All citations for Trinity Elms
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.
Last standard health inspection on record
March 19, 2026
Showing 1 to 23 of 23 citations
Immediate jeopardy to resident health or safety
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Past non-compliance: already corrected by the time of the inspection (August 1, 2024).
Immediate jeopardy to resident health or safety
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Past non-compliance: already corrected by the time of the inspection (July 24, 2024).
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.
Past non-compliance: already corrected by the time of the inspection (November 15, 2024).
No harm, with potential for more than minimal harm
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Past non-compliance: already corrected by the time of the inspection (February 4, 2026).
No harm, with potential for more than minimal harm
Ensure each resident receives an accurate assessment.
The home gave a date the problem would be corrected (March 31, 2026).
No harm, with potential for more than minimal harm
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
The home gave a date the problem would be corrected (March 31, 2026).
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.
The home gave a date the problem would be corrected (March 31, 2026).
No harm, with potential for more than minimal harm
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Past non-compliance: already corrected by the time of the inspection (February 4, 2026).
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.
The home gave a date the problem would be corrected (June 27, 2026).
No harm, with potential for more than minimal harm
Provide properly protected cooking facilities.
The home gave a date the problem would be corrected (June 27, 2026).
No harm, with potential for more than minimal harm
Ensure that residents are free from significant medication errors.
The home gave a date the problem would be corrected (April 30, 2025).
No harm, with potential for more than minimal harm
Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
The home gave a date the problem would be corrected (February 6, 2025).
No harm, with potential for more than minimal harm
Provide safe and appropriate respiratory care for a resident when needed.
The home gave a date the problem would be corrected (February 6, 2025).
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.
The home gave a date the problem would be corrected (January 20, 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.
The home gave a date the problem would be corrected (May 2, 2025).
No harm, with potential for more than minimal harm
Install proper backup exit lighting.
The home gave a date the problem would be corrected (May 2, 2025).
No harm, with potential for more than minimal harm
Inspect, test, and maintain automatic sprinkler systems.
The home gave a date the problem would be corrected (May 2, 2025).
No harm, with potential for more than minimal harm
Have generator or other power source capable of supplying service within 10 seconds.
The home gave a date the problem would be corrected (May 2, 2025).
No harm, with potential for more than minimal harm
Ensure medication error rates are not 5 percent or greater.
The home gave a date the problem would be corrected (September 18, 2023).
No harm, with potential for more than minimal harm
Inspect, test, and maintain automatic sprinkler systems.
The home gave a date the problem would be corrected (November 11, 2023).
No harm, with potential for more than minimal harm
Have generator or other power source capable of supplying service within 10 seconds.
The home gave a date the problem would be corrected (November 11, 2023).
No harm, with potential for minimal harm
Install corridor and hallway doors that block smoke.
The home gave a date the problem would be corrected (November 11, 2023).
No harm, with potential for minimal harm
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
The home has a plan to correct it (September 18, 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.