Annandale Care Center Inc

In the surveyor’s words

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

• Immediate jeopardy, isolatedF600Sep 30, 2021

  Based on interview and document review, the facility failed to thoroughly investigate and implement corrective action to keep residents safe following an allegation of staff (alleged perpetrator) to resident abuse for 2 of 2 residents (R1, R2) reviewed for abuse. This resulted in an immediate jeopardy. Additionally, 4 residents (R3, R4, R5, R6) alleged abuse against the same staff during the facility's removal plan implementation. The immediate jeopardy (IJ) began on 9/15/21 when, following an allegation of staff to resident physical abuse, the facility failed to interview other residents who worked with the alleged perpetrator (AP) who fit the description and worked during the alleged scheduled hours (overnights), failed to follow up with picture identification of AP and interview… […]

• Actual harm, isolatedF689Jun 17, 2025

  Based on observation, interview and record review, the facility failed to comprehensively assess environmental hazards and/or ensure the environment was free from accident hazards for 1 of 3 residents (R1) reviewed for falls. The facility's failures caused actual harm when R1 tripped and fell on a mechanical lift which resulted R1 suffering multiple rib fractures with hemothorax, unstable T11 fracture, and a large laceration to her elbow. Findings include: R1's admission Record dated 4/17/24, identified R1's diagnoses included dementia with other behavioral disturbance, Hospice care, muscle weakness, unsteady gait, impaired safety awareness, and history of falls. […]

• Actual harm, isolatedF689Jan 5, 2023

  Based on observation, interview and document review, the facility failed to ensure fall interventions were implemented as care planned to prevent falls for 1 of 2 residents (R1) reviewed for accidents. This resulted in actual harm when R1 fell from a toileting sling and was diagnosed with a left shoulder fracture. Findings include: R1's significant change Minimum Data Set (MDS) dated [DATE], indicated R1 had hemiplegia and anxiety. The MDS indicated R1 was cognitively impaired, did not reject care, transferred with extensive assist of two, was always incontinent of bladder and frequently incontinent of bowel. […]

• No harm, potential for more than minimal, widespreadF851May 15, 2024

  Based on interview and document review, the facility failed to submit accurate and/or complete data for staffing information at least quarterly or more often, including information for agency and contract staff, based on payroll and other verifiable and auditable data during (2023) 1 of 2 quarters reviewed (Quarter four) in Federal Fiscal Year (2023), to the Centers for Medicare and Medicaid Services (CMS), according to specifications established by CMS. This has the potential to affect all 34 residents residing in the facility. Findings include: Review of the Payroll Based Journal Report (PBJ) [NAME] Report 1705 D identified the following dates triggered for review: (October 1, 2023 to December 31,2023 - quarter one) for one star staffing rating. […]

• No harm, potential for more than minimal, widespreadF880Jan 6, 2021

  Based on interview and document review the facility failed to ensure all staff entering the facility were completing COVID screening prior to entering resident care area for the prevention and potential transmission of COVID-19. This had the potential to affect all 29 residents currently residing in the facility at the time of the COVID-19 focused survey. Findings include: On 1/04/21, at 11:00 a.m. the survey team entered the facility via the building's locked main entrance. Surveyors completed a COVID-19 symptom and screening questionnaire, reviewed by a facility' employee after. A facility employee took temperatures, assured eye protection and masks were in place, and hand hygiene was performed before allowing surveyors entrance to the facility. […]