staff or notify the physician of the weight loss, and the resident was not included in the monitoring list for weight loss. This lack of communication and failure to provide resident-centered care led to the deficiency.
The facility failed to maintain complete oxygen orders and proper equipment maintenance for two residents. One resident's oxygen concentrator was missing a side filter, contrary to manufacturer instructions, and lacked a specific flow rate in the order. Another resident's clinical record was not updated with the correct oxygen order after a hospital visit, leading to incorrect administration. The DON acknowledged the need for specific flow rates in orders.
Failure to Notify Provider of Significant Respiratory Decline
Penalty
Summary
The facility failed to notify the physician of a significant change in condition for one resident with diagnoses including congestive heart failure, chronic idiopathic pulmonary fibrosis, pulmonary hypertension, chronic respiratory failure, and a right humerus fracture. The resident’s oxygen order allowed continuous oxygen up to 5 LPM to keep saturation above 88%, but the clinical record showed the resident’s oxygen was increased to 8 LPM on 1/26/26, and there was no evidence the provider was notified of that increased oxygen requirement. The record also showed the resident had acute shortness of breath, oxygen saturation that was not improving despite increased oxygen, weakness, diffuse crackles, and rhonchi during a provider visit on 1/26/26. On 1/27/26, a late-entry nurse note documented that the resident’s POA reported the resident had been requesting to go to the hospital. The note also described increased anxiety and restlessness requiring frequent staff intervention and redirection, and that the resident was on 8 L via non-rebreather mask with repeated oxygen saturation drops into the 80s on nasal cannula. The record lacked evidence that the provider was notified of the resident’s request to transfer to the hospital or of the increased oxygen demand. The note discussed comfort measures and code status changes with the POA, but the record did not show provider notification of the resident’s change in condition. The provider was not aware of the resident’s respiratory distress until entering the room on 1/29/26 while following up on low blood glucose results. At that time, the provider observed the resident struggling to breathe, using accessory muscles, appearing uncomfortable, and trying to remove the oxygen mask. The provider stated she had not been aware the resident’s oxygen demand had increased to 8 LPM and that she had to order morphine to help the resident become comfortable. The DON stated she was unaware the resident had requested to go to the hospital and that staff needed more education, and surveyors confirmed the providers were not made aware of the resident’s request or the worsening respiratory condition before that visit.
Infection Control Program Not Followed for PPE Use and Medication Handling
Penalty
Summary
The facility failed to maintain its Infection Control Program by not ensuring staff used the required PPE in rooms under Enhanced Barrier Precautions and Contact Precautions, and by not ensuring a dropped medication pill was discarded after it fell onto the medication cart. The facility policy for Enhanced Barrier Precautions stated that gown and gloves are used during high-contact resident care activities to reduce transfer of MDROs, but on 2/2/26 a surveyor observed a PTA sitting on a resident’s bed next to the resident’s foley bag while assisting with foot and leg exercises without PPE, and an OTA kneeling beside the bed and leaning on it while applying lotion to the resident’s arm without PPE. A CNA later stated the resident was on EBP related to the foley and that PPE was needed for direct care such as bathing or draining the foley bag, but not when the resident was up in a chair. The facility policy for Contact Precautions stated that staff and medical providers were to wear a gown and gloves upon room entry. On 2/4/26, a CNA-M gave medications to a resident on Contact Precautions for shingles without wearing a gown or gloves, and the Infection Preventionist stated the CNA-M should have worn PPE. On 2/5/26, during a medication pass, CNA-M tipped over a medication cup and one pill fell onto the top of the medication cart; CNA-M initially tried to place the pill back into the cup with a spoon before being stopped, and the Infection Preventionist later stated the fallen pill should have been thrown away once it fell on the cart. Later that day, a provider and RN4 were observed in a room with a resident suspected of shingles while not wearing the PPE required by the Contact Precautions sign outside the door, and the provider stated she had just diagnosed the resident with shingles.
