Not rated by CMS — ratings are suppressed for new or low-volume facilities.
A standard survey is most likely before around December 2026
Estimate from public CMS data, current as of June 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Gallatin Manor during CMS and state inspections, most recent first.
The facility failed to maintain accurate records and proper administration of controlled substances for multiple residents, with missing Controlled Substance Proof of Use forms and inconsistent documentation between the eMAR and inventory records. Staff interviews revealed incomplete or delayed documentation, and several narcotic medication deliveries were not properly tracked or reconciled, resulting in significant gaps in accountability.
A resident with chronic pain and multiple medical conditions did not receive prescribed fentanyl patches for several days due to a change in order and lack of medication supply. The DON confirmed the pharmacy had not delivered the new dose, and an RN identified errors in the eMAR administration dates, resulting in missed doses. Facility policy requiring administration of medications as ordered was not followed.
The facility failed to offer pneumonia vaccinations according to CDC guidelines for five residents with various health conditions, including diabetes and chronic obstructive pulmonary disease. Documentation was lacking for offering appropriate vaccines or recording refusals. The facility's policy also did not include updated information on the PCV21 vaccine.
A resident with chronic kidney disease and severe cognitive impairment had an abnormal urinalysis indicating a potential urinary tract infection. Despite the lab results showing positive nitrates and elevated white blood cell count, there was no follow-up or treatment documented. Interviews revealed that the facility staff failed to ensure the physician addressed the abnormal findings, leading to a deficiency.
A resident with PTSD, schizophrenia, anxiety, and dementia did not receive an individualized care plan for PTSD in a facility. Despite reporting flashbacks and nightmares, staff did not track symptoms or monitor medication effectiveness. The DON acknowledged the lack of a care plan, and the facility had no PTSD care policy.
Failure to Maintain Accurate Controlled Substance Records and Administration
Penalty
Summary
The facility failed to maintain accurate records and proper administration of controlled substances for four out of five residents reviewed. Multiple discrepancies were identified between the Electronic Medication Administration Record (eMAR) and the Controlled Substance Proof of Use forms, with several forms missing entirely for various narcotic medications, including fentanyl patches, hydrocodone-acetaminophen, oxycodone-acetaminophen, and morphine. Staff interviews revealed that documentation was often incomplete or not performed in a timely manner, particularly on the eMAR, and that the Proof of Use forms were not consistently filed or scanned into the residents' electronic medical records. For one resident with complex medical needs, including Parkinson's disease and chronic pain, there were lapses in the administration of fentanyl patches due to pharmacy delivery delays and errors in order entry, resulting in missed doses over several days. Additionally, the Proof of Use forms for hydrocodone-acetaminophen were missing, and the number of tablets administered did not consistently match the records. Staff admitted to not always documenting PRN medication administration on the eMAR, relying instead on the Proof of Use forms, which were also not reliably maintained or stored. Similar issues were found for other residents with orders for controlled substances. For example, one resident with pain and muscle spasm diagnoses had multiple deliveries of oxycodone-acetaminophen with missing Proof of Use forms and inconsistent documentation between the eMAR and inventory forms. Another resident with dementia and a history of falls had missing forms for morphine deliveries, and the number of doses administered did not align across records. The facility's policies required accurate documentation and inventory of controlled substances, but these procedures were not followed, leading to significant gaps in accountability and recordkeeping.
Failure to Administer Ordered Narcotic Pain Medication
Penalty
Summary
A deficiency occurred when a resident with multiple diagnoses, including Parkinson's disease, chronic pain syndrome, and systemic inflammatory response syndrome, did not receive narcotic pain medication as ordered. The resident's care plan included administration of pain medication as prescribed by the physician. However, a change in the fentanyl patch order from 12 mcg/hr to 25 mcg/hr was made, but the facility did not have the 25 mcg/hr patches available. As a result, the resident did not receive any fentanyl patch from 4/17/25 through 4/21/25. The electronic medication administration record (eMAR) reflected this gap, and staff noted the absence of the medication during this period. The Director of Nursing confirmed that the pharmacy had not delivered the required medication, and the Registered Nurse identified that the administration dates were incorrect in the electronic record, leading to the missed doses. The facility's policy requires medications to be administered according to physician orders, but this was not followed due to the unavailability of the prescribed medication and lack of timely communication with the medical provider to address the issue. The resident was observed to be non-interviewable due to confusion at the time of the survey.
