Inspection Reports for Advanced Health Care Of Paradise

The inspection was conducted as a result of a complaint investigation completed on 07/23/2025 regarding a complaint numbered 2298213.

One deficiency was identified related to inappropriate discharge practices. The facility failed to ensure a resident was appropriately discharged with a safe and coordinated discharge plan, including providing choices of post-acute care providers suited to the resident's goals, preferences, needs, and circumstances.

Complaint 2298213 was investigated and a deficient practice was identified related to inappropriate discharge.

The inspection was conducted to evaluate the facility's compliance with discharge planning requirements, specifically ensuring that residents are appropriately prepared and assisted for safe transfer or discharge.

The facility failed to ensure that one of six sampled residents (Resident 6) was appropriately discharged with documented evidence of presenting post-acute care options suited to the resident's needs and preferences. The facility preferred using its own home health agency and lacked documentation showing that Resident 6 was offered other home health care options.

This Statement of Deficiencies was generated as a result of a Medicare Recertification Survey conducted from 03/18/2025 through 03/20/2025 in accordance with 42 Code of Federal Regulations (CFR) Chapter IV, Part 483, Requirements for Long Term Care Facilities.

The facility was found deficient in multiple areas including failure to provide proper Medicare Notice of Non-Coverage, failure to implement care plan interventions for pressure reducing devices, intravenous midline care, feeding assistance, and constipation care, failure to ensure proper documentation and administration of antimicrobial wipes, wound care, midline dressing changes, feeding assistance, bowel protocol implementation, and infection control measures including enhanced barrier precautions.

The inspection was conducted as a Medicare Recertification Survey to assess compliance with federal regulations for long term care facilities.

The facility was found deficient in multiple areas including failure to provide proper Medicare Notice of Non-Coverage, failure to implement comprehensive care plans, failure to meet professional standards in wound care and midline dressing changes, failure to provide required feeding assistance, failure to follow bowel care protocols, failure to maintain infection control measures, and failure to ensure proper use of pressure reducing devices.

The inspection was conducted to assess compliance with Medicare and Medicaid requirements, including review of beneficiary notification, care plan implementation, wound care, feeding assistance, infection control, and other regulatory standards.

The facility was found deficient in multiple areas including failure to provide proper Medicare Notice of Non-Coverage, incomplete implementation of care plans for pressure ulcers, intravenous midline care, feeding assistance, and constipation care. Documentation inaccuracies were noted in wound care and antimicrobial wipe application. Infection control measures were not consistently followed, and midline catheter care lacked proper physician orders and dressing changes. Feeding assistance orders were not consistently followed, placing residents at risk for malnutrition.

The inspection was conducted as a routine survey to assess compliance with regulatory requirements related to resident rights, care, medication administration, infection control, dialysis services, food safety, and medication management.

The facility was found deficient in multiple areas including failure to maintain written records of resident council meetings and grievances, lack of physician orders and care plans for splint use and IV therapy, improper oxygen administration, inadequate dialysis communication and infection control practices, medication errors exceeding 5%, unsecured medication carts exposing resident information, and food safety violations including expired products and improper hygiene practices.

The inspection was conducted as a result of a complaint investigation triggered by two complaints received by the facility.

Two complaints were investigated: one was verified with no deficient practice found, and the other could not be verified. No regulatory deficiencies were identified during the investigation.

Two complaints were investigated: Complaint #NV00068786 was verified with no deficient practice, and Complaint #NV00068510 could not be verified. No regulatory deficiencies were identified.

The inspection was conducted to evaluate the facility's compliance with care planning and infection control requirements, including the development of baseline care plans for residents and the implementation of infection prevention practices during intravenous medication administration.

The facility failed to develop an adequate baseline care plan for a resident with Clostridium difficile infection, lacking documentation of infection-related problems and interventions. Additionally, improper infection control practices were observed during IV medication administration, potentially exposing a resident with a compromised immune system to infection.

This inspection was conducted as a state licensure survey in conjunction with a Federal Recertification survey at the skilled nursing facility from 03/14/2023 through 03/17/2023.

The facility was found deficient for failing to ensure a criminal background check was performed every five years for one of twelve sampled employees, potentially exposing residents to risk. A plan of correction was submitted and approved.

