Inspection Reports for Jewish Senior Services

CT, 06604

Back to Facility Profile

Deficiencies per Year

16 12 8 4 0
2018
2019
2020
2021
2022
2023
2024
2025
Severe Moderate Low Unclassified

Census Over Time

0 70 140 210 280 350 Apr '18 Jun '19 Dec '21 Oct '23 Mar '25 Sep '25
Census Capacity
Inspection Report Renewal Census: 287 Capacity: 294 Deficiencies: 0 Sep 29, 2025
Visit Reason
The inspection was conducted as a licensing inspection for renewal purposes at the facility.
Findings
No violations of the General Statutes of Connecticut and/or regulations of Connecticut State Agencies were identified at the time of this inspection.
Employees Mentioned
NameTitleContext
Larry CondonAdministratorPersonnel contacted during the inspection
Sherry MercerDNSPersonnel contacted during the inspection
Inspection Report Complaint Investigation Deficiencies: 13 Sep 29, 2025
Visit Reason
Unannounced visits were conducted to Mozaic Senior Life for multiple investigations related to compliance with state regulations and statutes.
Findings
The facility was found deficient in multiple areas including failure to ensure dignified dining, failure to maintain privacy for urinary collection devices, failure to document and investigate grievances and allegations of neglect, failure to notify the State Ombudsman of resident discharge, failure to follow resident care plans, failure to follow physician orders, failure to maintain safe water temperatures, medication errors, unsafe medication storage, and inadequate infection control practices.
Complaint Details
The investigation was complaint-driven, focusing on allegations of neglect, dignity issues, medication errors, infection control, and safety concerns.
Deficiencies (13)
Description
Failed to ensure a dignified dining experience for Resident #245 and maintain privacy for Resident #250's urinary collection device.
Failed to document and retain resolution to a grievance for Resident #272.
Failed to report two allegations of neglect for Resident #272 to the State Agency.
Failed to investigate two allegations of neglect for Resident #272.
Failed to notify the State Ombudsman of Resident #295's hospital transfer.
Failed to follow Resident Care Plans for Residents #157, #259, and #272 including documentation of meal intake and two-staff assistance.
Failed to update Resident Care Plan for Resident #272 after allegations of neglect.
Failed to follow physician orders for Resident #125 regarding use of plastic silverware due to behavioral issues.
Failed to complete timely RN assessment of pressure ulcer, failed to clarify and follow physician order for wound treatment, and failed to ensure appropriate air mattress pressure settings for Resident #21.
Failed to maintain safe water temperatures and monitor water temperatures in resident rooms to prevent burns.
Failed to prevent a significant medication error involving transdermal fentanyl patches for Resident #228.
Failed to safely store medications and biologicals; medication cart and medication room left unlocked.
Failed to perform hand hygiene and wound care under clean conditions for Residents #21 and #179, and failed to maintain appropriate infection control practices for Resident #250's urinary collection device.
Report Facts
Weight loss: 13.4 Meals served: 402 Meals undocumented: 149 Meals served: 471 Meals undocumented: 167 Water temperature exceedances: 23 Rooms with hot water >120°F: 25
Employees Mentioned
NameTitleContext
Laura Trombley-NortonSupervising Nurse ConsultantSigned the initial notice letter.
LPN #1Licensed Practical NurseInterviewed regarding Resident #245 dining placement.
Director of Nursing (DNS)Director of NursingInterviewed regarding multiple deficiencies including dining policy, grievance documentation, neglect reporting, care plan adherence, medication storage, and infection control.
Nurse Aide (NA) #4Nurse AideInterviewed regarding urinary collection device privacy and positioning.
LPN #4Licensed Practical NurseInterviewed regarding urinary collection device privacy.
Resident Care Coordinator (RN #3)Registered NurseInterviewed regarding care plan adherence for Resident #272.
LPN #8Licensed Practical NurseInvolved in fentanyl patch medication error.
RN #2Registered NurseObserved and interviewed regarding wound care and air mattress settings.
Maintenance SupervisorMaintenance SupervisorInterviewed regarding water temperature monitoring and adjustments.
Pharmacy Regional DirectorPharmacy Regional DirectorInterviewed regarding fentanyl medication error.
LPN #2Licensed Practical NurseObserved and interviewed regarding infection control practices for Resident #179.
