Not rated by CMS — ratings are suppressed for new or low-volume facilities.
A standard survey is most likely before around November 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 Mineral Springs during CMS and state inspections, most recent first.
A resident with dysphagia was not provided with the prescribed pureed fruits and vegetables, instead receiving whole sliced pears and cut watermelon on multiple occasions. Staff confirmed these items were not pureed, despite clear physician orders, care plan interventions, and facility policy requiring pureed foods for this resident.
The facility failed to ensure accurate advance directives for two residents. One resident had conflicting documentation between a Full Code order and a DNR form, while another had discrepancies between a DNR order and a Full Code care plan. These inconsistencies were confirmed by nursing staff.
A facility failed to inform a resident and their DPOA about the option to use an outside pharmacy and the associated charges for services not covered by Medicaid/Medicare. The resident was admitted and provided an outside pharmacy prescription card, but the facility required the use of its own pharmacy, resulting in unexpected monthly co-pay charges. The facility's policy allows for noncontract pharmacy use, but this was not communicated, leading to the deficiency.
A resident received more doses of Acetaminophen than prescribed within a 48-hour period without notifying the physician, as required by the PRN order. The resident frequently reported pain levels above the mild pain threshold, yet was administered medication outside the prescribed parameters. Staff interviews confirmed the lack of documentation and notification to the provider.
The facility did not have an RN on duty for 8 consecutive hours on four days in September 2024. A review of staffing data showed no RN hours for these days, and the DON confirmed the lack of documentation for RN presence.
The facility failed to label and date medications properly, as observed in two medication carts. A medication cup with unlabeled pills and inhalers without open dates or resident identifiers were found. Staff confirmed the findings, with one unable to identify the owner of a Symbicort inhaler.
A facility failed to accurately document a resident's PTSD diagnosis in their medical record. Despite the resident having a documented diagnosis of PTSD, a social worker incorrectly marked that the resident had no history of trauma in the Social Services Assessment. The social worker admitted to not asking the resident about trauma, leading to the inaccurate assessment. This failure to follow the facility's Trauma Informed Care policy resulted in a deviation from proper documentation procedures.
The facility did not follow infection control guidelines for water management, failing to monitor control measures to minimize Legionella risk. The Infection Preventionist was unaware of any monitoring system, and logs showed inconsistent documentation of temperature and pressure checks. This deficiency potentially affected 48 residents, as there was no evidence of a system to ensure water safety.
The facility failed to provide adequate nursing staff, resulting in delayed care and medication administration for residents. Interviews with residents and staff revealed that low staffing levels led to increased incontinence incidents, missed showers, and delayed assistance. The facility's staffing assessment and daily staffing sheets confirmed consistent understaffing, impacting resident care.
The facility failed to follow physician orders and provide timely medication administration for several residents. A resident received medications like Ativan and Eliquis outside prescribed timeframes, while another's wound care was not documented as performed. Additionally, a resident's weight monitoring for CHF was not conducted, and another did not receive prescribed Lotrisone Cream and eye drops. Staff interviews confirmed these deficiencies, indicating non-compliance with medication management protocols.
The facility failed to ensure the activities program was directed by a qualified professional. The Director of Activities, promoted in September 2024, had been an activities aide since June 2024 and lacked necessary certifications, degrees, or experience. The facility's job description requires specific qualifications, which the Director did not meet, as confirmed by the Administrator.
The facility failed to designate a qualified Infection Preventionist with specialized training in infection prevention and control. Staff D, hired as the Infection Preventionist, lacked evidence of such training, as confirmed by interviews with Staff D and the DON. The facility's job description and policy required specialized training within 90 days of hire, which was not met.
A resident's needs were not accommodated as their call bell was consistently out of reach, hanging over a roommate's light fixture. The resident, unable to access the call bell, indicated they would have to yell for assistance. Observations confirmed the call bell's position remained unchanged, leaving the resident without a means to call for help.
The facility failed to maintain a clean environment on one unit, where smeared brown substances were observed on the carpet. Two residents were seen walking on these areas. A staff member confirmed the substance was from a resident's loose stools the previous evening.
