Adroit Care Rehabilitation and Nursing Center

In the surveyor’s words

From the most serious findings on record at Adroit Care Rehabilitation and Nursing Center, in the surveyor’s own words.

• Actual harm, isolatedF656Sep 2, 2025

  Complaint: 2600629, 2601350Based on interviews, review of medical records, and review of other pertinent facility documentation on 8/29/2025 and 9/02/2025, it was determined that the facility failed to a.) implement a resident's (Resident #1) comprehensive care plan for out on pass with escort only which resulted in the resident eloping and b.) develop a care plan for a resident post elopement. On 8/22/2025, Resident #1 was sitting outside the facility unescorted and was found wandering on a multi-lane highway by a passerby who brought the resident to the police precinct and had a syncopal episode (loss of consciousness) and was transferred to the emergency room.This deficient practice was identified for 1 of 3 sampled residents (Resident #1) and was evidenced by the following: According… […]

• No harm, potential for more than minimal, patternF813Mar 24, 2026

  Based on observation, interview, and review of pertinent facility documents, it was determined that the facility failed to ensure that food stored in residents' personal refrigerators was maintained in a safe and sanitary manner by failing to a.) ensure thermometers were present in residents' personal refrigerators to monitor internal temperatures, b.) routinely monitor and document refrigerator temperatures on a temperature log, c.) maintain food items at the appropriate internal temperatures, d.) discard food items in accordance with manufacturers' expiration or by the used by dates, and e.) routinely monitor and clean refrigerators.This deficient practice was identified in 6 of 6 residents' rooms (Rooms 302, 304, 314, 319, 330B, and 330C) reviewed for the use of personal refrigerators… […]

• No harm, potential for more than minimal, patternF584Nov 13, 2024

  Based on observation, interview, and review of pertinent facility documents it was determined that the facility failed to maintain a clean and sanitary environment for 2 of 2 shower rooms. The deficient practice was evidenced by the following: On 11/06/2024 at 10:58 AM, the surveyor entered the shower room on the second floor and observed tiles on the floor and various hygienic products left in the whirlpool tub. On 11/07/2024 at 09:49 AM, the surveyor entered the shower room on the second floor and observed tiles picked up and placed on the window sill, and items remained in the whirlpool tub. […]

• No harm, potential for more than minimal, patternF755Sep 6, 2023

  Based on observation, interview and record review, it was determined that the facility failed to provide pharmaceutical services in accordance with professional standards to a.) accurately obtain a blood pressure and accurately document the site, b.) accurately document the refusal of medications, d.) dispose of medications in a safe manner, c.) clarify and accurately administer a medication (Midodrine) according to a physician's order and d.) remove and dispose of controlled substances from active inventory when discontinued from March of 2023 until surveyor inquiry. The deficient practices occurred for two (2) of seven (7) residents, (Resident #56 and #75) reviewed for medication management and for two (2) of two (2) medication refrigerators inspected. […]

• No harm, potential for more than minimal, patternF880Nov 21, 2022

  Infection Control Covid-19 Survey Based on observations, interviews, and the review of other pertinent facility documents on 11/18/2022 and 11/21/2022, it was determined that the facility failed to thoroughly screen all staff for Covid-19 signs and symptoms in accordance with the facility's policy titled Employee Screening for Symptoms of Covid 19 and the Centers for Disease Control and Prevention (CDC) guidelines. This deficient practice was evidenced by the following: Reference: Centers for Disease Control and Prevention (CDC) COVID-19, Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the Coronavirus Disease 2019 (COVID-19) Pandemic, updated 2/2/22, showed .1. […]