Givens Health Center

In the surveyor’s words

From the most serious findings on record at Givens Health Center, in the surveyor’s own words.

• Immediate jeopardy, isolatedF689Apr 9, 2021

  Based on observations, record review and Physician and staff interviews, the facility failed to prevent a cognitively impaired resident with known wandering and exiting seeking behaviors from exiting the facility unsupervised and remaining outside in weather temperature of 14 degrees Fahrenheit, without staff knowledge, increasing the likelihood for hypothermia (low body temperature) to develop for 1 of 3 residents reviewed for accidents (Resident #4). The findings included: Resident #4 admitted to the facility on [DATE] with diagnoses that included Alzheimer's disease with behavioral disturbance. The Minimum Data Set (MDS) dated [DATE] assessed Resident #4 with severe impairment in cognition for daily decision making. […]

• No harm, potential for more than minimal, widespreadF886Aug 26, 2022

  Based on record review and staff interviews, the facility failed to follow the Centers for Disease Control and Prevention (CDC) guidelines by not testing residents and staff immediately in response to a staff member testing positive for COVID-19. The facility also failed to document COVID-19 test results in the residents' medical record for 3 of 3 residents reviewed (Resident #4, Resident #11, and Resident #25). These failures occurred during a COVID-19 pandemic. Findings included: 1. […]

• No harm, potential for more than minimal, patternF812Feb 6, 2025

  Based on observations and staff interviews, the facility failed to ensure 5 of 36 dishes ready for use on the tray line were free from dried scattered crumb like particles, provide expiration dates for 4 of 4 frozen boxes of pureed foods, label and date one stainless steel container of gravy and four cookie sheets of bacon that was located in 1 of 5 reach in coolers, and ensure 1 of 4 dietary staff restrained hair during food preparation. These practices had the potential to affect food served to residents. Findings included: 1. During the initial tour of the kitchen on 02/03/2025 at 11:12 AM the following areas of concern were observed. […]

• No harm, potential for more than minimal, isolatedF641Mar 18, 2026

  Based on record review and staff interviews, the facility failed to accurately code the fall history on the Minimum Data Set (MDS) assessment for 1 of 3 residents reviewed for accidents (Resident #4).Findings included:Resident #4 was admitted to the facility on [DATE] with diagnoses including Alzheimer's disease, heart failure, and dementia. Review of the nurse's progress note dated 08/22/2025, a fall event record dated 09/06/2025, and the nurse's progress note dated 09/26/2025 revealed Resident #4 had three unwitnessed falls in her room where she was found sitting on floor. The notes and fall record revealed after each fall the nurse assessed Resident #4 and Resident #4 had no injury. […]

• No harm, potential for more than minimal, isolatedF658Feb 6, 2025

  Based on record review, observation, staff and physician interviews, the facility failed to ensure residents had pain patches removed at bedtime as ordered for 2 of 29 residents reviewed for medication errors (Residents #45 and #31). Findings included: 1. Resident #45 was admitted on [DATE] with multiple diagnoses including wedge compression fracture of the thoracic vertebrae numbers 11-12 (lower end of the middle section of the spine) and low back pain. The quarterly Minimum Data Set (MDS) dated [DATE] revealed Resident #45 was severely cognitively impaired and was documented as requiring pain management. […]