Citations in South Carolina
Statistics, citations and compliance trends for long-term care facilities in South Carolina.
Statistics for South Carolina (Last 12 Months)
Financial Impact (Last 12 Months)
Latest citations in South Carolina
A resident with muscular dystrophy, paraplegia, and severe mobility dependence was transferred with a Hoyer lift using a blue sling sized for much heavier residents than her documented weight. During a shower transfer with 2 CNAs, she slipped through the sling, fell to the floor, and sustained a hematoma to the back of her head; EMS was called and a CT later showed a small scalp hematoma.
Unlabeled Food Stored in Kitchen: Food items in the kitchen were observed without required date labels, including turkey, hardboiled eggs, pork ribs, lima beans, and hamburger rolls. The DM confirmed that refrigerated and frozen foods should be dated when opened and stated there was no schedule for checking food for date labels or expired items.
A resident who needed ADL assistance had fingernails that were repeatedly observed as over one fourth inch long and dirty with brown/red or dark substance underneath them. The resident said staff would not cut his fingernails even when he asked, and both a CNA and an LPN confirmed the nails were not clean or trimmed as required by facility policy and the resident's care plan.
Failure to provide ordered hand devices for a resident with bilateral hand contractures. The resident had severe cognitive impairment and upper extremity impairment, and the care plan and order summary directed cushion carrots/palm guards to both hands every shift. During observations, one or both hands were without the device, and an LPN and the DON confirmed the resident should have a device placed in both contracted hands.
A facility failed to follow physician orders for oxygen administration and did not have oxygen storage bags present for two residents receiving oxygen. One resident with COPD and other respiratory diagnoses was observed receiving less oxygen than ordered, and an LPN confirmed the ordered flow rate was not being followed and that no storage bag was present. Another resident with acute respiratory failure with hypoxia and severe cognitive impairment was also observed receiving less oxygen than ordered, with an LPN confirming the discrepancy and the absence of a storage bag. The DON confirmed that oxygen orders should be followed and that storage bags should be present.
A resident with ESBL and severe cognitive impairment was placed on contact isolation, but the chart contained no physician's order for transmission-based precautions. Staff observed that the room had only a personal trash can, with no separate receptacle for isolation PPE, and the DON confirmed PPE had been disposed of in the resident's personal trash can.
Incorrect Hoyer Sling Size Used During Transfer
Penalty
Summary
The facility failed to properly secure a resident for transfer using a Hoyer lift when staff used an incorrect sling size. Facility policy required staff to validate the resident’s weight, evaluate sling size, and choose the correct sling based on manufacturer recommendations, noting that slings that are too large may allow a person to slip out. The manufacturer’s sling chart showed that the blue XL sling used for the transfer was recommended for residents weighing 275 to 500 lbs, while the resident’s documented weight was 120.9 lbs, with prior weights of 116.4 lbs and 114.8 lbs, which aligned with the red sling recommended for 75 to 150 lbs. The resident had diagnoses including muscular dystrophy, low back pain, age-related physical debility, displaced fracture of the second cervical vertebra, cognitive communication deficit, muscle weakness, severe protein-calorie malnutrition, and paraplegia. MDS assessments showed intact cognition with BIMS scores of 15 out of 15, and the care plan directed staff to provide a Hoyer lift with 2 staff for all transfers. The resident’s care plan also identified a fall risk related to decreased mobility, weakness, deconditioning, and paraplegia. During a shower transfer, two CNAs used the blue crisscross sling, and the resident slipped through the bottom opening where her butt sat, fell to the floor, and struck her back and head. Staff documented that the resident was found lying on her back underneath the Hoyer lift with her legs still over one of the lift legs, and a hematoma formed to the right occipital area of the head. EMS was called, spinal precautions were initiated, and a CT scan later showed a small right posterior scalp hematoma. The DON stated the resident preferred that sling, and observation of the sling in the room showed it was blue with no serial number or identifiable marking.
Unlabeled Food Stored in Kitchen
Penalty
Summary
Food products stored in the kitchen were found to be missing required date labels and, in some cases, were not covered. During observation with the Dietary Manager, the main refrigerator contained six slices of turkey in plastic wrap with no date label, 24 hardboiled eggs in plastic wrap with no date label, and a rack of 24 pork ribs wrapped in plastic with no date label. The main freezer storage room contained lima beans in two bags with no date label and two 24-packs of hamburger rolls with no date labels. The facility policy required all food to be labeled with the item name and the date opened, and the Dietary Manager confirmed that refrigerated and frozen foods should be dated when opened. The Dietary Manager also stated there was no schedule for checking all food for date labels or expired food.
