Colonial Nursing & Rehabilitation Center

In the surveyor’s words

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

• Immediate jeopardy, patternF600Dec 27, 2024

  Based on observation, record review and interview the facility failed to ensure residents had the right to be free from abuse and neglect for 5 of 11 residents reviewed for abuse and neglect. (Resident #1 #2, #4, #5, and #8) 1. The facility failed to ensure Resident #2 was free from abuse after Resident #2 indicated MA B physically assaulted her on 11/9/24. The facility failed to address the abuse, report/investigate the allegations of abuse or suspend the alleged perpetrator. 2. The facility failed to provide assistance and supervision for Resident #1 between the hours of 12:20 am and 5:30 am on 6/2/24. Resident #1 rolled out of bed and was not checked on during this time. 3. The facility failed to ensure residents were free from abuse from Resident #7. a. […]

• Immediate jeopardy, patternF607Dec 27, 2024

  Based on observation, record review, and interview the facility failed implement their abuse policy to ensure residents had the right to be free from abuse and neglect, allegations were investigated, 7 of 11 residents reviewed for abuse and neglect. (Resident #1, #2, # 3, #4, #5, #7, and #8) 1. The facility failed to ensure Resident #2 was free from abuse after Resident #2 indicated MA B physically assaulted her on 11/9/24. The facility failed to address the abuse, report/investigate the allegations of abuse or suspend the alleged perpetrator. 2. The facility failed to provide assistance and supervision for Resident #1 between the hours of 12:20 am and 5:30 am on 6/2/24. Resident #1 rolled out of bed and was not checked on during this time. 3. […]

• Actual harm, isolatedF689Dec 27, 2024

  Based on interview and record review, the facility failed to ensure a resident received adequate supervision and assistive devices to prevent accidents for 1 of 11 residents reviewed for accidents. (Resident #6) The facility failed to ensure CNA D prevented Resident #6 from failing during a mechanical lift transfer by transferring the resident alone. This facility failure could place residents at risk of injuries including lacerations and bruising to the forehead. Findings included: Record review of Resident #6's face sheet dated 12/16/24 indicated he was a [AGE] year-old male admitted to the facility on [DATE]. Some of his diagnoses were paralysis on the left side due to a stroke, need for assistance with personal care, generalized muscle weakness, and lack of coordination. […]

• No harm, potential for more than minimal, widespreadF727Jan 8, 2025

  Based on interview and record review, the facility failed to use the service of an RN for 8 consecutive hours 7 days a week. The facility did not have RN coverage on the following dates: 12/2/24 - 12/9/24, 12/13/24-12/18/24, 12/20/24-12/22/24, 12/25/24, and 12/28/24 - 1/6/2025. This failure has the potential to affect the residents in the facility and place them at risk of not having staff with advance care skills available to assist in their care needs. Finding included: Record review of the RN Coverage for months of December 2024 and January 2025 indicated there were no RN hours on the following dates: * 12/2/24 - 12/9/24 * 12/13/24-12/18/24 * 12/20/24-12/22/24 * 12/25/24 * 12/28/24 - 1/6/2025 During an interview on 1/6/2025 at 8:45 am, Administrator F, said the facility does not have a… […]

• No harm, potential for more than minimal, widespreadF731Jan 8, 2025

  Based on interview and record review, the facility failed to designate a registered nurse (RN) to serve as the DON on a full-time basis since 11/3/2024 The facility did not have a DON from 11/3/2024 to currant date. This failure could place residents at risk of lack of nursing oversight and a higher level of care. Findings include: Record review of DON Coverage from Raw Punch Report dated 1/7/2025 indicated last day of DON coverage was 11/3/2024 with punch out time of 2:38pm with a total of 6.70 hours. During Entrance Conference interview on 1/6/2025 at 8:45 AM with the administrator F, she said they currently do not have a DON. […]