Inspection Reports for Mira Vie at Warren
274 King George Rd, Warren, NJ 07059, United States, NJ, 07059
Back to Facility ProfileDeficiencies per Year
4
3
2
1
0
Severe
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Census Over Time
Notice
Deficiencies: 0
Nov 20, 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, NJDHSS Privacy Officer | Contact person for privacy notice inquiries |
Inspection Report
Complaint Investigation
Census: 69
Deficiencies: 3
Jan 24, 2024
Visit Reason
The inspection was conducted as a complaint investigation based on complaints NJ00140033 and NJ00163755 regarding compliance with New Jersey Administrative Code 8:36 for assisted living residences.
Findings
The facility was found not in substantial compliance due to failure to provide surveyor access to electronic medical records for 3 residents, failure to implement and enforce the fall risk prevention policy including documentation of falls in incident reports, and failure to provide requested medical records and documentation including physician certifications and progress notes.
Complaint Details
Complaint investigation based on complaints NJ00140033 and NJ00163755. The complaints were substantiated as deficiencies were found related to access to records and policy enforcement.
Deficiencies (3)
| Description |
|---|
| Failure to provide surveyor access to electronic medical records for 3 residents. |
| Failure to implement and enforce the Fall Risk Prevention Program, including lack of incident reports for falls for 3 residents. |
| Failure to provide requested medical records including physician certifications, progress notes, weight logs, and transfer forms for 3 residents. |
Report Facts
Residents reviewed: 3
Sample size: 3
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Executive Director | Executive Director (ED) | Named in findings related to failure to provide EMR access and failure to implement fall risk prevention policy. |
| Assistant Health Service Director | Assistant Health Service Director (AHSD) | Named in findings related to refusal to provide EMR access to surveyor. |
| Health Service Director | Health Service Director (HSD) | Interviewed regarding fall risk prevention and medical record documentation deficiencies. |
| Assisted Living Coordinator | Assisted Living Coordinator (ALC) | Provided documents to surveyor and explained document gathering process. |
Inspection Report
Complaint Investigation
Census: 75
Deficiencies: 4
Feb 16, 2021
Visit Reason
A COVID-19 Focused Infection Control Survey was conducted by the State Agency on 2/16/21 to assess compliance with infection control regulations and CDC recommended practices during the COVID-19 outbreak.
Findings
The facility was found not in compliance with infection control policies including failure to ensure residents were appropriately screened with full vital signs each shift, failure to limit communal dining and maintain social distancing of six feet during meals, and failure to consistently offer pneumococcal vaccinations upon admission or document refusals.
Complaint Details
The visit was complaint-related as a COVID-19 Focused Infection Control Survey triggered by concerns about infection control practices during an active outbreak.
Deficiencies (4)
| Description |
|---|
| Administrator failed to ensure residents were appropriately screened with full vital signs each shift during COVID-19 outbreak. |
| Facility failed to implement infection control policies to limit communal dining and maintain social distancing of six feet during meals. |
| Facility failed to develop and implement infection prevention and control program consistent with CDC and NJDOH guidelines to prevent spread of COVID-19. |
| Facility failed to develop policy and consistently offer pneumococcal vaccinations to residents upon admission and failed to document offered vaccination or refusals. |
Report Facts
Census: 75
Date of survey: Feb 16, 2021
Number of residents observed at dining tables: 8
Table length: 42
Distance between chairs: 60
Outbreak conclusion period: 28
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Executive Director | Executive Director | Interviewed regarding screening, outbreak phase, dining arrangements, and vaccination policies |
| Health Services Director | Health Services Director | Interviewed regarding vital signs monitoring, outbreak phase, and vaccination policies |
| Building Services Director | Building Services Director | Measured dining table and chair spacing during inspection |
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