All citations for Mitchell County Hospital Health Systems Ltcu

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 Mitchell County Hospital Health Systems Ltcu

Last standard health inspection on record

February 6, 2025

Showing 1 to 25 of 38 citations

No harm, with potential for more than minimal harm
Have properly located and lighted "Exit" signs.
Widespread (many residents). CMS level F.
Fire safety citation K-0293, Egress Deficiencies. Inspection of February 6, 2025. Found during a standard inspection.
The home gave a date the problem would be corrected (April 11, 2025).
No harm, with potential for more than minimal harm
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Widespread (many residents). CMS level F.
Fire safety citation K-0321, Smoke Deficiencies. Inspection of February 6, 2025. Found during a standard inspection.
The home gave a date the problem would be corrected (April 11, 2025).
No harm, with potential for more than minimal harm
Have a fire alarm with audible and visual signals that transmits the alarm automatically to notify emergency forces in event of fire.
Widespread (many residents). CMS level F.
Fire safety citation K-0343, Smoke Deficiencies. Inspection of February 6, 2025. Found during a standard inspection.
The home gave a date the problem would be corrected (April 11, 2025).
No harm, with potential for more than minimal harm
Have properly installed electrical wiring and gas equipment.
Widespread (many residents). CMS level F.
Fire safety citation K-0511, Services Deficiencies. Inspection of February 6, 2025. Found during a standard inspection.
The home gave a date the problem would be corrected (April 11, 2025).
No harm, with potential for more than minimal harm
Have simulated fire drills held at unexpected times.
Widespread (many residents). CMS level F.
Fire safety citation K-0712, Miscellaneous Deficiencies. Inspection of February 6, 2025. Found during a standard inspection.
The home gave a date the problem would be corrected (April 11, 2025).
No harm, with potential for more than minimal harm
Ensure that smoke control systems are tested and documented in accordance with established engineering principles.
Widespread (many residents). CMS level F.
Fire safety citation K-0771, Miscellaneous Deficiencies. Inspection of February 6, 2025. Found during a standard inspection.
The home gave a date the problem would be corrected (April 11, 2025).
No harm, with potential for more than minimal harm
Have generator or other power source capable of supplying service within 10 seconds.
Widespread (many residents). CMS level F.
Fire safety citation K-0918, Gas, Vacuum, and Electrical Systems Deficiencies. Inspection of February 6, 2025. Found during a standard inspection.
The home gave a date the problem would be corrected (April 11, 2025).
No harm, with potential for more than minimal harm
Have approved installation, maintenance and testing program for fire alarm systems.
Widespread (many residents). CMS level F.
Fire safety citation K-0345, Smoke Deficiencies. Inspection of May 31, 2023. Found during a standard inspection.
The home gave a date the problem would be corrected (August 8, 2023).
No harm, with potential for more than minimal harm
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
Widespread (many residents). CMS level F.
Fire safety citation K-0372, Smoke Deficiencies. Inspection of May 31, 2023. Found during a standard inspection.
The home gave a date the problem would be corrected (August 8, 2023).
No harm, with potential for more than minimal harm
Have simulated fire drills held at unexpected times.
Widespread (many residents). CMS level F.
Fire safety citation K-0712, Miscellaneous Deficiencies. Inspection of May 31, 2023. Found during a standard inspection.
The home gave a date the problem would be corrected (August 8, 2023).
No harm, with potential for more than minimal harm
Have restrictions on the use of highly flammable decorations.
Widespread (many residents). CMS level F.
Fire safety citation K-0753, Miscellaneous Deficiencies. Inspection of May 31, 2023. Found during a standard inspection.
The home gave a date the problem would be corrected (August 8, 2023).
No harm, with potential for more than minimal harm
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
Widespread (many residents). CMS level F.
Fire safety citation K-0761, Miscellaneous Deficiencies. Inspection of May 31, 2023. Found during a standard inspection.
The home gave a date the problem would be corrected (August 8, 2023).
No harm, with potential for more than minimal harm
Have generator or other power source capable of supplying service within 10 seconds.