Unclean and Untrimmed Fingernails
Penalty
Summary
The facility failed to ensure Resident 3's fingernails were kept clean and trimmed. Facility policy required daily cleaning and regular trimming of nails, and the resident's care plan and MDS indicated he needed assistance with ADLs, including personal hygiene, due to upper extremity impairment on one side. The resident had intact cognition with a BIMS score of 15 out of 15 and was admitted with diagnoses including neuralgia and neuritis. During an interview and observation, Resident 3 stated staff would not cut his fingernails even when he asked. On multiple observations, his fingernails were over one fourth inch long and had a brown/red or dark substance underneath them. CNA 1 and LPN 1 both observed the nails at the bedside and confirmed they were approximately one fourth inch long and dirty with substance underneath, and the LPN stated nail care was supposed to be provided every Sunday and as needed for sanitary reasons. Review of progress notes and hygiene task records showed no refusals of care during the reviewed period.
Failure to Provide Ordered Hand Devices for Resident with Bilateral Contractures
Penalty
Summary
The facility failed to ensure Resident 93, who was admitted with contractures of both hands, received the services needed to prevent further decrease in range of motion and mobility. The resident’s record showed diagnoses including contracture of the right hand and contracture of the left hand, and the quarterly MDS indicated severe cognitive impairment with upper extremity impairment on both sides. The facility policy stated that residents with limited ROM would receive treatment and services to increase and/or prevent further decrease in ROM. The resident’s order summary directed cushion carrots to both hands every shift for contraction, and the care plan reflected that order. However, progress notes from the review period did not document any behaviors or refusal of the device. During observations, the resident had a palm guard in the right contracted hand at one point, but the left contracted hand had no device; at another observation, the right hand had a palm guard and the left hand still had no device; and later the right hand had no palm guard and the left hand again had no device. An LPN confirmed the resident’s hands were hard to open and that a device should be placed in the palm to prevent further contracture, and the DON confirmed the resident should have a device placed in both contracted hands.
Failure to Follow Oxygen Orders and Provide Storage Bags
Penalty
Summary
The facility failed to follow physician orders for oxygen administration and failed to have oxygen storage bags present for 2 residents receiving respiratory care. R3 had diagnoses including respiratory failure with hypercapnia, chronic pulmonary edema, bronchitis, seasonal allergies, and COPD, and his MDS indicated he received oxygen therapy with intact cognition. His order was for oxygen at 4 LPM via nasal cannula, and his care plan directed oxygen as ordered. During observations, R3 was receiving oxygen at 3 LPM and later 3.5 LPM, and no storage bag was present. During interview, an LPN confirmed R3 was receiving 3.5 liters instead of the ordered 4 liters and confirmed no storage bag was present, noting one would be needed because the resident goes outside to smoke. R93 had diagnoses including acute respiratory failure with hypoxia, and his MDS indicated severe cognitive impairment and oxygen use. His order was for oxygen at 5 liters via nasal cannula every shift to keep oxygen above 90, and his care plan directed oxygen as ordered. During observations, R93 was receiving oxygen at 3.5 LPM and later 3 LPM, with no storage bag present. During interview and observation, an LPN confirmed R93 was receiving 4.5 liters instead of the ordered 5 liters and confirmed there was no storage bag present. The DON confirmed physician orders for oxygen should be followed and that storage bags should be present.
Isolation Order and Waste Disposal Deficiencies
Penalty
Summary
The facility failed to obtain a physician's order for isolation for Resident 28 and did not ensure appropriate isolation waste receptacles were available in the resident's room. Review of the resident's record showed a diagnosis including ESBL resistance, and the quarterly MDS documented a BIMS score of 4 out of 15, indicating severe cognitive impairment, along with MDRO status. The care plan identified the resident as being at risk for complications related to UTI and listed contact precautions related to UTI/ESBL, but the order summary contained no physician's order for transmission-based precautions. During observations, Resident 28 was in bed receiving IV fluids and was on contact isolation, yet no separate red or yellow trash cans were present in the room for isolation materials. Staff later confirmed that the resident only had a personal trash can for PPE disposal, and an LPN was unable to locate a physician's order for transmission-based isolation. The DON stated PPE had been going into the personal trash can and acknowledged there should have been an extra trash can or one by the door; the DON also confirmed there was unremoved PPE in the resident's personal trash can.