Failure to Follow Abuse Reporting and Protection Procedures
Penalty
Summary
The facility failed to implement its written abuse, neglect, exploitation, and misappropriation of property policy after a resident reported an allegation of abuse involving RN1. The policy stated that resident complaints of abuse, unexplained bruises or injuries, fear of another person, and refusal to be with a specific person were indicators of abuse, and that staff were to intervene immediately to protect residents in situations of actual or potential abuse or mistreatment. It also required staff to report suspected abuse immediately to a supervisor, with subsequent reports to the Administrator and DNS. On 1/27/26, CNA2 emailed the DNS that R41 whispered that RN1 scared him/her and that the resident had watched RN1 be rough with R16, saying to call for help if yelling was heard because the resident was scared of RN1. On 1/28/26, CNA3 emailed the DNS that R41 said he/she did not feel safe around RN1, described RN1 as being too rough with R16, and said to run to the room if screaming was heard. The DNS confirmed this was a delayed report of an allegation made on 1/27/26. During an interview on 2/5/26, R41 stated RN1 scolded R16, used both hands on R16's shoulders, and pushed R16 back into bed so forcefully that RN1 was over R16 in the bed, and stated that he/she was afraid of RN1 and had reported the incident to the CNAs. The DNS stated RN1 was the only nurse on the night shift and could have been covered by the on-call nurse, but CNAs were not typically aware of the on-call schedule or how to contact that nurse. Surveyors confirmed CNAs were unable to report the allegation immediately to a supervisor because they did not have access to the on-call information, and RN1 was allowed to continue working the remainder of the shift after the allegation was reported.
Failure to Provide Ordered Respiratory Care
Penalty
Summary
The facility failed to provide respiratory care as ordered for 2 of 16 residents reviewed. During a dining observation, R5 was seen sitting in the dining room wearing nasal cannula tubing connected to an empty oxygen tank, and RN2 confirmed that the tank was empty even though R5 was supposed to receive 2 L of oxygen continuously. For R16, the clinical record showed orders for continuous oxygen therapy up to 5 LPM by nasal cannula to keep oxygen greater than 88%, and Albuterol Sulfate nebulizer treatments three times daily as needed for dyspnea. Review of the treatment administration record showed that R16 received continuous oxygen at 8 LPM over the reviewed period, but the record lacked evidence of new orders for the increased oxygen amount, PRN nebulizer treatments for dyspnea, or notification of the provider about the change in condition. During interview, the DON and surveyors reviewed the record and confirmed that the respiratory care was not implemented as directed.
Inaccurate Clinical Record Documentation
Penalty
Summary
The facility failed to ensure that clinical records contained accurate and complete information for 3 of 17 sampled residents. For one resident, the DON confirmed the resident was admitted with an indwelling Foley catheter, yet a nurse note dated 1/28/26 documented that the resident did not have an indwelling catheter in place and described a sudden onset of incontinence. This documentation was confirmed as inaccurate during the surveyor interview with the DON. For a second resident, physician orders identified a pressure injury to the right Achilles heel, but weekly wound documentation described the wound as a healing stage 2 to the back of the left ankle/Achilles, and the care plan also identified the pressure injury on the left Achilles heel. RN2 stated the pressure injury was actually on the right heel and acknowledged documenting it incorrectly. For a third resident, activity documentation recorded participation in one-to-one socialization and afternoon activities on 2/1/26, but the Staff Development Coordinator stated the resident had died on 1/30/26, and the surveyor confirmed the record was inaccurately documented.
Failure to Maintain Resident Dignity with Foley Catheter Bag
Penalty
Summary
The facility failed to maintain the dignity of a resident, identified as Resident #29, in relation to the handling of urinary collection bags. The resident's care plan, dated May 25, 2023, specified that the Foley catheter bag should be covered to maintain dignity when the resident is out of their room. However, on two separate days during the survey, the resident's Foley catheter bag was observed with the blue covering riding up, exposing urine at the bottom of the bag. These observations occurred while the resident was in the dining room and in the doorway of their room, facing the hallway. The deficiency was confirmed by surveyors and the Staff Development Coordinator during these observations.
