Arbor View Care Center, LLC

In the surveyor’s words

From the most serious findings on record at Arbor View Care Center, LLC, in the surveyor’s own words.

• Immediate jeopardy, isolatedF760Mar 13, 2024

  Based on interviews, observations and record review, the facility failed to ensure one (#3) of three out of six sample residents were free from significant medication errors. Specifically, the facility failed ensure Resident #3 was administered anticoagulant medication (Pradaxa) for atrial fibrillation per physician's orders. The facility failed to ensure the resident's anticoagulant prescription was picked up from a specified pharmacy by facility staff and brought to the facility. This failure resulted in Resident #3 not being administered the anticoagulant medication for a total of nine doses from [DATE] to [DATE]. […]

• Actual harm, isolatedF689Feb 18, 2026

  Based on record review and interviews, the facility failed to ensure residents received adequate supervision to prevent accidents for one (#1) of three residents reviewed for accidents out of three sample residents.Resident #1 was admitted on [DATE] for long-term care with a diagnosis of dementia. According to the care plan, Resident #1 was determined to be a high fall risk. The resident was independent with ambulation. On 1/16/26 Resident #1 was found on the floor in another resident's room. The resident was not wearing appropriate footwear at the time of fall. After the fall, Resident #1 was not able to walk and required the use of a wheelchair. […]

• Actual harm, isolatedF692Jul 30, 2024

  Based on observations, record review and interviews, the facility failed to ensure one (#93) of three residents reviewed for nutrition received the care and services necessary to meet their nutritional needs and maintain their highest physical well-being out of 51 sample residents. Resident #93 was admitted to the facility for long term care on 3/27/24 with diagnoses of severe dementia with mood disturbance, hypothyroidism (underactive thyroid), depression and dysphagia of the oropharyngeal stage (food sticks to the mouth or throat or gets pocketed in cheeks). Upon admission (3/27/24), Resident #93 weighed 114.6 pounds (lbs). […]

• Actual harm, isolatedF692Mar 16, 2023

  Based on observations, record review and interviews, the facility failed to implement nutritional interventions for one (#89) of four residents reviewed for nutritional parameters out of 37 sample residents to maintain acceptable parameters of nutritional status. Resident #89, age 78, was admitted to the facility on [DATE] with diagnoses of dementia, post traumatic stress disorder, chronic kidney disease stage three, previous head injury with loss of consciousness, left side paralysis following a stroke, epilepsy, prostate enlargement, vitamin D deficiency, urinary incontinence, restlessness and agitation, depression and influenza (flu). […]

• Actual harm, isolatedF600Nov 5, 2021

  Based on record review, and interviews, the facility failed to ensure that residents had the right to be free from abuse, neglect, misappropriation of property, or exploitation for four (#6, #7, #8, and #9) out of nine sample residents reviewed. Specifically, the facility failed to prevent staff to resident abuse. On 10/3/21 a report was made by certified nurse aide (CNA) #9 of a witnessed incident of staff to resident abuse. CNA #10 was suspended and terminated following a facility investigation substantiating the abuse. Two Residents, #6 and #7, suffered bruising from the treatment by CNA #10. […]