Aaron Manor Nursing & Rehabilitation

In the surveyor’s words

From the most serious findings on record at Aaron Manor Nursing & Rehabilitation, in the surveyor’s own words.

• Actual harm, isolatedF689Nov 12, 2024

  Based on observations, clinical record review, review of facility policy, and interviews for 1 of 3 sampled residents (Resident #38) reviewed for falls, the facility failed to ensure the bed was left in a low position following the provision of care and failed to provide the level of assistance according to the plan of care, for a resident who was a high fall risk, which resulted in a fall with a major injury. The findings include: Resident #38 was admitted to the facility in August of 2024 with diagnoses that included history of falling, left hip fracture post hemiarthroplasty (hip replacement surgery), dementia and generalized muscle weakness. […]

• Actual harm, isolatedF692Nov 12, 2024

  Based on observations, interviews, clinical record review and facility policy, for 1 of 3 residents (Resident #3) reviewed for nutrition, the facility failed to monitor and accurately document fluid intake and bowel movements resulting in a prolonged hospitalization related to a severe fecal impaction and failed to make speech therapy and dietician referrals with a documented weight loss and poor meal intake. The findings include: Resident #3 was admitted to the facility in August of 2022 and had diagnoses that included spinal stenosis, dementia and protein-calorie malnutrition. […]

• Actual harm, isolatedF689Feb 26, 2024

  Based on clinical record review, facility documentation review, facility policy review, and interviews for one of three residents (Resident #1) reviewed for accidents, the facility failed to obtain the resident's weight in a safe manner while utilizing the mechanical lift and as a result, the resident fell out of the lift and sustained a head injury. The finding includes: Resident #1's diagnoses included neurocognitive disorder, cerebral infarction (stoke) with residual hemiplegia (paralysis of one side of the body). A Quarterly MDS assessment dated [DATE] identified Resident #1 had severe cognitive impairment and was dependent for transfers. The RCP dated 12/19/2023 identified Resident #1 required assist with transfers. […]

• No harm, potential for more than minimal, patternF812Jun 22, 2026

  Based on observations, interviews, and facility policy, the facility failed to ensure proper hand hygiene was performed during food preparation and service. The findings include: Observation and interview in the kitchen with the Dietary Manager on 6/16/26 at 12:27 PM during food preparation and lunch service identified [NAME] #1 removed her gloves and placed on new gloves 2 times without the benefit of hand hygiene prior to placing on the new gloves. The Dietary Manager indicated that she was aware of the issue and immediately instructed [NAME] #1 to wash her hands. Although the Dietary Manger placed a bottle of hands sanitizer immediately behind [NAME] #1, she was observed a third time failing to wash her hands with glove placement. […]

• No harm, potential for more than minimal, patternF761Nov 12, 2024

  51183 Based on observations, clinical record review, review of facility policy, interviews for 1 of 3 sampled residents (Resident #206) reviewed for pressure ulcers and observation of 1 of 1 medication rooms for medication storage and labeling, the facility failed to ensure that a resident's medications were stored in a designated secure area per facility policy and failed to discard expired vaccines and insulin vials after the beyond use date. The findings include: 1. Resident #206 was admitted to the facility in October of 2024 with diagnoses that included osteomyelitis of vertebra, sacral and sacrococcygeal region, depression, and generalized muscle weakness. […]