22 Reports
Inspection Report — Feb 20, 2026
Complaint Investigation
Date: Feb 20, 2026
Visit Reason
Complaint Survey-Desk Audit conducted on 02/20/2026.
Findings
The facility is in substantial compliance with the National Fire Protection Association 101 Life Safety Code, 2012 Edition as referenced in 42 CFR 483.90 (a - d) - Physical Environment. No deficiencies were cited.
Inspection Report — Jan 12, 2026
Complaint Investigation
Date: Jan 12, 2026
Visit Reason
Complaint survey conducted due to concerns about means of egress and safety on the second floor.
Findings
The facility failed to maintain one of three exits on the second floor clear of obstructions, specifically covering the push to exit button to prevent resident elopement, which could affect visitors or vendors.
Deficiencies (1)
K0211: Means of egress was not maintained clear on the second floor; the push to exit button was covered to prevent resident elopement, potentially obstructing emergency exit use.
Inspection Report — Jan 12, 2026
Plan of Correction
Date: Jan 12, 2026
Visit Reason
The document is a plan of correction for a Life Safety Code survey conducted on January 12, 2026, addressing means of egress deficiencies.
Findings
This document is the facility's plan of correction for the Life Safety Code survey conducted on January 12, 2026, specifically addressing the means of egress deficiency related to the obstruction of an exit on the second floor stairwell C. The facility has removed the obstruction and implemented education and audits to maintain compliance.
Report Facts
: Jan 12, 2026
: Feb 10, 2026
Employees mentioned
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Inspection Report — Aug 26, 2025
Biennial Survey
Date: Aug 26, 2025
Visit Reason
Recertification Survey conducted on 08/26/2025 to assess compliance with NFPA 101 Life Safety Code.
Findings
The facility failed to maintain required fireproofing in the HVAC room on the 4th floor due to missing fireproofing caused by conduit hangers. Additionally, the laundry ventilation system had multiple deficiencies including improperly assembled dryer ducts with screws, heavy lint accumulation posing a fire hazard, and unsecured dryer ventilation duct attached to propane piping. The laundry chute door latches were damaged and did not secure properly, compromising fire protection.
Deficiencies (3)
21.1.5.1: Fireproofing in the HVAC room on the 4th floor is missing in many locations due to conduit hangers scraping away the fireproofing.
18.5.1.1, 19.5.1.1, 9.1.1, 9.1.2: Dryer ventilation ducts were assembled with screws that could catch lint and reduce exhaust efficiency, lint buildup above ceiling tiles and floor deck presented a fire hazard, and the dryer ventilation duct was improperly secured to propane piping with steel mechanics wire.
8.4.3.5, 7.2.1.8, 19.5.4: Laundry chute door latches were damaged and no longer secured the door properly; a manual latch was installed modifying the chute, which does not meet fire protection system requirements.
Report Facts
: 1D1081-L1
: 1113
Inspection Report — Aug 26, 2025
Date: Aug 26, 2025
Visit Reason
Federal Recertification Survey for emergency preparedness and life safety compliance.
Findings
Waterville Center for Health and Rehab is in substantial compliance with 42 CFR Part 483.73 for Emergency Preparedness and the National Fire Protection Association 101 Life Safety Code 2012 Edition.
Inspection Report — Aug 25, 2025
Plan of Correction
Date: Aug 25, 2025
Visit Reason
The survey was conducted for the annual Long Term Care Survey Process for Federal Recertification and to investigate multiple incidents and complaints.
Findings
This document is the facility's plan of correction for the survey completed on 08/25/2025 addressing deficiencies related to advance directives, notification of changes, safe environment, discharge planning, PASARR screening, comprehensive care plans, drug regimen review, quality of care, accident hazards, food safety, resident records, infection control, and COVID-19 outbreak management.
Report Facts
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Inspection Report — Aug 25, 2025
Annual Inspection
Date: Aug 25, 2025
Visit Reason
The survey was conducted to investigate multiple incident reports and to assess compliance with federal regulations governing long term care facilities.
Findings
The facility failed to meet several federal requirements related to advance directives, notification of changes, resident rights, safe environment, discharge planning, PASARR screening, comprehensive care plans, medication regimen review, food safety, resident records, infection control, and quality of care.
Deficiencies (16)
F0578: The facility failed to ensure that residents and/or their representatives were provided written information concerning the right to formulate an advance directive.
