Diamond Ridge Healthcare Center

In the surveyor’s words

From the most serious findings on record at Diamond Ridge Healthcare Center, in the surveyor’s own words.

• Immediate jeopardy, patternF584Aug 23, 2023

  Based on observation, interview and record review, the facility failed to maintain the facility cooling system to provide eight of 12 sampled residents (Residents 1, 2, 3, 4, 5, 6, 7, 8) an environment with a safe and comfortable temperature. The failure to prevent excessive heat (temperatures in excess of 81 F, degrees Fahrenheit) in the facility resulted in physical discomfort for Residents 3, 4, 6, 7; Resident 5 was nauseous for three days; Resident 2 had difficulty sleeping; and Resident 1 was unable to receive restorative nursing care for two days. […]

• No harm, potential for more than minimal, widespreadF812Aug 15, 2024

  Based on observation, interview, and record review the facility failed to store and prepare foods in a sanitary manner that prevented foodborne illness for the facility when: 1. Eleven unlabeled and undated sandwiches were stored in the refrigerator, 2. Multiple food items were stored in the dry storage room beyond use by date, and 3. Two outdated sandwiches and eight grapes with mold was stored on Resident 54's bedside table. These failures had the potential for residents to be exposed to food borne illness. Findings: 1. During a concurrent observation and interview on [DATE] at 7:30 a.m. […]

• No harm, potential for more than minimal, patternF655Aug 15, 2024

  Based on interview and record review, the facility failed to timely develop and provide a baseline care plan for three of 32 sampled residents (Resident 108, 109, and 363) when the baseline care plans were not developed within 48 hours of Resident 108, 109 and 363's admission and the baseline care plan written summaries were not provided to the Resident 108, 109, 363 and the representatives. This failure had the potential to reduce the continuity of care and communication between Resident 108, 109, 363, the representatives, and the facility staff. […]

• No harm, potential for more than minimal, patternF677Aug 15, 2024

  Based on observation, interview, and record review, the facility failed to ensure four of four sampled residents (Residents 28, 21, 63 and 84) received necessary care to maintain good grooming and personal hygiene when: 1. Resident 28 had long facial hair and long fingernails with black matter underneath, 2. Resident 21 had long fingernails with black matter underneath, 3. Resident 63 had long, thick facial hair, and 4. Resident 84 had long facial hair. This failure resulted in Residents 28, 21, 63 and 84 at risk for skin irritation and infection. Findings: 1. […]

• No harm, potential for more than minimal, patternF880Aug 15, 2024

  Based on observation, interview, and record review, the facility failed to maintain and observe infection control practices when: 1. Certified Nursing Assistant (CNA) 4 did not wear face shield inside COVID-19 isolation room, 2. CNA 5 did not perform hand hygiene before entering Resident 166's room, 3. a glucometer (a device used to check blood sugar level) was stored inside the medication cart had traces of dark red stains around it, 4. a tray full of multiple single-use lancet supplies (a small sharp device that pricks the skin to draw a blood sample for testing blood sugar levels), a bottle of blood sugar test strips, alcohol pads and a glucometer device was placed on top of Resident 35's bed was not disinfected by Licensed Vocational Nurse (LVN) 4 after use, 5. […]