Colonial Haven

In the surveyor’s words

From the most serious findings on record at Colonial Haven, in the surveyor’s own words.

• No harm, potential for more than minimal, widespreadF880Feb 13, 2024

  Licensure Reference Number 175 NAC 12-006.17 Based on record review and interview; the facility failed to implement an opportunistic waterborne pathogens plan, to prevent the growth of Legionella and other opportunistic waterborne pathogens in the facility's water system. This had the potential to affect all facility residents. The facility census was 27. Findings are: Reviewed the facility Legionella Management Policy dated 1/18 with a revision date of 1/24 revealed the following; the facility defined and controlled the management of Legionella bacteria in the water systems within the facility, the facility Legionella management team included the facility Administrator, the facility Maintenance Director, and the facility Infection Preventionist and or Quality Assurance Coordinator, the… […]

• No harm, potential for more than minimal, widespreadF880Jan 25, 2023

  Licensure Reference Number 175 NAC 12-006.17 Based on observation, interview, and record review; the facility failed to implement infection control practices to prevent potential cross contamination including the spread of COVID-19 related to: 1) performing hand hygiene at appropriate intervals during the provision of incontinence cares for Resident 5; and 2) failure to develop/implement interventions for unvaccinated staff to assure mitigation of COVID-19. This had the potential to affect all residents in the facility. The total sample size was 24 and the census was 27. Findings are: A. Review of the facility policy Hand Hygiene Procedure dated 9/22 revealed it was the policy of the facility to educate and to provide work practices to aid in the prevention of the spread of infection. […]

• No harm, potential for more than minimal, widespreadF727Aug 11, 2022

  Licensure Reference Number 175 NAC 12-006.04C1 and 175 NAC 12-006.04C2 Based on interview and record review; the facility failed to ensure 8 hours of consecutive Registered Nurse (RN) coverage every 24 hours was provided and to designate/employ a full time Director of Nursing. This had the potential to affect all facility residents. The total sample size was 7 and the facility census was 27. Findings are: A. Review of the Director of Nursing (DON) Job Description dated 3/29/21 revealed the DON reported to the facility Administrator. […]

• No harm, potential for more than minimal, widespreadF880Aug 11, 2022

  Licensure Reference Number 175 NAC 12-006.17A Based on interview and record review; the facility failed to maintain an infection control program, educate staff regarding infection control and prevention measures, and complete resident, staff, and contractor/visitor screenings for COVID-19, to prevent the potential spread of infections. This had the potential to affect all facility residents. The facility census was 27. Findings are: A. Review of the facility Novel Coronavirus Prevention and Response Policy (undated) revealed the following; -the facility Infection Preventionist (person/s trained to provide direction and monitoring of infections and or potential infections to prevent infections and the spread of infections within the facility) would assess the facilities risk associated… […]

• No harm, potential for more than minimal, widespreadF882Aug 11, 2022

  Licensure Reference Number 175 NAC 12-006. 17 Based on interview and record review the facility failed to maintain an employ an Infection Preventionist. This had the potential to affect all facility residents. The facility census was 27. Findings are: A. Review of the facility Novel Coronavirus Prevention and Response Policy (undated) revealed the following; -the facility Infection Preventionist (person/s trained to provide direction and monitoring of infections and or potential infections to prevent infections and the spread of infections within the facility) would assess the facilities risk associated with COVID-19 -staff should be alert to resident signs of COVID-19 (fever, chills, cough, shortness of breath, difficulty breathing, fatigue, muscle/body aches, headache, new loss of… […]