Widespread (many residents). CMS level F.
Fire safety citation K-0918, Gas, Vacuum, and Electrical Systems Deficiencies. Inspection of May 31, 2023. Found during a standard inspection.
The home gave a date the problem would be corrected (August 8, 2023).
No harm, with potential for more than minimal harm
Establish policies and procedures for medical documentation.
Widespread (many residents). CMS level F.
Emergency preparedness citation E-0023, Emergency Preparedness Deficiencies. Inspection of November 22, 2021. Found during a standard inspection.
The home gave a date the problem would be corrected (December 22, 2021).
No harm, with potential for more than minimal harm
Establish policies and procedures for volunteers.
Widespread (many residents). CMS level F.
Emergency preparedness citation E-0024, Emergency Preparedness Deficiencies. Inspection of November 22, 2021. Found during a standard inspection.
The home gave a date the problem would be corrected (December 22, 2021).
No harm, with potential for more than minimal harm
Have stairways and smokeproof enclosures used as exits that meet safety requirements.
Widespread (many residents). CMS level F.
Fire safety citation K-0225, Egress Deficiencies. Inspection of November 22, 2021. Found during a standard inspection.
The home gave a date the problem would be corrected (December 22, 2021).
No harm, with potential for more than minimal harm
Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.
Pattern (more than a few residents). CMS level E.
Health citation F-0882, Infection Control Deficiencies. Inspection of February 6, 2025. Found during a standard inspection.
The home gave a date the problem would be corrected (March 25, 2025).
No harm, with potential for more than minimal harm
Have approved installation, maintenance and testing program for fire alarm systems.
Pattern (more than a few residents). CMS level E.
Fire safety citation K-0345, Smoke Deficiencies. Inspection of February 6, 2025. Found during a standard inspection.
The home gave a date the problem would be corrected (April 11, 2025).
No harm, with potential for more than minimal harm
Add 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.
Pattern (more than a few residents). CMS level E.
Fire safety citation K-0222, Egress Deficiencies. Inspection of May 31, 2023. Found during a standard inspection.
The home gave a date the problem would be corrected (August 8, 2023).
No harm, with potential for more than minimal harm
Inspect, test, and maintain automatic sprinkler systems.
Pattern (more than a few residents). CMS level E.
Fire safety citation K-0353, Smoke Deficiencies. Inspection of May 31, 2023. Found during a standard inspection.
The home gave a date the problem would be corrected (August 8, 2023).
No harm, with potential for more than minimal harm
Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.
Pattern (more than a few residents). CMS level E.
Fire safety citation K-0914, Gas, Vacuum, and Electrical Systems Deficiencies. Inspection of May 31, 2023. Found during a standard inspection.
The home gave a date the problem would be corrected (August 8, 2023).
No harm, with potential for more than minimal harm
Have approved installation, maintenance and testing program for fire alarm systems.
Pattern (more than a few residents). CMS level E.
Fire safety citation K-0345, Smoke Deficiencies. Inspection of November 22, 2021. Found during a standard inspection.
The home gave a date the problem would be corrected (December 22, 2021).
No harm, with potential for more than minimal harm
Inspect, test, and maintain automatic sprinkler systems.
Pattern (more than a few residents). CMS level E.
Fire safety citation K-0353, Smoke Deficiencies. Inspection of November 22, 2021. Found during a standard inspection.
The home gave a date the problem would be corrected (December 22, 2021).
No harm, with potential for more than minimal harm
Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.
Isolated (one or a few residents). CMS level D.
Health citation F-0700, Quality of Life and Care Deficiencies. Inspection of February 6, 2025. Found during a standard inspection.
The home gave a date the problem would be corrected (March 25, 2025).
No harm, with potential for more than minimal harm
Inspect, test, and maintain automatic sprinkler systems.
Isolated (one or a few residents). CMS level D.
Fire safety citation K-0353, Smoke Deficiencies. Inspection of February 6, 2025. Found during a standard inspection.
The home gave a date the problem would be corrected (April 11, 2025).

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.