Fellowship Village

In the surveyor’s words

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

• Actual harm, isolatedF689Dec 16, 2021

  Based on clinical record review, observation, resident interview, staff interviews and facility record review the facility failed to provide adequate nursing supervision to prevent injuries for 1 of 4 residents reviewed (Residents #1). The concern was corrected by the facility on December 2, 2021 prior to surveyor entrance by completing staff education on hoyer lift use and audits. No concerns with hoyer transfers were made during the investigation. The F689 at a (G) level will be considered past non-compliance. The facility reported a total census of 33 residents. Findings include: The Minimum Data Set (MDS) assessment dated [DATE] for Resident #1 documented diagnoses of [CONDITION(S)], [CONDITION(S)], [CONDITION(S)], and [CONDITION(S)] and [CONDITION(S)] following a cerebral infarction. […]

• No harm, potential for more than minimal, widespreadF851Sep 5, 2024

  Based on the Center for Medicare and Medicaid Services (CMS) Payroll Based Journal (PBJ) Staffing Data Report for Quarter 2, 2024 (January 1 - March 31) review, facility staffing reports review, and staff interviews, the facility failed to submit accurate staff reports for the PBJ Staffing Data Report. The facility reported a census of 31 residents. Findings include: The PBJ Staffing Data Report run date 8/29/24 triggered for Failure to have Licensed Nursing Coverage 24 Hours/Day-Four or More Days Within the Quarter with less than 24 Hours/Day Licensed Nursing Coverage. […]

• No harm, potential for more than minimal, patternF803Sep 5, 2024

  Based on observation, document review and staff interview the facility failed to follow the menu and prepare food to meet the nutritional needs for 11 of 31 residents reviewed. The facility reported a census of 31 residents. Findings include: Continuous observation of lunch meal service on 9/4/24 from 11:20 AM - 11:45 AM revealed no bread or garlic bread served to the residents that had requested on the menu sheets. Review of menu sheets revealed 11 residents requested garlic bread. Review of document titled, Week 4 Menu documented bread to be served at lunch meal. On 9/4/24 at 11:54 AM Staff B Certified Dietary Manager (CDM) stated garlic bread was offered at the lunch hour on the menu on accident and was not served. […]

• No harm, potential for more than minimal, patternF812Jul 20, 2022

  Based on observation, facility policy, and staff interview, the facility failed to ensure the kitchen was clean, sanitary, and opened food was dated. The facility reported a census of 31 residents. Findings include: Observation on 7/17/22 at 9:43 AM revealed the following: a. Bowls on a shelf to the left of the serving window stored right side up. b. Plate covers to the right of the serving window stored right side up. c. [NAME] 2 door refrigerator with a tray of poured drinks stored uncovered. d. Lower shelf of a table under the window with metal bowls nested and stored right side up. e. Bulk flour and sugar bins without a date label. f. […]

• No harm, potential for more than minimal, patternF880Jul 20, 2022

  Based on observations, staff interviews, facility policy, and CDC recommendations the facility staff failed to properly wear face coverings for healthcare workers. The facility reported a census of 31 residents. Findings include: 1. Observation on 7/17/22 at 9:05 AM., Staff C, Certified Nursing Assistant enter Resident #13's room without a mask on. 2. Observation on 7/17/22 at 10:41 AM Staff B, Dietary walked in the kitchen and was moving dishes around. Staff B had a mask underneath their chin exposing mouth and nose area. 3. Observation on 7/17/22 at 12:58 PM of Staff B, dietary in the kitchen placing clean cups onto a serving tray and was noted to have a mask underneath their chin exposing the mouth and nose area. […]