Below average — CMS composite of the measures below.
A standard survey is most likely before around August 2026
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 Russell Park Rehabilitation & Living Center during CMS and state inspections, most recent first.
The facility did not ensure that two authorized staff signed the controlled substance shift count sheets at each shift change for multiple medication carts, resulting in incomplete records for the receipt and disposition of controlled drugs, as confirmed by the DON and facility policy.
Two residents who smoked were not assessed for their ability to smoke safely, as required by facility policy. One resident was found with cigarettes and a lighter at bedside and reported occasional staff supervision while smoking outside, but had no documented assessment or contract. Another resident, who smoked independently, also lacked a completed smoking assessment, despite having cigarettes in their possession. The DON confirmed that these assessments, which determine if residents can keep smoking materials at bedside, were not completed as required.
Surveyors found that several residents with respiratory conditions were using oxygen tubing and nebulizer equipment that was not changed or stored according to physician orders and facility policy. Staff documented tubing changes as completed, but observations showed outdated tubing in use and improper storage of respiratory equipment, indicating a failure to maintain a sanitary environment and follow prescribed care schedules.
Surveyors observed unsanitary conditions in the kitchen, including food debris, dirt, and spillage on floors and equipment, as well as soiled dish racks. Additionally, a Dietary Aid with facial hair was found not wearing a beard restraint as required by facility policy, only applying it after being prompted by surveyors.
A review of CNA education records and staff interviews confirmed that several CNAs did not receive the required 12 hours of annual in-service training, including dementia care, resident rights, and abuse/neglect prevention, as mandated for the year. Documentation for these trainings was not available for any of the CNAs reviewed.
Surveyors found multiple deficiencies in facility maintenance and housekeeping, including stained and dirty caulking around toilets, damaged shower curtains, chipped paint on doors and heaters, uncleanable surfaces due to duct tape and marred walls, and a resident's electric wheelchair with food debris. These issues were confirmed by the Environmental Services Director and Administrator.
Staff did not consistently monitor or document urinary output for two residents with indwelling catheters, despite care plans requiring this intervention. Both residents had medical conditions necessitating catheter use, and their care plans specified monitoring and documentation of urine output, which was not carried out as written.
Annual performance evaluations were not completed for five CNAs employed for over a year, as confirmed by the DON and a review of employee records. Documentation for the required 2024 evaluations was missing for all affected staff.
The facility did not provide sufficient documentation to justify the ongoing use of psychotropic medications for two residents. One resident continued to receive multiple psychotropic drugs after a fall without a documented risk-benefit assessment, while another had a PRN order for Lorazepam that exceeded the 14-day limit without clinical justification.
A resident with a physician's order for 7 units of Aspart insulin was instead given 12 units of Humalog insulin. The nurse on duty could not verify the amount administered, and the error was later confirmed by the DON. The resident expressed anxiety and requested additional blood glucose checks after being informed of the incident.
Surveyors found that an LPN failed to label and properly dispose of open biologicals, including an unlabeled Basaglar insulin pen and an Epinephrine injection, as required by manufacturer instructions. The issue was confirmed and discussed with the DON.
Surveyors and the FSD observed a heavily soiled garbage storage area with food and trash debris behind three dumpsters, confirming the area was not maintained in a sanitary condition.
The Quality Assurance Committee failed to ensure the effectiveness of a corrective plan for a previously cited deficiency regarding the maintenance of a sanitary environment to prevent disease and infection related to respiratory care, resulting in the same issue being cited again during a follow-up survey, as confirmed by the Administrator and DON.
A facility failed to maintain accurate clinical records for a resident with a stage 4 pressure ulcer, as repositioning was not consistently documented or performed. Interviews confirmed the lack of compliance with repositioning orders. Additionally, another resident was prescribed psychotropic medications without appropriate diagnoses, violating the facility's policy. The DON confirmed these deficiencies with surveyors.
The facility failed to implement infection control precautions for residents with indwelling catheters, leading to multiple infections. A resident with a neurogenic bladder and another with a history of urosepsis were not placed on Enhanced Barrier Precautions or contact precautions despite having ESBL diagnoses. Staff were unaware of the infection status and necessary precautions. The DON confirmed the oversight and acknowledged the need for precautions for all residents with catheters.
The facility failed to ensure call bell accessibility for two residents. Observations showed one resident's call bell was hanging from the wall and attached to a wiffleball at the end of the bed, while another's was tucked under them, both out of reach. CNAs noted that one resident rarely uses the call bell, relying on their roommate to use it instead, and acknowledged that staff should ensure call bells are accessible.
