Inspection Reports for Aristacare At Manchester

The facility was found deficient in multiple areas including failure to treat residents with dignity and respect, incomplete and inaccurate skilled nursing facility advanced beneficiary notices, improper care of feeding tubes, unsecured medication storage, incomplete medical record documentation, inadequate infection prevention and control practices, and failure to administer annual influenza vaccination to a resident.

Complaint NJ183978 substantiated for failure to maintain accurate and complete medical records for Resident #150, including multiple blank entries in MAR/TAR indicating medications and treatments were not administered or documented properly.

The facility failed to maintain medical records accurately and completely for 1 of 46 residents reviewed, evidenced by multiple blank entries in the Medication Administration Record (MAR) and Treatment Administration Record (TAR) for Resident #150, indicating medications and treatments were not documented as given or completed.

Complaint #: NJ176392. The facility was found deficient in CNA staffing for residents on 3 of 14 day shifts during the two weeks prior to the survey, specifically on 09/08/24, 09/15/24, and 09/18/24. The complaint was substantiated with findings of noncompliance.

The facility was found not in compliance with New Jersey Administrative Code 8:39 regarding staffing ratios, failing to meet required CNA staffing levels on multiple day and evening shifts. The facility was required to submit a Plan of Correction to address these deficiencies.

Complaint NJ #169435 related to failure to develop individualized care plans for Resident #234 with aggressive behaviors. Complaint NJ #165621 related to failure to supervise Resident #535 who eloped the facility, posing immediate jeopardy. The facility disputed the citations.

The facility failed to develop and implement individualized care plans addressing aggressive behaviors for Resident #234, failed to adequately supervise Resident #24 who was a fall risk resulting in a fall and injury, and failed to adequately supervise Resident #535 who eloped the facility, posing immediate jeopardy to resident safety. The facility disputed the citations.

The complaint investigation revealed multiple deficiencies including failure to obtain physician orders for orthotic devices and skin tear treatment, inadequate supervision leading to elopement, failure to follow fall risk care plans, incomplete dialysis communication, inaccurate narcotic medication ordering, improper provision of thickened liquids, failure to document incidents properly, and improper infection control practices.

The facility failed to obtain physician orders for orthotic devices and skin tear treatment for Resident #24, failed to adequately supervise Resident #535 who eloped, failed to follow fall risk care plans for Resident #24, failed to maintain accurate dialysis communication for Resident #19, failed to complete DEA 222 forms properly, failed to provide pudding thick liquids as ordered for Resident #24, failed to document an incident timely for Resident #183, and failed to properly store respiratory equipment for Residents #40 and #241.

Complaint #s: 158574, 158700, 159171, 159192, 163170, 165621, 168216, 169055, 169435, 171625. Complaint investigation revealed multiple deficiencies including Immediate Jeopardy related to failure to provide physician ordered treatment and adequate supervision.

The facility was found in substantial compliance with emergency preparedness but had multiple deficiencies including Immediate Jeopardy related to failure to provide physician ordered treatment and adequate supervision, care plan deficiencies, failure to meet professional standards for orthotic devices and skin tear treatments, inadequate dialysis communication, medication administration errors, infection control lapses, staffing shortages, and life safety code violations.

The investigation was triggered by a complaint regarding the care of Resident #2, who had a history of depression and anxiety and was found deceased with a bathrobe tie around the neck. The complaint included concerns about failure to prevent harm, failure to follow clinical protocols, failure to update care plans, and failure to administer medications properly.

The facility failed to provide necessary services to prevent physical harm to Resident #2, failed to follow its Abuse and Neglect Clinical Protocol, failed to reevaluate and revise the Care Plan after changes in Resident #2's behavior, and failed to administer medications according to physician orders and clinical standards.

Complaint #NJ 158362 was substantiated as the facility failed to report a serious injury incident involving Resident #2 to the NJDOH and did not follow their own reporting policy.

The facility was found not in substantial compliance with 42 CFR Part 483, Subpart B, due to failure to report an accident/incident resulting in serious bodily injury of a resident (Resident #2) to the New Jersey Department of Health and failure to follow the facility's policy on Unusual Occurrence Reporting.

The facility was found not in compliance with infection control regulations, specifically failing to ensure proper removal and disposal of personal protective equipment (PPE) by housekeeping staff exiting rooms of residents under COVID-19 precautions. Additionally, the facility failed to maintain required minimum direct care staff to resident ratios for several shifts.

Deficiencies were cited related to expired medical supplies in emergency carts and improper labeling and maintenance of kitchen food items and equipment.

The facility was found to be in noncompliance with several Life Safety Code requirements including missing instructional signage on delayed egress doors, obstructions in stairwells, incomplete sprinkler coverage in stairwells, lack of monthly elevator firefighter service testing documentation, and failure to certify generator transfer time within 10 seconds.

The facility failed to ensure that expired suction equipment supplies, nasal cannula, and saline solution were removed from emergency carts. Additionally, the facility did not maintain kitchen equipment properly to prevent microbial growth and failed to label and date opened food products according to professional standards.

Complaint #: NJ146180 and NJ147873. The facility was found not in substantial compliance with staffing requirements as per NJDOH memo dated 01/28/2021. The Nursing Home Administrator acknowledged failure to meet staffing directives due to staff not reporting to work or calling out sick.

The facility was found not in substantial compliance with New Jersey staffing requirements, failing to meet minimum staffing ratios for 30 of 35 shifts reviewed, including deficiencies in total staff for four of 35 overnight shifts. Despite recruitment efforts and increased pay rates, staffing shortages persisted.

The facility failed to implement timely transmission-based precautions for residents during a COVID-19 outbreak, did not ensure hand hygiene was performed before meals, and had improper PPE use and disposal practices by staff, including a Certified Nursing Aide who removed PPE incorrectly and disposed of used PPE improperly. The receptionist conducting COVID-19 testing also failed to follow proper infection control procedures.

The facility was found not to be in compliance with 42 CFR §483.80 infection control regulations due to a staff member failing to don appropriate Personal Protective Equipment (PPE) while entering a resident's room under droplet precautions. The deficiency was isolated to one staff member who was subsequently terminated, and corrective actions including staff education and audits were implemented.