Frankfort Terrace

In the surveyor’s words

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

• Immediate jeopardy, widespreadF689Jun 20, 2023

  Based on observation, interview and record review the facility failed to secure hazardous chemicals in a locked storage area in accordance with the facility policy. There were 96 ambulatory residents, all with psychiatric illness with access to the hallway where the chemicals were stored. This failure presented a serious health risk to all 96 residents residing in the facility. This failure resulted in Immediate Jeopardy. The Immediate Jeopardy began on June 14, 2023, when hazardous chemicals were observed in an unsecured hallway during the environmental tour. On June 14, 2023, at 12:48 PM with V16 (housekeeping supervisor) hazardous chemicals were observed in an unsecured hallway that leads to the kitchen and laundry room. […]

• No harm, potential for more than minimal, widespreadF812Jun 10, 2026

  Based on observation, interview and record review, the facility failed to maintain the kitchen in sanitary conditions, failed to follow labeling and storage procedures in dry storage, cooler and freezers and failed to follow sanitation guidance for dishes. This applies to all 113 residents that receive food prepared in the facility kitchen.The findings include: Facility Long Term Care facility application for Medicare and Medicaid dated June 8, 2026, showed that the facility census was 113 residents. […]

• No harm, potential for more than minimal, widespreadF880Jun 10, 2026

  Based on observation, interview, and record review, the facility failed to identify areas in the facility that are at risk for Legionella and other waterborne pathogens according to the facility's water management program. This applies to all 113 residents residing in the facility. The findings include:The CMS-671 form titled, Long-Term Care Facility Application for Medicare and Medicaid dated June 8, 2026, showed the facility's census was 113. On June 8, 2026, at various times, multiple observations were made of residents' rooms having showerheads and sinks with faucets. On June 10, 2026, at 10:08 AM, V14 (Maintenance Director) stated the facility had two water tanks on each unit, and they had five total units. […]

• No harm, potential for more than minimal, widespreadF812Jun 7, 2024

  Based on observation, interview, and record review, the facility failed to properly label, date, seal, and store food items in the kitchen and use proper sanitation while checking food temperatures. This applies to all residents that receive oral nutrition and foods prepared in the facility kitchen. Findings include: The facility's Long-Term Care Facility Application for Medicare and Medicaid (Form CMS-Centers for Medicare and Medicaid Services-671) dated [DATE] documents that the total census was 101 residents. On [DATE] at 10:49 AM, V9 (Dietary Manager) said there are no NPO (Nothing by Mouth) residents. All 101 residents eat from the facility kitchen. […]

• No harm, potential for more than minimal, widespreadF880Jun 7, 2024

  Based on interview and record review the facility failed to implement and document measure that prevent the waterborne pathogen Legionella and provide an up-to-date infection control policy. \This applies to all 101 residents that resided in the facility. Findings include: On 6/6/24 at 12:48 PM, V4 Maintenance Director stated corporate is responsible for testing for legionella and would have the reports. V4 stated he never heard of legionella. V4 stated each wing has hot water heater. V4 stated the last time he checked water temperatures was in March 2024. V4 stated he wasn't documenting because there were problems with the water heaters giving accurate temperatures. […]