Failure to Maintain Accurate Controlled Substance Shift Counts
Penalty
Summary
The facility failed to maintain an adequate system for recording the receipt and disposition of all controlled drugs, resulting in insufficient detail to enable accurate reconciliation. During a review of three medication carts (Cart A, Cart B & C, and the Nurse Treatment cart), it was observed that the required signatures from two authorized medication administrators were missing from the Shift Count pages on multiple dates. The facility's policy requires that incoming and outgoing nurses count all Schedule 2 controlled substances and other medications with a risk of abuse or diversion at each shift change and document the results on a Controlled Substance Count Verification/Shift Count Sheet. However, on numerous occasions, the required documentation was not completed as indicated by the absence of signatures, despite the facility's practice of counting controlled substances approximately three times a day at shift changes. The Director of Nursing Services confirmed the findings, acknowledging that a significant number of required signatures were missing from the narcotic books. The deficiency was identified through record review, observation, and staff interview, and it was corroborated by the facility's own policy dated 8/1/24, which outlines the procedures for inventory control of controlled substances. No information was provided regarding specific residents affected or their medical conditions at the time of the deficiency.
Failure to Complete Smoking Assessments and Contracts for Residents
Penalty
Summary
The facility failed to complete required smoking assessments and contracts for two residents who were identified as smokers. One resident, who had been smoking since admission approximately two weeks prior, was observed with cigarettes and a lighter at the bedside. The resident confirmed that staff occasionally accompanied them to the designated outdoor smoking area. Review of the medical record showed no evidence of a smoking assessment or a signed smoking contract upon admission or after the facility became aware of the resident's smoking. The Director of Nursing Services (DNS) confirmed that the assessment was not completed until after the surveyor's inquiry. Another resident, also identified as a smoker, was found with multiple boxes of cigarettes in their room, including one in their shirt pocket and two on the windowsill. The resident was reported by an LPN to go out alone to smoke. Review of this resident's clinical record, who was admitted several months prior, also lacked evidence of a completed smoking assessment. The DNS confirmed that no assessment had been completed for this resident, and acknowledged that the assessment determines whether residents may keep smoking materials at bedside or require them to be secured. The facility's policy requires a smoking assessment upon admission or when a resident begins smoking, and quarterly thereafter.
Failure to Maintain Sanitary Respiratory Care Equipment and Adhere to Change Schedules
Penalty
Summary
The facility failed to maintain a sanitary environment and adhere to physician orders and facility policy regarding respiratory care for five residents requiring oxygen therapy or nebulizer treatments. Multiple residents were observed using oxygen tubing and nasal cannulas that were not changed according to the prescribed weekly schedule, with tubing dated well beyond the required change interval. Documentation on the Treatment Administration Record (TAR) indicated that tubing changes were recorded as completed, but direct observation showed otherwise. Additionally, nebulizer equipment was improperly stored, with one resident's nebulizer mask and tubing left unlabeled and on a dresser, and another resident's oxygen cannula left wrapped around a cylinder caddy handle instead of being stored in a protective bag as required by policy. Residents involved had significant respiratory diagnoses, including acute and chronic respiratory failure, hypoxia, COPD, metastatic lung cancer, and end-stage emphysema, necessitating strict adherence to respiratory care protocols. Staff interviews revealed inconsistent understanding and application of the facility's policy, with some staff stating tubing was changed every two weeks despite orders and documentation indicating weekly changes. The facility's own policy required nasal cannulas to be changed every two weeks and stored in a plastic bag when not in use, and nebulizer parts to be cleaned and stored properly, but these procedures were not consistently followed.
Failure to Maintain Kitchen Sanitation and Staff Compliance with Beard Restraints
Penalty
Summary
The facility failed to maintain the kitchen in a clean and sanitary condition, as evidenced by observations of food debris and trash on the kitchen floor, under equipment, and shelving. Additional findings included dirt and debris in the hood system, the fan in the walk-in refrigerator, and the fly zapper. The reach-in refrigerator, walk-in refrigerator, and walk-in freezer all had dirt, debris, and spillage on their floors. Plastic coverings on racks containing clean dishes were found to be in poor condition and soiled with dry liquid residue. These conditions were confirmed by the Food Service Director during the survey. Furthermore, a Dietary Aid with facial hair was observed not wearing a beard restraint while in the kitchen, contrary to facility policy, and only applied the restraint after surveyor intervention. The facility's policy requires all employees to wear appropriate hair restraints to prevent hair from contacting exposed food.
Failure to Provide Required Annual CNA In-Service Training
Penalty
Summary
The facility failed to ensure that all Certified Nursing Assistants (CNAs) employed for more than one year received the required 12 hours of annual in-service education, including training in dementia care, resident rights, and abuse/neglect prevention. A review of employee education records for five CNAs revealed a lack of documentation showing completion of these mandatory trainings for the year 2024. Each CNA's file was specifically noted to be missing evidence of the required education hours and content areas. Interviews with the Business Office Manager and the Director of Nursing Services confirmed that there was no documentation available to demonstrate that the five CNAs had received the necessary annual in-service training. The deficiency was identified through both record review and staff interviews, with no evidence provided to show compliance with the training requirements for the specified period.