A resident did not receive any showers over a three-month period, despite the facility's policy requiring showers as per request or schedule. The resident's family had previously raised concerns about the lack of weekly showers. The Clinical Nursing Officer confirmed the absence of documentation for showers during this time.
The facility did not provide weekend activities for residents in September 2024, as confirmed by the Resident Council and activity calendars. Residents expressed dissatisfaction with the lack of activities, and the Director of Activities confirmed no plans were made for weekends, with supplies locked away.
A resident with a pressure ulcer did not receive necessary treatment and services, as the facility failed to document weekly wound assessments. The resident developed a pressure ulcer around the Achilles tendon after having a cast placed on their left leg. Despite the facility's policy requiring weekly documentation, wound measurements were only recorded sporadically over a month, which was confirmed by the DON.
A resident's insulin regimen was not administered timely, with doses given significantly late, contrary to physician orders. Additionally, low blood glucose events were not properly treated or documented, and providers were not notified, as confirmed by staff interviews.
A facility failed to maintain a medication error rate below 5%, resulting in a 5.56% error rate. A resident was prescribed Olanzapine 2.5 mg for borderline personality disorder and Metoprolol Succinate ER 100 mg for hypertension. A nurse administered Olanzapine 5 mg instead of the prescribed dose and omitted Metoprolol. The nurse confirmed these errors, violating the facility's policy on the six rights of medication administration.
The facility failed to maintain proper storage and labeling of medications, with expired and unlabeled vials found in the medication room and cart. A resident self-administered nasal sprays without secure storage, and an unlocked medication cart was left unattended in a hallway. Staff confirmed these deficiencies, including improper disposal of medications.
The facility did not have a documented Quality Assurance and Performance Improvement (QAPI) plan. An interview with the Administrator revealed the absence of a written QAPI plan, indicating a failure to establish formalized procedures for QAPI and QAA activities.
A resident on Coumadin for atrial fibrillation did not receive the medication for five days due to a missed INR test and lack of follow-up orders. The resident showed symptoms of complications and was sent to the hospital, where they were diagnosed with bilateral pulmonary embolisms.
Failure to Provide Prescribed Pureed Diet for Resident with Dysphagia
Penalty
Summary
A resident with a history of dysphagia had a physician's order for a regular/liberalized dysphagia advanced texture diet, specifically requiring pureed fruits and vegetables. The resident's care plan identified them as being at nutritional risk due to dysphagia, with interventions in place to provide a dysphagia diet as ordered. Despite these orders and care plan interventions, observations on two separate occasions revealed that the resident was served whole sliced pears and cut pieces of watermelon, rather than pureed fruits as required. Staff interviews confirmed that these items were not pureed and did not meet the dietary requirements specified for the resident. Further review of the resident's speech therapy discharge summary confirmed the ongoing need for pureed fruits and vegetables due to swallowing issues. The facility's own Diet and Nutrition Care Manual and policy on therapeutic diet orders also specified that foods for residents on a dysphagia puree diet must be provided in pureed form. Both dietary and nursing staff were responsible for ensuring therapeutic diets were provided as prescribed, but failed to do so in this instance, resulting in the resident not receiving the appropriate diet texture as ordered.
Failure to Ensure Accurate Advance Directives
Penalty
Summary
The facility failed to ensure the residents' right to formulate advance directives for two residents. For Resident #102, there was a discrepancy between the physician's order for Full Code, dated 2/15/25, and a Portable Do Not Resuscitate (DNR) form, dated 7/11/22, which indicated the resident was a DNR. Additionally, the care plan for advanced directives confirmed the resident's code status as DNR. This inconsistency was confirmed by a Registered Nurse during an interview. Similarly, for Resident #152, there was a conflict between the physician's order for DNR, dated 2/18/25, and the care plan for advanced directives, which indicated a Full Code status, dated 2/14/25. This discrepancy was confirmed by a Nurse Manager during an interview.