Inspection Report Census: 285 Capacity: 294 Deficiencies: 0 Jul 9, 2025
Visit Reason
The inspection was conducted as a Desk Audit on July 9, 2025.
Findings
No violations of the General Statutes of Connecticut and/or regulations of Connecticut State Agencies were identified at the time of this inspection.
Inspection Report Census: 32 Deficiencies: 0 Apr 5, 2025
Visit Reason
Inspection to identify violations of the General Statutes of Connecticut and/or regulations of Connecticut State Agencies at the time of the inspection.
Findings
Violations of the General Statutes of Connecticut and/or regulations of Connecticut State Agencies were identified during the inspection. See attached violation letter for details.
Report Facts
Census: 32
Employees Mentioned
NameTitleContext
Elizabeth T HeineySurvey Team LeaderNamed as Survey Team Leader and report submitter
Inspection Report Complaint Investigation Census: 280 Capacity: 294 Deficiencies: 0 Mar 31, 2025
Visit Reason
The inspection was conducted as a complaint investigation related to Complaint Investigations #43419.
Findings
No violations of the General Statutes of Connecticut and/or regulations of Connecticut State Agencies were identified at the time of this inspection.
Complaint Details
Complaint Investigation #43419 was the reason for the visit; no violations were found.
Report Facts
Licensed Bed/Bassinet Capacity: 294 Census: 280
Employees Mentioned
NameTitleContext
Larry CondonAdministratorPersonnel contacted during inspection
Sherry MercerDONPersonnel contacted during inspection
Deborah SmithRN, NCReport submitted by
Inspection Report Complaint Investigation Census: 280 Capacity: 294 Deficiencies: 0 Mar 4, 2025
Visit Reason
A complaint investigation survey was conducted at Mozaic Senior Life on March 4 and 5, 2025, to determine compliance with 42 CFR Part 483 requirements for long term care facilities.
Findings
Deficiencies were cited as a result of this complaint investigation survey.
Complaint Details
Complaint Investigation Survey, ACT Reference Numbers CT #43120 and #43122.
Report Facts
Licensed Bed Capacity: 294 Census: 280
Employees Mentioned
NameTitleContext
Andrew BanoffAdministratorPersonnel contacted during the inspection.
Larry CondonPersonnel contacted during the inspection.
Sherry MercerDirector of Nursing (DNS)Personnel contacted during the inspection.
Inspection Report Complaint Investigation Census: 281 Capacity: 294 Deficiencies: 0 Jan 31, 2025
Visit Reason
The inspection visit was conducted as part of complaint investigations #42714.
Findings
No violations of the General Statutes of Connecticut and/or regulations of Connecticut State Agencies were identified at the time of this inspection.
Complaint Details
Complaint investigation #42714 was conducted and found no violations.
Employees Mentioned
NameTitleContext
Larry CondonAdministratorPersonnel contacted during the inspection.
Sherry MercerDirector of NursingPersonnel contacted during the inspection.
Deborah SmithRN, NCReport submitted by.
Inspection Report Enforcement Deficiencies: 7 Apr 2, 2024
Visit Reason
The Department of Public Health conducted multiple unannounced inspections between August 23, 2022 and December 21, 2023, resulting in findings of Immediate Jeopardy related to medication errors, failure to implement care plans, inadequate supervision, and safety issues including resident elopement and pressure ulcers. This Consent Order formalizes enforcement actions and corrective requirements.
Findings
The Department found multiple serious deficiencies including failure to accurately transcribe medication orders leading to hypoglycemic events and hospitalizations, inadequate assistance with mobility and protective equipment, failure to prevent falls and pressure ulcers, and ineffective resident elopement prevention measures. Immediate Jeopardy was identified on several occasions, and civil penalties were imposed.
Severity Breakdown
Immediate Jeopardy: 4
Deficiencies (7)
DescriptionSeverity
Failure to ensure medication orders were accurately transcribed to the eMAR resulting in a hypoglycemic event and hospitalization.Immediate Jeopardy
Failure to ensure unit nurse had access to emergency glucagon during hypoglycemic event.Immediate Jeopardy
Failure to implement plan of care for appropriate assistance with bed mobility and protective equipment.
Failure to provide ambulatory assistance and supervision resulting in a fall with significant injury.
Failure to prevent development of Stage III pressure ulcer and deep tissue injury.
