Phoenix of Fairlawn

In the surveyor’s words

From the most serious findings on record at Phoenix of Fairlawn, in the surveyor’s own words.

• Immediate jeopardy, widespreadF880Jan 12, 2022

  Based on the unprecedented global pandemic that resulted in the Presidential declaration of a State of National Emergency dated 03/13/20, review of Centers for Medicare and Medicaid Services (CMS) memoranda, review of Centers for Disease Control and Prevention (CDC) guidelines, review of the facility's COVID-19 line list, review of facility policies, observations, staff and resident interviews and record review the facility failed to ensure staff members self-screened for COVID-19 prior to working in the facility and failed to ensure staff donned appropriate personal protective equipment (PPE) including gowns, gloves, N95 respirator masks and face shields or goggles when providing care to residents who were confirmed COVID-19 positive. […]

• Immediate jeopardy, isolatedF757Jan 28, 2022

  Based on medical record review, review of hospital records, interview with staff and Physician #211, observation, review of the facility [MEDICATION(S)]/[MEDICATION(S)] monitoring policy, and review of the Medscape Guidelines 2020, the facility failed to ensure adequate monitoring was completed for one resident (Resident #70) who received the oral anticoagulant (blood thinning) medication, [MEDICATION(S)]. The failure to monitor the anticoagulant therapy resulted in Immediate Jeopardy and potential serious-life threatening harm for Resident #70 who did not receive ordered prothrombin time (PT) and International Normalized Ratio (INR) testing after starting antibiotics on 01/04/22. […]

• Actual harm, isolatedF689Oct 24, 2022

  Based on observation, record review, and interview, the facility failed to ensure care planned interventions were in place to prevent falls for Resident #11, Resident #53, Resident #37 and Resident #20. Actual harm occurred when Resident #11 and Resident #53 suffered a fall with a fracture nose and right femur respectively and were admitted to the hospital. This affected four residents (Resident #11, Resident #20, Resident #37, and Resident #53) out of six residents reviewed for falls. The facility census was 57. Findings include: 1. […]

• Actual harm, isolatedF689Apr 22, 2022

  Based on medical record review, review of facility fall investigation, and interview the facility failed to maintain safety to prevent a fall with injury during care. This resulted in actual harm when an unsecured stabilizer bar swung open during incontinence care and Resident #1 rolled over the bar, fell out of bed to the floor, and sustained a head injury requiring hospitalization . This affected one of three residents reviewed for falls. The facility census was 64. Findings include: Review of the medical record for Resident #1 revealed an admitted [DATE]. Resident #1 had a discharge date of [DATE]. Diagnoses included heart failure, cerebral infarction, [CONDITION(S)], [CONDITION(S)], and incontinence. […]

• No harm, potential for more than minimal, widespreadF926Apr 28, 2025

  Based on observation, staff interview, and policy review, the facility failed to ensure smoking safety was followed on facility grounds per facility policy. This had the potential to affect all 55 residents of the facility. The census was 55. Findings Include: Observation on 04/28/25 at 9:57 A.M. of the facility parking lot with Maintenance Director (MD) #511 revealed cigarette butts disposed of in mulch beds. The mulch bed nearest the facility dumpsters contained 17 cigarette butts. The mulch bed nearest the wooden [NAME]-cochere (a covered porch where vehicles can pick up and drop off people) at the main entrance contained 10 cigarette butts. […]