Inspection Reports for
Job Haines Home
250 Bloomfield Ave, Bloomfield, NJ 07003, NJ, 07003
Back to Facility ProfileDeficiencies (last 4 years)
Deficiencies (over 4 years)
3 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
42% better than New Jersey average
New Jersey average: 5.2 deficiencies/yearDeficiencies per year
8
6
4
2
0
Occupancy
Latest occupancy rate
98% occupied
Based on a February 2023 inspection.
This facility has shown a steady increase in demand based on occupancy rates.
Occupancy rate over time
Notice
Deficiencies: 0
Date: Nov 19, 2025
Visit Reason
This document serves to inform individuals about the privacy practices of NJDHSS, including how their medical information may be used and disclosed, and their rights related to this information.
Findings
The notice explains the types of information covered, reasons for use and disclosure of health information, individuals' rights to access and control their information, and the legal duties of NJDHSS to protect privacy.
Report Facts
Effective date: 2011
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Devon L. Graf | Director, Office of Legal and Regulatory Compliance | Listed as NJDHSS Privacy Officer contact for the notice |
Inspection Report
Annual Inspection
Deficiencies: 1
Date: Apr 4, 2025
Visit Reason
The inspection was conducted to assess compliance with federal guidelines regarding accurate coding of the Minimum Data Set (MDS) for residents, specifically reviewing immunization status and documentation accuracy.
Findings
The facility failed to accurately code the MDS for 1 of 5 residents reviewed, specifically Resident #9's pneumococcal vaccine status was incorrectly marked as up to date despite lacking proper documentation of offer, education, or declination. The error was acknowledged as a typographical mistake by the MDS Coordinator.
Deficiencies (1)
Failure to accurately code the Minimum Data Set (MDS) for Resident #9's pneumococcal vaccine status, reflecting it as current when it was not.
Report Facts
Residents reviewed for immunization status: 5
Residents affected: 1
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Registered Nurse/Unit Manager | RN/UM | Interviewed regarding immunization offer and documentation procedures |
| Registered Nurse/Infection Preventionist | RN/IP | Provided information on facility guidelines and vaccine declination documentation |
| Licensed Practical Nurse/MDS Nurse | LPN/MDSN | Acknowledged the MDS coding error during interview |
| MDS Coordinator | MDSC | Acknowledged the typographical error in MDS data entry |
| Director of Nursing | DON | Informed about the documentation concerns and participated in meetings with surveyors |
| Licensed Nursing Home Administrator | Administrator | Participated in meeting discussing the inaccurate MDS |
| Assistant Director of Nursing/Infection Preventionist | ADON/IP | Participated in meeting discussing the inaccurate MDS |
Inspection Report
Annual Inspection
Census: 39
Capacity: 40
Deficiencies: 4
Date: Feb 22, 2023
Visit Reason
A Recertification Survey was conducted to determine compliance with 42 CFR Part 483, Requirements for Long Term Care Facilities.
Findings
Deficiencies were cited related to pharmacy services including failure to remove expired IV medication sets and improper execution of DEA Form 222. Additionally, a Life Safety Code survey found noncompliance with emergency lighting and generator manual stop station requirements.
Deficiencies (4)
Failed to reconcile, identify and remove three expired intravenous medication supply sets in the medication cart on the subacute unit.
Failed to ensure accurate execution of DEA Form 222, including not making a copy of the order form before sending to the pharmacy.
Failed to provide battery-powered emergency lighting at the emergency generator transfer switch as required by NFPA 110.
Failed to ensure the 50 KW diesel emergency generator had a remote manual stop station to prevent inadvertent operation.
Report Facts
Census: 39
Total Capacity: 40
Sample Size: 14
Deficiency Completion Date: Mar 17, 2023
Inspection Report
Routine
Deficiencies: 2
Date: Feb 22, 2023
Visit Reason
The inspection was conducted to evaluate the facility's pharmaceutical services, specifically to assess compliance with medication management including the handling of expired intravenous medication sets and the proper execution of DEA Form 222 for controlled substances.
