Kensington Health and Rehabilitation

In the surveyor’s words

From the most serious findings on record at Kensington Health and Rehabilitation, in the surveyor’s own words.

• No harm, potential for more than minimal, isolatedF758Feb 18, 2022

  Based on record review, interviews, and review of facility policies titled, Behavioral Assessment, Intervention, and Monitoring, Mood and Behavior, and Antipsychotic Medication Use, the facility failed to ensure Resident Identifier (RI) #75 received adequate monitoring related to the use of antipsychotic and antidepressant medications. Specifically, the facility failed: 1. to ensure RI #75 was monitored for behaviors for which an antipsychotic medication ([MEDICATION(S)]) was administered. This deficient practice affected RI #75, one of three sampled residents reviewed for unnecessary medications who received an antipsychotic medication; and 2. to ensure RI #75 was monitored for side effects of an antipsychotic ([MEDICATION(S)]) and an antidepressant ([MEDICATION(S)]) medication. […]

• No harm, potential for more than minimal, isolatedF759Feb 18, 2022

  Based on record review, observations, interviews, and review of a facility policy titled, Administration of Medications, the facility failed to ensure a medication error rate less than 5%. There were 3 errors in 33 opportunities, which resulted in a 9.09% medication error rate involving Resident Identifier (RI) #62 and RI #20 during medication pass. Specifically, the facility failed to ensure: 1. RI #62 received a Senna tablet and a multivitamin with mineral tablet as ordered by the physician; and 2. […]