Heritage Place

In the surveyor’s words

From the most serious findings on record at Heritage Place, in the surveyor’s own words.

• No harm, potential for more than minimal, widespreadF727Jun 13, 2025

  Based on interview and record review, the facility failed to ensure the designated Director of Nursing (DON) worked 40 hours a week. This failed practice had the potential to place all residents (based on a census of 44) at risk of not receiving quality nursing services due to a lack of oversight. Findings: During the entrance conference interview on 6/9/25 at 10:45 AM, the DON stated she was designated as the DON and Administrator of the facility. She further stated she worked 35 hours per week as the DON and 5 hours per week as the Administrator. During a follow-up interview on 6/11/25 at 2:03 PM, the DON stated she did not complete a timecard because she was not required to clock-in. […]

• No harm, potential for more than minimal, widespreadF761Jun 13, 2025

  Based on observation and interview, the facility failed to ensure medical supplies were labeled appropriately and removed from storage if expired. These failed practices placed all residents (based on a census of 44) at risk for adverse effects or complications from use of the expired products. Findings: Central Medical Supply Room: An observation on [DATE] at 10:05 AM, of the central medical supply room, revealed the following expired medical supplies: 1 - Bard 16 french (diameter size) urethral catheters with a coude tip (meaning, the tip is slightly bent, helping the catheter bypass obstructions within the urethra that would hinder a straight catheter's path), expired on [DATE]; and 2 - Bard 24 french urethral catheter, expired on [DATE]. […]

• No harm, potential for more than minimal, widespreadF812Jun 13, 2025

  Based on observation, interview, and record review, the facility failed to ensure food was stored under proper sanitary conditions in the main kitchen and in the Sitka [NAME] unit. This failed practice placed all residents (based on a census of 44), who received food from both kitchens at risk for foodborne illness and communicable disease. Findings: Main Kitchen An observation, during the initial kitchen tour, on 6/9/25 at 8:09 AM, revealed: 1) Dry Storage/Pantry: - 1 opened 25 ounce bottle of Traditional Style Rotisserie Seasoning, 3/4 full, received on 11/12/20, no open date; - 1 opened 16 ounce bottle of Whole Celery Seeds, 5/6 full, received on 10/12/20, no open date; - 1 opened 4 ounce bottle of Whole Tarragon Leaves, 3/4 full, received on 10/3/20, no open date, and; - 1 opened 18… […]

• No harm, potential for more than minimal, widespreadF812May 17, 2024

  Based on observation, interview, and record review, the facility failed to ensure that food was stored, prepared, and served in accordance with professional standards for food safety. Specifically, the facility failed to ensure: 1) food was stored under proper sanitation and food handling practices in the main kitchen; 2) food was stored under proper sanitation and food handling practices on the Sitka [NAME] unit; and 3) the dishwasher water temperature was at appropriate temperature range, prior to washing dishes, for proper sanitation of all dishware and food service equipment. These failed practices had the potential of causing or spreading foodborne illness to all residents, based on a census of 43. […]

• No harm, potential for more than minimal, widespreadF803Dec 6, 2021

  Based on record review, observations, and interview the facility failed to ensure: 1) menus had been reviewed and approved for nutritional adequacy, 2) substitutions were approved, and 3) reasonable efforts were made to ensure resident's menus were followed based on individual requests for 2 residents (#s 35 and 44). This failed practice placed all residents receiving food from the facility, (based on 47 residents), at risk for weight loss, poor nutrition, and an unsatisfactory dining experience. Findings: Menus Review of the menu for 12/02/21 at lunch revealed the residents were to receive, Rice Pilaf, Savory Carrots, Spice Cake, Beef Burgundy, Winter Mix Vegetables, and Mashed Potatoes. […]