Findings
The facility failed to remove three expired intravenous medication supply sets from a medication cart and did not properly execute a DEA Form 222, lacking a required copy for record retention and incomplete line item information. The facility policies require removal of expired supplies and proper DEA form handling, but these were not followed.
Deficiencies (2)
Failure to reconcile, identify, and remove three expired intravenous medication supply sets from the medication cart.
Failure to accurately execute a DEA Form 222, including not making a copy of the form before sending to the pharmacy and incomplete completion of the last line on the form.
Report Facts
Deficiencies cited: 2
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Director of Nursing | Director of Nursing | Involved in clarifying pharmacy invoices and DEA Form 222 execution process |
| Registered Nurse | Registered Nurse | Present during inspection of medication cart with expired IV sets |
Inspection Report
Routine
Census: 35
Deficiencies: 2
Date: Mar 15, 2021
Visit Reason
Routine standard survey conducted to assess compliance with federal regulations for long term care facilities.
Findings
The facility was found not in substantial compliance with federal requirements, with deficiencies related to improper storage of controlled substances, unsanitary food preparation and storage practices, and expired nutritional supplements.
Deficiencies (2)
Failed to ensure controlled substances were stored in a manner to prevent loss or diversion; narcotic storage boxes in medication refrigerators were not permanently affixed.
Failed to store potentially hazardous foods properly, maintain kitchen environment and equipment in a sanitary manner, and discard expired nutritional supplements.
Report Facts
Sample Size: 15
Expired nutritional supplement containers: 23
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Unit Manager Registered Nurse | Unit Manager Registered Nurse (UMRN) | Present during medication refrigerator inspection and acknowledged deficiencies. |
| Food Service Director | Food Service Director (FSD) | Present during food preparation area inspection and involved in corrective actions. |
| Director of Nursing | Director of Nursing (DON) | Informed of deficiencies and responsible for ongoing compliance monitoring. |
| Administrator | Administrator | Informed of deficiencies during survey. |
Inspection Report
Routine
Deficiencies: 3
Date: Mar 15, 2021
Visit Reason
The inspection was conducted to evaluate compliance with regulations regarding the storage and handling of controlled substances and nutritional supplements, as well as food safety and sanitation standards in the facility.
Findings
The facility failed to ensure controlled substances were securely stored to prevent loss or diversion, and failed to properly store and discard expired nutritional supplements. Additionally, food preparation and storage areas were found unsanitary with damaged food containers and improperly stored utensils.
Deficiencies (3)
Failure to ensure controlled substances were stored in locked compartments that prevent removal, as medication refrigerator shelves with locked boxes were removable.
Failure to discard expired nutritional supplements; 23 containers of honey thick liquid supplements were expired as of 3/6/21.
Failure to maintain kitchen environment and equipment in a sanitary manner, including keys stored touching a cleaned whisk, grease-like particulates on can opener, soiled plates stored with clean dishware, and dented cans in use.
Report Facts
Expired nutritional supplement containers: 23
Dented cans: 5
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Unit Manager, Registered Nurse (UMRN) | Present during medication refrigerator inspections and acknowledged storage issues | |
| Food Service Director (FSD) | Present during food preparation area inspection and acknowledged sanitation issues | |
| Administrator and Director of Nursing | Notified of concerns by surveyors |
Inspection Report
Complaint Investigation
Census: 34
Deficiencies: 0
Date: Dec 8, 2020
Visit Reason
The inspection was conducted as a complaint survey based on Complaint #: NJ00132628.
Complaint Details
Complaint #: NJ00132628; the survey was complaint-based and the facility was found compliant.
Findings
The facility was found to be in compliance with the requirements of 42 CFR Part 483, Subpart B, for Long Term Care Facilities based on this complaint survey.
Report Facts
Sample Size: 7
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