Facility Fails to Maintain Clean and Homelike Environment
Penalty
Summary
During an environmental services tour, multiple deficiencies were observed throughout the facility, indicating a failure to maintain a safe, clean, and homelike environment for residents. In the A Unit shower/spa room, the caulking around the base of the toilet was stained and dirty, all four shower curtains were stained or ripped, and both the heater unit and entrance door had chipped or missing paint, creating uncleanable surfaces. Several resident rooms in the A Unit had issues such as missing or damaged privacy curtain hooks, chipped or marred walls with black marks, stained or dirty caulking around toilets, discolored flooring, dusty bathroom exhaust fans, and doors with chipped or missing laminate. A wash basin was also found sitting on the floor under a sink in one room. In the B Unit, similar issues were noted, including stained and dirty caulking and flooring around toilets, duct tape stuck to the bathroom floor creating uncleanable surfaces, and a baseboard heater with separated metal parts. Additionally, a resident's electric wheelchair was found to be dirty and dusty, with food crumbs and debris present. The C Unit also had a resident room with a door that had chipped, gouged, and missing laminate. These findings were confirmed by the Environmental Services Director and the Administrator during the tour.
Failure to Implement Care Plan Interventions for Indwelling Catheters
Penalty
Summary
The facility failed to implement care plan interventions for two residents who required indwelling urinary catheters. Both residents had documented medical conditions—one with obstructive uropathy and neuromuscular dysfunction of the bladder, and the other with neurogenic bladder and a history of urinary tract infections—that necessitated the use of indwelling catheters. Their care plans specifically included interventions to record the amount, color, and characteristics of urine, and to monitor and document urinary output. Record reviews and interviews revealed that staff did not consistently monitor or document urinary output for either resident, as required by their care plans. Documentation from CNAs and the Nurse Treatment Administration Record lacked evidence of this monitoring. Interviews with the Administrator and the Director of Nursing Services confirmed that urinary output was not documented unless there was a physician's order, despite the care plan directives. This resulted in the facility not following the established care plans for these residents.
Failure to Complete Annual CNA Performance Evaluations
Penalty
Summary
The facility failed to complete annual performance evaluations for Certified Nursing Assistants (CNAs) as required, with no evidence of evaluations being conducted for five CNAs who had been employed for more than one year. Employee records for each of these CNAs, hired between 2002 and 2023, did not contain documentation of an annual performance evaluation for the year 2024. This deficiency was confirmed during an interview with the Director of Nursing Services, who acknowledged that the annual evaluations had not been completed for these staff members. No information regarding the medical history or condition of residents was provided in relation to this deficiency.
Failure to Justify and Limit Psychotropic Medication Use
Penalty
Summary
The facility failed to provide adequate documentation to justify the continued use of psychotropic medications for two residents. For one resident admitted in September 2024, the consultant pharmacist identified several medications, including Risperidone, Lorazepam, Fluoxetine, and Trazodone, as potential contributors to a recent fall. The pharmacist recommended that the physician evaluate these medications for their role in the fall and document a risk versus benefit assessment if therapy was to continue. The physician initially responded with 'Thank you. No change.' and later, after further inquiry, noted that the medications were being titrated for dementia and for safety/dignity, but did not provide a specific assessment or justification as recommended. For another resident, there was a provider order for Lorazepam 0.5 mg orally as needed for anxiety disorder, with no stop date, exceeding the required 14-day limit for PRN psychotropic medications. As of the date of review, the medical record did not contain evidence of clinical rationale to continue the medication beyond 14 days. These findings were confirmed through record review and interviews with the Director of Nursing Services.
Failure to Follow Physician Orders for Insulin Administration
Penalty
Summary
A physician's order was in place for a resident to receive 7 units of Aspart insulin subcutaneously three times daily. On one occasion, the resident returned from dialysis and a blood glucose check was performed. The nurse on duty administered insulin but was unable to verify the amount given when questioned by the charge nurse and the resident. The resident reported being told by the charge nurse that the wrong amount was given, but neither the nurse on duty nor the resident could specify the exact dosage at that time. Further review and interview with the Director of Nursing Services confirmed that the resident was given 12 units of Humalog insulin instead of the ordered 7 units of Aspart insulin. The nurse on duty also informed the night charge nurse of the situation, and the resident expressed anxiety and requested additional blood glucose monitoring. The physician's order was not followed, resulting in the administration of the incorrect type and dosage of insulin.
