Prescott Village Nursing & Rehabilitation

In the surveyor’s words

From the most serious findings on record at Prescott Village Nursing & Rehabilitation, in the surveyor’s own words.

• Actual harm, isolatedF689Mar 25, 2025

  Based on clinical record review, staff interviews, and facility documentation and policy review, the facility failed to ensure safe assistance was provided for one resident (#2) to prevent an accident during a hoyer lift transfer. The deficient practice could result in further incidents of staff providing unsafe assistance, resulting in harm to residents. Findings include: Resident #2 was admitted to the facility on [DATE], with diagnoses including unspecified open wound of right foot, multiple fractures of pelvis with stable disruption of pelvic ring, hypothyroidism, epilepsy, and disorder of bone density and structure. […]

• No harm, potential for more than minimal, widespreadF812Jan 25, 2024

  Based on observations, staff interviews, facility process and procedures, the facility failed to ensure that dishes and utensils were cleaned under sanitary conditions. The deficient practice could result in residents becoming ill. Findings include: The initial walk through of the kitchen was conducted on January 22, 2024 at 10:37 AM with the senior cook (staff #76), who stated that he was in charge of the kitchen. Staff #76 stated that the temperature gauge on the dishwasher had not been working since December 31, 2023, but he had been using an external thermometer in a red plastic cover to manually temp the dishwasher to ensure that the dishwasher was 160 degrees during the washing and rinse cycle. […]

• No harm, potential for more than minimal, patternF552Mar 6, 2026

  Based on closed record review, staff interviews, and review of policies and procedures, the facility failed to ensure informed consents were obtained for psychotropic medications and/or opioids for 3 residents (#42, #8 and #6). The sample size was 4 and the Universe was 50. The deficient practice could lead to residents receiving medications without fully understanding the risks and benefits. This could also increase the likelihood of adverse drug events.Findings include:Regarding Resident #42-Resident #42 was admitted to the facility on [DATE] with diagnoses that included type 2 diabetes, dysphagia, unspecified Dementia, acute kidney failure, and cognitive communication deficit. […]

• No harm, potential for more than minimal, patternF658Mar 6, 2026

  Based on closed record review, staff interview, and review of policies and procedures, the facility failed to ensure that medications were administered within the parameters established by physician's orders for three (#4, #42, and #52) out of five residents. The universe was 50. The deficient practice could cause over or under dosing of residents, altered mental status, or other health complications.Findings include:Regarding resident #42-Resident #42 was admitted to the facility on [DATE] with diagnoses that included type 2 diabetes, dysphagia, unspecified Dementia, acute kidney failure, and cognitive communication deficit. […]

• No harm, potential for more than minimal, patternF756Mar 6, 2026

  Based on closed record review, staff interview, and review of policies and procedures, the facility failed to ensure that a licensed pharmacist performed a medication regimen review (MRR) for four (#4, #6, #8, and #42) out of five residents. The census was 50. The deficient practice could result in residents having preventable harm, functional decline, hospitalizations, or death.Findings include:Regarding Resident #4-Resident #4 was admitted to the facility on [DATE] with diagnoses that included aftercare following joint replacement surgery, dysphagia, cognitive communication deficit, and acute kidney failure. The Quarterly Minimum Data Set (MDS), dated [DATE], revealed Resident #4 had a Brief Interview for Mental Status (BIMS) score of 14 which indicated she was cognitively intact. […]