Amie Holt Care Center

In the surveyor’s words

From the most serious findings on record at Amie Holt Care Center, in the surveyor’s own words.

• No harm, potential for more than minimal, widespreadF812Feb 29, 2024

  Based on observation, staff interview, review of the dishwasher and refrigerator/freezer temperature log sheets, manufacturer's instructions, hot and cold food temperature logs, policy and procedures, and the 2022 FDA Food Code, the facility failed to ensure a sanitary environment in 1 of 1 kitchen and failed to ensure temperatures were monitored for 5 of 5 refrigerator/freezers which stored food for resident use outside of the kitchen (downstairs pantry, upstairs pantry, 100 hallway, 200 hallway, and 400 hallway). The census was 28. The findings were: Related to temperature monitoring of food storage units: 1. Review of the December 2023, the January 2024, and February 2024 temperature monitoring log sheets for food storage areas outside of the kitchen showed the following concerns: a. […]

• No harm, potential for more than minimal, widespreadF812Feb 3, 2022

  Based on observation, staff interview, review of the food code, and policy and procedure review, the facility failed to ensure sanitary meal service during 1 of 2 meal observations. The census was 32. The findings were: 1. Observation on 2/2/22 at 4:20 PM showed cook #1 left the griddle area and without removing her gloves or performing hand hygiene, obtained a pot holder, opened the oven, and removed a tray of bacon. She checked the bacon, opened the oven, and returned the bacon to the oven. The cook left the service area and entered the storage area, opened a drawer, and obtained a pair of tongs. […]

• No harm, potential for more than minimal, patternF880Apr 24, 2025

  Based on observation, resident and staff interview, and policy and procedure review, the facility failed to ensure infection prevention practices were implemented during meal delivery during 2 of 3 meal observations in the main dining room. The census was 32. The findings were: 1. Observation on 4/22/25 from 4:48 PM showed dietary aide #1 was taking orders for the evening meal using a pen and pad of paper. After obtaining the orders the dietary aide returned to the kitchen and obtained milk, coffee, and hot water, and served the beverages to residents with her fingers touching the rims of the cups. Further observation showed the dietary aide continued to serve beverages to residents in the same manner without performing hand hygiene. 2. […]

• No harm, potential for more than minimal, patternF583Feb 29, 2024

  Based on observation, staff interview, and policy and procedure review, the facility failed to ensure residents' private health information was protected for 3 out of 16 (#11, #19, #26) resident rooms observed and during multiple random observations of the medication cart. The census was 28. The findings were: 1. Random observation on 2/26/24 from 4 PM to 6 PM showed LPN #1 left the medication cart unattended (not in the vicinity) several times with private medical information observable on the computer screen (EMR) which included the resident's name, medication, medication dose, and administration time, and was visible for unauthorized people to read. Staff from different departments, visitors, and other residents were noted to pass by the medication cart during this timeframe. 2. […]

• No harm, potential for more than minimal, patternF561Feb 3, 2022

  Based on resident and staff interview and medical record review, the facility failed to ensure resident preferences were assessed and implemented for 3 of 4 sample residents (#3, #17, #82) reviewed for bathing. The findings were: 1. Review of the annual MDS assessment dated [DATE] showed resident #3 had diagnoses [MEDICAL RECORD OR PHYSICIAN ORDER] . The resident required extensive physical assistance of 1 person for dressing, toilet use, personal hygiene, and bathing. Further review showed the resident felt it was somewhat important to choose between a tub bath, shower, bed bath, or sponge bath. The following concerns were identified: a. […]