Failure to initiate missing resident policy and ineffective exit door alarms leading to resident elopement.Immediate Jeopardy
Failure to ensure medications were administered to the right resident causing significant medication error and hospital admission.Immediate Jeopardy
Report Facts
Civil fine amount: 24000 Civil fine amount: 10000 INC minimum hours per week: 24 Consent Order duration: 1 Retention period for records: 5
Employees Mentioned
NameTitleContext
Andrew BanoffPresident and CEOSigned Consent Order as Licensee representative
Jennifer Olsen ArmstrongSection Chief, Facility Licensing and Investigations SectionSigned Consent Order on behalf of Department of Public Health
Kim HriceniakPublic Health Services ManagerContact for reports required by Consent Order
Inspection Report Complaint Investigation Census: 285 Capacity: 287 Deficiencies: 5 Feb 7, 2024
Visit Reason
The inspection was conducted as a complaint investigation related to allegations of abuse and failure to ensure resident safety and proper notification following incidents.
Findings
The facility was found to have multiple violations related to failure to notify the psychiatric provider of changes in resident behavior, failure to ensure residents were free from physical abuse, failure to revise care plans following incidents, and failure to report suspected mistreatment within required timeframes.
Complaint Details
The complaint investigation involved allegations of abuse including physical altercations between residents and mistreatment by staff. The investigation substantiated violations related to failure to notify providers, failure to prevent abuse, failure to revise care plans, and failure to report allegations timely.
Deficiencies (5)
Description
Failure to notify the psychiatric provider following a change in behavioral symptoms leading to resident-on-resident physical assault.
Failure to ensure a resident was free from physical abuse by another resident.
Failure to revise the comprehensive care plan following a witnessed resident-to-resident physical altercation.
Failure to ensure a resident was free from staff-to-resident abuse and failure to report suspected mistreatment to the overseeing state agency within required time frames.
Failure to report a suspected allegation of mistreatment to the overseeing state agency within required time frames.
Report Facts
Licensed Bed Capacity: 287 Census: 285 Plan of Correction Completion Date: Mar 20, 2024
Employees Mentioned
NameTitleContext
Katie PearseAssistant AdministratorPersonnel contacted during inspection
Sherry MercerDirector of Nursing Services (DNS)Personnel contacted during inspection and monitor for compliance
Lawrence CondonSenior Vice PresidentSigned Plan of Correction letter
Margaret McKinneySupervising Nurse ConsultantRecipient of Plan of Correction letter
Registered Nurse RN #1Nursing SupervisorInterviewed regarding resident incidents and supervision
Licensed Practical Nurse LPN #1Charge NurseInterviewed regarding resident care and medication attempts
Physician Assistant PA #1Physician AssistantInterviewed regarding resident behavior and notification expectations
Director of NursingInterviewed regarding notification and prevention policies
Registered Nurse RN #2Nursing SupervisorInterviewed regarding resident mistreatment allegations
Licensed Practical Nurse LPN #2Charge NurseInterviewed regarding resident care and call bell incidents
Nurse Aide NA #2Nurse AideInterviewed regarding resident mistreatment and call bell incidents
Homemaker #1Interviewed regarding resident care and observations
Recreation Staff #1Interviewed regarding resident observations and reporting
Inspection Report Renewal Census: 290 Capacity: 294 Deficiencies: 0 Oct 15, 2023
Visit Reason
The inspection was conducted as a renewal licensing inspection for the facility.
Findings
Violations of the General Statutes of Connecticut and/or regulations of Connecticut State Agencies were identified at the time of this inspection.
Employees Mentioned
NameTitleContext
Andrew BurnettAdminPersonnel contacted during the inspection
Sherry MercerDNSPersonnel contacted during the inspection
Inspection Report Complaint Investigation Census: 287 Capacity: 294 Deficiencies: 9 Aug 23, 2022
Visit Reason
Unannounced visits were made to Jewish Senior Services concluding on November 9, 2021, for the purpose of conducting multiple investigations including complaint investigations. The August 23, 2022 visit was for a complaint investigation survey to determine compliance with long term care facility regulations.
Findings
The facility was found noncompliant with several regulations including failure to assess pressure wounds timely, maintain a safe environment, provide competent staff, secure medication rooms, and ensure staff wore identification badges. Medication administration errors and failure to follow medication administration rights were also noted, resulting in significant resident harm.
