Inspection Reports for Silver Healthcare Center

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A Recertification Survey was conducted to determine compliance with 42 CFR Part 483, Requirements for Long Term Care Facilities, including medication administration, staffing, infection control, and life safety code compliance.

The facility was found deficient in multiple areas including medication administration errors, failure to maintain minimum staffing ratios, incomplete drug enforcement administration records, infection control lapses, and life safety code violations. Deficiencies were cited across medication management, staffing, infection prevention, and emergency preparedness.

The inspection was conducted as a complaint investigation based on complaints NJ00176688 and NJ00170937 to assess compliance with staffing requirements and other regulatory standards.

The facility was found not in compliance with New Jersey Administrative Code 8:39 standards for licensure of Long Term Care Facilities due to failure to meet minimum staffing ratios on multiple day shifts. The facility must submit a Plan of Correction to address these deficiencies.

The complaint investigation found the facility deficient in CNA staffing on multiple day shifts during the weeks of 09/01/2024 to 09/07/2024 and 11/10/2024 to 11/23/2024, with fewer CNAs than required by state law. No residents were directly affected as per routine monitoring, but all residents could be affected by the staffing deficiencies.

The inspection was conducted based on multiple complaints (NJ00176419, NJ00176430, NJ00176543, NJ00176626) to determine compliance with federal and state regulations for long term care facilities.

The facility was found to be non-compliant with New Jersey Administrative Code 8:39 standards for licensure of Long Term Care Facilities due to failure to meet minimum staffing ratios for Certified Nurse Aides (CNAs) on 5 of 14 day shifts during the review period. A plan of correction was required.

Complaint investigation based on four complaint numbers: NJ00176419, NJ00176430, NJ00176543, NJ00176626. The facility was found non-compliant with staffing requirements but no residents were affected. The facility must submit a Plan of Correction.

A Recertification Survey was conducted to determine compliance with 42 CFR Part 483, Requirements for Long Term Care Facilities.

Deficiencies were cited related to reasonable accommodations, safe and homelike environment, comprehensive care plans, following physician orders, catheter care, respiratory care, pharmacy services, medication storage and labeling, food safety, licensure compliance, infection prevention and control, immunizations, staffing, and life safety code compliance.

Complaint #: NJ 169959, 172797, 172731, 172664, 173098, 173137, 173170, 173420, 173499, 173568, 173837, 173857, 174044. The facility was found not in compliance with NJ Administrative Code 8:39 standards for licensure of Long Term Care Facilities.

Routine standard survey inspection of Silver Healthcare Center to assess compliance with federal and state regulations for long term care facilities.

The facility was found not in substantial compliance with several regulatory requirements including resident access to survey results, safe and clean environment, comprehensive care planning, professional standards in medication administration, dialysis communication, food safety, staffing ratios, and life safety code compliance. Deficiencies were cited in multiple areas including failure to maintain accessible survey results, housekeeping issues, incomplete care plans, medication errors, incomplete dialysis communication forms, food storage and sanitation issues, staffing shortages, and life safety code violations related to lighting, sprinkler system maintenance, fire extinguisher inspections, corridor door smoke resistance, HVAC ventilation, electrical safety, and emergency power system testing.

The inspection was conducted based on Complaint #NJ168821 to investigate allegations related to staffing ratios at Silver Healthcare Center.

The facility was found not in compliance with New Jersey staffing requirements for direct care staff to resident ratios on 2 of 14 day shifts reviewed (10/29/2023 and 10/30/2023). No negative outcomes to residents were identified related to this deficiency.

Complaint #NJ168821 was investigated and substantiated with findings of deficient CNA staffing on 10/29/2023 and 10/30/2023. No negative outcomes to residents were noted.

A routine recertification survey was conducted to determine compliance with 42 CFR Part 483, Requirements for Long Term Care (LTC) Facilities, including complaint investigations NJ00163045 & NJ00163818.

The facility was found to be in substantial compliance with emergency preparedness requirements but had deficiencies related to abuse reporting, accuracy of assessments, care planning, quality of care, life safety code violations, and infection control. A plan of correction was submitted and a revisit was conducted on 07/20/2023 confirming compliance.

Complaint NJ00163045 and NJ00163818 were investigated during the survey. The complaint was substantiated with findings related to abuse reporting, care planning, and quality of care.

The inspection was conducted as a complaint investigation based on multiple complaint numbers including NJ160013, NJ160679, NJ161661, NJ161662, NJ161679, NJ161680, NJ161681, NJ161682, and NJ161683. The facility was found not in substantial compliance with federal requirements during this complaint visit.

