Exceptional Care for Children

In the surveyor’s words

From the most serious findings on record at Exceptional Care for Children, in the surveyor’s own words.

• No harm, potential for more than minimal, patternF880May 19, 2026

  Based on observation, interview, and record review, it was determined that for four (R13, R21, R24, and R27) out of twenty-two sampled residents, the facility failed to ensure enhanced barrier precautions (EBP) were followed. Findings include:According to the CDC (Implementation of Personal Protective Equipment (PPE) Use in Nursing Homes to Prevent Spread of Multidrug-resistant Organisms (MDROs, Updated July 12, 2022),Nursing home residents with wounds or indwelling medical devices, such as catheters, tracheostomies (breathing tubes), or feeding tubes, are more likely to get and carry these germs.Enhanced Barrier Precautions (EBP) are designed to reduce the spread of these germs.EBP includes the use of a gown and gloves when providing high contact care to these residents. […]

• No harm, potential for more than minimal, isolatedF609May 19, 2026

  Based on interview and record review, it was determined that for one (R41) out of one resident reviewed for resident rights, the facility failed to have evidence of notification to law enforcement after a controlled medication was not returned to the facility. Findings include:Review of R41's clinical record revealed:7/30/2024 - R41 was admitted to the facility with diagnoses including spastic quadriplegic cerebral palsy.1/23/26 - An order entered in R41's clinical record documented, diazepam - Schedule IV [controlled substance] tablet.Special instructions: Give every 6 hours as needed for increased spasticity, prior to transport.4/3/26 1:53 PM - A Nursing Progress Note documented, [FM1] arrived to pick up [R41] around 1230 [12:30 PM] for LOA [leave of absence].[R41] left the facility.with… […]

• No harm, potential for more than minimal, isolatedF712Jun 17, 2024

  Based on record review and interview, it was determined that for three (R1, R2 and R3) out of three residents reviewed for hospitalization , the facility failed to ensure that the physician conducted the required visits. Findings include: 1. Review of R1's clinical record revealed: 12/28/24 - R1 was admitted to the facility to the facility. 12/28/24 - R1 was examined by a physician and a Health Appraisal Visit documented the encounter in the electronic medical record (EMR). 4/10/24 - R1 was examined by a physician and a Health Appraisal Visit documented the encounter in the EMR. R1 went 104 days between physician visits. During the first 90 days of an admission to a skilled nursing facility, by regulation a patient must be examined every 30 days. 2. […]

• No harm, potential for more than minimal, isolatedF600May 28, 2024

  Based on interview and review of the clinical record and other documentation as indicated, it was determined that for one (R3) out of one resident reviewed for abuse, the facility failed to ensure that R3, a non-verbal, medically challenged dependent teenager, was free from physical and verbal abuse from a staff person on 9/9/23, which caused R3 to cry. Based on observations of staff interactions with R3 during the current survey, staff interviews, record review since the 9/9/23 incident and consideration of the reasonable person concept revealed that R3 did not have a psychosocial outcome. Review and verification of the facility's immediate actions and no further incidents, the facility was in substantial compliance as of 9/26/23. The 9/9/23 incident was past non-compliance. […]

• No harm, potential for minimal, patternF641May 28, 2024

  Based on record review and interview, it was determined that for four (R3, R21, R28, R33) out of eight residents reviewed for resident assessments, the facility failed to accurately report the resident's status. Findings include: According to the CMS (Centers for Medicare and Medicaid Services) RAI (Resident Assessment Instrument) Version 3.0 Manual, October 2023, page A-20, under A1005 Ethnicity and A1010 Race, the Steps for Assessment: Interview Instructions . 2. If the resident is unable to respond, the assessor may ask a family member, significant other, and/or guardian/legally authorized representative . 4. Respondents should be offered the option of selecting one or more ethnic [and racial] designations . 5. […]