Failure to Offer Pneumonia Vaccinations per CDC Guidelines
Penalty
Summary
The facility failed to ensure that pneumonia vaccinations were offered in accordance with CDC recommendations for five residents reviewed for immunizations. The deficiency was identified through interviews and record reviews, revealing that the facility did not have documentation to show that residents were offered the appropriate pneumococcal vaccines or any documentation of refusal. This issue affected residents with various medical conditions, including diabetes mellitus, malignant neoplasm, chronic obstructive pulmonary disease, and heart failure. Resident 25, who had type 2 diabetes mellitus and a malignant neoplasm, received the PCV13 vaccine in 2014 but was not documented as having been offered another pneumococcal vaccine afterward. Similarly, Resident 12, with type 2 diabetes mellitus, received the PPSV23 vaccine in 2015, but there was no documentation of being offered another vaccine. Resident 26, with multiple health conditions including chronic obstructive pulmonary disease, had no record of receiving any pneumonia vaccinations. Resident 4, with a history of pneumonia and heart failure, had received both PCV13 and PPSV23 vaccines but lacked documentation of being offered further vaccination options as per CDC guidelines. Resident 8, with chronic obstructive pulmonary disease and prediabetes, had records of receiving pneumonia vaccines but without specific details on the types administered. The facility's policy did not include updated information regarding the PCV21 vaccine, which is an option in the current CDC guidelines.
Failure to Follow Up on Abnormal Urinalysis
Penalty
Summary
The facility failed to provide appropriate follow-up treatment and services for a resident with an abnormal urinalysis, which indicated a potential urinary tract infection. The resident, who was admitted with a diagnosis of chronic kidney disease and had a severe cognitive impairment, was always incontinent of bladder. A physician's note ordered a urinalysis due to the resident's increased behaviors and insomnia. The urinalysis results showed abnormal findings, including positive nitrates, elevated white blood cell count, and many bacteria, suggesting a possible infection. However, there was no documentation of follow-up or treatment orders in the resident's medical record. Interviews with facility staff revealed that the abnormal urinalysis results were not followed up on, and there was no documentation of any physician's orders addressing the lab findings. The Director of Nursing, who also served as the infection prevention nurse, was unable to locate any follow-up documentation or orders for antibiotics. The Licensed Practical Nurse stated that lab results are typically faxed to the doctor for review and orders, but in this case, the physician's office confirmed receiving the results without any subsequent action. This lack of follow-up and documentation led to the deficiency identified by the surveyors.
Failure to Develop PTSD Care Plan for Resident
Penalty
Summary
The facility failed to develop an individualized plan of care for a resident diagnosed with PTSD, schizophrenia, anxiety, and dementia. The resident, a war veteran, reported experiencing flashbacks and nightmares due to PTSD, but the staff did not provide any specific interventions to address these symptoms. Despite being prescribed Prazosin for PTSD, there was no plan in place to monitor the effectiveness of the medication or track the resident's symptoms. Interviews with staff revealed a lack of awareness and action regarding the resident's PTSD symptoms, with no tracking or monitoring being conducted. The Director of Nursing acknowledged that the Interdisciplinary Team should have developed a care plan for the resident's PTSD but had not done so. Additionally, the Social Service Director confirmed that while other behavioral issues were being tracked, PTSD symptoms were not. The facility administrator admitted that there was no policy in place for PTSD care, highlighting a systemic oversight in addressing the mental health needs of residents with PTSD.
What surveyors are citing around you — mapped
All 10 risk areas, ranked with evidence
Repeat citations, what's rising near you, and quality measures — ranked so department heads know exactly where to look first.
Illustrative
What surveyors actually found near you
We read the 20 citations issued within 25 miles in the last 12 months — and tell you exactly what happened, in plain English, matched to your record.
Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
Illustrative
A prioritized, do-first checklist
Every risk area becomes concrete audit steps drawn from real citations at facilities like yours — run them this week, before your window opens.
Illustrative
Risk indicators are statistical estimates from public CMS data — not predictions, findings, or compliance advice.
Nursing homes near Ridgway
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Eldorado Rehab & Healthcare | 9.7 mi | — | 1 | 0 |
| Saline Care Nursing & Rehab | 16 mi | — | 0 | 0 |
| Axiom Healthcare Of Harrisburg | 16.4 mi | — | 4 | 0 |
| Wabash Senior Living & Rehab | 20.5 mi | — | 1 | 0 |
| White County Rehab And Nursing | 20.7 mi | — | 0 | 0 |
Every risk area ranked, a do-first checklist, and your local survey patterns
Built specifically for Gallatin Manor.
100% money-back within 48 hours.
Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release August 2026) and official state health department websites.