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Compliance trends in South Carolina
Data through Apr 2026Comparisons below measure the most recent period May 2025 – Apr 2026 against the prior period May 2024 – Apr 2025 (two equal 12-month windows). The most recent 1 months are excluded because CMS is still publishing them.
Top tags by month · last 24 months
dashed = still reportingMonthly citation counts for the 5 most-cited tags. The dashed tail is the 1-month reporting lag.
Frequency movers
Biggest change in how often each tag is cited, as a rate per 100 inspections (so it isn't skewed by survey volume): May 2025 – Apr 2026 vs the prior period May 2024 – Apr 2025. Only tags with at least 20 citations in both periods are shown.
Severity movers
Tags whose average scope/severity shifted the most: May 2025 – Apr 2026 vs the prior period May 2024 – Apr 2025. The number is the average severity on the A–L scale (A=0…L=11); the letter is the band it falls in. A rise means the same tag is being cited at a more serious level — note the average can move enough to rank here while staying within the same letter. Same 20-citation minimum applies.
Care domain movers
Citations grouped into CFR care domains — F-tags by their §483 regulatory section (CMS State Operations Manual, Appendix PP) — measured as a rate per 100 inspections: May 2025 – Apr 2026 vs the prior period May 2024 – Apr 2025. Share is the domain's portion of citations this period; avg severity is the mean scope/severity letter and immediate jeopardy the percentage cited at J–L, both over the current period. Domains with at least 20 citations in both periods are shown; the sparkline tracks the last 12 months (left = oldest).
Immediate jeopardies · this period
Citations at the most serious scope/severity — J–L, immediate jeopardy, residents placed at risk of serious harm or death — over May 2025 – Apr 2026 vs the prior period May 2024 – Apr 2025. "Surveys with an IJ" counts distinct health inspections that had at least one.
Survey activity · by month
faded/dashed = still reportingCitations each month split into complaint-driven (unscheduled, triggered by grievances) vs standard surveys — bars, left axis — with the number of inspections as a line on the right axis. Rising inspections signal more scrutiny; a rising complaint share means more off-cycle surveys. The most recent 1 months are still being reported.
Deficiency-free survey rate
Share of health surveys that found zero deficiencies — the odds of a clean survey. May 2025 – Apr 2026 vs the prior period May 2024 – Apr 2025; the most recent 1 months are still being reported (dashed).
Penalties · by month
faded = still reportingTotal civil money penalty dollars imposed on the state's facilities each month — how hard the state is enforcing. The most recent 1 months are still being reported, and penalties often lag citations by several months.
Emerging tags
Tags that weren't established last period but surged — an early warning, distinct from movers (which track already-common tags). Criteria: fewer than 20 citations in the prior period, but at least 10 this period and 2.5× their prior volume. The sparkline shows monthly counts over the last 12 months (left = oldest).
Trusted data from CMS and state health departments
Every citation, penalty and Plan of Correction is sourced from public CMS records (latest release July 29, 2026) and official state health department websites — never guesswork.
