Granger Nursing & Rehabilitation Center

In the surveyor’s words

From the most serious findings on record at Granger Nursing & Rehabilitation Center, in the surveyor’s own words.

• Immediate jeopardy, patternF880Feb 3, 2023

  Based on observation, interview, record review, and policy review, the facility failed to: 1. Sanitize glucometers between uses for three (Resident (R) 43, R44, and R7) of five residents observed receiving fingerstick blood sugar (FSBS) tests and 2. perform hand hygiene for two (R45 and R39) of seven residents observed received medications, 3. during incontinent care for R38, and 4. during the tracheostomy care for R9. The failure to sanitize glucometers between residents resulted in an Immediate Jeopardy (IJ) at F880-K: Infection Control due to the increased likelihood to cause serious harm due to the potential of cross-contamination of blood-borne pathogens. On 2/2/23 at 3:53 PM, the Administrator and Director of Nursing (DON) were notified of the IJ at F880 Infection Control. […]

• Immediate jeopardy, isolatedF742Oct 19, 2021

  Based on record and policy review, observations, resident and staff interviews, the facility failed to follow up effectively when a resident threatened suicide and failed to provide the recommended psychiatric services for a resident with mental health diagnosis [MEDICAL RECORD OR PHYSICIAN ORDER] . The staff also failed to minimize the risks of a resident who had past suicide attempts, failed to follow through with notifications to the physician and family, and failed to provide increased monitoring or securing the environment from potential hazards such as utensils (knife, fork), call light and bed control cords, TV wires, and oxygen tubing that could be used potentially to self-harm. […]

• Actual harm, isolatedF692Sep 29, 2022

  Based on clinical record review, observations, family and staff interviews, and policy review, the facility failed to prevent resident weight loss and overall health decline for one of three residents reviewed for oral cares and maintenance of nutritional status (Resident #4). The facility reported a census of 53 residents. Findings include: The Minimum Data Set (MDS) admission assessment dated [DATE] documented Resident #4 had diagnoses [MEDICAL RECORD OR PHYSICIAN ORDER] . The MDS revealed the resident had a brief interview for mental status score of 0 indicating severely impaired cognition. The MDS documented the resident had no natural teeth or tooth fragment (edentulous), weighed 182 pounds (lbs), and on a mechanically altered diet. […]

• Actual harm, isolatedF689Oct 19, 2021

  Based on record and policy review and staff interview, the facility failed to ensure a resident received adequate nursing supervision for a resident with a history of falls for 1 of 3 residents reviewed. Resident #19 fell in his room with fracture on 4-18-21. The intervention following the fall was resident to be in the lobby area after getting up. The current care plan, and care plan in place on 4-18-21, directed staff to assist resident to lay down in-between meals or place in recliner. The resident fell again with fracture 7-29-21 after staff left him unsupervised in his room in a wheelchair. The facility reported a census of 43 residents. 1. […]

• No harm, potential for more than minimal, widespreadF801Jan 9, 2025

  Based on facility records and staff interviews, the facility failed to have a clinically qualified nutrition professional who met the required qualifications of a Certified Dietary Manager or a full time Registered Dietician. Findings Include: On 1/8/2025 at 1:46 PM, the Dietary Manager stated she did not have certification as a dietary manager. She stated she had completed courses to obtain certification, but the classes would not officially finish until 1/15/2025. An email provided by the Registered Dietician on 1/8/2025 at 2:53 PM stated she was only physically in the building one day a week. In an interview on 1/8/2025 at 2:42 PM with The Administrator, he stated the Registered Dietician is in the building one day a week. […]