Complaint Details
Complaint investigations #30709, 29938, 25799 in 2021 and #00032653, 00032679 in 2022 were conducted. Violations were substantiated as deficiencies were cited.
Deficiencies (9)
Description
Failed to ensure a pressure wound was assessed upon admission or within 24 hours as per facility policy.
Failed to maintain a safe and hazard free environment, including blocking egress with furniture.
Failed to provide competent staff to ensure resident safety, including staff sleeping on duty.
Failed to ensure insulin vials and pens were dated when opened and medication room was secured.
Failed to ensure staff had identification badges in place on their person.
Failed to document safety checks implemented after a suicide attempt.
Failed to ensure newly licensed nurse demonstrated proficiency in medication administration.
Failed to ensure annual performance evaluations were completed yearly for staff.
Medication administration error resulting in significant harm and hospital admission of a resident.
Report Facts
Licensed Bed Capacity: 294 Census: 287 Dates of Onsite Inspection: 2021 inspections on 11-7-21, 11-8-21, 11-9-21; 2022 inspection on 8-23-22 Compliance Date: Multiple compliance dates including 12/21/21, 8/23/22, 10/03/22
Employees Mentioned
NameTitleContext
Larry CondonSenior Vice PresidentNamed in plan of correction letters and administrative correspondence
Andrew BanoffAdministratorFacility administrator named in multiple sections and correspondence
Stacey BardinDNSDirector of Nursing Services named in inspection and plan of correction
Sandra Vermont-HollisSupervising Nurse ConsultantSigned complaint investigation and notice letters
Maureen Golas MarkureSupervising Nurse ConsultantSigned complaint investigation and notice letters
LPN #1Named in multiple medication administration and competency deficiencies
RN #1Named in medication administration and supervision deficiencies
Inspection Report Census: 287 Capacity: 294 Deficiencies: 0 Aug 23, 2022
Visit Reason
Visit or revisit for the purpose of extended survey.
Findings
No violations of the General Statutes of Connecticut and/or regulations of Connecticut State Agencies were identified at the time of this inspection.
Employees Mentioned
NameTitleContext
Larry CondonSenior Vice President, AdministratorPersonnel contacted during inspection
Stacey BardenDNSPersonnel contacted during inspection
Inspection Report Complaint Investigation Census: 285 Capacity: 294 Deficiencies: 4 Aug 10, 2022
Visit Reason
The inspection was conducted as a complaint investigation survey to determine compliance with 42 CFR Part 483 requirements for long term care facilities, triggered by complaints CT# 00032653 and CT# 00032679.
Findings
Violations of Connecticut State Agencies regulations were identified, including significant medication errors resulting in hospital admission, failure to ensure newly licensed nurse competency, and incomplete annual employee performance evaluations. Immediate jeopardy findings were noted related to medication administration errors.
Complaint Details
The visit was complaint-related based on complaints CT# 00032653 and CT# 00032679. Violations were substantiated as indicated by the findings of medication errors and other deficiencies.
Severity Breakdown
Immediate Jeopardy: 2
Deficiencies (4)
DescriptionSeverity
Failure to ensure staff verified resident identity prior to medication administration, resulting in a significant medication error and hospital admission for Resident #1.Immediate Jeopardy
Failure to ensure newly licensed nurse demonstrated proficiency to administer medications safely and efficiently.
Failure to complete annual performance evaluations for employees timely.
Failure to ensure medications were administered to the right resident in accordance with physician's order, resulting in significant medication error and hospital admission.Immediate Jeopardy
Report Facts
Licensed Bed Capacity: 294 Census: 285 Compliance Date: Aug 23, 2022 Compliance Date: Oct 3, 2022
Employees Mentioned
NameTitleContext
Larry CondonSenior Vice President & AdministratorPersonnel contacted during inspection and author of Plan of Correction letter.
Stacey BardinDNSDirector of Nursing Services involved in findings related to medication administration.
Danuta BruzasRNFLIS staff who signed the inspection report.
Maureen Golas MarkureSupervising Nurse ConsultantAuthor of the notice letter regarding the complaint investigation.
LPN #1Licensed Practical NurseNamed in multiple medication error findings and deficiencies.
RN #1Registered NurseNursing supervisor involved in medication error incident.
