Brandon Oaks Nursing and Rehabilitation Center

In the surveyor’s words

From the most serious findings on record at Brandon Oaks Nursing and Rehabilitation Center, in the surveyor’s own words.

• No harm, potential for more than minimal, widespreadF812Sep 8, 2023

  Based on observation, staff interview, and facility document review, facility staff failed to ensure food was stored under safe and sanitary conditions in the main kitchen. The findings included: The facility staff failed to dispose of out of date carnation sweetened condensed milk. The box containing the cans of milk included a best before date of August 2023. 09/07/23 8:15 a.m., the surveyor toured the main kitchen area with dietary employee #1 and #2. During this observation the surveyor along with dietary employee #1 observed an opened box of carnation sweetened condensed milk (cans) with a best before date of August 2023. Dietary employee #1 removed this box from the food supply and stated they would dispose of the items. […]

• No harm, potential for more than minimal, widespreadF812Aug 24, 2021

  Based on observation, staff interview and facility document review, facility staff failed to ensure food was stored under safe and sanitary conditions in 1 walk-in freezer and 1 drink/prep refrigerator. The findings: 1. Frozen carrots, California blend vegetables, pre-cooked hamburger patties, and pretzel bagels were not sealed in a container within the walk-in freezer. During the initial kitchen tour accompanied by the facility's food service manager on [DATE] at approximately 4:30 p.m., there were opened boxes of frozen carrots, California blend vegetables and pre-cooked hamburger patties. These foods were in a plastic bag within the boxes with the plastic bags opened, not sealed or tied closed. There were pretzel bagels in an opened, not sealed or tied plastic bag sitting on a shelf. […]

• No harm, potential for more than minimal, isolatedF755Aug 13, 2026

  Based on staff interview, clinical record review, and facility document review, the facility staff failed to obtain provider ordered medications for (1) one of (25) twenty-five current sampled residents, Resident #54. Findings included:A facility policy entitled Subject: Unavailable Medications with a reviewed date of 1/2022 read in part, The facility must make every effort to ensure that medications are available to meet the needs of each resident. 1. Nursing staff shall: a. Contact the pharmacy to reorder the medication. b. Notify the attending physician of the situation and explain the circumstances, expected availability and optional therapy (ies) that are available. c. Notify the responsible party/POA. d. […]

• No harm, potential for more than minimal, isolatedF641Sep 8, 2023

  Based on staff interview and clinical record review, the facility staff failed to accurately code a significant change MDS assessment to capture the residents hospice status for 1 of 15 current residents, Resident #31. The findings included: The facility staff failed to code Resident #31's significant change minimum data set (MDS) assessment to indicate the resident was receiving hospice services. Resident #31's face sheet included the diagnoses cerebrovascular disease, vascular dementia, and encounter for palliative care-hospice. […]

• No harm, potential for more than minimal, isolatedF755Sep 8, 2023

  Based on resident interview, staff interview, clinical record review, and facility document review, the facility staff failed to ensure the nursing staff correctly implemented the facility's scheduled/controlled medication monitoring system to accurately account for the facility's scheduled/controlled medications for 1 of 15 current residents. Resident #19. The findings included: For Resident #19, the facility failed to ensure narcotics were accurately accounted for. Resident #19's face sheet included the diagnoses other acute postprocedural pain, hypertension, and presence of right artificial hip joint. […]