This inspection was conducted as a result of a Complaint Investigation at the facility on 06/16/2022, triggered by complaint #NV00065329 with multiple allegations regarding resident care and communication.

The investigation found that none of the allegations could be substantiated. Residents, family members, and staff interviews supported that communication was adequate, neglect was denied, urinary tract infection and catheter care were appropriately managed, referrals were planned but delayed due to pandemic challenges, and residents were treated with dignity and respect. The resident discharged was stable at discharge with no regulatory deficiencies identified.

Complaint #NV00065329 included six allegations: 1) Difficult communication after hospital admission; 2) Resident neglect; 3) Urinary tract infection and catheter care; 4) Failure to refer to urology; 5) Employees told not to talk to resident; 6) Resident discharged dehydrated, malnourished, and septic. None of these allegations were substantiated based on interviews, documentation, and clinical records.

The inspection was initiated as a Medicare Recertification survey and Facility Reported Incident Investigation regarding seven Facility Reported Incidents (FRIs), including six related to resident falls and one regarding employee-to-resident abuse.

The investigation found all six FRIs regarding resident falls were substantiated with no regulatory deficiencies identified. However, a regulatory deficiency was identified related to baseline care plans not being person-centered or properly reflecting fall risk interventions for 12 of 15 sampled residents. Additional deficiencies were found related to medication administration, physician orders not followed for compression stockings and fall mats, missing physician orders for knee compression sleeves, failure to follow fall mat orders for multiple residents, improper Foley catheter sizes used without physician orders, delayed PICC line dressing changes, incomplete dialysis agreements and communication, and infection control issues including improper cleaning of glucometers and PPE usage.

The visit was complaint-related, triggered by seven Facility Reported Incidents including falls and alleged employee-to-resident abuse. The abuse allegation was not substantiated.

The inspection was conducted as an initial Medicare certification Life Safety Code (LSC) survey using the 2012 edition of NFPA 101, Life Safety Code, to assess compliance with fire safety and emergency preparedness requirements.

The facility was found deficient in several areas including fire alarm system maintenance, sprinkler system spare heads, fire drills, emergency preparedness training, fire door automatic closing devices, electrical equipment maintenance, and emergency preparedness communication plans. Some deficiencies were acknowledged and corrective actions planned or underway.

This inspection was conducted as a Focused Infection Control Survey and Complaint Investigation related to COVID-19 infection control practices at the facility.

The investigation found that the facility had one positive COVID-19 resident and no presumptive cases at the time of inspection. The facility implemented infection control measures including screening, PPE use, isolation protocols, and staff education. The complaint allegations regarding notification of COVID-19 status to caregivers and retesting practices were substantiated with no regulatory deficiencies. No regulatory deficiencies were identified overall.

Complaint #NV00063075 was substantiated with no regulatory deficiencies. Allegations included failure to notify local caregivers about resident's COVID-19 positive status, failure to retest residents within 90 days, and misinformation about quarantine and discharge timing. All allegations were either substantiated with no deficiencies or could not be substantiated based on documentation and interviews.

The inspection was conducted as a complaint investigation initiated on 03/16/2021 regarding allegations of resident wounds and hospital admission due to dehydration, malnourishment, bedsores, and kidney malfunction.

The investigation substantiated two complaints related to a resident's wound on the scrotum and hospital admission due to dehydration and malnourishment, while a third allegation regarding raw skin on the lower abdomen was not substantiated. The facility failed to notify the physician of a wound for one resident, leading to a regulatory deficiency.

Complaint #NV00063160 was substantiated. Allegation #1 regarding a wound on the scrotum was substantiated. Allegation #2 regarding hospital admission with dehydration and malnourishment was substantiated without deficiency. Allegation #3 regarding raw skin on the lower abdomen was not substantiated.

The inspection was conducted as a Centers for Medicare and Medicaid Services (CMS) Focused Infection Control survey to investigate regulatory compliance for Infection Control and Prevention related to COVID-19.

The facility had seven positive COVID-19 cases and twenty presumptive cases at the time of inspection. The facility implemented infection control measures including separate entrances, PPE usage, resident monitoring, and staff education. No regulatory deficiencies were identified.