HR #1Human Resources RepresentativeInterviewed regarding annual performance evaluations.
MD #1Medical DoctorInterviewed regarding Resident #1's medication error and hospital admission.
Inspection Report Plan of Correction Deficiencies: 2 Mar 30, 2022
Visit Reason
Unannounced visit was conducted at Friedman Home Care and Chaifez Family Hospice on 3/30/2022 for the purpose of recertification, state re-licensure, and COVID-19 staff vaccination survey.
Findings
Standard-level deficiencies were identified related to supervision of licensed practical nurses and home health aides, and failure to monitor and verify clinical documentation completeness, accuracy, and timely submission. The agency was in compliance with staff vaccination regulatory requirements at the time of the survey.
Deficiencies (2)
Description
Failure to ensure supervision of licensed practical nurses (LPN) and home health aides (HHA) as per agency policy, including inadequate documentation of supervisory visits.
Failure to monitor and verify documentation for completeness, accuracy, and timely submission, and failure to develop an agency policy for monitoring clinical documentation.
Report Facts
Patients reviewed: 4 Supervisory visit frequency: 14 Supervisory visit frequency: 30
Employees Mentioned
NameTitleContext
Elizabeth ZicanAdministratorSigned the Plan of Correction document
Inspection Report Complaint Investigation Census: 288 Capacity: 294 Deficiencies: 1 Dec 9, 2021
Visit Reason
The inspection was conducted as a complaint investigation based on multiple complaint numbers (#26281, #26419, #28742, #29874, and #30663) and to identify violations of Connecticut State regulations.
Findings
The facility was found to have violations related to failure to complete an admission skin assessment for a resident with an alteration in skin condition. Documentation deficiencies were noted in skin assessments and care plans for the resident. The facility's wound management program and monitoring procedures were reviewed.
Complaint Details
Complaint investigation involved multiple complaint numbers (#26281, #26419, #28742, #29874, and #30663). The report does not explicitly state substantiation status.
Deficiencies (1)
Description
Failure to complete an admission skin assessment for Resident #5 with an alteration in skin condition; documentation failed to reflect skin assessments and wound care interventions.
Report Facts
Licensed Bed Capacity: 294 Census: 288 Dates of onsite inspection: December 9, 13, 14, and 15, 2021 Audit frequency: 24 Plan of correction completion date: January 7, 2022
Employees Mentioned
NameTitleContext
Stacey BardinDirector of NursingPersonnel contacted during inspection.
Larry CondonAdministratorPersonnel contacted and author of Plan of Correction letter.
Karen GworekSupervising Nurse ConsultantSigned the notice letter and involved in the inspection process.
Aneta PredkaSurvey Team Leader and report submitter.
Inspection Report Renewal Census: 281 Capacity: 294 Deficiencies: 0 Nov 7, 2021
Visit Reason
The inspection was conducted as a renewal licensing inspection and included review of complaint investigations (FRIs: 30709, 29938, 25799). The visit also involved verification of CMP fund, CRF grant, Shift Coach, and full-time Infection Prevention and Control Specialist.
Findings
The inspection included complaint investigations and licensing renewal. No violations of the General Statutes of Connecticut and/or regulations were identified at the time of the inspection. The facility was found to be in compliance with infection prevention and control requirements and other regulatory standards.
Complaint Details
Complaint investigations referenced include FRIs 30709, 29938, and 25799. The complaints were reviewed as part of the inspection, but no violations were identified at the time of inspection.
Report Facts
Licensed Bed Capacity: 294 Census: 281 Inspection Dates: Inspection conducted on 11/7/21, 11/8/21, and 11/9/21
Employees Mentioned
NameTitleContext
Andrew BanoffAdministratorPersonnel contacted during inspection
Stacey BardinDNSPersonnel contacted during inspection
Leah ClarkSurvey Team LeaderSurvey team leader for the inspection
Sandra Vermont-HollisSupervisorSupervisor for the inspection
Inspection Report Complaint Investigation Census: 243 Capacity: 294 Deficiencies: 0 Aug 19, 2020
Visit Reason
A COVID-19 Focused Infection Control Survey and Complaint Investigation were conducted to determine compliance with infection control regulations related to COVID-19 at Jewish Senior Services.