Failure to Inform Resident of Pharmacy Options and Charges
Penalty
Summary
The facility failed to inform a resident and their Durable Power of Attorney (DPOA) about the option to use an outside pharmacy and the associated charges for services not covered by Medicaid/Medicare. The resident was admitted in December 2024, and during the admission process, the facility did not discuss the option of using an outside pharmacy with the resident or their DPOA. The DPOA provided the facility with an outside pharmacy prescription card, but the facility required the use of its own pharmacy, resulting in monthly co-pay charges that would not have occurred with the resident's preferred pharmacy. The facility's policy allows residents to request medications from a noncontract pharmacy, but this information was not communicated to the resident or their DPOA, leading to unexpected charges.
Failure to Follow Physician's Orders for Pain Management
Penalty
Summary
The facility failed to adhere to physician's orders for pain management for Resident #44, as identified through interviews and record reviews. The resident had a physician's order for Acetaminophen 325 mg, to be administered as needed for mild pain, with a stipulation to notify the physician if more than three doses were given within 48 hours. However, the Medication Administration Record (MAR) showed that the resident received four doses within 48 hours on two separate occasions, and there was no documentation that the physician was notified as required. Additionally, the resident frequently reported pain levels of 5 or above on a numeric pain scale of 1 to 10, which was outside the parameters for mild pain as defined by the facility. Despite this, the resident was administered Acetaminophen outside of the PRN order parameters without notifying the provider. Interviews with the Nurse Manager and the Advanced Practical Registered Nurse confirmed the lack of documentation and notification to the provider regarding the deviation from the prescribed pain management plan.
Failure to Ensure RN Coverage
Penalty
Summary
The facility failed to ensure that a Registered Nurse (RN) was on duty for 8 consecutive hours a day, 7 days a week, as required. This deficiency was identified for four specific days in September 2024. A review of the Facility's Payroll Based Journal Staffing Data Report for Quarter 4 2024 revealed that there were no RN hours submitted for the dates of September 1, 15, 28, and 29, 2024. An interview with the Director of Nursing confirmed these findings and indicated that the facility could not provide documentation to show that an RN was on duty during these dates.
Medication Labeling and Dating Deficiency
Penalty
Summary
The facility failed to ensure that medications were labeled and dated according to currently accepted professional principles, as observed in two medication carts. During an observation, a small clear plastic medication cup containing three unlabeled and undated pills was found in the top drawer of a medication cart, which was confirmed to belong to a resident. Additionally, another medication cart contained a Symbicort inhaler without a box, bag, resident identifier, or open date, and an Advair Diskus inhaler in a box for another resident without an open date or expiration date. The pharmacy instructions indicated that the Advair Diskus should be discarded one month after opening, and the manufacturer's instructions for Symbicort stated it should be discarded within three months after removal from the pouch. Staff interviews confirmed the findings, with one staff member unable to identify the owner of the Symbicort inhaler.
Inaccurate Documentation of PTSD in Resident's Medical Record
Penalty
Summary
The facility failed to ensure accurate documentation of medical records for a resident diagnosed with Post Traumatic Stress Disorder (PTSD). A review of the resident's medical record showed a diagnosis of PTSD, but the Social Services Assessment and Documentation, completed by a social worker, inaccurately indicated that the resident had no history of trauma or PTSD. The social worker admitted during an interview that they did not ask the resident about trauma, leading to the inaccurate completion of the assessment. The facility's policy on Trauma Informed Care outlines a multi-pronged approach to identifying a resident's history of trauma, including asking residents about triggers and using various assessment tools. However, this policy was not followed in the case of the resident with PTSD, as the social worker did not conduct a thorough assessment to identify the resident's trauma history. This oversight resulted in a failure to document the resident's condition accurately, which is a deviation from the facility's established procedures.
Failure to Monitor Legionella Control Measures
Penalty
Summary
The facility failed to adhere to established infection control guidelines for water management, specifically in monitoring control measures to minimize the risk of Legionella and other opportunistic pathogens. During an interview, the Infection Preventionist was unaware of any system in place to monitor these control measures. A review of the facility's Legionella Water Management policy from 2017 indicated that domestic water tanks were designed to be inhospitable to Legionella bacteria due to high temperature and volume use, and were purged monthly by maintenance staff. However, the facility's documentation did not support consistent monitoring of these measures. The facility's boiler room daily inspection and maintenance logs revealed significant gaps in monitoring temperature and pressure, with only 10 out of 31 days in August and 4 out of 14 days in September being documented. The Maintenance Director confirmed these findings, indicating a lack of evidence for consistent control measures to prevent the introduction and spread of Legionella. This deficiency potentially affected the facility's census of 48 residents, as there was no documented system to ensure the safety of the water supply.
