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WATERS OF SYRACUSE SKILLED NURSING FACILITY, THE Inspection Report, Violations & Safety Grade (SYRACUSE, Indiana)

500 E PICKWICK DR, SYRACUSE, Indiana 46567

Phone: 5744574401

CMS Overall:1/5

Overview & Bed Count

Certified Beds
66
Avg Residents/Day
38.7
Ownership
For profit - Limited Liability company
Provider Type
Medicare and Medicaid
County
Kosciusko
Sprinkler Systems
Yes
Special Focus
None
Abuse Icon
No

CMS Star Ratings

Overall1/5
Health1/5
Staffing1/5
Quality4/5

Nurse Staffing Check

MetricThis FacilityIndiana AvgDifference
RN Hours per Resident per Day0.450.68-0.22
Total Nurse Hours per Resident per Day3.423.73-0.31
CMS Staffing Rating1/52.6/5-
Nursing Staff Turnover57.4%45.9%-

Health Citation History

34 health citations on record

DateCategoryDescriptionSeverity
2026-05-21Quality of Life and Care DeficienciesProvide appropriate treatment and care according to orders, resident’s preferences and goals.G – Actual Harm
2026-05-21Nutrition and Dietary DeficienciesProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.E – Moderate Harm Potential
2026-05-21Resident Rights DeficienciesReasonably accommodate the needs and preferences of each resident.D – Moderate Harm Potential
2026-05-21Resident Rights DeficienciesImmediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.D – Moderate Harm Potential
2026-05-21Freedom from Abuse, Neglect, and Exploitation DeficienciesPrevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.D – Moderate Harm Potential
2026-05-21Nursing and Physician Services DeficienciesEnsure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.D – Moderate Harm Potential
2026-05-21Pharmacy Service DeficienciesEnsure each resident’s drug regimen must be free from unnecessary drugs.D – Moderate Harm Potential
2026-05-21Pharmacy Service DeficienciesEnsure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.D – Moderate Harm Potential
2026-05-21Environmental DeficienciesMake sure there is a pest control program to prevent/deal with mice, insects, or other pests.D – Moderate Harm Potential
2025-01-10Quality of Life and Care DeficienciesEnsure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.G – Actual Harm
2025-01-10Nutrition and Dietary DeficienciesProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.E – Moderate Harm Potential
2025-01-10Resident Rights DeficienciesHonor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.D – Moderate Harm Potential
2025-01-10Resident Rights DeficienciesGive residents notice of Medicaid/Medicare coverage and potential liability for services not covered.D – Moderate Harm Potential
2025-01-10Resident Assessment and Care Planning DeficienciesPASARR screening for Mental disorders or Intellectual DisabilitiesD – Moderate Harm Potential
2025-01-10Resident Assessment and Care Planning DeficienciesCreate and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admittedD – Moderate Harm Potential
2025-01-10Resident Assessment and Care Planning DeficienciesDevelop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.D – Moderate Harm Potential
2025-01-10Resident Assessment and Care Planning DeficienciesDevelop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.D – Moderate Harm Potential
2025-01-10Quality of Life and Care DeficienciesProvide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.D – Moderate Harm Potential
2025-01-10Quality of Life and Care DeficienciesProvide enough food/fluids to maintain a resident's health.D – Moderate Harm Potential
2025-01-10Quality of Life and Care DeficienciesProvide safe and appropriate respiratory care for a resident when needed.D – Moderate Harm Potential
2025-01-10Quality of Life and Care DeficienciesProvide safe, appropriate pain management for a resident who requires such services.D – Moderate Harm Potential
2025-01-10Quality of Life and Care DeficienciesProvide safe, appropriate dialysis care/services for a resident who requires such services.D – Moderate Harm Potential
2025-01-10Pharmacy Service DeficienciesEnsure each resident’s drug regimen must be free from unnecessary drugs.D – Moderate Harm Potential
2025-01-10Pharmacy Service DeficienciesImplement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.D – Moderate Harm Potential
2025-01-10Nutrition and Dietary DeficienciesEnsure food and drink is palatable, attractive, and at a safe and appetizing temperature.D – Moderate Harm Potential
2025-01-10Infection Control DeficienciesProvide and implement an infection prevention and control program.D – Moderate Harm Potential
2024-02-09Resident Rights DeficienciesGive residents notice of Medicaid/Medicare coverage and potential liability for services not covered.D – Moderate Harm Potential
2024-02-09Resident Assessment and Care Planning DeficienciesDevelop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.D – Moderate Harm Potential
2024-02-09Quality of Life and Care DeficienciesProvide activities to meet all resident's needs.D – Moderate Harm Potential
2024-02-09Quality of Life and Care DeficienciesProvide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.D – Moderate Harm Potential
2024-02-09Quality of Life and Care DeficienciesProvide safe and appropriate respiratory care for a resident when needed.D – Moderate Harm Potential
2024-02-09Pharmacy Service DeficienciesEnsure that residents are free from significant medication errors.D – Moderate Harm Potential
2024-02-09Pharmacy Service DeficienciesEnsure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.D – Moderate Harm Potential
2024-02-09Infection Control DeficienciesProvide and implement an infection prevention and control program.D – Moderate Harm Potential

Fire Safety Citation History

17 fire safety citations on record

DateCategoryDescriptionSeverity
2026-05-21Emergency Preparedness DeficienciesImplement emergency and standby power systems.F – Moderate Harm Potential
2026-05-21Egress DeficienciesAdd doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.F – Moderate Harm Potential
2026-05-21Egress DeficienciesInstall proper backup exit lighting.F – Moderate Harm Potential
2026-05-21Egress DeficienciesHave properly located and lighted "Exit" signs.F – Moderate Harm Potential
2026-05-21Egress DeficienciesMeet other general requirements that are deficient.F – Moderate Harm Potential
2026-05-21Smoke DeficienciesHave approved installation, maintenance and testing program for fire alarm systems.F – Moderate Harm Potential
2026-05-21Smoke DeficienciesInspect, test, and maintain automatic sprinkler systems.F – Moderate Harm Potential
2026-05-21Miscellaneous DeficienciesHave simulated fire drills held at unexpected times.F – Moderate Harm Potential
2026-05-21Gas, Vacuum, and Electrical Systems DeficienciesHave generator or other power source capable of supplying service within 10 seconds.F – Moderate Harm Potential
2026-05-21Gas, Vacuum, and Electrical Systems DeficienciesHave proper fire barriers, ventilation and signs for the transfilling of oxygen.F – Moderate Harm Potential
2026-05-21Smoke DeficienciesProvide properly protected cooking facilities.E – Moderate Harm Potential
2026-05-21Smoke DeficienciesInstall corridor and hallway doors that block smoke.E – Moderate Harm Potential
2026-05-21Gas, Vacuum, and Electrical Systems DeficienciesEnsure proper usage of power strips and extension cords.D – Moderate Harm Potential
2024-02-09Egress DeficienciesHave exits that are accessible at all times.F – Moderate Harm Potential
2024-02-09Egress DeficienciesKeep aisles, corridors, and exits free of obstruction in case of emergency.E – Moderate Harm Potential
2024-02-09Smoke DeficienciesEnsure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.E – Moderate Harm Potential
2024-02-09Miscellaneous DeficienciesHave posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.E – Moderate Harm Potential

Total Penalties & Fines

$0
Total Fine Amount (CMS)
0
Number of Fines
1
Total Penalties
DateTypeFine AmountPayment Denial
2025-01-10Payment Denial-13 days starting 2025-02-14

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