Findings
Deficiencies were cited as a result of the COVID-19 focused infection control survey and complaint investigation regarding infection prevention and control practices to prevent COVID-19 transmission.
Complaint Details
The visit was complaint-related under ACTS Reference Number CT #28276, conducted to investigate infection control compliance related to COVID-19.
Inspection Report Routine Deficiencies: 1 May 9, 2020
Visit Reason
An unannounced visit was made to Jewish Senior Services on May 9, 2020 for the purpose of conducting a COVID-19 focused infection control survey.
Findings
The facility failed to ensure appropriate infection control practices were implemented to prevent and control the spread of infection during the COVID-19 pandemic, including improper hand hygiene and reuse of isolation gowns by staff.
Deficiencies (1)
Description
Failure to ensure appropriate infection control practices during COVID-19 pandemic, including staff reusing isolation gowns and not sanitizing hands before donning gloves.
Employees Mentioned
NameTitleContext
Karen GworekSupervising Nurse ConsultantSigned the notice letter regarding the infection control survey and violations.
Andrew BanoffAdministratorFacility administrator addressed in the report and plan of correction.
RN #1Registered NurseObserved during the infection control survey and interviewed regarding PPE practices.
NA #1Nurse AideObserved donning PPE improperly during the infection control survey.
Director of NursingInterviewed regarding PPE reuse practices and hand hygiene expectations.
Inspection Report Plan of Correction Deficiencies: 1 May 9, 2020
Visit Reason
An unannounced visit was made to Jewish Senior Services on May 9, 2020 by a representative of the Facility Licensing and Investigations Section of the Department of Public Health for the purpose of conducting a COVID-19 focused infection control survey.
Findings
A violation of the Regulations of Connecticut State Agencies and/or General Statutes was noted during the visit related to improper hand hygiene and reuse of isolation gowns by nursing staff. The facility was required to submit a plan of correction addressing these issues.
Deficiencies (1)
Description
Nurse Aide #1 did not wash hands before donning gloves and was reusing isolation gowns for the entire shift without sanitizing hands, contrary to infection control practices.
Report Facts
Compliance date: Jun 1, 2020
Employees Mentioned
NameTitleContext
Karen GworekSupervising Nurse ConsultantSigned the notice letter and provided instructions regarding the violations
Larry CondonSenior Vice PresidentSigned the plan of correction response letter
Inspection Report Abbreviated Survey Deficiencies: 1 May 9, 2020
Visit Reason
A COVID-19 Focused Infection Control Survey was conducted to determine compliance with 42 CFR Part 483 Requirements for Long Term Care Facilities, including proper infection prevention and control practices to prevent the development and transmission of COVID-19.
Findings
The facility failed to ensure appropriate infection control practices during the COVID-19 pandemic, specifically related to the reuse of isolation gowns without proper hand hygiene. Observations and interviews revealed that a nurse aide donned an isolation gown with ungloved hands without sanitizing, contrary to facility policy and infection control standards.
Severity Breakdown
SS=D: 1
Deficiencies (1)
DescriptionSeverity
Failure to ensure appropriate infection control practices related to hand hygiene when reusing isolation gowns during the COVID-19 pandemic.SS=D
Employees Mentioned
NameTitleContext
NA #1Nurse AideObserved donning isolation gown without sanitizing hands and re-educated on infection control.
RN #1Registered NurseConducted facility tour and provided information about PPE practices.
Director of NursingDirector of NursingInterviewed regarding staff PPE reuse practices and infection control policies.
Inspection Report Desk Audit Census: 281 Capacity: 294 Deficiencies: 0 Aug 9, 2019
Visit Reason
The document is a desk audit inspection conducted to review compliance with the General Statutes of Connecticut and regulations of Connecticut State Agencies for the facility.
Findings
No violations of the General Statutes of Connecticut and/or regulations of Connecticut State Agencies were identified at the time of this inspection. The report indicates that a plan of correction was approved and violation #1 was corrected.
Report Facts
Licensed Beds: 294 Census: 281
Employees Mentioned
NameTitleContext
Catherine VioletteClinical DirectorPersonnel contacted during the inspection and notified of plan of correction approval
Nicholas TomczykReport submitted by
Inspection Report Annual Inspection Deficiencies: 1 Jun 6, 2019
Visit Reason
The inspection was conducted to assess the accuracy of resident assessments, specifically reviewing the discharge Minimum Data Set (MDS) for Resident #280 to verify correct documentation of discharge disposition.