The inspection was a Focused Infection Control survey conducted to assess compliance with infection control and prevention requirements related to COVID-19 in a long term care facility.

The facility had implemented infection control measures including designated COVID-19 and quarantine units, staff screening, PPE use, and environmental cleaning. No regulatory deficiencies were identified during the survey.

The inspection was conducted as a result of a complaint investigation triggered by two complaints alleging medication administration delays and lack of nurse assistance with transfers.

Two complaints were investigated; both were not substantiated. A separate complaint regarding COVID-19 care was substantiated without deficiency. The facility had one COVID-19 positive resident with appropriate PPE use and staff education. No regulatory deficiencies were identified.

Complaint #NV00061421 was not substantiated regarding evening medication delays and nurse assistance with transfers. Complaint #NV00061599 was substantiated without deficiency related to COVID-19 care, including dedicated staff assignment, staff education, notification of new admissions, and PPE accessibility.

The inspection was conducted as a result of a complaint investigation regarding allegations about resident care and facility processes.

The investigation substantiated allegations that the resident developed ketoacidosis due to inadequate diabetes treatment and that physician orders were not followed. Other allegations related to lost personal items and family contact were not substantiated. Deficiencies were identified related to medication orders and blood glucose monitoring.

Complaint #NV000596969 was investigated with substantiated allegations that the resident developed ketoacidosis due to improper diabetes treatment and that physician orders were not followed. Other allegations about lost personal items and family contact were not substantiated.

This visit was a Centers for Medicare and Medicaid Services (CMS) Focused Infection Control survey conducted to assess compliance with infection prevention and control requirements, including COVID-19 related protocols.

The facility was found to have no regulatory deficiencies. The infection control program, PPE supplies, screening procedures, and COVID-19 precautions were reviewed and found adequate with no issues identified.

This survey was a COVID-19 Focused Infection Control survey initiated by Centers for Medicare and Medicaid Services (CMS) to assess infection control practices in the facility.

No deficient practices were identified during the survey. The facility confirmed adequate personal protective equipment availability and staff acknowledged ongoing infection control training. An infection control educational packet was provided.

The inspection was conducted as a result of Facility Reported Incidents (FRI) to investigate five reported incidents including allegations of employee to resident altercation, resident abuse, resident falls with injury, and resident elopement.

Five facility reported incidents were investigated; four incidents could not be substantiated, one incident was substantiated with no regulatory deficiency identified, and no regulatory deficiencies were found overall.

Five facility reported incidents were investigated: 1) employee to resident altercation - not substantiated; 2) resident abuse - not substantiated; 3) resident fall with injury - not substantiated; 4) resident fall with injury - substantiated with no regulatory deficiency; 5) resident elopement - not substantiated.

The inspection was conducted as the initial Medicare Certification Survey for the facility.

No regulatory deficiencies were identified during the survey. Two active and two closed records were reviewed.

The inspection was conducted as an Emergency Preparedness survey in conjunction with a Medicare certification survey to assess compliance with federal and state emergency preparedness requirements.

The facility failed to develop and maintain a comprehensive emergency preparedness program including an annually reviewed emergency plan, facility-based hazard vulnerability assessment, collaboration with local emergency officials, shelter-in-place policies, transportation arrangements, communication plans including primary and alternate means, and a means to provide occupancy and needs information to authorities.

Initial Medicare certification Life Safety Code (LSC) survey conducted at the facility.

The facility was surveyed using the 2012 edition of NFPA 101 Life Safety Code. Deficiencies were identified related to emergency lighting runtime testing, smoke barrier doors not closing and latching properly, electrical system labeling and testing, HVAC system door clearances, fire drill staff knowledge, and generator load testing and documentation.

This inspection was conducted as an initial state licensure survey for the facility to be licensed for 38 skilled nursing beds.

No regulatory deficiencies were identified during the initial state licensure survey. No further action is necessary.

This was an initial state licensure construction standards survey conducted for a new 38-bed Skilled Nursing Facility to ensure compliance with applicable construction and life safety codes.

The facility failed to ensure that the construction and operating features conformed to the 2015 NFPA 101 Life Safety Code and the 2006 AIA Guidelines. Deficiencies included missing wire mesh panels on direct-vent gas fireplaces and inadequate HVAC filtration systems.

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