Inspection Reports for
Wilmington Nursing and Rehabilitation

The visit was complaint-related, investigating allegations of failure to provide timely admission orders, inadequate documentation of urostomy and pelvic drain care, failure to maintain nutrition and hydration, untimely lab testing, and infection control deficiencies. Findings were substantiated as described in the deficiencies.

The facility failed to ensure timely admission orders for wound care, proper documentation of urostomy and pelvic drain output, maintenance of adequate nutrition and hydration for residents, timely completion of laboratory tests, and implementation of infection prevention protocols including Enhanced Barrier Precautions and safe sharps disposal.

The facility was found noncompliant with Delaware Code Chapter 11 Nursing Staffing requirements, failing to maintain the required CNA staffing ratios of 1:9 during the day shift and 1:10 during the evening shift for the week of 3/30/25 to 4/5/25. The administrator educated the staff scheduler and implemented audits to ensure compliance.

The visit was complaint-related as indicated by the combined Follow Up and Complaint Survey. Specific complaint details are not separately stated but deficiencies relate to resident rights, care planning, pressure ulcer care, environmental safety, and infection control.

The survey identified deficiencies related to resident rights, care planning, pressure ulcer prevention and treatment, infection control, and environmental safety. The facility failed to ensure resident self-determination, proper care plan conferences, adequate pressure ulcer care, and maintenance of a safe environment free of accident hazards.

The facility was found deficient in multiple areas including failure to support resident self-determination, inadequate care plan revisions, improper treatment and monitoring of residents, medication errors, insufficient supervision to prevent accidents, inadequate nutrition and hydration management, and unsafe environmental conditions.

The facility was found to have multiple deficiencies including failure to provide adequate staffing hours, failure to develop and implement comprehensive care plans, failure to accurately assess and manage pressure ulcers, pain management issues, medication errors, and deficiencies in food safety and resident rights. The facility also failed to ensure proper documentation and follow-up in several areas including hospice care, nutrition, and wound care.

The facility had multiple deficiencies including failure to provide informed consent for treatment, inadequate resident self-determination support, inaccurate assessments, incomplete care plans, improper medication and treatment administration, insufficient infection control practices, and failure to maintain accurate clinical documentation.

This was a follow-up survey to a complaint and extended survey ending April 10, 2024. The deficiencies relate to the complaint investigation.

The facility was found deficient in scheduling timely follow-up eye care appointments and in preventing and treating pressure ulcers. Root cause analyses identified failures in admission appointment scheduling and skin check observation processes. The facility implemented new processes and education to address these issues, with compliance monitoring planned.

The visit was triggered by a complaint regarding failure to report injuries and falls timely and failure to provide appropriate follow-up care and documentation. The complaint was substantiated based on findings of delayed reporting and inadequate documentation.

The facility was found to be in substantial compliance with federal requirements but failed to report injuries of unknown origin within required timeframes and failed to ensure proper notification and documentation of resident falls and injuries. Deficiencies included failure to notify the State Agency within 8 hours of an injury, failure to notify and document post-fall assessments timely, and failure to update the facility assessment and governing body documents.

The complaint investigation was triggered by incidents including a resident being sent to the wrong cardiology appointment, failure to notify providers of injuries, and inadequate care for pressure ulcers and bladder management. The Immediate Jeopardy was declared on 2024-04-08 and abated on 2024-04-10.

The facility failed to ensure correct resident identification for medical appointments, resulting in an Immediate Jeopardy event. Additionally, the facility failed to notify providers of resident injuries, provide appropriate pressure ulcer care, and properly implement physician-ordered bladder scanning. The facility also failed to update governing body documents and the facility assessment to include all personnel classifications.

The facility was found to have multiple deficiencies including failure to provide immediate access to emergency personnel, inadequate environment and grievance handling, failure to protect residents from abuse and involuntary seclusion, incomplete PASARR screenings, deficient care planning, inadequate assistance with activities of daily living, failure to provide appropriate treatments and medications, insufficient nursing staff leading to delayed medication administration, poor pressure ulcer care, inadequate pain management, failure to monitor hydration and nutrition, and poor ventilation in the dementia unit. Immediate jeopardy was identified due to insufficient nursing staff resulting in delayed critical medication administration.

The facility was found deficient in multiple areas including failure to provide adequate resident care, medication errors, insufficient staffing leading to delayed medication administration, inadequate infection control practices, failure to maintain safe environment and equipment, and lack of required staff training. Immediate Jeopardy was identified related to medication administration delays and staffing shortages.

The report details multiple deficiencies related to residents' rights, personnel screening, nursing staffing, medication administration, resident care, abuse prevention, grievance handling, and quality of care. The facility failed to meet several regulatory requirements including tuberculosis screening, drug testing, adult abuse registry checks, and adequate staffing levels. Numerous clinical record reviews revealed failures in care planning, treatment, and monitoring of residents.

The facility was found deficient in multiple areas including accident prevention, supervision of residents with aggressive behaviors, bowel and bladder care, nutrition and hydration, pain management, medication regimen review, infection prevention and control, staff training, and resident rights. Several corrective actions and plans of correction were implemented with completion dates mostly by 9/25/2023.

The visit was complaint-related, investigating multiple concerns including inadequate nail care, improper feeding tube care, food temperature issues, inaccurate transfer documentation, and infection control failures. The complaints were substantiated based on observations, interviews, and record reviews.

The facility was found deficient in multiple areas including failure to provide nail care for a resident unable to perform ADLs, improper verification of feeding tube placement, serving food at unappetizing temperatures, inaccurate documentation of resident transfers, and inadequate infection prevention and control practices including improper PPE use and failure to label contaminated linen.