All citations for Trinity Community

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.

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Last standard health inspection on record

April 3, 2025

Showing 1 to 16 of 16 citations

  1. Harm to a resident

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

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

    Health citation F-0684, Quality of Life and Care Deficiencies. Inspection of April 18, 2024. Found during a complaint inspection.

    The home gave a date the problem would be corrected (April 19, 2024).

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

    Establish roles under a Waiver declared by secretary.

    Widespread (many residents). CMS level F.

    Emergency preparedness citation E-0026, Emergency Preparedness Deficiencies. Inspection of February 28, 2019. Found during a standard inspection.

    The home gave a date the problem would be corrected (April 8, 2019).

  3. 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 February 28, 2019. Found during a standard inspection.

    The home gave a date the problem would be corrected (April 8, 2019).

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

    Use approved construction type or materials.

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

    Fire safety citation K-0161, Construction Deficiencies. Inspection of February 28, 2019. Found during a standard inspection.

    The home gave a date the problem would be corrected (April 8, 2019).

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

    Keep aisles, corridors, and exits free of obstruction in case of emergency.

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

    Fire safety citation K-0211, Egress Deficiencies. Inspection of February 28, 2019. Found during a standard inspection.

    The home gave a date the problem would be corrected (April 8, 2019).

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

    Install corridor and hallway doors that block smoke.

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

    Fire safety citation K-0363, Smoke Deficiencies. Inspection of February 28, 2019. Found during a standard inspection.

    The home gave a date the problem would be corrected (April 8, 2019).

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

    Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months.

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

    Health citation F-0636, Resident Assessment and Care Planning Deficiencies. Inspection of February 28, 2019. Found during a standard inspection.

    The home gave a date the problem would be corrected (April 8, 2019).

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

    Assure that each resident’s assessment is updated at least once every 3 months.

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

    Health citation F-0638, Resident Assessment and Care Planning Deficiencies. Inspection of February 28, 2019. Found during a standard inspection.

    The home gave a date the problem would be corrected (April 8, 2019).

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

    Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.

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

    Health citation F-0640, Resident Assessment and Care Planning Deficiencies. Inspection of February 28, 2019. Found during a standard inspection.

    The home gave a date the problem would be corrected (April 8, 2019).

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

    Ensure a qualified health professional conducts resident assessments.

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

    Health citation F-0642, Resident Assessment and Care Planning Deficiencies. Inspection of February 28, 2019. Found during a standard inspection.

    The home gave a date the problem would be corrected (April 8, 2019).

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

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

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

    Health citation F-0684, Quality of Life and Care Deficiencies. Inspection of February 28, 2019. Found during a standard inspection.

    The home gave a date the problem would be corrected (April 8, 2019).

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

    Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

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

    Health citation F-0689, Quality of Life and Care Deficiencies. Inspection of February 28, 2019. Found during a standard inspection.

    The home gave a date the problem would be corrected (April 8, 2019).

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

    Provide safe, appropriate dialysis care/services for a resident who requires such services.

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

    Health citation F-0698, Quality of Life and Care Deficiencies. Inspection of February 28, 2019. Found during a standard inspection.

    The home gave a date the problem would be corrected (April 8, 2019).

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

    Ensure each resident’s drug regimen must be free from unnecessary drugs.

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

    Health citation F-0757, Pharmacy Service Deficiencies. Inspection of February 28, 2019. Found during a standard inspection.

    The home gave a date the problem would be corrected (April 8, 2019).

  15. 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.

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

    Health citation F-0758, Pharmacy Service Deficiencies. Inspection of February 28, 2019. Found during a standard inspection.

    The home gave a date the problem would be corrected (April 8, 2019).

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

    Provide or obtain laboratory tests/services when ordered and promptly tell the ordering practitioner of the results.

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

    Health citation F-0773, Administration Deficiencies. Inspection of February 28, 2019. Found during a standard inspection.

    The home gave a date the problem would be corrected (April 8, 2019).

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.