Apple Rehab Watertown

In the surveyor’s words

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

• Actual harm, isolatedF689Jun 18, 2024

  Based on a review of clinical records, facility documentation, facility policy and interviews, for two of 5 residents (Resident #27 and 41) at risk for falls, the facility failed to implement interventions including adequate supervision to prevent falls consistent with the resident's needs resulting in injury. The findings include: 1. Resident #27 was admitted to the facility in June 2021 with diagnoses that included diabetes, atrial fibrillation, and convulsions. The care plan dated 10/25/23 identified Resident #27 was at risk to fall due to a history of frequent falls with injury, decreased mobility, worsening dementia, history of CVA, and noncompliance with calling and waiting for assistance due to decline in cognition and safety awareness. […]

• Actual harm, isolatedF689Jul 25, 2022

  Based on review of the clinical record, tour of Resident #1's unit and staff interview for one of one resident (Resident #1) reviewed for accidents, the facility failed to provide supervision to prevent Resident #1 from accessing an unsecured stairwell, where he/she fell down the stairwell while self propelling in the wheelchair and sustained a right distal femur fracture. The findings include: Resident #1's diagnoses included dementia with behavioral disturbance, Alzheimer's disease and Diabetes Mellitus. A quarterly Minimum Data Set (MDS) assessment dated [DATE] identified Resident #1 was severely cognitively impaired and required extensive assistance from 2 staff for bed mobility, transfers, dressing, toilet use and personal hygiene. […]

• Actual harm, isolatedF602Dec 2, 2021

  Based on clinical record reviews, review of facility documentation and interviews for one sampled resident (Resident #1) who was reviewed for allegation of abuse, the facility failed to ensure resident was free from misappropriation of resident funds. The findings include: Resident #1 diagnoses [MEDICAL RECORD OR PHYSICIAN ORDER] . The quarterly Minimum Data Set (MDS) assessment dated [DATE] identified Resident #4 had intact cognition, not depressed, no behavior concerns, and an assist of 1 with bed mobility, transfers, and personal hygiene. Ambulates with assist of one with a walker and able to self-propel in wheelchair. […]

• No harm, potential for more than minimal, patternF568Jun 18, 2024

  Based on review of facility documentation, facility policy, and interviews, the facility failed to place resident council funds in an interest-bearing account and hold, safeguard, manage, and account for the funds. The findings include: The Resident Council Funds bank account statements dated 4/1/21 to 4/30/24 identified that the account was closed on 4/14/21 and there was $1808.64 withdrawn at that time. Review of the resident council meeting minutes from 1/1/23 to 3/24/24 failed to reflect any discussion of resident council funds. Interview with Residents #13, 17, 23, 33, 35, and 61 on 6/16/24 at 2:00 PM indicated that there was a council president and secretary but not a treasurer. […]

• No harm, potential for more than minimal, patternF583Jun 18, 2024

  Based on review of facility documentation, facility policy, and interviews the facility failed to ensure the residents private information was kept confidential. The findings include: Observation on 6/17/24 at 8:10 AM of medication administration identified LPN #7 moved the medication cart to the room of Resident #23. LPN #7 opened the medication cart and prepared the medications for Resident #23. At 8:15 AM, LPN #7 entered Resident #23's room, without the benefit of closing the computer screen, and gave Resident #23 his/her medications. LPN #7 then exited the room noting that the computer screen had been open with 16 residents' personnel demographics such as names, photo, and room number visible. […]