Failure to Adhere to Resident's Bathing Schedule
Penalty
Summary
The facility failed to honor a resident's right to self-determination by not adhering to the resident's choice in bathing frequency. A resident reported to a surveyor that they were not receiving their scheduled weekly showers, instead only receiving a shower approximately once a month. This was corroborated by a review of the Certified Nursing Assistant (CNA) documentation, which showed that the resident had only received two showers between November 1, 2024, and January 7, 2025. The resident was scheduled for a shower on Mondays, but the documentation and physical observation of the shower room indicated that the resident did not receive their scheduled shower on January 6, 2025. The Director of Nursing Services confirmed the discrepancy in the resident's shower schedule, noting that two instances were documented as the resident refusing bathing.
Deficiencies in Resident Care Plans
Penalty
Summary
The facility failed to ensure that the care plan for two residents was resident-centered, updated, and implemented effectively. For one resident, who transitioned to hospice care, the care plan identified potential issues such as constipation, fluid volume deficit, and disruptive behaviors related to dementia. However, observations revealed that the care plan was not followed, as the resident was found without fluids within reach and with a Hoyer sling left under them, contrary to the care plan's instructions. Staff interviews indicated that the care plan was not updated to reflect the resident's current needs, such as allowing the Hoyer sling to remain for comfort and addressing the resident's response to reduced stimulation. Another resident experienced significant weight loss over several months, yet their care plan was not adequately updated to address this issue. The care plan initially set goals for meal consumption and weight maintenance, but these goals were revised without addressing the use of nutritional supplements or the resident's meal preferences. The care plan also lacked specific parameters for weight monitoring, which contributed to the failure to prevent further weight loss. The surveyor confirmed that the care plan was not resident-centered or updated to effectively monitor and treat the resident's unintended weight loss.
Failure to Address Significant Weight Loss in a Resident
Penalty
Summary
The facility failed to address significant weight loss for a resident, identified as Resident #33 (R33), who experienced a 12.17% weight loss over a period of less than six months. Despite being prescribed a nutritional supplement, Carnation Instant Breakfast, to be given at each meal, the resident's weight continued to decline from 98.6 pounds to 86.6 pounds. The dietary notes indicated an involuntary weight loss and set goals to maintain a certain weight range, but these goals were not met, and no effective interventions were implemented to prevent further weight loss. The dietary manager did not communicate food preferences to staff or notify the physician of the weight loss, relying instead on interdisciplinary team meetings for care planning. The care plan for R33 was not updated to reflect the resident's nutritional needs or preferences, and the approach did not address the use of supplements or weight monitoring parameters. The Director of Nursing Services confirmed that the care plan was not resident-centered or updated to prevent further unintended weight loss. Additionally, the Staff Development Coordinator, responsible for monitoring residents with weight loss, did not include R33 in the monitoring list, and the provider was not notified of the significant weight loss. This lack of communication and failure to implement a resident-centered care plan contributed to the deficiency.
Incomplete Oxygen Orders and Equipment Maintenance Deficiencies
Penalty
Summary
The facility failed to provide complete and appropriate respiratory care for two residents using oxygen concentrators. For one resident, the oxygen concentrator was observed to be missing a side filter, which is against the manufacturer's instructions that explicitly state not to operate the concentrator without the filter installed. This issue was observed on two consecutive days, and the resident's order for oxygen therapy was incomplete as it did not specify the flow rate, only stating to keep oxygen saturation above 88%. For another resident with a diagnosis of chronic obstructive pulmonary disease, the facility did not update the clinical record with the correct physician order after the resident returned from the hospital. The order specified oxygen to be administered at 2 liters per minute to maintain saturation above 90%, but the concentrator was set at 3 liters per minute. The Director of Nursing Services acknowledged that the physician orders should include the specific amount of liters to administer, confirming the deficiency in the documentation and execution of the oxygen therapy orders.
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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 Caribou
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Caribou Rehab And Nursing Center | 1.6 mi | ★★★★★ | 1 | 0 |
| Borderview Rehab & Living Ctr | 21 mi | ★★★★★ | 5 | 0 |
| Aroostook Health Center | 23.8 mi | ★★★★★ | 22 | 0 |
| Mercy Home | 30.5 mi | — | 0 | 0 |
| High View Rehabilitation And Living Center | 37.7 mi | ★★★★★ | 0 | 0 |
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Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release August 2026) and official state health department websites.