All citations for Islands Skilled Nursing & Rehabilitation

State inspectors check nursing homes that take Medicare or Medicaid against federal rules, usually about once a year, and also look into complaints. Each rule a home did not meet is a citation.

Back to Islands Skilled Nursing & Rehabilitation

Last standard health inspection on record

April 30, 2025

Showing 1 to 25 of 64 citations

  1. Harm to a resident

    Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.

    Isolated (one or a few residents). CMS level G.

    Health citation F-0726, Nursing and Physician Services Deficiencies. Inspection of July 18, 2024. Found during a complaint inspection.

    The home gave a date the problem would be corrected (September 13, 2024).

  2. No harm, with potential for more than minimal harm

    Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data.

    Widespread (many residents). CMS level F.

    Health citation F-0851, Administration Deficiencies. Inspection of April 30, 2025. Found during a standard inspection.

    The home gave a date the problem would be corrected (June 27, 2025).

  3. No harm, with potential for more than minimal harm

    Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.

    Widespread (many residents). CMS level F.

    Health citation F-0921, Environmental Deficiencies. Inspection of April 30, 2025. Found during a standard inspection.

    The home gave a date the problem would be corrected (June 27, 2025).

  4. No harm, with potential for more than minimal harm

    Post nurse staffing information every day.

    Widespread (many residents). CMS level F.

    Health citation F-0732, Nursing and Physician Services Deficiencies. Inspection of May 16, 2024. Found during a standard inspection.

    The home gave a date the problem would be corrected (July 8, 2024).

  5. No harm, with potential for more than minimal harm

    Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations (including nights and weekends) and emergencies.

    Widespread (many residents). CMS level F.

    Health citation F-0838, Administration Deficiencies. Inspection of May 16, 2024. Found during a standard inspection.

    The home gave a date the problem would be corrected (June 30, 2024).

  6. No harm, with potential for more than minimal harm

    Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.

    Pattern (more than a few residents). CMS level E.

    Health citation F-0550, Resident Rights Deficiencies. Inspection of April 30, 2025. Found during a standard inspection.

    The home gave a date the problem would be corrected (June 27, 2025).

  7. No harm, with potential for more than minimal harm

    Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

    Pattern (more than a few residents). CMS level E.

    Health citation F-0656, Resident Assessment and Care Planning Deficiencies. Inspection of April 30, 2025. Found during a standard inspection.

    The home gave a date the problem would be corrected (June 27, 2025).

  8. No harm, with potential for more than minimal harm

    Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

    Pattern (more than a few residents). CMS level E.

    Health citation F-0656, Resident Assessment and Care Planning Deficiencies. Inspection of May 16, 2024. Found during a standard inspection.

    The home gave a date the problem would be corrected (July 12, 2024).

  9. No harm, with potential for more than minimal harm

    Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

    Pattern (more than a few residents). CMS level E.

    Health citation F-0657, Resident Assessment and Care Planning Deficiencies. Inspection of May 16, 2024. Found during a standard inspection.

    The home gave a date the problem would be corrected (June 30, 2024).

  10. No harm, with potential for more than minimal harm

    Provide appropriate treatment and care according to orders, resident’s preferences and goals.

    Pattern (more than a few residents). CMS level E.

    Health citation F-0684, Quality of Life and Care Deficiencies. Inspection of May 16, 2024. Found during a standard inspection.

    The home gave a date the problem would be corrected (July 12, 2024).

  11. No harm, with potential for more than minimal harm

    Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.

    Pattern (more than a few residents). CMS level E.

    Health citation F-0756, Pharmacy Service Deficiencies. Inspection of May 16, 2024. Found during a standard inspection.

    The home gave a date the problem would be corrected (June 25, 2024).

  12. No harm, with potential for more than minimal harm

    Implement 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.

    Pattern (more than a few residents). CMS level E.

    Health citation F-0758, Pharmacy Service Deficiencies. Inspection of May 16, 2024. Found during a standard inspection.

    The home gave a date the problem would be corrected (July 12, 2024).

  13. No harm, with potential for more than minimal harm

    Ensure medication error rates are not 5 percent or greater.

    Pattern (more than a few residents). CMS level E.

