Above average — CMS composite of the measures below.
A standard survey is most likely before around September 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 Covenant Living Of Keene during CMS and state inspections, most recent first.
The facility did not follow its antibiotic stewardship protocols, as antibiotic time outs were not completed for three residents who were prescribed antibiotics for wound and urinary tract infections. The Infection Preventionist confirmed the omissions and also did not report missed time outs or infections not meeting criteria to the quality committee.
A resident did not receive a required monthly medication regimen review (MRR) by a licensed pharmacist, as confirmed by record review and interview with the DON. Facility policy mandates monthly MRRs for all residents, but documentation for one month was missing.
Two residents did not have their care plans updated after significant changes in their condition or physician orders. One resident's care plan did not include the application of a physician-ordered wrist splint, and another resident's care plan was not revised after a fall, despite facility policy requiring such updates. The DON confirmed these omissions.
A facility failed to document adequate indications for a resident's use of Quetiapine, an antipsychotic medication prescribed for dementia with other behaviors. The resident's records lacked documentation of targeted behaviors or specific conditions justifying the medication, contrary to the facility's policy and FDA guidelines. The DON confirmed these findings.
The facility inaccurately coded the use of restraints for two residents on their MDS assessments. One resident was noted to use a grab bar, not a side rail, to get out of bed, while another used grab bars to shift position. These were incorrectly documented as bedrail restraints. The MDS Coordinator confirmed the errors.
Failure to Implement Antibiotic Stewardship Protocols
Penalty
Summary
The facility failed to implement its established antibiotic stewardship protocols for monitoring appropriate antibiotic use for three residents. According to the facility's Antibiotic Stewardship Guidelines, an 'antibiotic time out' is required every time antibiotics are prescribed, with a reassessment within 48 hours to adjust or discontinue treatment as indicated. Record review showed that three residents were prescribed antibiotics for wound infection and urinary tract infections, but no antibiotic time outs were completed for these orders. During an interview, the Infection Preventionist confirmed that the required antibiotic time outs were not performed and that missed time outs or infections not meeting criteria were not reported to the quality committee.
Missed Monthly Medication Regimen Review by Pharmacist
Penalty
Summary
The facility failed to ensure that a licensed pharmacist performed a monthly medication regimen review (MRR), including a review of the medical chart, for one of five residents reviewed for unnecessary medications. Specifically, a review of records revealed that one resident did not have a documented MRR for August 2024. This finding was confirmed during an interview with the Director of Nursing, who acknowledged the absence of the required review. The facility's policy requires the consultant pharmacist to review each resident's medication regimen and medical chart at least monthly.
Failure to Revise Care Plans Following Changes in Resident Condition and Physician Orders
Penalty
Summary
The facility failed to revise and update care plans for two residents following changes in their conditions and physician orders. For one resident, observation revealed that a wrist splint, ordered by the physician to be applied each morning and removed in the evening, was not addressed in the resident's care plan. The Director of Nursing confirmed that the intervention for the wrist splint had not been added to the care plan, despite the standing physician order. For another resident, a review of the medical record showed that the resident experienced a fall, but the care plan was not updated to include new interventions following the incident. The Director of Nursing confirmed that the care plan had not been revised after the fall, and the facility's policy requires care plans to be updated as residents' conditions change and to implement additional interventions if falls recur. These findings indicate that the facility did not ensure care plans were revised in accordance with changes in residents' needs and physician directives.
Inadequate Documentation for Antipsychotic Medication Use
Penalty
Summary
The facility failed to ensure that a resident on antipsychotic medication had an adequate indication of use documented in the clinical record. The resident was prescribed Quetiapine, an antipsychotic medication, for dementia with other behaviors. However, there was no documentation of identified targeted behaviors or specific conditions related to dementia that justified the use of Quetiapine. This lack of documentation was noted in the resident's provider notes and care plan over several dates, indicating a failure to comply with the facility's policy on psychotropic medication use. The Director of Nursing confirmed the findings during an interview. The facility's policy requires a comprehensive review of the resident's signs and symptoms to identify underlying causes before considering psychotropic medication. Additionally, the FDA's instructions for Quetiapine highlight that it is not approved for treating dementia-related psychosis, and there is an increased risk of death in elderly patients with dementia-related psychosis treated with antipsychotic drugs. Despite these considerations, the facility did not document the necessary indications for the resident's use of Quetiapine.
Inaccurate Coding of Restraints on MDS Assessments
Penalty
Summary
The facility failed to accurately reflect the use of restraints for two residents on their Minimum Data Set (MDS) assessments. For Resident #6, the Quarterly MDS indicated the use of a bedrail restraint daily. However, observations and interviews revealed that the resident used a grab bar, not a side rail, to get out of bed, which should not have been coded as a restraint. Similarly, for Resident #3, the MDS also indicated daily use of a bedrail restraint. Observations showed the resident using grab bars on both sides of the bed to shift position, which were incorrectly coded as restraints. Staff A, the MDS Coordinator, confirmed these findings, acknowledging that the grab bars were not side rails and should not have been coded as restraints on the MDS.
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Illustrative
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.
Illustrative
A prioritized, do-first checklist
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Illustrative
Risk indicators are statistical estimates from public CMS data — not predictions, findings, or compliance advice.
Nursing homes near Keene
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Keene Center, Genesis Healthcare | 2.2 mi | ★★★★★ | 6 | 0 |
| Langdon Place Of Keene | 3.2 mi | ★★★★★ | 2 | 0 |
| Alpine Healthcare Center | 4.2 mi | ★★★★★ | 4 | 0 |
| Cheshire County Home | 6.6 mi | ★★★★★ | 4 | 0 |
| Applewood Center | 14.4 mi | ★★★★★ | 0 | 0 |
Every risk area ranked, a do-first checklist, and your local survey patterns
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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 July 2026) and official state health department websites.