Failure to Properly Label and Dispose of Open Biologicals
Penalty
Summary
Surveyors observed that the facility failed to properly label and dispose of open biologicals in accordance with manufacturer specifications during an inspection of one of three medication carts. Specifically, an opened and unlabeled Basaglar (insulin) Kwik Pen was found, which, according to the manufacturer's instructions, should be discarded 28 days after first use, but lacked a date indicating when it was opened. Additionally, an Epinephrine injection was present with a manufacturer expiration date of 4/2025, but it was either undated or expired. These findings were confirmed by the LPN present at the time of observation and subsequently discussed with the Director of Nursing Services. No information about the residents involved or their medical conditions was provided in the report.
Unsanitary Garbage Storage Area Observed
Penalty
Summary
Surveyors, accompanied by the Food Service Director, observed a heavily soiled garbage storage area containing three trash dumpsters. Food and trash debris were noted behind all three dumpsters. This unsanitary condition was directly observed and confirmed during the survey. No information regarding residents or their medical history was included in the report.
Repeat Deficiency in Sanitary Environment for Respiratory Care
Penalty
Summary
The facility's Quality Assurance Committee did not ensure the effectiveness of the Plan of Correction for previously identified deficiencies from the Annual Long Term Care Survey Process. Specifically, the federal citation F695, related to failure to maintain a sanitary environment to help prevent the development and transmission of disease and infection associated with respiratory care, was cited again during a follow-up survey. This repeat deficiency was confirmed through record review and interviews with the Administrator and the Director of Nursing.
Deficiencies in Clinical Record Accuracy and Psychotropic Medication Orders
Penalty
Summary
The facility failed to maintain complete and accurate clinical records for a resident with a stage 4 pressure ulcer. The resident was supposed to be repositioned every two hours as per the provider's orders, but the documentation from July 11 to August 13 lacked evidence of compliance. Interviews with the resident, a Licensed Practical Nurse (LPN), Certified Nursing Assistants (CNAs), and the Director of Nursing confirmed that the repositioning was not consistently documented or performed as ordered. The resident expressed that staff did not follow the repositioning schedule, and the LPN and CNAs indicated that the documentation was either assumed or incomplete. Additionally, the facility did not ensure that psychotropic medication orders for another resident included appropriate diagnoses. The resident was prescribed several psychotropic medications, including Sertraline, Lorazepam, and Trazodone, without corresponding diagnoses as required by the facility's Psychoactive Medication Use Policy. The Director of Nursing confirmed with surveyors that the medications lacked appropriate diagnoses, which was a violation of the facility's policy.
Failure to Implement Infection Control Precautions for Residents with Catheters
Penalty
Summary
The facility failed to implement an effective infection prevention and control program for residents with indwelling medical devices, specifically foley catheters. Three residents were identified as not being placed on Enhanced Barrier Precautions (EBP) or contact precautions despite having conditions that warranted such measures. Resident #1, who was admitted with a neurogenic bladder requiring a foley catheter, was not placed on EBP upon admission and later developed urosepsis secondary to a urinary tract infection. Despite a diagnosis of Escherichia coli with extended spectrum beta-lactamase (ESBL) activity, there was no evidence of contact precautions being implemented. Staff, including a Licensed Practical Nurse (LPN) and a Certified Nursing Assistant (CNA), were unaware of the resident's infection status and the necessary precautions. Similarly, Resident #3, with a history of urosepsis and a urinary catheter, was not placed on EBP upon admission and was later diagnosed with ESBL without subsequent contact precautions. Staff interviews revealed a lack of awareness regarding the resident's infection status and the required precautions. Resident #2, also with an indwelling catheter, was observed without EBP despite having a recent order for antibiotics due to a urinary tract infection. The Director of Nursing (DON) confirmed that residents with catheters had multiple infections and were not placed on appropriate precautions, acknowledging a gap in following CDC guidelines.
Failure to Ensure Call Bell Accessibility for Residents
Penalty
Summary
The facility failed to make reasonable accommodations to ensure the call system was within reach for two residents. Observations on August 13, 2024, revealed that the call bell for Resident #2 was hanging from the wall and attached to a wiffleball at the end of the bed, making it inaccessible. Similarly, the call bell for Resident #1 was found tucked under the resident, also out of reach. Interviews with Certified Nursing Assistants (CNAs) indicated that Resident #2 rarely uses the call bell, relying instead on their roommate, Resident #1, to use it on their behalf. CNA #2 acknowledged that all staff should ensure call bells are within reach for all residents.
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What surveyors actually found near you
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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 Lewiston
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| St Mary's D'youville Pavilion | 0.3 mi | ★★★★★ | 3 | 1 |
| Montello Manor | 1 mi | ★★★★★ | 2 | 0 |
| Marshwood Center | 1.8 mi | ★★★★★ | 12 | 0 |
| Odd Fellows Health Care Center | 2.6 mi | ★★★★★ | 10 | 0 |
| Clover Health Care | 2.9 mi | ★★★★★ | 7 | 1 |
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