Findings
The facility failed to provide accurate assessment data for Resident #280, as the discharge MDS incorrectly indicated discharge to an acute care hospital due to a data input error, which was acknowledged and planned to be corrected by the Director of Nurses.
Severity Breakdown
No Harm with Only a Potential for Minimal Harm: 1
Deficiencies (1)
DescriptionSeverity
Failure to provide accurate assessment data in the discharge Minimum Data Set for Resident #280.No Harm with Only a Potential for Minimal Harm
Report Facts
Deficiency count: 1
Employees Mentioned
NameTitleContext
Director of NursesInterviewed regarding the data input error in the discharge MDS
Inspection Report Renewal Deficiencies: 1 Jun 6, 2019
Visit Reason
Unannounced visits were made on June 3, 4, 5, and 6, 2019 by representatives of the Facility Licensing & Investigations Section for the purpose of conducting a licensure inspection and certification survey.
Findings
The facility failed to ensure the dignity of Resident #240 was maintained during dining, as the resident's urinary catheter bag was observed uncovered and visible to others. Nursing staff were re-educated on the use of privacy bags for residents with urinary catheters, and audits will be conducted to ensure compliance.
Deficiencies (1)
Description
Facility failed to ensure Resident #240's dignity was maintained by not covering the urinary catheter bag during dining and therapy sessions.
Report Facts
Dates of unannounced visits: 4
Employees Mentioned
NameTitleContext
RN #1Registered NurseIdentified that catheter bags should be covered and that it is a nursing staff responsibility.
DNSDirector of NursesStated there is no policy regarding covering urinary catheter bags but it is an expected practice.
Inspection Report Renewal Deficiencies: 2 Jun 6, 2019
Visit Reason
Unannounced visits were made to Jewish Senior Services by representatives of the Department of Public Health for the purpose of conducting a licensing renewal and certification inspection.
Findings
The report identified violations related to failure to ensure resident dignity during dining and inaccurate assessment data for a resident. Specific issues included uncovered urinary catheter bags and data input errors in discharge disposition. Plans of correction were submitted to address these deficiencies.
Deficiencies (2)
Description
Failure to ensure Resident #240's dignity during dining due to uncovered catheter bag visible to others.
Failure to provide accurate assessment data for Resident #280, including a data input error in discharge disposition.
Report Facts
Resident ID: 240 Resident ID: 280 Date: Jun 3, 2019 Date: Jun 5, 2019
Employees Mentioned
NameTitleContext
Cher MichaudSupervising Nurse ConsultantSigned letter and contact for questions regarding deficiencies
Larry CondonSenior Vice PresidentSigned Plan of Correction letter
Lawrence CondonAdministratorFacility administrator named in report
Inspection Report Renewal Census: 283 Capacity: 294 Deficiencies: 2 Jun 6, 2019
Visit Reason
Unannounced visits were made to Jewish Senior Services for the purpose of conducting a licensing renewal and certification inspection.
Findings
Violations of Connecticut General Statutes and regulations were identified during the inspection, including uncovered urinary catheter bags and inaccurate assessment data. Plans of correction were submitted to address these issues.
Deficiencies (2)
Description
Resident #240 was observed with an uncovered catheter bag with urine visible, which is contrary to expected nursing staff responsibility and facility policy.
Facility failed to provide accurate assessment data for Resident #280 due to a data input error on the discharge Minimum Data Set (MDS).
Report Facts
Licensed Bed Capacity: 294 Census: 283 Inspection Dates: 4
Employees Mentioned
NameTitleContext
Lawrence CondonAdministratorPersonnel contacted during inspection and author of plan of correction letter.
Cher MichaudSupervising Nurse ConsultantSigned the notice letter and involved in facility licensing and investigations.
Registered Nurse #1Interviewed regarding uncovered catheter bag observation.
Director of NursesInterviewed regarding catheter bag policy and discharge data input error.
Inspection Report Follow-Up Census: 287 Capacity: 294 Deficiencies: 1 Sep 4, 2018
Visit Reason
An unannounced visit was made to review compliance with the Plan of Correction submitted due to a violation letter dated August 21, 2018.
Findings
The facility was found to be in substantial compliance with the Public Health Code. Citation #2018-49 was verified as corrected and no new violations were identified during this visit.