Staffing Deficiencies Lead to Delayed Care and Medication Administration
Penalty
Summary
The facility failed to provide sufficient nursing staff to meet the needs of its residents, as evidenced by multiple interviews and record reviews. Residents reported delays in receiving care and medications due to staff being too busy. One resident mentioned waiting for 45 minutes for assistance while on the toilet, highlighting the impact of staffing shortages on resident care. Staff interviews corroborated these accounts, revealing that low staffing levels led to delayed medication administration, increased incontinence incidents, and missed showers for residents. Staff members, including Licensed Nursing Assistants (LNAs) and Medication Nursing Assistants (MNAs), reported that at times, only one LNA was available for 25 residents, making it challenging to provide necessary care. They also noted that during certain shifts, there was only one nurse available for 50 residents, further exacerbating the issue. The facility's staffing assessment indicated that there should have been more staff on duty, but the daily staffing sheets revealed numerous instances where staffing levels were below the required numbers. The facility's daily staffing sheets from July 1, 2024, to September 11, 2024, showed consistent understaffing, with many shifts lacking the necessary number of LNAs and nurses. This staffing deficiency was confirmed by the facility's scheduler. Additionally, an Advanced Practice Registered Nurse expressed concerns about residents not receiving consistent wound care due to staffing issues, indicating that the deficiency affected various aspects of resident care.
Medication and Treatment Administration Deficiencies
Penalty
Summary
The facility failed to adhere to physician orders and provide timely medication administration for several residents, leading to deficiencies in care. Resident #47 experienced multiple instances where medications such as Ativan and Eliquis were administered outside the prescribed timeframes, with some doses given hours late or too close together. This was confirmed by staff interviews, indicating a lack of adherence to scheduled medication times. Resident #1's treatment for skin breakdown was not documented as performed on several occasions, despite a physician's order to change dressings daily. The Director of Nursing confirmed the lack of documentation, suggesting a failure in following through with prescribed wound care. Similarly, Resident #34 received medications, including Lantus and Hydralazine, at incorrect times, with some doses administered hours late or inappropriately close together. The Advanced Practice Registered Nurse was unaware of these discrepancies, highlighting a communication gap in medication administration. Resident #17's weight monitoring for congestive heart failure was not conducted as ordered, with missed weight recordings and a lack of notification to the provider about significant weight gain. Resident #26 did not receive prescribed Lotrisone Cream due to unavailability and missed doses of eye drops following cataract surgery. Staff interviews confirmed these omissions, indicating a failure to ensure medication availability and administration. These deficiencies reflect a pattern of non-compliance with physician orders and medication management protocols.
Unqualified Director of Activities
Penalty
Summary
The facility failed to ensure that the activities program was directed by a qualified professional, affecting a census of 78 residents. An interview with the Director of Activities, who was promoted in September 2024, revealed that they had been working as an activities aide since June 2024 and lacked prior certifications, degrees in recreation, or experience in an activity program. The facility's job description for the Director of Recreation Services requires certification by the National Certification Council of Activity Professionals or the National Council of Therapeutic Recreation Certification, a bachelor's degree in therapeutic recreation, or two years of experience in a social or recreational program, with one year in a patient activity program in a healthcare setting. An interview with the Administrator confirmed that the Director of Activities did not meet these qualifications.
Failure to Designate Qualified Infection Preventionist
Penalty
Summary
The facility failed to designate a qualified Infection Preventionist who had completed specialized training in infection prevention and control. During a record review on September 11, 2024, it was found that the facility could not provide evidence of such training for Staff D, who was hired on May 23, 2024, and was currently serving as the Infection Preventionist. An interview with Staff D confirmed the lack of specialized training. Additionally, an interview with Staff E, the Director of Nursing, corroborated these findings. The facility's job description for the Infection Preventionist, revised on August 3, 2020, required the completion of specialized training within 90 days of hire. Furthermore, the facility's policy on the Infection Prevention and Control Program, revised on July 1, 2024, outlined the responsibilities of the Infection Preventionist, which included developing, implementing, monitoring, and maintaining the program.