The facility failed to develop and implement comprehensive care plans for residents, failed to prevent and treat pressure ulcers, failed to maintain adequate staffing ratios, and failed to ensure proper documentation and assessment of residents. Multiple deficiencies were cited related to care planning, skin integrity, resident records, and mandatory access to care.

The complaint investigation was based on multiple complaint numbers NJ160013, NJ160679, NJ161661, NJ161662, NJ161679, NJ161680, NJ161681, NJ161682, and NJ161683. The facility was found not in substantial compliance with federal requirements. Specific complaints included failure to develop care plans, prevent pressure ulcers, maintain staffing ratios, and maintain proper documentation.

The inspection was conducted based on complaint #NJ158549 to investigate allegations of failure to protect a resident and related concerns.

The facility was found not in substantial compliance with requirements due to failure to protect a resident from abuse and failure to follow physician orders and facility policies. Deficient practices were identified related to abuse prevention, medication administration, and documentation.

Complaint #NJ158549 was substantiated. The investigation revealed that Resident #2 was physically abused by another resident and the facility failed to protect Resident #2 and follow physician orders and policies. The abuse was reported and investigated, and corrective actions were implemented.

Complaint investigation triggered by complaints NJ00156717 and NJ00156435 to determine compliance with 42 CFR Part 483, Subpart B, for long term care facilities.

The facility was found not in substantial compliance with multiple deficiencies including staffing shortages, failure to obtain timely criminal background checks and health screenings for employees, failure to provide dignified dining experience, failure to maintain call bells within reach, failure to provide required Medicaid notices, failure to update care plans and discharge summaries, medication administration errors, failure to follow therapeutic diet orders, unsafe environment issues including unsecured janitor closet, and infection control deficiencies including lack of a qualified infection preventionist and inadequate COVID-19 vaccination tracking.

Complaint investigation for NJ00156717 and NJ00156435. Immediate Jeopardy identified for unsafe environment, medication errors, and therapeutic diet noncompliance.

A Life Safety Code Survey was conducted by the New Jersey Department of Health, Health Facility Survey and Field Operations on 08/24/22, 08/25/22, and 08/29/2022 to assess compliance with Medicare/Medicaid participation requirements and the 2012 Edition of the National Fire Protection Association (NFPA) 101, Life Safety Code.

The facility was found to be noncompliant with multiple Life Safety Code requirements including fire door ratings and inspections, exit door maintenance, exit ramp guardrails, exit signage, hazardous area enclosures, cooking equipment safety, fire alarm system installation, sprinkler system coverage, smoke barrier integrity and doors, electrical system safety including GFCI outlets and essential electrical systems, elevator inspections, fire drills, and smoking regulations. Corrective actions were planned or implemented for all deficiencies.

The inspection was conducted based on complaints #NJ15116, #NJ153829, and #NJ154125 regarding the facility's compliance with long term care regulations.

The facility was found not in substantial compliance with requirements related to notification of changes in resident condition, updating care plans for new wounds, and providing consistent turning, repositioning, and incontinence care for residents. Specifically, failures were noted in notifying responsible parties of condition changes, updating care plans for wounds, and documenting care interventions for pressure ulcers.

Complaint investigation based on allegations related to failure to notify family of condition changes, failure to update care plans, and inadequate care for pressure ulcers. The facility was found not in substantial compliance.

Complaint investigation and recertification survey conducted to determine compliance with 42 CFR Part 483, Subpart B, for long term care facilities. Immediate jeopardy situations were identified related to environmental hazards, medication administration, infection control, and safety.

The facility was found non-compliant with multiple regulatory requirements including unsafe physical environment due to broken handrails, unsecured hazardous chemicals, medication administration errors by untrained staff, infection control breaches including presence of flies and improper PPE use, inadequate staffing levels, failure to maintain equipment such as dryers and call bell systems, and failure to conduct timely assessments and quality assurance activities. Immediate jeopardy was identified and removal plans were submitted and verified.

Complaint NJ149075 and NJ149176 triggered a recertification survey and complaint investigation. Immediate jeopardy was identified related to environmental hazards, medication errors, infection control breaches, and safety risks. The facility submitted removal plans which were verified. Non-compliance remained at lower scope and severity for some deficiencies.

