3 Reports
Inspection Report — Dec 4, 2024
CMS
Date: Dec 4, 2024
Visit Reason
The inspection was conducted to investigate compliance with regulations regarding timely notification of resident transfers to the State Long Term Care Ombudsman, posting of daily nurse staffing information, and sanitary storage of cookware.
Findings
The facility failed to notify the State Long Term Care Ombudsman of a hospital transfer for one resident, did not post complete daily nurse staffing information in a readily accessible place, and failed to maintain sanitary storage of cookware as evidenced by a sheet pan found on the floor.
Deficiencies (3)
Failed to notify the State Long Term Care Ombudsman of facility-initiated transfer for one resident.
Failed to post daily nurse staffing information in a prominent place accessible to residents and visitors, and failed to include total number and actual hours worked by nursing staff.
Failed to maintain a safe, sanitary environment by storing cookware improperly, evidenced by a sheet pan on the floor.
Report Facts
Residents affected: 81
Residents affected: 80
Employees mentioned
| Name | Title | Context |
|---|---|---|
| S3BOM | Business Office Manager | Responsible for Emergency Transfer Log and confirmed omission of Resident #57 |
| S1ADM | Administrator | Confirmed omission of Resident #57 on Emergency Transfer Log and commented on nurse staffing posting |
| S2RN | Registered Nurse | Interviewed regarding nurse staffing posting accessibility and content |
| S4RD | Registered Dietician | Confirmed sheet pan was improperly stored on the floor |
Inspection Report — Nov 15, 2023
Annual Inspection CMS
Date: Nov 15, 2023
Visit Reason
The inspection was conducted to assess compliance with timely completion of resident assessments, specifically focusing on discharge Minimum Data Set (MDS) assessments.
Findings
The facility failed to ensure a discharge MDS assessment was completed timely for 1 out of 39 sampled residents, potentially affecting a total census of 77 residents. The discharge assessment for Resident #56 was never initiated despite the resident's discharge on 07/31/2023.
Deficiencies (1)
Failure to complete a timely discharge Minimum Data Set (MDS) assessment for Resident #56.
Report Facts
Residents sampled: 39
Inspection Report — Oct 19, 2022
Annual Inspection CMS
Date: Oct 19, 2022
Visit Reason
The inspection was conducted as a routine annual survey of the nursing home facility to assess compliance with health and safety regulations.
Findings
No health deficiencies were found during the inspection.
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