Allied Services Meade Street Skilled Nursing

In the surveyor’s words

From the most serious findings on record at Allied Services Meade Street Skilled Nursing, in the surveyor’s own words.

• No harm, potential for more than minimal, patternF755Mar 7, 2025

  Based on a review of clinical records, controlled medication records, select facility policy, and a staff interview, it was determined the facility failed to implement procedures to ensure the accuracy of controlled medication records for four residents out of 23 residents reviewed. (Residents 23, 61,76 and 350). Findings include: A review of facility policy titled Administration of Medication Schedule II-V Control Drugs, last reviewed by the facility on October 14, 2024, revealed the facility will comply with federal and state laws and regulations in the handling, storage, disposal, and record-keeping of Schedule II-V controlled medication. […]

• No harm, potential for more than minimal, patternF656May 3, 2024

  Based on observation, clinical record review, and staff interviews it was determined the facility repeatedly failed to implement a resident's care plan for pressure relieving measures for one resident out of 25 sampled (Resident 85). Findings include: Review of Resident 85's clinical record revealed that the resident was admitted to the facility March 7, 2024, with diagnoses to include right femur (thigh) fracture and diabetes. Review of Resident 85's current comprehensive care plan initially dated March 8, 2024, indicated that the resident has potential for skin breakdown related to alteration in mobility. Review of the planned interventions failed to indicate that the resident's heels were to be floated over a pillow in bed. […]

• No harm, potential for more than minimal, patternF684May 3, 2024

  Based on a review of clinical records, and resident and staff interviews, it was determined the facility failed to provide person-centered care consistent with professional standards of practice by failing to follow physician orders for medication administration for four residents (Residents 69, 85, 90 and 100) out of 25 sampled Findings included: A clinical record review revealed that Resident 100 was admitted to the facility on [DATE], with diagnoses that included heart failure (a condition that develops when the heart doesn't pump enough blood to meet the body's needs) and hypertension (a condition where the body's blood pressure is higher than normal). […]

• No harm, potential for more than minimal, patternF725May 3, 2024

  Based on observation, a review of clinical records, and staff and resident interviews it was determined that the facility failed to provide and/or efficiently deploy sufficient nursing staff to consistently provide timely and quality of care to residents, including timely provision of assistance to residents requiring the assistance of two nursing staff members for activities of daily living as evidenced by four out of 25 sampled residents (Residents 78, 80, 94 and 161). Findings include: An observation on April 30, 2024 at 6:30 PM revealed that the resident in resident room [ROOM NUMBER]-B was ringing their call bell for assistance for 26 minutes. […]

• No harm, potential for more than minimal, patternF809May 3, 2024

  Based on observation, review of the minutes from Resident Council Meetings, scheduled facility mealtimes, and select facility policy, and resident and staff interviews it was determined that the facility failed to ensure the provision of a nourishing (satisfying to the resident) evening snack when greater than 14 hours elapsed from the supper meal to breakfast the next day for residents including eight residents of 25 sampled (Resident 7, 10, 57, 61, 64, 78, 90 and 104). Findings include: Review of the facility's policy titled Snacks Policy, last reviewed October 2, 2023, indicated that a variety of snacks are available on the units throughout the day. […]