Inspection Reports for
Morristown Post Acute Rehab And Nursing Center

The facility was found deficient in multiple areas including failure to post prior year's inspection results in an accessible location, failure to implement physical therapy interventions for a resident, inadequate treatment for a resident with PTSD, medication administration errors including failure to follow physician orders for Midodrine, discrepancies in narcotic medication accountability resulting in 23 unaccounted doses of Morphine, and failure to timely acquire and administer medications for a resident.

The facility failed to ensure proper dish machine sanitation, consistent use of personal protective equipment (PPE) for residents on enhanced barrier precautions, timely administration of a COVID-19 vaccine, prompt testing for respiratory syncytial virus (RSV), and adequate contact tracing during a COVID-19 outbreak. These failures had the potential to affect many residents.

Complaint number NJ00178715 was investigated and the facility was found not in substantial compliance with requirements related to laboratory services and physician orders.

The facility was found not in substantial compliance with requirements related to obtaining and notifying physician orders for laboratory services. Additionally, the facility failed to maintain required staffing ratios for certified nurse aides on multiple day shifts.

Complaint #NJ00178715. The complaint was substantiated based on record review and interviews indicating missing physician orders for lab services performed on three residents.

The facility failed to obtain documented physician orders for laboratory services performed on three of four residents reviewed. Interviews with staff confirmed the absence of physician orders in the electronic medical records despite lab services being performed.

Complaint #NJ176547 was substantiated with findings that the facility failed to provide proper incontinent care to Resident #2, who required such care. The facility was not in substantial compliance with 42 CFR Part 483, Subpart B, based on this complaint visit.

The facility was found not in substantial compliance with requirements related to bowel/bladder incontinence care for one of three residents reviewed (Resident #2). The facility failed to provide appropriate incontinent care and treatment to prevent urinary tract infections and maintain continence as much as possible.

Complaint #NJ176547 was substantiated based on observations, interviews, and record review indicating deficient incontinence care for Resident #2.

The facility failed to provide appropriate incontinence care and was observed to have a dependent resident wearing two incontinence briefs simultaneously, with soiling and urine saturation through to the bed pad. Interviews with staff confirmed that this was not standard practice and that incontinence care should be provided frequently to prevent skin breakdown.

The inspection included a complaint investigation related to staffing and care issues, including failure to maintain minimum staffing ratios and failure to follow PASARR screening requirements.

The facility was found not to be in substantial compliance with 42 CFR 483 subpart B, with deficiencies related to PASARR coordination, accident hazard prevention, tube feeding management, infection control, staffing ratios, sprinkler system installation, and electrical system maintenance.

The facility was found to be noncompliant with sprinkler system installation requirements, specifically missing sprinkler heads on four balconies and painted sprinkler escutcheon caps in the rehabilitation area. Additionally, the facility failed to document annual electrical outlet testing as required by NFPA 99.

The facility was found deficient in multiple areas including failure to update PASARR screenings for residents with new mental illness diagnoses, inadequate fall prevention interventions for a resident, failure to properly label enteral feeding containers, and improper glove use during intravenous medication administration. These deficiencies posed risks of inadequate mental health services, potential accidents, risk of expired or inaccurate enteral nutrition, and cross contamination from infectious agents.

Complaint numbers NJ00168549 and NJ00168552 were substantiated based on observations, interviews, and documentation review showing LPN #1 administered medications and accepted orders without a current license.

The facility failed to ensure that medications were administered only by licensed nurses, as LPN #1 administered medications and accepted physician orders while her nursing license was expired and reinstatement was pending. This affected four residents and violated facility policies and state regulations.

Complaint numbers NJ00168549 and NJ00168552 triggered the investigation. The complaint was substantiated by findings that LPN #1 administered medications and accepted physician orders while her license was expired and reinstatement was pending.

The facility failed to properly implement medication administration policies, with an unlicensed LPN administering medications and accepting physician orders despite an expired license. Multiple verbal and telephone orders were transcribed and administered by this LPN, who was also assigned to administrative roles without a current license. The facility policies require medication administration only by licensed personnel.

The complaint survey was triggered by multiple complaint numbers including NJ00150851, NJ00154206, NJ00154288, NJ00154964, NJ00155911, NJ00156313, NJ00158509, NJ00158516, NJ00159860, NJ00161013, NJ00161674, NJ00164049, NJ00164272, NJ00164562.

