Gulf Valor Rehabilitation by Harborview

In the surveyor’s words

From the most serious findings on record at Gulf Valor Rehabilitation by Harborview, in the surveyor’s own words.

• No harm, potential for more than minimal, patternF695Dec 9, 2021

  Based on observations, staff interviews, resident interview, record review, and policy review the facility failed to administer oxygen only with a physician order in accordance with the facility policy for 3 of 5 residents sampled for respiratory care (residents #15, #63, and #69) and failed to administer the physician ordered amount of oxygen for 1 of 5 sampled residents reviewed for respiratory care. (resident #109) The findings include: Resident #109 Observations of resident number 109 were conducted on 12/7/21 at 8:56 AM, 1:26 PM, 4:02 PM, and on 12/8/21 at 8:13 AM and 10:06 AM. During the observations the resident was in his room and had oxygen at 2 liters per minute via nasal cannula and concentrator in place. […]

• No harm, potential for more than minimal, isolatedF554Dec 11, 2025

  Based on observation, staff interviews, record review, and policy review, the facility failed to ensure the interdisciplinary team assessed and determined residents were capable of self-administration of medications prior to allowing 1 of 1 sampled resident to self-administer medications. (Resident # 82)The findings include:On 12/08/2025 at 11:26 AM, an observation of Resident #82 was conducted. He was in bed and was non-verbal. He had several medications inside a large plastic cup on his overhead table within reach. […]

• No harm, potential for more than minimal, isolatedF880Dec 11, 2025

  Based on observations, staff interviews, and record review, the facility failed to implement appropriate infection control procedures during incontinence care for 1 of 1 resident on isolation Transmission Based Precautions. (Resident #81)The findings include: On 12/11/25 at 9:24 AM, Staff C, a Certified Nursing Assistant (CNA), was observed providing incontinence care, including peri-care and a brief change, to Resident #81. After completing care, the staff disposed of his gloves and gown in the trash bag located in the room, then proceeded to exit the room without hand washing or using hand sanitizer. Staff C used the hand sanitizer dispenser located outside the door. […]

• No harm, potential for more than minimal, isolatedF554Aug 22, 2024

  Based on observations, resident record review, interviews, and facility policy review, the facility failed to evaluate a resident for self-administration of medications for 1 of 1 resident sampled. (Resident #103) The findings include: On 8/19/24 at 12:49 PM, Resident #103 was observed with an inhaler at bedside. She stated she had an inhaler at bedside so she could use it when she needed it. Resident #103 stated it was just albuterol and she had it for a long time. The inhaler's label read Albuterol Sulfate. This inhaler was again observed on the bedside table on 8/20/24 at 5:07 PM. (Photographic evidence was obtained) A review of Resident #103's medical record was conducted. […]

• No harm, potential for more than minimal, isolatedF644Aug 22, 2024

  Based upon record review, observations, and interviews the facility failed to submit a level II screening for 1 out of 3 residents reviewed with a significant change in mental health and newly evident diagnosis of a serious mental disorder. (Resident #107) The findings include: On 8/20/24, a record review of Resident #107's level I PASARR was completed. The PASARR was dated 10/28/22 and had no indication of mental health or suspected mental health or intellectual disability indicated. However, review of the resident's medical record indicated added diagnoses of Disorganized Schizophrenia on 04/18/2023, major depressive disorder on 1/16/23, and Vascular Dementia severe, with other behavioral disturbances on 04/20/23. […]