Care Nursing & Rehabilitation

In the surveyor’s words

From the most serious findings on record at Care Nursing & Rehabilitation, in the surveyor’s own words.

• No harm, potential for more than minimal, patternF849May 28, 2026

  Based on observation, interview and record review, the facility failed to have a written agreement with the hospice that is signed by an authorized representative of the hospice and an authorized representative of the LTC facility before hospice care is furnished to any resident and an interdisciplinary team member collaborate with hospice representatives and coordinate the hospice care planning process for each resident receiving hospice services, to ensure quality of care for the resident, ensuring communication with the hospice medical director, the resident's attending physician and others participating in the provision of care for 2 (Resident #10, Resident #60) of 16 residents reviewed for hospice services.The facility failed to maintain a written hospice contract that was signed by… […]

• No harm, potential for more than minimal, patternF728Jan 8, 2026

  Based on interviews and record reviews, the facility failed to not use any individual working in the facility as a nurse aide for more than four months unless that individual had completed a training and competency evaluation program for 3 (SNA A, SNA B, and SNA C) of 6 student nurse aides reviewed for nursing services.The facility failed to ensure SNA A, SNA B, and SNA C were certified within four months of hire.This failure could place residents at risk for receiving inappropriate care from individuals whose skill level was not known. Findings included:Record review of SNA A's employee files revealed SNA A had a hire date of [DATE] and no evidence SNA A was certified as a nurse aide at that time. […]

• No harm, potential for more than minimal, patternF689Mar 15, 2025

  Based on observation, interview, and record review, the facility failed to ensure the resident environment remained as free of accident hazards as possible, in four out of ten resident rooms on 1 of 4 halls (The middle hall) reviewed for accident hazards, in that; The facility failed to ensure that the hot water temperatures in the sinks for 4 resident rooms did not exceed the maximum of 110 degrees Fahrenheit. This failure could place residents at risk for injuries related to hot water temperatures. The findings included: Record review of Resident #15's admission record dated 02/26/2025 indicated she was admitted to facility on 04/25/2024 with diagnoses of dementia and major depression. […]

• No harm, potential for more than minimal, patternF755Jan 18, 2024

  Based on observations, interviews and record review it was determined the facility failed to provide pharmaceutical services that ensure the accurate administering of drugs for 2 of 3 medication carts and 1 of 1 treatment cart observed for medications stored and properly labeled, in that:. Two of the medication carts had insulin pens that were opened but not dated when placed into use. The treatment cart had an opened undated TB vial. These failures could place residents at risk of receiving medications that were expired and not produce the desired effect. Findings included: During an observation and interview on [DATE] at 11:40 AM the treatment cart was inspected with the interim DON present. The interim DON was shown the opened and undated TB vial. […]

• No harm, potential for more than minimal, patternF761Jan 18, 2024

  Based on observation, interview and record review the facility failed to store all drugs and biologicals in locked compartments for 1 of 1 treatment cart and 2 of 3 nurse carts reviewed for medication storage and security. The treatment medication cart was left unlocked and unsupervised. The nurse medication carts were left unlocked and unsupervised. These failures could place clients at risk for drug diversion or accidental ingestion. Findings included: During an observation and interview on 01/16/24 beginning at 11:27 AM a medication cart was seen unlocked and unattended. There were a couple of residents that passed by the unlocked medication cart. LVN A entered into the building from an outside door and said it was her cart and she had just stepped out. […]