Inspection Reports for
Sunrise Manor Center for Nursing and Rehabilitation

Multiple level 2 deficiencies related to quality of care including comprehensive care plan, drug regimen review, food sanitation, accident hazards, and resident call system; all corrected by May 29, 2025.

The facility failed to develop a comprehensive person-centered care plan for Resident #50 addressing bowel and bladder incontinence, despite documented diagnoses and physician orders. Staff interviews confirmed the omission and responsibility for initiating the care plan was acknowledged by nursing supervisors.

The facility was found deficient in multiple areas including failure to develop comprehensive care plans for residents, inadequate supervision during mechanical lift transfers, lack of physician documentation on medication regimen disagreements, improper food storage temperatures, and inaccessible call bells for residents.

The facility failed to protect residents from sexual abuse, specifically involving Resident #1 with severe cognitive impairment engaging in sexual activity with Resident #2 who had intact cognition. The facility did not adequately evaluate or intervene to protect Resident #1 or other cognitively impaired residents, resulting in actual psychosocial harm and immediate jeopardy to resident health and safety.

Level 2 deficiency in administration and level 4 immediate jeopardy deficiency for free from abuse and neglect; both corrected by January 8, 2025.

Level 2 deficiencies in comprehensive care plan and resident records; Level 2 life safety code deficiencies including electrical systems, emergency lighting, gas equipment storage, hazardous areas enclosure, fire drills, means of egress, ramps, and sprinkler system; all corrected by January 12, 2024.

The facility failed to ensure residents received oxygen therapy according to physician orders and did not maintain complete and accurate medical records for residents. Two residents were observed receiving oxygen at higher flow rates than ordered, and one resident's eye condition was not properly documented.

The facility failed to ensure that each resident's medical record documented receipt of the influenza vaccine or documented refusal or contraindication. Two of four residents reviewed lacked proper documentation of influenza vaccination or consent, indicating incomplete vaccine administration and consent processes.

Level 2 deficiency for influenza and pneumococcal immunizations; corrected by September 15, 2023.

Level 2 deficiency for investigating/preventing alleged violations and level 4 immediate jeopardy deficiency for reporting alleged violations; both corrected by early 2023.

Level 2 deficiency in infection preventionist qualifications/role; corrected by February 3, 2023.

Life Safety Code deficiencies including electrical systems, fire drills, means of egress, ramps, and sprinkler system with mostly level 1 and level 2 severities; all corrected by late 2022.

The facility failed to maintain a clean and homelike environment as evidenced by multiple resident complaints and observations of dirty floors, clogged shower drains, and debris in resident rooms. Additionally, the facility did not ensure that medication irregularities identified by the licensed pharmacist were addressed by the physician, specifically a failure to update the administration time for Synthroid for one resident.