    Health citation F-0759, Pharmacy Service Deficiencies. Inspection of May 16, 2024. Found during a standard inspection.

    The home gave a date the problem would be corrected (August 2, 2024).

  14. No harm, with potential for more than minimal harm

    Provide and implement an infection prevention and control program.

    Pattern (more than a few residents). CMS level E.

    Health citation F-0880, Infection Control Deficiencies. Inspection of May 16, 2024. Found during a standard inspection.

    The home gave a date the problem would be corrected (July 25, 2024).

  15. No harm, with potential for more than minimal harm

    Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.

    Pattern (more than a few residents). CMS level E.

    Health citation F-0550, Resident Rights Deficiencies. Inspection of May 25, 2023. Found during a standard inspection.

    The home gave a date the problem would be corrected (June 30, 2023).

  16. No harm, with potential for more than minimal harm

    Allow residents to easily view the nursing home's survey results and communicate with advocate agencies.

    Pattern (more than a few residents). CMS level E.

    Health citation F-0577, Resident Rights Deficiencies. Inspection of May 25, 2023. Found during a standard inspection.

    The home gave a date the problem would be corrected (July 1, 2023).

  17. No harm, with potential for more than minimal harm

    Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.

    Pattern (more than a few residents). CMS level E.

    Health citation F-0623, Resident Rights Deficiencies. Inspection of May 25, 2023. Found during a standard inspection.

    The home gave a date the problem would be corrected (June 30, 2023).

  18. No harm, with potential for more than minimal harm

    Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.

    Pattern (more than a few residents). CMS level E.

    Health citation F-0625, Resident Rights Deficiencies. Inspection of May 25, 2023. Found during a standard inspection.

    The home gave a date the problem would be corrected (July 7, 2023).

  19. No harm, with potential for more than minimal harm

    Provide appropriate treatment and care according to orders, resident’s preferences and goals.

    Pattern (more than a few residents). CMS level E.

    Health citation F-0684, Quality of Life and Care Deficiencies. Inspection of May 25, 2023. Found during a standard inspection.

    The home gave a date the problem would be corrected (June 30, 2023).

  20. No harm, with potential for more than minimal harm

    Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.

    Pattern (more than a few residents). CMS level E.

    Health citation F-0725, Nursing and Physician Services Deficiencies. Inspection of May 25, 2023. Found during a standard inspection.

    The home gave a date the problem would be corrected (June 29, 2023).

  21. No harm, with potential for more than minimal harm

    Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.

    Pattern (more than a few residents). CMS level E.

    Health citation F-0756, Pharmacy Service Deficiencies. Inspection of May 25, 2023. Found during a standard inspection.

    The home gave a date the problem would be corrected (June 30, 2023).

  22. No harm, with potential for more than minimal harm

    Ensure 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.

    Pattern (more than a few residents). CMS level E.

    Health citation F-0761, Pharmacy Service Deficiencies. Inspection of May 25, 2023. Found during a standard inspection.

    The home gave a date the problem would be corrected (July 5, 2023).

  23. No harm, with potential for more than minimal harm

    Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

    Pattern (more than a few residents). CMS level E.

    Health citation F-0812, Nutrition and Dietary Deficiencies. Inspection of May 25, 2023. Found during a standard inspection.

    The home gave a date the problem would be corrected (June 19, 2023).

  24. No harm, with potential for more than minimal harm

    Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.

    Pattern (more than a few residents). CMS level E.

    Health citation F-0842, Resident Assessment and Care Planning Deficiencies. Inspection of May 25, 2023. Found during a standard inspection.

    The home gave a date the problem would be corrected (June 18, 2023).

  25. No harm, with potential for more than minimal harm

    Provide and implement an infection prevention and control program.

    Pattern (more than a few residents). CMS level E.

    Health citation F-0880, Infection Control Deficiencies. Inspection of May 25, 2023. Found during a standard inspection.

    The home gave a date the problem would be corrected (June 30, 2023).

Source: CMS Provider Information, Fire Safety Deficiencies, Health Deficiencies, Citation Code Look-up, data as of September 30, 2026. Inspection results describe the home at the time of each inspection.