The facility was found not in substantial compliance with federal and state regulations, with deficiencies in resident record access, family notification of significant changes, transfer notices, care plan participation, quality of care, food preferences, call system functionality, and staffing ratios.

The investigation was complaint-driven, focusing on allegations of delayed provision of resident records, failure to notify family of hospital transfers, inadequate transfer notices, lack of resident/family involvement in care planning, incorrect oxygen administration, failure to honor food preferences, and non-functioning call light in a resident's bathroom.

The facility failed to provide resident records within required timeframes, failed to notify family representatives of significant condition changes and hospital transfers, did not provide proper transfer notices with appeal rights, did not consistently invite residents or their representatives to care plan meetings, administered oxygen at incorrect flow rates, served meals containing foods residents disliked, and had a non-functioning call light in a resident's bathroom.

Complaint investigation based on complaints NJ159600, NJ160892, NJ160895. Facility found not in substantial compliance with 42 CFR Part 483, Subpart B for long term care facilities.

The facility was found not in substantial compliance with multiple regulatory requirements including failure to notify residents/families of room changes, failure to allow visitation rights, incomplete care plans, failure to meet professional standards in medication documentation, inadequate ADL documentation, missing admission agreement, inadequate infection preventionist qualifications, and failure to meet minimum staffing ratios.

The survey was conducted based on a complaint survey. The facility was found not in compliance with requirements based on this complaint investigation.

The facility was found non-compliant due to failure to ensure adequate supervision during resident transfer, failure to consistently implement policies on personal property and charting/documentation for three residents, and failure to have a governing body properly managing policies. Documentation audits revealed missing assistance records for activities of daily living for multiple residents.

The complaint survey was based on multiple complaint numbers (NJ00153845, NJ00153924, NJ00149642, NJ00147097, NJ00153323, NJ001520245) alleging abuse, neglect, and failure to follow professional standards and policies. The survey found substantiated deficiencies in reporting, documentation, and personal property management.

The facility was found not in compliance with requirements related to reporting alleged violations, professional standards of care, documentation, and personal property policies. Specific deficiencies included failure to report an injury of unknown origin, failure to follow physician orders and document properly, and failure to inventory and document residents' personal belongings.

The facility was found non-compliant due to failure to provide proper fire sprinkler coverage in 12 of 13 resident sleeping room closets and failure to maintain proper ventilation in 3 of 13 resident bathroom exhaust systems. Corrective actions included installation of escutcheons around sprinkler heads and repair of bathroom exhaust fans.

The facility was found not in compliance with mandatory staffing requirements, specifically failing to maintain the minimum direct care staff-to-resident ratios as mandated by New Jersey state law. The facility documented multiple days with staffing ratios exceeding the required limits, particularly during day and night shifts.

Complaint NJ 00146254 involved allegations of neglect related to incontinence care, hygiene, staffing, and abuse investigations.

The facility was found deficient in multiple areas including failure to provide timely and appropriate incontinence care, inadequate staff responsiveness, improper use of incontinent briefs, poor hygiene and grooming of residents, failure to investigate and report abuse allegations, improper medication administration including missed doses and late insulin administration, inadequate infection control practices, unsanitary conditions in the kitchen and equipment, failure to maintain proper staffing ratios, and failure to follow physician orders for therapeutic diets and respiratory care.

The facility was found to be noncompliant with several Life Safety Code requirements including improper egress door locking mechanisms, lack of stair tread marking stripes, inadequate emergency illumination, incomplete sprinkler system coverage, and sprinkler system maintenance issues such as sprinkler heads being obstructed by plastic caps during construction.

The complaint investigation involved multiple complaints alleging abuse and misappropriation of property. The allegation involved Resident #5 who reported being punched by a Licensed Practical Nurse (LPN #1) on 10/28/2020. The facility failed to report this allegation to law enforcement. The resident had no physical marks on the chest, but the nurse had a skin tear on the arm. The Administrator confirmed no police report was filed. The facility policy requires reporting all alleged violations to appropriate authorities within specified timeframes.

The facility was found not in compliance with 42 CFR Part 483, Subpart B, specifically failing to report an allegation of staff to resident physical abuse to local law enforcement for one resident. The investigation revealed that a staff member allegedly punched a resident in the chest, but the facility did not notify police as required by policy and regulations.