A Life Safety Code Survey was conducted by the New Jersey Department of Health, Health Facility Survey and Field Operations on 10/18/21 and 10/19/21 to assess compliance with Medicare/Medicaid participation requirements related to Life Safety from Fire and the 2012 Edition of the National Fire Protection Association (NFPA) 101, Life Safety Code.

The facility was found to have multiple deficiencies related to life safety code including failure to maintain proper building construction documentation, obstructed means of egress, malfunctioning delayed egress doors, inadequate emergency lighting, improper exit signage, lack of self-closing devices on hazardous area doors, fire alarm system notification deficiencies, sprinkler system maintenance issues, portable fire extinguisher inspection lapses, corridor door smoke resistance failures, smoke barrier door gaps, HVAC ventilation failures, elevator out of service, electrical system clearance violations, generator testing documentation missing, improper use of extension cords and power strips, and unsafe storage of oxygen cylinders.

A monitoring visit was conducted on 10/23/21.

The report contains initial comments indicating the monitoring visit and census count; no specific deficiencies or findings are detailed.

State monitoring visit to assess compliance with the New Jersey Administrative Code, Chapter 8:39, Standards for Licensure of Long Term Care Facilities.

The facility was found to be in compliance with the applicable standards for licensure of long term care facilities.

The inspection was conducted as a complaint survey based on multiple complaint intakes (NJ147121, NJ146330, NJ148023, and NJ147262) to investigate allegations of abuse and misappropriation of property involving residents.

The facility failed to report an allegation of abuse involving two residents to the state survey agency within the required timeframe. The incident involved resident-to-resident physical abuse that was not reported for 11 days. The facility re-educated staff and updated policies to prevent recurrence.

Complaint Intake NJ148023 involved failure to report an allegation of abuse for 1 of 2 abuse investigations reviewed, involving 2 residents. The facility did not report the resident-to-resident abuse incident to the New Jersey Department of Health within the required time frame, with an 11-day delay.

The inspection was conducted as a complaint survey based on multiple complaint intakes alleging resident-to-resident abuse and failure to provide a safe environment.

The facility failed to prevent resident-to-resident abuse involving Resident #13 assaulting multiple residents, resulting in an Immediate Jeopardy (IJ) situation. The facility also failed to maintain a clean environment, provide adequate supervision to prevent resident altercations, and follow up on pharmacy recommendations. A Removal Plan was accepted and partially implemented by the time of revisit.

The complaint investigation was triggered by multiple complaint intakes (NJ145040, NJ144427, NJ141661, NJ142926, NJ145386, NJ145690, NJ135912, NJ145455, NJ145806, NJ145778) alleging resident-to-resident abuse involving Resident #13 assaulting residents #3, #14, #15, #16, and #17. The Immediate Jeopardy began on 07/29/2021 and was removed on 08/09/2021 after a Removal Plan was accepted by NJDOH.

The inspection was conducted based on complaints NJ143348 and NJ143758, focusing on incontinence care, respiratory/tracheostomy care, medication administration, and medical record documentation.

The facility failed to provide proper incontinence care to residents, failed to follow respiratory care plans and document treatments properly, administered medication without valid physician orders and failed to monitor effectiveness, and maintained inaccurate and copied medical record documentation for multiple residents.

Complaint numbers NJ143348 and NJ143758 triggered the investigation focusing on incontinence care, respiratory care, medication administration, and medical record documentation.

The inspection was conducted based on multiple complaints identified by complaint numbers NJ00139490, NJ00134411, NJ00135379, and NJ00136324.

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.

Complaint numbers NJ00139490, NJ00134411, NJ00135379, and NJ00136324 were investigated and found to be unsubstantiated as the facility was in compliance.

A COVID-19 Focused Infection Control Survey was conducted by the New Jersey Department of Health to assess compliance with infection control regulations and CDC recommended practices.

The facility was found to be in compliance with 42 CFR §483.80 infection control regulations and had implemented CMS and CDC recommended practices to prepare for COVID-19.

A COVID-19 Focused Infection Control Survey was conducted by the New Jersey Department of Health to assess compliance with infection control regulations related to COVID-19.

The facility was found to be in compliance with 42 CFR §483.80 infection control regulations and has implemented the CMS and CDC recommended practices for COVID-19.

A COVID-19 Focused Infection Control Survey was conducted by the New Jersey Department of Health to assess compliance with infection control regulations related to COVID-19.

The facility was found to be in compliance with 42 CFR §483.80 infection control regulations and has implemented the CMS and CDC recommended practices for COVID-19.