Deficiencies (1)
Description
Violation 1 was found to be in compliance; Citation #2018-49 was found to be in compliance.
Report Facts
License Capacity: 294 Census: 287
Employees Mentioned
NameTitleContext
Erena FitzgeraldDirector of NursingPersonnel contacted during inspection
Lawrence CondonSenior Vice PresidentPersonnel contacted during inspection and notified of compliance
Danuta BruzasRN NCReport submitted by and signed inspection report
Inspection Report Complaint Investigation Census: 282 Capacity: 296 Deficiencies: 1 Jul 16, 2018
Visit Reason
The inspection was conducted as a complaint investigation based on complaint numbers 23604, 23605, and 23522, with unannounced visits made on July 16, 17, 18, and 19, 2018.
Findings
Violations of Connecticut State regulations were identified during the inspection, including failure to provide adequate supervision to prevent a resident from falling out of bed, resulting in injury. The facility was cited and issued a violation letter with a plan of correction required.
Complaint Details
The complaint investigation involved multiple residents, focusing on an incident where Resident #1 fell from bed and later expired. The investigation found inadequate supervision and failure to follow the care plan for repositioning and assistance. The complaint was substantiated with citations issued.
Deficiencies (1)
Description
Failure to provide adequate supervision during care to prevent a resident from falling out of bed, resulting in injury.
Report Facts
Licensed Bed Bassinet Capacity: 296 Census: 282 Inspection Dates: 4 Citation Number: 1 Plan of Correction Completion Date: Aug 30, 2018 Weekly Audits Duration: 3
Employees Mentioned
NameTitleContext
Andrew BanoffAdministratorNamed as personnel contacted during the inspection and referenced in correspondence.
Karen GworekSupervising Nurse ConsultantSigned violation and plan of correction letters related to the inspection.
Larry CondonSenior Vice PresidentSigned letters submitting the plan of correction and correspondence regarding the violation.
Inspection Report Census: 293 Capacity: 294 Deficiencies: 0 Jun 20, 2018
Visit Reason
The visit was a desk audit conducted on 2018-06-20 to review the plan of correction for a violation letter dated 2018-05-07, including review of facility practices, documentation, and interviews.
Findings
Violations numbered 1a through 12a were noted to be corrected, and as a result, no violations were identified at the time of the desk audit.
Report Facts
Violation count: 12
Employees Mentioned
NameTitleContext
Donna M. OrtellePublic Health Services ManagerReport submitted by and signed as Public Health Services Manager
Kathy VioletteClinical Nursing DirectorPersonnel contacted during inspection
Inspection Report Renewal Census: 287 Capacity: 294 Deficiencies: 10 Apr 18, 2018
Visit Reason
Unannounced visits were made to Jewish Senior Services on April 18, 19, 23 and 24, 2018 for the purpose of conducting a licensure and certification inspection as part of the renewal process.
Findings
The facility was found to have multiple violations related to resident care, including failure to provide timely assistance for bowel incontinence, incomplete MDS assessments, failure to ensure resident choices were honored, inadequate pressure ulcer prevention, medication storage issues, and infection control deficiencies. The facility submitted a plan of correction and noted a 5-star rating for staffing from CMS.
Deficiencies (10)
Description
Failure to provide care in a dignified manner for bowel incontinence, including delayed response to call lights and inadequate staff assistance.
Failure to ensure residents' choices were honored, including shower frequency requests not being communicated or honored.
Failure to complete comprehensive MDS assessments in accordance with regulatory requirements.
Failure to transmit MDS assessments to the state agency in a timely manner.
Failure to implement interventions to prevent pressure ulcers and to offload heels appropriately.
Failure to provide necessary care and services to prevent incontinent episodes.
Failure to provide sufficient staffing to prevent incontinent episodes and to respond timely to call lights.
Failure to store medications in a secure manner, with medications left unsecured on the floor.
Failure to prepare food in a sanitary manner, including dietary staff not wearing required beard restraints and hair nets.
Failure to follow infection control practices for a resident on isolation precautions.
Report Facts
Licensed Bed Capacity: 294 Census: 287 Inspection Dates: Inspection visits occurred on 2018-04-18, 2018-04-19, 2018-04-23, and 2018-04-24. Compliance Date: 2018

Loading inspection reports...