Ball Pavilion, The

In the surveyor’s words

From the most serious findings on record at Ball Pavilion, The, in the surveyor’s own words.

• No harm, potential for more than minimal, widespreadF812May 12, 2023

  Based on observations and staff interviews, it was determined that the facility failed monitor the sanitizing functions of the dish machine in the main kitchen, and store food and food containers in a safe and sanitary manner in one of three nourishment refrigerators (B wing). Findings include: Review of a facility policy entitled, Dish Machine Temperatures dated July 2022, indicated that dish machine temperatures will be taken at the beginning of breakfast, dinner, supper dish runs, and any temperature that is below regulation (160-180 Fahrenheit degrees (F) wash, 180-200 F final rinse) will be reported immediately to the supervisor/coordinator on duty, and in the event that a dish machine is not working properly, paper products will be used for meal service. […]

• No harm, potential for more than minimal, patternF812Mar 27, 2026

  Based on review of facility policies, observations, and staff interviews, it was determined that the facility failed to ensure that food was stored in accordance with standards for food safety for one of six kitchen refrigerators, and three of three pantry refrigerator/freezers; and failed to monitor resident's personal refrigerators for temperatures for one of one residents reviewed with personal refrigerators (Resident R55).Findings include: Review of a facility policy entitled Cooler and Freezer Storage dated 2/19/26, revealed Leftover prepared foods will be discarded if not used within three days of preparation. […]

• No harm, potential for more than minimal, patternF880Mar 27, 2026

  Based on review of facility policy, observations, and staff interviews, it was determined that the facility failed to prevent the potential for cross contamination (the spreading of germs/microorganisms from one surface to another) during the administration of intravenous (IV) medications for one resident (Resident R49); the administration of feeding tube medications for one resident (Resident R52); and the administration of oral medications for two residents (Residents R15 and R63) observed during medication administration.Findings include:A facility policy entitled, Enhanced Barrier Precautions dated 2/19/26, indicated that enhanced barrier precautions will be implemented for all staff who care for residents during high-contact care activities and included device care and/or use of… […]

• No harm, potential for more than minimal, patternF756Mar 21, 2025

  Based on review of facility contract and policy, and clinical record review, and staff interviews, it was determined that the facility failed to ensure that monthly pharmacy drug regimen reviews were completed for five of five residents reviewed (Residents R11, R13, R17, R30, and R52). Findings include: A facility contract entitled Care Apothecary Consultant Pharmacy Retainer Agreement dated 6/07/24, indicated that: monthly reviews of the drug regimen of each resident at Ball Pavilion will be conducted; recommendations, plans for implementation, and continuing assessment regarding medication policies and use through dated, and signed reports will be provided to administrator; and the pharmacy agrees to be responsible for providing continuous Consultant Pharmacist Services to the facility… […]

• No harm, potential for more than minimal, patternF584May 12, 2023

  Based on observations and staff interviews, it was determined that the facility failed to maintain a clean homelike environment for two of two resident neighborhoods (A and B Wings). Findings include: Observations between 5/09/23, and 5/11/23, of eight resident wheelchairs (Residents R1, R2, R4, R25, R32, R34, R36, R39, and R50) revealed wheelchairs with dried solid/food substances, dried liquid, and a build-up of dust and debris on the wheelchair armrest, seats, wheels, and frames. One resident wheelchair was observed to have a torn armrest that had been taped with black plastic electrical tape, and one resident wheelchair to have an armrest in disrepair. During an interview on 5/11/23, at 11:00 a.m. […]