Care and Rehab - Boscobel

In the surveyor’s words

From the most serious findings on record at Care and Rehab - Boscobel, in the surveyor’s own words.

• Immediate jeopardy, isolatedF692Jan 30, 2025

  Based on interview and record review, the facility failed to ensure residents received adequate fluid and food intake to maintain acceptable parameters of hydration and nutrition for 1 of 3 Residents reviewed for nutrition (R1). R1's fluid intake was not documented or evaluated to ensure he was meeting his required daily fluid needs. R1's care plan was not updated with individualized approaches to increase fluid intake to prevent dehydration after it was revealed on 12/27/24 that he had elevated labs indicative of reduced kidney function. R1 was hospitalized with elevated lab value, dehydration, an acute kidney injury, hypernatremia, metabolic encephalopathy, and severe sepsis. […]

• No harm, potential for more than minimal, widespreadF880Jul 16, 2026

  Based on interview and record review, the facility did not establish and maintain an infection prevention and control program designed to provide a safe, sanitary, and comfortable environment and to help prevent the development and transmission of communicable diseases and infections for 3 of 12 residents (R5, R10, and R48) reviewed for infection control with the potential to affect the census of 39.R5 did not receive the RSV (Respiratory Syncytial Virus) vaccine he requested.R10 was removed from COVID isolation before the required time.R48 was removed from COVID isolation before the required time.This is evidenced by:The facility's policy Infection Prevention and Control Program, dated 4/28/25, includes: 5. […]

• No harm, potential for more than minimal, widespreadF812Jan 26, 2022

  Based on observation and interview, the facility did not prepare, distribute, and serve food in accordance with professional standards for food service safety. This has the potential to affect all 34 residents. Surveyors observed moldy strawberries in the refrigerator. Findings include On 1/24/22 at 9:19 AM, Surveyor observed 4 individual 1 quart containers of strawberries. The four containers had a date of 1/6/22 stickered on them. Each container had strawberries with visible mold (white and green mossy appearing substance). At 9:21 AM, Surveyor interviewed DA D (Dietary Aide) while showing the strawberries to her. DA D stated the strawberries had mold on them and the date on containers is the received date. […]

• No harm, potential for more than minimal, widespreadF880Jan 26, 2022

  Based on observation, interview and record review, the facility did not ensure it maintained an infection prevention and control program designed to provide a safe, sanitary, and comfortable environment to help prevent the development and transmission of communicable disease and infections such as COVID-19. This had the potential to affect all 34 residents (R) in the facility. The facility allowed staff who had tested positive for COVID-19 to return to work after a 5 day quarantine without evidence of being in a contingency staffing situation and the facility has not been tracking/trending the areas in which an ill employee last worked prior to illness to increase monitoring of those residents potentially exposed. […]

• No harm, potential for more than minimal, patternF578Jul 3, 2024

  Based on interview and record review the facility failed to ensure that all residents were able to formulate an advance directive, specifically related to code status, for 9 of 12 residents (R7, R185, R8, R22, R13, R28, R11, R17, & R10) reviewed for code status of total sample of 34 residents. R7's Provider Orders for Scope of Treatment (POST) form is dated and signed by the physician but not the resident or resident representative. R185's POST form is dated and signed by the physician but not the resident or resident representative. R185 does not have Advance Directives in place and no documentation to show the facility spoke with R185 regarding Advance Directives. R8's POST form is dated and signed by the physician but not the resident or resident representative. […]