Belmont Manor Nursing Home, In

In the surveyor’s words

From the most serious findings on record at Belmont Manor Nursing Home, In, in the surveyor’s own words.

• Actual harm, isolatedF658Jul 20, 2023

  Based on records reviewed and interviews for one of three sampled residents (Resident #1), who was cognitively intact, was at high risk for falls, and required extensive physical assistance of two staff members to meet his/her care needs, the Facility failed to ensure he/she was provided nursing care and treatment in accordance with professional standards of practice, when on 06/09/23 during the overnight shift, after finding Resident #1 on the floor in his/her room by Nurse #1 after an unwitnessed fall, he/she was not adequately assessed for potential injuries, Nurse #1 had not documented the incident, and had not informed on coming shift nursing staff of the incident so they could monitor Resident #1 for potential injuries. […]

• Actual harm, isolatedF688Apr 16, 2021

  Based on policy review, record review and interview the facility failed to prevent a decline in range of motion for 1 one Resident (#46) out of a total sample of 29 residents. Findings include: Review of the facility policy titled, Range of Motion, dated June 2017 indicated the following: -It is the policy of [NAME] Manor to provide range of motion during daily care to all residents in need. -Range of motion is performed by CNA (Certified Nursing Assistant) during daily care of the resident. -For those residents who require a specific range of motion program, the rehab department will develop, implement, and educate designated staff members to perform the specialized range of motion program as indicated. […]

• No harm, potential for more than minimal, patternF695Dec 31, 2025

  Based on observations, record reviews, and interviews, the facility failed to: 1. ensure respiratory care was provided consistently with professional standards of care for one Resident (#148) out of a sample of 31 residents and 2. failed to maintain respiratory equipment to ensure it was clean and prepared for use.Findings include: Review of the facility policy titled Oxygen Administration, undated, indicated the following: The purpose of this procedure is to provide guidelines for oxygen administration. -Turn on the oxygen. Unless otherwise ordered, start the flow of oxygen at the rate of 2-3 Liters per minute. […]

• No harm, potential for more than minimal, patternF851Dec 31, 2025

  Based on record review and interview, the facility failed to electronically submit direct care staffing data to the Centers for Medicare and Medicaid Services (CMS) for the entire reporting period, Fiscal Year (FY) Quarter 4 2025 (July 1 - September 30), in accordance with the schedule specified by CMS.Findings include:Review of the facility's policy titled Payroll Based Journal (PBJ), dated as revised February 2024, indicated but was not limited to:Policy: [NAME] Manor is required to submit staffing hours to CMS every 3 months beginning with the data for July, August, September 2016 (This is called 2016 Q4). […]

• No harm, potential for more than minimal, patternF880Dec 31, 2025

  Based on record review, interview and observation, the facility failed to ensure it implemented infection control measures for one of one applicable sampled Resident (#84) with a diagnosis of influenza. Specifically, the facility failed to follow physician orders for droplet precautions and failed to ensure staff utilized appropriate personal protective equipment in Resident #84's room and on the unit.Findings include: Review of the Center for Disease Control guidance titled Interim Guidance for Influenza Outbreak Management in Long-term Care and Post-Acute Care Facilities dated 9/17/24 indicated, but was not limited to, the following: - Implement standard and droplet precautions for all residents with suspected or confirmed influenza. […]