Community Subacute and Transitional Care Center

In the surveyor’s words

From the most serious findings on record at Community Subacute and Transitional Care Center, in the surveyor’s own words.

• Immediate jeopardy, patternF692Dec 16, 2022

  Based on observations, interviews and record review, the facility failed to ensure residents received proper hydration and health care for eight of 12 residents (Resident 18, Resident 82, Resident 33, Resident 78, Resident 26, Resident 44, Resident 60, and Resident 19) with tracheostomies (tracheostomy or trach, a surgical opening in front of the neck into the windpipe. A tube is placed into the hole to keep it open for breathing) and gastrotomy tubes (GT, a tube inserted through the abdomen to provide that bring nutrition directly to the stomach) when: 1. […]

• No harm, potential for more than minimal, widespreadF732Dec 19, 2025

  Based on observation, interview and record review, the facility failed to ensure daily nurse staffing information contained all required information and was posted in a prominent readily accessible place to residents and visitors when:1. Daily nurse staffing information was posted behind nursing station 1 and nursing station 2, which was inaccessible to residents and visitors.2. Daily nurse staffing information did not include the actual hours worked by Registered Nurse (RN)s, Licensed Vocational Nurse (LVN)s, and Certified Nursing Assistant (CNA)s.This failure resulted in restricted public access to posted nurse staffing information for 99 out of 99 residents admitted within the facility which had the potential to result in residents not knowing how many total or actual direct care hours… […]

• No harm, potential for more than minimal, widespreadF812Aug 30, 2024

  Based on observation, interview, and record review, the facility failed to store, prepare, and serve food in accordance with professional standards for food service safety when: 1. The cook failed to follow the diet order for three of three residents (Residents 56, 69, and 88). 2. The facility failed to have an air gap (an unobstructed vertical space between the water outlet and the flood level of a fixture), under the food preparation sink. These failures had the potential to result in residents being exposed to contaminated food which could lead to food born illness for all residents who receive food prepared in the kitchen and had the potential for Resident 56, Resident 69 and Resident 88 to have weight gain or loss by diet orders not being followed. Findings: 1. […]

• No harm, potential for more than minimal, widespreadF761Dec 16, 2022

  Based on observation, interview, & record review, the facility failed to ensure medications used were labeled and stored in accordance with professional standards and facility policy and procedure when: 1. Two boxes of over-the-counter bisacodyl (medication used for constipation) was expired in North 1 medication room and was not segregated from medications currently used by nursing staff. 2. Resident 82's punctured vial of Lantus (insulin medication for diabetes) was opened and did not have a sticker with a resident identifier or an open date on the medication. 3. Resident 45's Fluticasone propion-salmeterol (fluticasone-propionate salmeterol, a combination of drugs used to treat difficulty breathing) was labeled with the wrong expiration date. 4. […]

• No harm, potential for more than minimal, patternF880Dec 19, 2025

  Based on observation, interview and record review, the facility failed to establish and maintain a safe, sanitary, and comfortable environment to help prevent the development and transmission of communicable (contagious) diseases and infections for four of ten sampled residents (residents 107,7, 39, and 42) when:1. A dignity bag was not correctly put on Resident 107's urine catheter bag and the urine catheter bag was touching the floor. This failure placed Resident 107 at risk to develop a Catheter-Associated Urinary Tract Infection (CAUTI -a serious infection occurring when germs enter the urinary system through a urinary catheter).2. […]