Facility profile · CCN 056177
Double Tree Post Acute Care Center
50 federal citations on record , including 1 at the Immediate Jeopardy level, and 1 federal enforcement actions totaling $10,842.
Record summary
Federal record · Q1 202650
Total citations
36
Last 3 years
1
Actual harm+
1
Federal penalties
$10,842
Total fines
2
Overall ★ rating
Most common violation categories here
Most common F-tags at this facility
Citation history
50 on record| Survey | F-Tag | Violation | Severity | Source |
|---|---|---|---|---|
| Dec 22, 2025 | F600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | D | Complaint |
| Jul 9, 2025 | F609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | Complaint |
| Jul 9, 2025 | F600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | D | Complaint |
| Oct 24, 2024 | F600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | D | Complaint |
| Oct 3, 2024 | F908 | Keep all essential equipment working safely. | E | Standard |
| Oct 3, 2024 | F803 | Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident. | D | Standard |
| Oct 3, 2024 | F761 | 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. | E | Standard |
| Oct 3, 2024 | F760 | Ensure that residents are free from significant medication errors. | E | Standard |
| Oct 3, 2024 | F759 | Ensure medication error rates are not 5 percent or greater. | E | Standard |
| Oct 3, 2024 | F755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | E | Standard |
| Oct 3, 2024 | F684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | J | Standard |
| Apr 17, 2024 | F600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | E | Complaint |
| Dec 28, 2023 | F880 | Provide and implement an infection prevention and control program. | D | Complaint |
| Aug 17, 2023 | F925 | Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. | F | Standard |
| Aug 17, 2023 | F921 | Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | E | Standard |
| Aug 17, 2023 | F908 | Keep all essential equipment working safely. | E | Standard |
| Aug 17, 2023 | F880 | Provide and implement an infection prevention and control program. | E | Standard |
| Aug 17, 2023 | F813 | Have a policy regarding use and storage of foods brought to residents by family and other visitors. | E | Standard |
| Aug 17, 2023 | F812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E | Standard |
| Aug 17, 2023 | F809 | Ensure meals and snacks are served at times in accordance with resident’s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times. | E | Standard |
| Aug 17, 2023 | F804 | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | E | Standard |
| Aug 17, 2023 | F761 | 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. | E | Standard |
| Aug 17, 2023 | F759 | Ensure medication error rates are not 5 percent or greater. | E | Standard |
| Aug 17, 2023 | F758 | 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. | D | Standard |
| Aug 17, 2023 | F756 | Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. | D | Standard |
| Aug 17, 2023 | F755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | E | Standard |
| Aug 17, 2023 | F698 | Provide safe, appropriate dialysis care/services for a resident who requires such services. | D | Standard |
| Aug 17, 2023 | F657 | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | D | Standard |
| Aug 17, 2023 | F656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | E | Standard |
| Aug 17, 2023 | F641 | Ensure each resident receives an accurate assessment. | D | Standard |
| Aug 17, 2023 | F584 | Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. | E | Standard |
| Aug 17, 2023 | F578 | 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. | D | Standard |
| Aug 17, 2023 | F550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | Standard |
| Jul 18, 2023 | F552 | Ensure that residents are fully informed and understand their health status, care and treatments. | D | Complaint |
| Jun 15, 2023 | F656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | D | Complaint |
| Apr 27, 2023 | F684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | Complaint |
| Apr 6, 2023 | F658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | Complaint |
| Apr 6, 2023 | F607 | Develop and implement policies and procedures to prevent abuse, neglect, and theft. | D | Complaint |
| Mar 21, 2023 | F604 | Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment. | D | Complaint |
| Mar 9, 2023 | F609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | Complaint |
| Mar 7, 2023 | F656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | D | Complaint |
| Jul 22, 2021 | F880 | Provide and implement an infection prevention and control program. | E | Standard |
| Jul 22, 2021 | F812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | B | Standard |
| Jul 22, 2021 | F810 | Provide special eating equipment and utensils for residents who need them and appropriate assistance. | D | Standard |
| Jul 22, 2021 | F806 | Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options. | E | Standard |
| Jul 22, 2021 | F761 | 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. | D | Standard |
| Jul 22, 2021 | F759 | Ensure medication error rates are not 5 percent or greater. | D | Standard |
| Jul 22, 2021 | F692 | Provide enough food/fluids to maintain a resident's health. | E | Standard |
| Jul 22, 2021 | F656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | D | Standard |
| Jul 22, 2021 | F558 | Reasonably accommodate the needs and preferences of each resident. | D | Standard |
Federal enforcement history
Federal regulators have imposed 1 enforcement actions against this facility, including 1 civil money penalties totaling $10,842 .
| Date | Type | Fine | Payment denial |
|---|---|---|---|
| Oct 3, 2024 | Fine | $10,842 | — |
About this record
A citation is a finding by a state survey team working under federal contract. It is not a court
judgment. The description above is drawn verbatim from federal public datasets. Facilities have
the right to appeal findings through an Informal Dispute Resolution (IDR/IIDR) process.
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