Heritage House Nursing and Rehabilitation

In the surveyor’s words

From the most serious findings on record at Heritage House Nursing and Rehabilitation, in the surveyor’s own words.

• Immediate jeopardy, isolatedF689Jan 31, 2024

  Based on record reviews and interviews, the facility failed to ensure a resident's environment remained free of accident hazards and a received adequate supervision and assistance devices to prevent accidents for (Resident #1) one resident reviewed for transfers. The facility failed to ensure Resident #1 was transferred properly as stated in the resident's care plan and MDS. An IJ was identified on 01/30/2024. The IJ Template was provided to the facility on [DATE] at 06:16 p.m. While the facility was removed on 01/31/2024, the facility remained out of compliance at a scope of isolated and a severity with no actual harm due to the facility's need to evaluate the effectiveness of the corrective systems. This failure may put resident at risk for falls and injuries. […]

• No harm, potential for more than minimal, patternF585Jan 22, 2026

  Based on observation, interviews, and record review, the facility failed to ensure prompt resolution of grievances regarding the resident's right to file a grievance for 3 of 3 confidential residents interviewed for grievances.1. The facility failed to notify residents in writing of the findings and actions of the grievances they filed. 2. The facility failed to have prominent postings of who the grievance official was.3. The facility failed to inform residents and their family groups of how to file an anonymous grievance. […]

• No harm, potential for more than minimal, patternF812Jan 22, 2026

  Based on observations, interviews, and record review, the facility failed to store food in accordance with professional standards for food service safety in the facility's 1 of 1 kitchen reviewed. 1. The facility failed to properly label and/or date food items.2. The facility failed to dispose of expired food items. 3. The facility failed to correctly seal food items. 4. The facility failed to discard spoiled food items.These practices could cause foodborne illness or choking, particularly in a vulnerable population.Findings included:In an observation on 1/20/2026 at 9:00 AM of cooler 1 of 2 revealed the following:- Bacon in a zip top bag that was not labeled with an expiration date. - Celery that was brown, in a zip top bag dated 1-06 with no expiration date. […]

• No harm, potential for more than minimal, patternF644Oct 19, 2024

  Based on interview and record review, the facility failed to refer all level I residents and all residents with newly evident or possible serious mental disorder, intellectual disability, or a related condition for level II resident review upon a significant change in status assessment for 3 of 3 residents (Resident #3, #24 and #29) assessments reviewed for PASARR evaluations. The facility failed to demonstrate a PASRR I was completed on Resident #03 and failed to refer her to the appropriate, State-designated authority when she was diagnosed with bipolar disorder. […]

• No harm, potential for more than minimal, patternF657Oct 19, 2024

  Based on interviews, and record review, the facility failed to ensure each resident's person-centered comprehensive care plan was reviewed and revised by the interdisciplinary team after each assessment for 2 (Resident #4, Resident # 28) of 8 residents reviewed for care plans. The facility failed to ensure Resident #4)comprehensive care plan was updated when he quit smoking. The facility failed to ensure Resident # 28's comprehensive care plan reflected current physician orders for weights . These failures could place residents at risk of receiving inadequate or unnecessary interventions not individualized to their health care needs. […]