Some of the Latest Corrective Actions taken by Facilities in South Carolina
- Reeducated facility staff on the elopement policy and Abuse, Neglect & Misappropriation policy to reinforce prevention and response expectations (J - F0689 - SC)
- Reviewed new-admission elopement risk assessments in Clinical Morning Meeting to validate assessment accuracy and interventions when indicated (J - F0689 - SC)
- Reviewed quarterly elopement risk assessments to validate assessment accuracy and interventions when indicated (J - F0689 - SC)
- Inspected facility exit doors to validate doors were functioning properly (including administrator rounds with maintenance) (J - F0689 - SC)
- Secured and alarmed all exit doors and verified them weekly by maintenance to support ongoing environmental controls (J - F0689 - SC)
- Tested the wander guard system weekly with a maintenance log to ensure ongoing functionality (J - F0689 - SC)
- Educated all staff on wandering/elopement policy and immediate response procedures for a missing resident to standardize prevention and response actions (J - F0689 - SC)
- Reviewed results in QWAPI meetings monthly for 3 months with corrective actions implemented as needed (J - F0689 - SC)
Failure to Supervise High-Risk Wanderer Resulting in Elopement
Penalty
Summary
The deficiency involves the facility’s failure to provide adequate supervision and prevent an elopement for a resident with known cognitive impairment and wandering behaviors. The resident had dementia with severe cognitive impairment, a BIMS score of 7/15, generalized muscle weakness, unsteadiness on feet, and abnormal gait and mobility. The admission MDS and care plan identified the resident as at risk for falls and elopement, with documented wandering throughout the facility and a recent elopement. An elopement risk observation completed shortly before the incident documented that the resident did not have safe decision-making capabilities. Nursing staff reported that the resident remained ambulatory with good strength and endurance, had impaired judgment and poor safety awareness, and required close supervision due to ongoing exit-seeking behaviors. On the day of the incident, staff last observed the resident in a safe environment ambulating in the facility between approximately 5:30 PM and 5:40 PM, which was described as baseline behavior. Around this same time frame, the alarm on a dining room/fire exit door near the dietary department sounded. Dietary staff responded, visually checked the area, reported not seeing anyone, re-engaged or disarmed the alarm, and returned to the kitchen. Multiple staff later acknowledged that it was difficult to hear the alarm in the kitchen and that they were unable to determine how long the alarm had been sounding before it was noticed. The facility’s elopement policy required immediate notification of all employees and a prompt, thorough search process when a resident was considered missing, but there is no indication that a facility-wide code or missing resident procedure was initiated at the time the door alarm sounded. Subsequently, between approximately 5:50 PM and 6:05 PM, the resident’s CNA noticed the resident was not in the room to receive a dinner tray and began looking for the resident, prompting a census head count. Staff were unable to locate the resident in the building, and a search was initiated. Around 6:08 PM to 6:39 PM, an employee leaving work by car believed they saw the resident near a nearby Dollar General store and called the facility. A nurse drove to the store but did not find the resident. During this period, the local police were notified by Dollar General about a suspicious person with a hospital bracelet. Police located the resident at a nearby intersection; the police report described the resident as delirious, disoriented, and unable to provide coherent responses. EMS was requested, and the resident was transported to a hospital emergency department. The facility later confirmed that the resident had eloped from the building and was found with a wander guard still in place, and staff, including the administrator and DON, were unable to state exactly how the resident exited the building, though they believed it may have been through the dining room door whose alarm had sounded earlier. Interviews with staff revealed additional gaps related to supervision and elopement procedures. One CNA assigned to 1:1 care for the resident stated it was her first day in that role and could not confirm how long the resident had been on 1:1 care. Another CNA, who had recently completed orientation, reported not receiving any in-service training related to elopements and stated that the survey interview was the first time she heard about the resident’s exit from the building. The LPN on duty reported that the resident had been on 30-minute checks due to wandering, last saw the resident around 5:25 PM–5:30 PM, and assumed the resident was doing usual laps in the facility. The DON and administrator both acknowledged that staff could not determine how long the door alarm had been sounding before it was heard and that staff responded by looking outside, not seeing anything, and shutting off the alarm. These actions and inactions, in the context of a known high-risk, cognitively impaired, exit-seeking resident, led to a successful elopement and formed the basis of the cited deficiency under 42 CFR 483.25 for failure to keep the environment free of accident hazards and provide adequate supervision.
Removal Plan
- Evaluate resident at emergency room; confirm no injuries.
- Initiate and continue 1:1 supervision for the resident.
- Assess each exit door to validate doors are working properly.
- Update the resident’s elopement risk assessment to reflect current status.
- Update the resident’s care plan and resident profile.
- Complete an elopement drill.
- Administrator will notify the charge nurse, Director of Nursing, and Social Service designee that a resident is missing as part of drill procedure.
- Director of Nursing/designee will announce Code [NAME] to signal the elopement drill procedure.
- Director of Nursing/designee will organize an immediate and thorough search of the center and surrounding grounds; complete the entire search process within 30 minutes.
- If search fails to locate resident within allotted time, Administrator/designee will place a mock telephone call to appropriate community agencies, resident's legal representative, and attending physician; staff will provide mock police with physical identifying information.
- Continue the search if resident not located, including having staff search surrounding streets by car for a 2 mile radius.
