Inspection Reports for
Preferred Care at Hamilton

Complaint #175979 regarding failure to prevent and properly manage a stage 3 pressure ulcer in Resident #167. The complaint was substantiated based on interviews, record reviews, and observations.

The facility failed to conduct a new PASRR level one assessment after a resident was newly diagnosed with a mental illness. Additionally, the facility failed to implement interventions to prevent the development and worsening of a stage 3 pressure ulcer, failed to document daily wound care observations properly, and failed to ensure physician evaluation of skin care issues. The kitchen sanitation was also found deficient with improper hand hygiene, improper use of beard nets, and unsanitary storage of food and equipment.

The facility was found deficient in multiple areas including failure to maintain resident dignity during feeding and catheter care, inadequate environmental cleanliness, incomplete care planning for fall prevention, improper PICC line dressing care, respiratory care deficiencies, inadequate pain assessment documentation, medication storage and documentation errors, insufficient monitoring of psychoactive medication effects, poor kitchen sanitation and food safety practices, improper disposal of soiled linens and waste, and failure to properly manage soiled medical equipment.

Complaint numbers NJ 172211, #175979, #177635, #182108 were investigated as part of this survey. Deficiencies were substantiated and corrective actions were implemented.

The facility was found to have multiple deficiencies related to resident rights, safe environment, care planning, treatment and prevention of pressure ulcers, pain management, pharmacy services, food safety, infection control, and life safety code compliance. Corrective actions were implemented and documented for all cited deficiencies.

The facility failed to ensure that six of eleven sampled residents' MDS assessments were transmitted within 14 days after completion, as required by the Resident Assessment Instrument manual.

The facility was found to be noncompliant with several Life Safety Code requirements including missing required signage on delay-egress doors, failure to conduct smoke detection sensitivity testing every other year, and failure to inspect fire doors annually. These deficiencies potentially affected all 103 residents.

The survey included a complaint investigation component but no deficiencies were issued related to specific complaint intakes listed (NJ149370, NJ151215, NJ152516, NJ153172, NJ153308, NJ156275, NJ156731, NJ157698).

The facility was found not in substantial compliance with certain regulatory requirements including timely transmission of Minimum Data Set (MDS) assessments, missing signage on delay-egress doors, lack of biennial smoke detector sensitivity testing, and failure to conduct annual fire door inspections. Corrective actions and re-education plans were implemented.

Complaint numbers NJ00148819 and NJ00164462 were investigated. The facility was found in noncompliance with staffing requirements but was ultimately found in compliance with 42 CFR Part 483, Subpart B, for Long Term Care Facilities based on this complaint survey.

The facility was found deficient in maintaining the required minimum staff-to-resident ratios mandated by New Jersey for multiple day, evening, and night shifts over several weeks. The deficiency had the potential to affect all residents, though no specific residents were identified as affected.

Complaint #NJ00149893 was substantiated as the facility was found not in substantial compliance with 42 CFR Part 483, Subpart B, based on the presence of a portable electric heater in resident rooms, which posed a safety risk.

The facility failed to maintain a safe environment for 2 of 3 residents observed during the environmental tour due to the presence of a portable electric heater in a resident room, which is against facility policy and safety regulations. The heater was removed immediately and corrective actions were implemented to prevent recurrence.

Complaint numbers NJ146992 and NJ148000 were investigated. The complaint intake NJ146992 found that the facility failed to report an unwitnessed injury for Resident #1. The complaint was substantiated as the requirement was not met.

The facility failed to report an unwitnessed injury for one resident as required by regulations. The investigation revealed deficiencies in reporting alleged violations involving abuse or injuries of unknown origin.

The facility failed to consistently follow its policy to document refused medications for Resident #18, as evidenced by multiple instances where medications were not administered but refusals were not properly documented in the Medication Administration Records (MAR) or progress notes.

The facility was found to be in noncompliance with fire safety requirements including failure to provide occupant notification devices in the enclosed courtyard, incomplete sprinkler system coverage in a storage room, and improper maintenance of sprinkler escutcheon plates. Corrective actions and plans for ongoing monitoring were outlined.

The facility was found to be in noncompliance with fire safety requirements including failure to provide audible and visible fire alarm notification devices in the enclosed courtyard, incomplete sprinkler coverage in a linen closet, and improper sprinkler escutcheon plates on 25 of 50 sprinkler heads. Corrective actions were planned and completed as verified in a follow-up revisit.

Complaint# NJ 141848 was investigated and found the facility not in substantial compliance with regulatory requirements based on the complaint visit.

The facility was found not in substantial compliance due to failure to follow physician's orders and facility policies regarding medication and oxygen administration for one of three residents sampled. Deficient practices included missing vital signs documentation and improper adherence to physician orders.