Pinnacle Health & Rehab at N Berwick

In the surveyor’s words

From the most serious findings on record at Pinnacle Health & Rehab at N Berwick, in the surveyor’s own words.

• No harm, potential for more than minimal, widespreadF812Oct 30, 2024

  Based on observations and interviews, the facility failed to maintain a clean kitchen floor and ensure products in the walk-in refrigerator and freezer were labeled and/or dated and failed to remove expired foods available for use for 1 of 3 kitchen tours. Findings: A surveyor completed Initial Kitchen Tour on [DATE] from 9:30 a.m. to 10:15 a.m. with the Food Service Director in which the following findings were observed: - The floor in the kitchen had a significant amount of visible crumbs/dirt debris and was discolored/stained in many areas and worn in appearance. During an interview with the Food Service Director, it was revealed that the flooring throughout the kitchen was very porous and was difficult to clean. […]

• No harm, potential for more than minimal, widespreadF880Oct 30, 2024

  Based on record review and interview, the facility failed to maintain an Infection Control Program designed to help prevent the development and transmission of disease and infection relating to Legionella and failed to implement the elements of the Legionella Water Management Program. This has the potential to effect all 59 residents. Finding: The facility's Legionella Water Management Program initiated on 10/18/19, states Specific measures used to control the introduction and/or spread of Legionella (e.g. […]

• No harm, potential for more than minimal, patternF584Oct 30, 2024

  Based on observations and interviews, the facility failed to adequately provide housekeeping and maintenance services necessary to maintain the building in a sanitary, orderly, and comfortable manner pertaining to floors for 1 of 1 facility tour (10/30/24). Findings: A surveyor conducted a facility environment tour on 10/30/24 from 1:20 p.m. to 1:35 p.m. with the Maintenance Director in which the following findings were observed: The entrance from the hallway into the resident room floor had black tape on the floor going from each side of the door frame for Rooms 19, 20, 21, 22, 23, 25, 27, 28, 31, 32, and 34. […]

• No harm, potential for more than minimal, patternF695Oct 30, 2024

  Based on observations and interviews, the facility failed to provide oxygen therapy in a sanitary manner for 4 of 5 sampled residents using oxygen (#6, #9, #22, #29) Findings: 1. On 10/28/24 at 9:30 a.m., a surveyor observed Resident #29's oxygen concentrator and found the intake filter coated in dust and debris. 2. On 10/28/24 at 9:45 a.m., a surveyor observed Resident #9's oxygen concentrator and found the intake filter coated in dust and debris. In addition, Resident #9's oxygen tubing was being stored in an unsanitary manner coiled on top of the concentrator with the tubing touching the floor. 3. On 10/28/24 at 10:09 a.m., a surveyor observed Resident #22 wearing oxygen via nasal cannula attached to an oxygen concentrator. […]

• No harm, potential for more than minimal, patternF883Oct 30, 2024

  Based on review of the facility's immunization policy, record review and interview, the facility failed to implement their pneumococcal immunization policy for 3 of 5 residents whose immunization records were reviewed (#4, #25, #48) Findings: The facility's Pneumococcal Vaccine policy and procedure revised on 2/1/2020 states, Prior to or upon admission, residents will be assessed for eligibility to receive the pneumococcal vaccine series, and when indicated, will be offered the vaccine series with in (30) days of admission to the facility unless medically contraindicated or the resident has already been vaccinated and Administration of the pneumococcal vaccines or revaccinations will be made in accordance with current Centers for Disease Control and Prevention (CDC) recommendations at the… […]