Inspection visit
Fire Safety inspection
Citations
14 citations recorded*CMS
This is a Fire Safety survey. CMS cites these findings under the Life Safety Code and Emergency Preparedness rules, a separate set from the health (F-tag) deficiencies. The codes and grading differ, so these do not link to the health violation pages.
What do CMS severity letters mean?
Serious (G-L). Actual harm to a resident, or immediate jeopardy. Codes G through I indicate actual harm; J through L indicate immediate jeopardy to resident health or safety.
General (A-F). No actual harm found, or harm that is minimal. The facility must still submit a Plan of Correction. Most CMS citations land here.
Each letter combines severity with scope: how many residents the deficiency affected.
- 0023GeneralS&S Dpotential for harm
Establish policies and procedures for medical documentation.
- 0026GeneralS&S Dpotential for harm
Establish roles under a Waiver declared by secretary.
- 0035GeneralS&S Dpotential for harm
Provide family notifications of emergency plan.
- 0036GeneralS&S Dpotential for harm
Establish emergency prep training and testing.
- 0039GeneralS&S Dpotential for harm
Conduct testing and exercise requirements.
- 0222GeneralS&S Dpotential for 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.
- 0353GeneralS&S Dpotential for harm
Inspect, test, and maintain automatic sprinkler systems.
- 0363GeneralS&S Dpotential for harm
Install corridor and hallway doors that block smoke.
- 0511GeneralS&S Dpotential for harm
Have properly installed electrical wiring and gas equipment.
- 0712GeneralS&S Dpotential for harm
Have simulated fire drills held at unexpected times.
- 0741GeneralS&S Dpotential for harm
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
- 0761GeneralS&S Epotential for harm
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
- 0920GeneralS&S Dpotential for harm
Ensure proper usage of power strips and extension cords.
- 0923GeneralS&S Dpotential for harm
Have proper medical gas storage and administration areas.
FAQ · About this visit
Common questions about this visit
What happened during the September 4, 2025 survey of HIGHLAND MANOR OF FALLON REHABILITATION LLC?
This was a inspection survey of HIGHLAND MANOR OF FALLON REHABILITATION LLC on September 4, 2025. The surveyor cited 14 deficiencies, recorded on the federal Form 2567 statement of deficiencies.
Were any deficiencies cited at HIGHLAND MANOR OF FALLON REHABILITATION LLC on September 4, 2025?
Yes, 14 deficiencies were cited, each with a CMS Scope and Severity grade. The first was: "Establish policies and procedures for medical documentation."
What type of survey was this?
This was a inspection survey conducted by state surveyors under federal Centers for Medicare & Medicaid Services (CMS) oversight. Findings are published on CMS Care Compare.
SourceView on CMS Care Compare
Next steps
Concerned about a resident’s care?Find your local ombudsman through the Eldercare Locatoror file a complaint with your state survey agency.
Researching this visit professionally?Book a 15-minute calland we will walk through what we have on file.
Data from CMS Care Compare public records. Dataset last refreshed . If you believe any information is inaccurate, report it here.