Apple Rehab Shelton Lakes

In the surveyor’s words

From the most serious findings on record at Apple Rehab Shelton Lakes, in the surveyor’s own words.

• No harm, potential for more than minimal, patternF842Jul 20, 2026

  Based on review of the clinical records, facility documentation, facility policy, and staff interviews, for 8 of 8 residents (Residents #4, Resident #5, Resident #7, Resident #70, Resident #81, Resident #109, Resident #110, and Resident #112) reviewed for advance directives, the facility failed to ensure the medical records contained appropriate provider documentation to support a physician's order authorizing a Registered Nurse (RN) to pronounce death. Specifically, the medical records lacked provider documentation indicating the residents' deaths were anticipated and that RN pronouncement of death was appropriate. […]

• No harm, potential for more than minimal, patternF584Dec 9, 2024

  Based on observations of the environment, review of facility policy and interviews, the facility failed to maintain a safe, clean homelike environment. The findings included: 1. An observation on 12/02/24 at 10:45 AM identified the following: a) room [ROOM NUMBER] Discolored and stained toilet seat. Stained tile and walls around toilet. b) room [ROOM NUMBER] Marred walls. c) room [ROOM NUMBER] - stained [NAME] in the bathroom, marred walls. d) room [ROOM NUMBER] marred closet door, large amount of brown staining on curtain next to bed #1. e) room [ROOM NUMBER]- Marred walls, exposed sheetrock next to bed #1. f) room [ROOM NUMBER]- Large smeared brown stain above garbage in front of bed #2, missing closet baseboard rusted commode seat, brown dried stain drops along wall. […]

• No harm, potential for more than minimal, patternF684Dec 9, 2024

  Based on clinical record review and staff interviews for 1 sampled resident (Resident #23) reviewed for edema, the facility failed to consistently conduct weights according to physician orders. The findings include: Resident #23 's diagnoses included Congestive Heart Failures (CHF), localized edema and type 2 diabetes mellitus. A physician's order dated 9/25/24 directed daily weight in AM one time a day for CHF. The quarterly Minimum Data Set assessment dated [DATE] identified Resident #23 as cognitively impaired and requires supervision/ touching assistance with personal hygiene and maximal assistance with dressing and toileting hygiene. The Resident Care plan dated 10/18/24 identified CHF. […]

• No harm, potential for more than minimal, patternF685Dec 9, 2024

  Based on clinical record reviews, facility documentation, facility policy and interviews for 5 of 5 sampled residents (Residents #16, #18, #23, #76 and #83) reviewed for quality of care, the facility failed to ensure residents receive proper treatement to maintain adequate hearing. The findings included: 1. Resident #16's diagnoses included dementia and major depressive disorder. The quarterly Minimum Data Set (MDS) assessment dated [DATE] identified Resident #16 as severely cognitively impaired and required two person assist with activities of daily living (ADL). The Resident Care Plan (RCP) dated [DATE] identified Resident #16 was hearing impaired, wore a hearing aid and refused at times. […]

• No harm, potential for more than minimal, patternF761Dec 9, 2024

  Based on observations, review of facility policy and staff interviews, the facility failed to ensure Intravenous Therapy (IV) supplies located in the medication storage room and the central supply were stored and labeled appropriately and the facility failed to ensure supplies were not expired. The facility also failed to ensure left over resident supplies were returned to the pharmacy after therapy completion, discharge, or transfer from facility. The findings included: 1. An observation and interview with the Infection Preventionist (IP) RN #11 on [DATE] at 12:00PM identified the following : individually wrapped loose Intravenous (IV) heparin and saline flushes in large boxes on the lower shelf, several clear bags containing IV flush syringes ordered to particular residents on top of the… […]