Resident's Call Bell Inaccessibility
Penalty
Summary
The facility failed to accommodate the needs of a resident by not ensuring their call bell was within reach. During an observation, it was noted that the resident's call bell was hanging over their roommate's light fixture, making it inaccessible to the resident. The resident, who was unable to reach the call bell, stated in an interview that they would have to yell for help if needed. Subsequent observations confirmed that the call bell remained in the same inaccessible position, with the resident either sitting in a wheelchair or napping in bed, unable to reach it.
Failure to Maintain Clean Environment
Penalty
Summary
The facility failed to maintain a clean and homelike environment on one of its units. During an observation on the [NAME] Unit, three large areas of a smeared brown substance were found adhered to the carpet. One area, approximately 4 feet long and 1 foot wide, was located in the hallway, while two other areas, each approximately 2 feet long and 1 foot wide, were in front of the nursing station. Two residents were observed walking on these areas. An interview with a Licensed Nursing Assistant revealed that the substance was from a resident who had loose stools the previous evening.
Failure to Provide Scheduled Showers for a Resident
Penalty
Summary
The facility failed to provide showers for a resident, identified as Resident #42, as part of their Activities of Daily Living (ADL) care. A review of the facility's policy on resident showers revealed that showers should be provided as per request or according to the facility's schedule, ensuring resident safety. However, documentation from July, August, and September 2024 showed that Resident #42 did not receive any showers, and there was no record of the resident refusing showers. This was confirmed during an interview with the Clinical Nursing Officer, who acknowledged the lack of documentation for showers during the specified period. Additionally, a Care Plan Meeting Note from July 2024 indicated that the resident's family had expressed concerns about the resident not receiving weekly showers.
Lack of Weekend Activities for Residents
Penalty
Summary
The facility failed to provide facility-sponsored groups and individualized activities to support residents based on their preferences, interests, and needs during weekends in September 2024. An interview with the Resident Council, consisting of eight residents, revealed complaints about the absence of weekend activities for the past two weekends, with nothing scheduled on the September activities calendar for weekends. One resident reported watching television all day, while seven others stated there was nothing for them to do. A review of the September 2024 activity calendars confirmed the lack of documented activities on Saturdays and Sundays throughout the month. Interviews with two residents indicated their willingness to attend weekend activities. The Director of Activities, who works Monday through Friday, confirmed these findings and stated that no activities were planned for weekends when they were not working, and the activity supplies were inaccessible as the office was locked.
Failure to Ensure Weekly Pressure Ulcer Assessments
Penalty
Summary
The facility failed to provide necessary treatment and services for a resident with a pressure ulcer, as evidenced by the lack of weekly documentation of wound assessments. The resident, who had a cast on their left leg, developed a pressure ulcer around the Achilles tendon. Despite the facility's policy requiring weekly reviews and documentation of skin assessments and pressure injury progression, the resident's wound measurements were only recorded on five occasions over a period of more than a month. This was confirmed by the Director of Nursing during an interview, acknowledging that the required weekly measurements were not conducted.
Failure in Timely Insulin Administration and Monitoring
Penalty
Summary
The facility failed to ensure timely administration and adequate monitoring of a diabetic resident's insulin regimen. The resident expressed concerns about inconsistent blood sugar levels and questioned the accuracy of insulin administration. A review of the resident's medical records revealed multiple instances where insulin doses were administered significantly later than the scheduled times, including doses of Fiasp and Lantus insulins. These delays ranged from 1.5 to over 3 hours late, which did not align with the physician's orders for administration before meals. Additionally, the facility's policy required medications to be administered within 60 minutes of the scheduled time, which was not adhered to in these cases. Furthermore, the facility did not adequately respond to instances of low blood glucose levels. On two occasions, the resident's capillary blood glucose (CBG) levels were recorded as low, but the necessary treatment with Insta-Glucose Gel was not documented as administered, nor were repeat CBGs conducted as required. There was also no documentation of provider notification regarding these low blood sugar events. Interviews with staff confirmed the lack of documentation and notification, indicating that the necessary actions were not taken to address the resident's low blood sugar levels.
