Harris Hill Center, Genesis HealthCare

In the surveyor’s words

From the most serious findings on record at Harris Hill Center, Genesis HealthCare, in the surveyor’s own words.

• Immediate jeopardy, isolatedF880Jun 4, 2024

  Based on interview and record review, it was determined that the facility failed to ensure that 1 of 4 residents reviewed for insulin was free from exposure to bloodborne and bacterial pathogen transmission when staff administered the resident insulin from another resident's used insulin pen (Resident Identifier #1). Findings include: Interview on 6/4/24 at 9:30 a.m. with Staff C (Registered Nurse) revealed that he/she was Resident #1's evening nurse on 5/28/24 and that he/she was not able to locate Resident #1's Humalog 75/25 insulin or any back-up/emergency stock in the medication room for the 6:00 p.m. ordered dose. Staff C confirmed that he/she went to another medication cart to use another resident's (Resident #2) Humalog 75/25 insulin pen. […]

• No harm, potential for more than minimal, patternF656Jan 23, 2023

  Based on interview, observation, and record review, it was determined that the facility failed to develop and implement a comprehensive care plan for 2 of 2 residents reviewed for position and mobility (Resident identifiers are #4 and #50), and for 2 of 5 residents reviewed for unnecessary mediations in a final sample of 33 residents (Resident identifiers are #23 and #50). Findings include: Resident #4 Observation on 1/18/23 at approximately 8:49 a.m. of Resident #4 revealed a left hand orthotic on side table. Further observation of Resident #4 revealed left had to be contracted. Review on 1/19/23 at approximately 3:42 p.m. […]

• No harm, potential for more than minimal, patternF725Jan 23, 2023

  Based on observation, interview, and record review, it was determined that the facility failed to provide sufficient staff to meet the needs of the residents on the third floor Dementia Unit on days and evenings for 16 out of 30 days of nursing schedule reviewed (Resident identifiers are #23, #33, #41, and #69). Findings include: Review on 1/18/23 at approximately 11:00 a.m. of the facility assessment Section II. Staffing, Training, Service & Personnel revealed the following: .A.1. Function- Sufficiency Analysis Summary 1. Staffing and scheduling systems - Daily discussions regarding staffing on each of the units. The Unit Managers provide updates on resident needs. The scheduler will make staffing adjustments based on census and acuity. […]

• No harm, potential for more than minimal, patternF761Jan 23, 2023

  Based on observation, interview, and record review, it was determined that the facility failed to ensure medication are stored in accordance with professional standards for vaccines, inhalers, and expired medications for 1 of 2 medication rooms and 2 out of 2 medication carts observed. Findings include: Standard: Review on 1/19/23 of the Centers for Disease Control and Prevention (CDC) website titled, Vaccine Storage and Handling Toolkit, dated January 2023, retrieved from:https://www.cdc.gov/vaccines/hcp/admin/storage/toolkit/storage-handling-toolkit.pdf, revealed .Handle With Care: Protect Your Vaccines Protect Your Patients .Keep your storage units and vaccines within the appropriate temperature ranges. Check and record storage unit min/max temperatures at start of each workday. […]

• No harm, potential for more than minimal, patternF761Jan 6, 2022

  Based on observation, interview, and review of manufacturer's instructions and policy, it was determined that the facility failed to label opened medications with an opening date/expiration date and separate expired medications from rotation on 2 out of 2 medication carts and 1 out of 1 medication room observed. Findings include: 3rd floor medication cart Observation on 1/4/22 at approximately 7:15 a.m. of the medication cart on the 3rd floor named Low Side Medication Cart revealed the following expired medications: [MEDICAL RECORD OR PHYSICIAN ORDER] (house stock) stool softener, expiration date 12/21 (1 bottle) Resident #52 [MEDICATION(S)] inhaler, expiration date 11/21 Resident #12 [MEDICATION(S)] Oxalade 20 mg (milligrams), expiration date 9/4/21 (1 medication card) Resident #12… […]