- When the volunteer resident is located, the charge nurse will complete a head-to-toe assessment.
- Social Services designee will assess the resident for emotional distress.
- Director of Nursing will notify appropriate community agencies, attending physician, and resident's legal representative.
- Facility Quality Assurance Committee will investigate the incident and implement interventions to prevent reoccurrences.
- When missing resident is found, make an announcement: Code [NAME] all clear.
- Update elopement risk assessments for all residents.
- Place residents identified as elopement risk in the elopement binder and update their care plans and profiles.
- Reeducate facility staff on the elopement policy and Abuse, Neglect & Misappropriation policy.
- Provide education to any staff not receiving this education prior to their next scheduled shift.
- Review new admission elopement risk assessments in Clinical Morning Meeting to validate accuracy and interventions if indicated.
- Review quarterly elopement risk assessments to validate accuracy and interventions if indicated.
- Maintenance Director/designee will inspect facility exit doors to validate doors are functioning properly.
- Administrator will round with the Maintenance Director validating doors are functioning properly.
- Hold an Ad Hoc QACPI.
- Notify the Medical Director of the incident and plan.
- Present results of audits in the QAPI Committee meeting for review and recommendations.
Failure to Monitor Wander Guard and Supervise Resident Resulting in Elopement
Penalty
Summary
The deficiency involves the facility’s failure to ensure adequate supervision and prevent a successful elopement for one resident identified as at risk for wandering and elopement. The resident was admitted with diagnoses including traumatic subdural hemorrhage, muscle weakness, difficulty in walking, and need for assistance with personal care. An admission MDS showed a BIMS score of 9/15, indicating moderate cognitive impairment, and documented that the resident used a wheelchair and required substantial assistance for most ADLs. The facility’s own policy defined wandering and elopement, required staff training on elopement prevention, and called for interventions and care plan documentation for residents at risk of elopement. Physician orders were in place directing staff to check the resident’s wander guard for effectiveness and function every shift beginning shortly after admission. However, review of the MAR/TAR for the period from admission through the date of elopement showed that this order was not consistently documented as completed. For the period 01/30/26–02/19/26, there was an order to check the wander guard every shift, but it was only signed once on the date of the elopement for the first shift. There was no documentation on the MAR/TAR for January related to checking the wander guard, despite the order being in effect. The resident’s care plan, initiated on admission and revised on 02/19/26, identified behavioral symptoms of wandering and elopement related to impaired cognition and impulsivity, and included an intervention to equip the resident with a wander guard upon admission for 48 hours and to check the device’s proper functioning every shift, but the documented implementation of these checks was lacking. In the days leading up to the elopement, progress notes documented that the resident needed frequent redirection due to wandering in and out of other residents’ rooms, and that staff discussed with the resident’s representative the possibility of obtaining a sitter because of these behaviors. Another note described the resident being found seated on a fall mat after getting out of bed to remove pictures from the wall and pack his bag, indicating ongoing impulsive and wandering behavior. On the night of the elopement, a CNA reported that the resident had been described as hard to redirect and constantly pacing the unit in his wheelchair. Later that night, the resident was found wandering in the parking lot and brought back inside by a CNA; the nurse documented that the door alarm was not going off at the time the resident was found outside. The resident’s representative later stated that he had been informed that the front door was not working properly and that the resident had a wander guard device that should have locked the door when he left, but the door did not function correctly, allowing the resident to exit the building. Based on these findings, surveyors determined that the facility failed to provide adequate supervision and accident prevention, resulting in a successful elopement and an Immediate Jeopardy determination at F689. The State Agency determined that the facility’s non-compliance with federal health and safety regulations caused or was likely to cause serious injury, harm, impairment, or death, and identified the Immediate Jeopardy as related to 42 CFR 483.25, Quality of Care. The Immediate Jeopardy was determined to have existed as of the date of the elopement. The survey findings emphasized the lack of documented adherence to physician orders and care plan interventions for checking the wander guard device, the presence of documented wandering and impulsive behaviors, and the fact that the resident was able to leave the building without triggering a door alarm. These combined actions and inactions led to the conclusion that the facility did not ensure the environment was free from accident hazards and did not provide adequate supervision to prevent the resident’s elopement.
Removal Plan
- Resident was immediately located and safely returned to the facility.
