Inspection Reports for Preferred Care At Wall

Complaint NJ186923 and NJ186877 were investigated. The complaint was substantiated based on observation, interviews, and record review. The CNA placed a floor mat and other items restricting the resident's movement, which was confirmed by video evidence. The CNA was suspended pending investigation. The LPN failed to return calls. The resident was severely cognitively impaired and dependent on staff for toileting.

The facility failed to ensure that a resident's movement in and out of bed was not restricted. A Certified Nursing Assistant placed a floor mat, bedside tray table, and wheelchair against the resident's bed, restricting movement. The CNA was suspended pending investigation, and the Licensed Practical Nurse failed to return calls. The facility policy defines physical restraints and prohibits their use for convenience or discipline.

Complaint investigation for NJ186877 and NJ186923 was substantiated based on observations, interviews, medical record review, and video evidence showing improper restraint use on Resident #2 during the night shift. The Licensed Practical Nurse failed to return phone calls during the investigation.

The facility was found not in substantial compliance with requirements related to the right to be free from physical restraints. Specifically, Resident #2 was subjected to inappropriate use of restraints, including being placed and secured with a bedside tray table and wheelchair, which was not justified by medical symptoms. The facility failed to ensure proper staff response and documentation, and corrective actions were required.

The facility was found deficient in multiple areas including inaccurate PASARR screening, failure to update care plans to reflect resident preferences, improper incontinence care, inadequate documentation and rationale for psychotropic medication use, unsanitary kitchen and pantry equipment, and failure to maintain proper infection control precautions during resident care.

The survey included complaint investigations numbered 171958, 176667, and 181275. The complaints were substantiated as deficiencies were cited in multiple areas including PASARR screening and care planning.

Deficiencies were cited related to PASARR screening for mental disorders and intellectual disabilities, comprehensive care plans, ADL care provision, psychotropic medication use, food safety, life safety code compliance including exit ramps, emergency lighting, fire alarm system maintenance, sprinkler system maintenance, and infection prevention and control. Corrective actions and plans of correction were documented with completion dates.

Complaint #: NJ00144545, NJ00146272. The facility was found non-compliant with staffing requirements but no care concerns were substantiated during the complaint survey.

The facility was found deficient in maintaining the required minimum direct care staff-to-resident ratio for Certified Nursing Assistants (CNAs) on 22 of 28 day shifts, potentially affecting all residents. Despite the deficiencies, no care concerns were reported during the identified shifts. The facility has ongoing recruitment and retention efforts and plans to monitor staffing closely.

The facility was found deficient in maintaining multiuse food-contact surface cutting boards to prevent microbial growth, properly storing, labeling, and dating potentially hazardous foods, and performing hand hygiene according to infection control standards. Observations included unlabeled opened food containers, deeply pitted and discolored cutting boards, and improper hand washing technique by staff.

Deficiencies were cited related to food safety practices including improper labeling and storage of food, hand hygiene, and use of cutting boards. Additional deficiencies included failure to maintain required staffing ratios, fire safety code violations including lack of annual fire door inspections, inadequate illumination of means of egress, incomplete fire alarm system inspections, sprinkler system maintenance issues, HVAC system deficiencies, and generator remote manual stop station absence.

The facility was found not in compliance with infection control procedures, specifically failing to properly doff personal protective equipment (PPE) to prevent the spread of infection among residents on transmission-based precautions. Observations and interviews revealed staff and visitors did not consistently follow PPE protocols, including improper removal and disposal of gowns.

The facility was found noncompliant with multiple life safety code requirements including egress door signage and operation, exit discharge obstructions, emergency lighting, exit signage, hazardous area enclosures, fire alarm system installation and maintenance, sprinkler system installation and maintenance, portable fire extinguisher inspection, corridor wall construction, smoke barrier door integrity, and improper use of electrical extension cords.

The facility was found not in substantial compliance with federal requirements, with deficiencies noted in pharmacy services related to controlled medication accounting and storage, infection prevention and control practices, and environmental maintenance in the Food Service Department.

Deficiencies were cited related to resident rights and dignity during meal service, pharmacy services including medication storage and administration errors, and nutritive value and temperature of food served to residents requiring feeding assistance. The facility implemented plans of correction including staff re-education, audits, and quality assurance monitoring.

The facility was found deficient in ensuring residents were served meals in a dignified manner, properly storing and administering medications, and providing food at safe and appetizing temperatures. Specific issues included delayed meal service causing resident hunger, medication left unattended or borrowed from other residents, and food served cold to a resident requiring feeding assistance.