Chambers Health and Rehabilitation

In the surveyor’s words

From the most serious findings on record at Chambers Health and Rehabilitation, in the surveyor’s own words.

• Immediate jeopardy, widespreadF880Mar 5, 2021

  Based on observation, record review and interview the facility failed to ensure residents with positive COVID-19 test results were placed on the COVID-19 unit, the same staff caring for positive COVID 19 residents were not caring for residents that were negative for COVID 19, and failed to designate a specific wing or hall in the building as a designated COVID 19 unit and an area for quarantined residents. These failed practices resulted in Immediate Jeopardy that caused or was likely to cause serious harm, injury or death to 15 residents who resided on 100 hall who were negative for Covid-19, 17 residents who resided on 200 hall who were negative for Covid-19, and 10 residents who resided on 300 hall who were negative for Covid-19. […]

• No harm, potential for more than minimal, widespreadF814Mar 5, 2021

  Based on observation and interview, the facility failed to ensure trash was properly contained within 3 of 3 dumpsters, to minimize the presence of foul odors and decrease the potential for pest infestation. The failed practice had the potential to affect all 49 residents who resided in the facility, as documented on the Resident Census and Conditions of Residents form dated 03/01/21. The findings are: 1. On 03/02/2021 at 11:49 AM, there were tin pop cans, plastic pop bottles, latex gloves, styrofoam containers, styrofoam cups, broken glass, cardboard, surgical masks, balloons, and cigarette butts on the ground by 3 dumpsters. 2. On 03/02/2021 at 01:11 PM, the Administrator was asked, Should there be trash on the ground around the dumpsters? She stated, No. […]

• No harm, potential for more than minimal, patternF812Aug 1, 2024

  Based on observation and interview, the facility failed to ensure expired food items were promptly removed from stock to maintain freshness and prevent potential cross contamination, failed to ensure dietary staff practiced good hand washing to prevent potential cross contamination, and manufacturer specification was followed to maintain food quality. These failed practices had the potential to affect 47 residents who received meals from the kitchen (Total Census: 47), as stated on a list provided by the Dietary Manager on [DATE] at AM. The findings are: 1. On [DATE] at 9:30 AM, a container of grated parmesan cheese on a shelf in the 2-door refrigerator had an expiration date [DATE]. 2. On [DATE] at 9:45 AM, the following observations were made on a shelf in the kitchen storge room: a. […]

• No harm, potential for more than minimal, patternF689Aug 10, 2023

  Based on observation, interview, and record review, the facility failed to maintain the hot water temperature in resident rooms at a safe temperature to prevent scalding of residents in 20 (Rooms 201-219) resident rooms on the 200 Hall in the facility. On 08/07/2023 at 9:35 AM the surveyor tested the water temperature in the bathroom in room [ROOM NUMBER]. The surveyor was unable to hold their hand in the water due to the temperature being too hot. On 08/07/2023 at 11:00 AM Maintenance #1 tested the water temperature in room [ROOM NUMBER] in the presence of the surveyor. Maintenance #1 stated the temperature was 145 degrees Fahrenheit and stated, I usually try and keep it between 110 and 115 degrees Fahrenheit. […]

• No harm, potential for more than minimal, patternF759Aug 10, 2023

  Based on observation, interview, and record review the facility medication error rate was 5.71%. The findings are: During the medication pass observation, the error rate was 5.71 %. A review of Resident #21 August physicians order noted an order for, Neurontin Capsule 400 MG three times a day related to pain in the right foot, with an order date of 9/11/20. The order further stated to be given in addition to 100mg to =500mg. A review of Resident #21 Medication Administration Record (MAR) for 8/1/23 through 8/31/23 noted the Neurontin was administered at 8:00 AM, 12:00 PM, and 4:00 PM. On 8/09/23 at 8:09 AM during an observation of medication pass, Licensed Practical Nurse (LPN) #1 administered Resident #21 Neurontin 100mg capsule. […]