F0580: The facility failed to notify the resident, physician, and resident representative promptly of changes including injury, decline, or room changes.
F0580: The facility failed to notify a resident's physician of the discontinuation of a wound vacuum device and did not provide an order for wet to dry dressing.
F0584: The facility failed to provide a safe, clean, comfortable, and homelike environment, including housekeeping and maintenance services, on 3 of 4 units.
F0627: The facility failed to ensure appropriate transfer and discharge procedures, including documentation and notification, consistent with resident rights and regulatory requirements.
F0645: The facility failed to conduct PASARR screening and preadmission screening for individuals with mental disorders and intellectual disabilities.
F0656: The facility failed to develop and implement comprehensive person-centered care plans for residents, including measurable objectives and timeframes.
F0657: The facility failed to timely review and revise care plans by an interdisciplinary team and failed to include participation of residents and representatives.
F0684: The facility failed to adequately assess and monitor residents for unnecessary medications and failed to document interventions for anticoagulant use and COVID-19 status.
F0689: The facility failed to maintain a safe environment free of accident hazards, including proper storage of germicidal wipes and adequate supervision to prevent resident elopement.
F0756: The facility failed to properly review residents' drug regimens monthly and failed to report irregularities to the attending physician and medical director.
F0757: The facility failed to ensure residents' drug regimens were free from unnecessary drugs, including excessive doses and inadequate monitoring.
F0812: The facility failed to maintain food safety requirements, including proper storage, labeling, and sanitation in kitchen and kitchenette areas.
F0814: The facility failed to properly dispose of garbage and refuse, leading to pest infestation risks.
F0842: The facility failed to maintain complete and accurate resident medical records, including documentation of range of motion exercises, bathing, and refusals.
F0880: The facility failed to establish and maintain an effective infection prevention and control program, including proper handling of linens and notification during a COVID-19 outbreak.
Report Facts
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Inspection Report — Nov 15, 2024
Follow-Up
Date: Nov 15, 2024
Visit Reason
On-site follow-up visit conducted for Long Term Care Survey recertification and multiple reported incidents and complaints.
Findings
The facility was found to be in compliance with 42 CFR Part 483, Subpart B, Requirements for Long Term Care Facilities; no deficiencies were cited.
Report Facts
: 48842
: 48683
: 48363
: 47975
: 47617
: 47498
: 47476
: 46903
Inspection Report — Oct 9, 2024
Plan of Correction
Date: Oct 9, 2024
Visit Reason
The document is a facility's plan of correction for the Federal Survey dated 10/09/2024 addressing multiple deficiencies related to fire safety, egress, and emergency systems.
Findings
This document is the facility's plan of correction for the Federal Survey completed on 10/09/2024. It addresses deficiencies related to fire safety, egress doors, emergency lighting, fire alarm systems, sprinkler systems, and hazardous areas as cited under multiple K-tags including K133, K200, K211, K222, K223, K271, K291, K293, K321, K324, K325, K341, K351, K353, K754, K761, K920, and K923.
Report Facts
: 2 hour fire barrier separations
: Means of Egress Requirements
: Wall mounted fan found below 6 feet
: Second floor patio gate to be fixed to swing
: Doors with self-closing devices
: Discharge from exits
: Emergency lighting
: Exit signage
: Hazardous areas - enclosure
: Cooking facilities
: Alcohol based hand rub dispenser
: Fire alarm system installation
: Sprinkler system installation
: Sprinkler system maintenance and testing
: Mobile trash and soiled linen carts
: Fire doors assemblies
: Electrical equipment - power cords and extension cords
: Gas equipment - cylinder and container storage
Inspection Report — Sep 10, 2024
Biennial Survey
Date: Sep 10, 2024
Visit Reason
The survey was conducted to assess compliance with health and safety regulations including fire safety, emergency preparedness, and facility maintenance.
Findings
The facility was found to have multiple deficiencies including fire safety issues such as penetrations in fire barriers, inadequate fire alarm and sprinkler system coverage, improper storage of oxygen cylinders, and unsafe use of power strips. Several fire doors lacked required hardware or had unreadable labels. Mobile trash and soiled linen carts were found unattended in corridors. Alcohol-based hand rub dispensers were improperly installed near ignition sources.
Deficiencies (18)
K133: Multiple occupancies lacked required 2-hour fire barrier separations, with penetrations compromising fire resistance.
K200: Means of egress requirements were not met; a corridor exit passed through an intervening room, though corrected during survey.