- Full nursing assessment completed by licensed nurse; no injuries noted.
- Physician/Medical Director and responsible party notified by administrator.
- Resident placed on increased monitoring immediately.
- Wandering/elopement risk reassessed.
- Care plan updated to include enhanced interventions.
- Wander guard applied and verified functioning.
- Staff education initiated by administrator.
- Incident reported per facility policy and state requirements.
- Facility conducted a 100% audit of all residents for elopement risk.
- Verified wander guard placement and function for all residents.
- Verified accuracy of assessments and care plans for all residents.
- Updated care plans to include individualized interventions such as secured unit placement/discharge plan and structured activities to reduce wandering.
- Conducted environmental safety checks.
- All exit doors secured and alarmed and verified by maintenance department weekly.
- Wander guard system tested by maintenance department weekly with a log.
- All staff education completed by DON/Administrator on policy/protocol for wandering and elopement and immediate response procedures if a resident is missing.
- Results reviewed in QWAPI meetings monthly for 3 months, with corrective actions implemented as needed.
Failure to Protect Cognitively Impaired Resident From Physical Abuse by CNA
Penalty
Summary
The deficiency involves a failure to protect a resident from physical abuse by a CNA. The facility’s abuse policy defines physical abuse as including hitting, slapping, and controlling behavior through corporal punishment. The resident involved was admitted with major depressive disorder and dementia with agitation, and a recent MDS showed a BIMS score of 7/15, indicating severe cognitive impairment. The resident was generally independent with toileting and transfers. On the day of the incident, the resident was on a locked dementia unit and had experienced bowel incontinence, leaving the bathroom soiled. A CNA entered the resident’s room to assist with cleaning the bathroom. During this interaction, the resident became agitated and combative, reportedly spitting on the CNA and striking the CNA in the face with a wet washcloth containing bowel movement. The CNA later reported that she responded by holding the resident’s hands above her head and then making contact with the resident’s face with an open hand, described as a slap or “smudging” the resident’s face. The CNA admitted to multiple staff, including the charge nurse, DON, Administrator, and Social Services, that she had put her hands on the resident and struck the resident in the face with an open hand in retaliation for the resident’s actions. A police report documented that the CNA admitted to assaulting the resident with an open-hand slap during a physical altercation. Staff who assessed the resident after the incident noted that the resident appeared visibly upset but had no visible injuries, and the resident was unable to recall the specific events due to severe cognitive impairment. The State Agency determined that the facility’s non-compliance with abuse regulations caused or was likely to cause serious harm and cited the facility under 42 CFR 483.12 for failure to ensure the resident was free from physical abuse.
Removal Plan
- Removed CNA3 from the resident care area after the incident.
- Interviewed CNA3 regarding the incident.
- Terminated CNA3 by the Administrator and DON.
- Notified law enforcement of the incident.
- Submitted a report to the Regional Ombudsman.
- Completed a nursing assessment and body audit of R1; no injuries found.
- Notified R1's family/responsible party of the incident.
- Monitored residents for psychosocial distress or changes by nursing staff and Social Services.
- Provided 1:1 re-education for staff working in skilled nursing on abuse and appropriate response/intervention and workplace fatigue.
- Conducted an investigation and determined there was no physical evidence of abuse.
- Social worker interviewed all residents on Unit 3 regarding abuse, whether any abuse had been witnessed/experienced, and whether residents felt safe.
- Social worker interviewed residents on other skilled units regarding abuse and whether residents felt safe.
- Arranged for MD and PA to evaluate R1; MD issued new medication orders and PA checked on the resident.
- Obtained family consent for a psychiatric evaluation.
- Social worker contacted the family and obtained updates; family visited and reported no changes in mood/behavior/psychosocial status.
- Social worker checked in on R1 and monitored for changes.
- Initiated in-house education for all staff working in Skilled Nursing on types/definitions of abuse, dementia with abuse prevention, de-escalation of behaviors, and how to appropriately avoid these situations.
- Re-educated staff on who the Abuse Coordinator is and how to notify the Abuse Coordinator of concerns.
- Reviewed the abuse policy with staff.
- Obtained statements from all staff who work in Skilled Nursing.
- Continued education ongoing.
- Nursing management (DON, ADON, Unit Managers) to conduct rounding and audits for signs of abuse.
- Held QAPI and updated it regarding this issue.
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