Medication Administration Error Exceeds Acceptable Rate
Penalty
Summary
The facility failed to maintain a medication error rate below 5 percent during medication administration, resulting in a 5.56 percent error rate. This deficiency was identified during an observation of medication administration for a resident. The resident had physician's orders for Olanzapine 2.5 mg to be taken in the morning for borderline personality disorder and Metoprolol Succinate ER 100 mg to be taken once daily for hypertension. However, a registered nurse was observed administering Olanzapine 5 mg instead of the prescribed 2.5 mg and omitting the administration of Metoprolol Succinate ER 100 mg. The nurse confirmed these errors during an interview. The facility's medication administration policy requires adherence to the six rights of medication administration, including the right dosage, which was not followed in this instance.
Medication Storage and Labeling Deficiencies
Penalty
Summary
The facility failed to maintain proper storage and labeling of medications, as observed in both the medication room and medication cart. In the [NAME] Medication Room, an open vial of Tuberculin PPD-Aplisol was found without an open date or expiration date, and another vial was expired. The manufacturer's instructions specify that vials in use for more than 30 days should be discarded. Staff M, a Registered Nurse, confirmed these findings. Additionally, the Brettonwoods Medication Cart contained a medication cup with pre-poured pills lacking a resident identifier and an open Insulin Basaglar (Lantus) Qkwikpen without an open date or expiration date, contrary to the manufacturer's instructions that the pen should not be used for more than 28 days after opening. Staff L, a Medication Nursing Assistant, confirmed these observations. Further deficiencies were noted with Resident #26, who self-administered nasal sprays without a secure place to store them in the room. An unlocked medication cart was observed in the hallway of the [NAME] Woods Unit, with no staff present and residents nearby, violating the facility's policy that all drugs and biologicals must be stored in locked compartments. Additionally, Resident #34's Lantus was found expired, and Staff N, a Registered Nurse, was observed improperly disposing of an Olanzapine tablet in an uncovered trash receptacle attached to the medication cart, contrary to the facility's policy on hazardous waste pharmaceuticals. Staff N confirmed the medication cart was left unlocked and the Lantus was expired.
Failure to Maintain a Comprehensive QAPI Plan
Penalty
Summary
The facility failed to develop, implement, and maintain an effective comprehensive, data-driven Quality Assurance and Performance Improvement (QAPI) plan. During an interview with the Administrator, it was revealed that the facility was unable to provide documentation of a written QAPI plan. This indicates a lack of formalized procedures and documentation necessary for conducting QAPI and Quality Assessment and Assurance (QAA) activities.
Failure to Administer Anticoagulation Therapy
Penalty
Summary
The facility failed to provide necessary care and services for a resident receiving anticoagulation therapy. The resident, who was on Coumadin for atrial fibrillation, did not receive the medication for five days due to a lapse in monitoring and follow-up. The resident's medical record indicated an order for Coumadin to be administered until April 25, with a follow-up INR test scheduled for April 26. However, the INR test was not conducted, and no new orders for Coumadin were obtained, resulting in the resident not receiving the medication. On May 1, the resident exhibited symptoms of potential complications, including cyanotic lips, elevated heart rate, and low oxygen saturation. A nurse practitioner's note confirmed that the resident had not received Coumadin since April 25 and was sent to the emergency room due to concerns of acute pulmonary embolism. The resident was subsequently admitted to the hospital with bilateral pulmonary embolisms, highlighting the facility's failure to ensure proper anticoagulation management.
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Illustrative
What surveyors actually found near you
We read the 3 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
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Nursing homes near North Conway
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Merriman House | 3.6 mi | — | 0 | 0 |
| Mountain View Community | 22.7 mi | — | 3 | 0 |
| Wolfeboro Bay Center | 30.5 mi | — | 0 | 0 |
| Norway Center For Health & Rehabilitation, Llc | 31.7 mi | — | 0 | 0 |
| Coos County Nursing Home | 32.2 mi | — | 5 | 0 |
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