K211: Minimum headroom clearance was not maintained due to wall-mounted and ceiling fans protruding below 6'8".
K222: Egress doors had improper locking arrangements requiring badge access, and a patio gate swung opposite the path of egress.
K223: Doors in exit passageways and hazardous areas were not self-closing or held open by compliant release devices.
K271: Exit discharge did not provide a level, hard-packed all-weather travel surface; patio exits led onto lawn.
K291: Emergency lighting was inadequate, with the basement lacking appropriate emergency lighting.
K293: Exit signage was insufficient, with the basement lacking appropriate exit and directional signs.
K321: Hazardous areas were not properly enclosed or protected by fire barriers or automatic extinguishing systems; penetrations were found in fire-rated walls and ceilings, and wheelchair battery charging was done in an unprotected library area.
K324: Cooking facilities on the fourth floor were open to the corridor without required smoke detection within 20 feet.
K325: Alcohol-based hand rub dispensers were installed within 1 inch of ignition sources in multiple locations.
K341: Fire alarm system was deficient; no notification devices or pull stations were found in the basement.
K351: Sprinkler system had unprotected combustible projections exceeding 4 feet without sprinkler coverage at multiple building entrances.
K353: Sprinkler system maintenance was inadequate; a sprinkler head was painted over, impairing function.
K754: Mobile soiled linen and trash carts exceeding 32 gallons were found unattended in corridors, not stored in hazardous areas as required.
K761: Fire door assemblies lacked required floor strike plates and had paint obscuring labels.
K920: Power strips and extension cords were improperly used for non-patient-care electrical equipment and as substitutes for fixed wiring.
K923: Oxygen cylinder storage closet contained combustible items within 5 feet of cylinders and exceeded allowable tank volume; storage did not meet fire protection requirements.
Report Facts
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Inspection Report — Sep 9, 2024
Annual Inspection
Date: Sep 9, 2024
Visit Reason
The survey was conducted as part of the annual Long Term Care Survey Process for Federal Recertification, including investigation of complaints and incidents.
Findings
The facility was found not in substantial compliance with regulations governing skilled nursing facilities. Deficiencies were identified related to abuse, neglect, misappropriation, minimum staffing rules, physical restraints, and menu posting.
Deficiencies (5)
4.J.1: The facility failed to ensure all staff are knowledgeable of the Adult Protective Services Act and failed to report an incident involving tying residents to chairs to law enforcement or the State Survey Agency within required timeframes.
4.J.2: The facility failed to fully investigate an incident involving unnecessary physical restraint of a resident by tying them to a wheelchair, and failed to report the incident timely to law enforcement or the State Survey Agency.
9.A.4: The facility failed to meet minimum nursing staff-to-resident ratios on multiple days, including 7/22/24, 7/26/24, 8/29/24, 8/31/24, and 9/4/24.
11.A: The facility failed to ensure a resident's right to be free from physical restraints, as a resident was found restrained to a wheelchair with a bedsheet tied with a double knot without proper documentation or physician's order.
18.D.6: The facility failed to post the current menu plan conspicuously and readably for personnel, residents, and dietetic services staff on all units during the survey period.
Report Facts
: Jul 25, 2024
: 8:38 p.m.
: 5
: 35
: 1:5
: 1:10
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Document — HSI911 POC
Date: HSI911 POC
Inspection Report — 1D1081 L1 SOD
Date: 1D1081 L1 SOD
Visit Reason
Federal Recertification Survey for Long Term Care Facilities
Findings
The facility is not in substantial compliance with the National Fire Protection Association 101, Life Safety Code, 2012 Edition, as evidenced by multiple deficiencies in building construction, utilities, and fire safety systems.
Deficiencies (3)
K0161: The facility failed to maintain the required fireproofing in the HVAC room on the 4th floor, where fireproofing was missing due to conduit hangers scraping it away.
K0511: The facility failed to maintain laundry ventilation piping and surrounding areas; dryer ducts were improperly assembled with screws that catch lint, heavy lint accumulation was found above ceiling tiles, the dryer ventilation ductwork was improperly secured to a propane pipeline, and a dryer was used for drying cleaning rags without documentation of rating.
K0541: The laundry chute door latches were damaged and no longer secured the door when self-closing; a manual latch was installed modifying the chute, which violates fire protection system requirements.
Report Facts
: Aug 26, 2025
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