Rae Ann Suburban

In the surveyor’s words

From the most serious findings on record at Rae Ann Suburban, in the surveyor’s own words.

• Immediate jeopardy, isolatedF689Dec 5, 2023

  Based on observation, closed medical record review, hospital record review, review of a police report, review of staff witness statements, review of the facility elopement policy and procedure and interviews, the facility failed to provide adequate supervision to prevent Resident #84, who had a diagnosis of dementia with behavioral disturbances and lacked sufficient decision-making ability to make an informed decision to leave the facility, from eloping from the facility. This resulted in Immediate Jeopardy and the potential for serious life-threatening harm on 11/12/23 at approximately 4:30 P.M. […]

• Actual harm, isolatedF686May 19, 2023

  Based on record review, interview, and facility policy review, the facility failed to implement adequate and necessary interventions to prevent, timely identify and properly treat pressure ulcers for Resident #7. Actual Harm occurred on 02/17/23 when Resident #7, who was admitted on [DATE] with no skin breakdown, and required extensive assistance from one staff for bed mobility and transfers, developed two in-house acquired unstageable pressure ulcers (characterized by full-thickness skin and tissue loss in which the extent of tissue damage cannot be determined because it is obscured by debris, slough, or eschar) to the left and right coccyx area which were not identified prior to being unstageable. […]

• No harm, potential for more than minimal, widespreadF812Jun 11, 2025

  Based on observation and staff interview, the facility failed to ensure its kitchen area was maintained in a clean and sanitary condition. This had the potential to affect all 77 residents receiving food from the kitchen. The facility identified two (#40 and #80) resident who received no food from the kitchen. The facility census was 79. Findings include: Observation during tour of the kitchen, conducted with Dietary Manager (DM) #796 on 06/02/25 from 9:15 A.M. through 9:48 A.M., revealed the the drawer under a food processor had crumbs and dirt in the drawer, one drawer in the food preparation area contained a dirty knife, the drawer with serving utensils had crumbs and debris in the bottom, and there were milk crates with containers of milk stored directly on the refrigerator floor. […]

• No harm, potential for more than minimal, widespreadF847Jun 11, 2025

  Based on review of the facility's arbitration agreement and staff interview, the facility failed to ensure its arbitration agreement did not contain any language that prohibits or discourages the resident or anyone else from communicating with federal, state, or local officials and any other relevant advocacy agencies (id est (i.e.) State Survey Agency, Office of the State Long Term Care Ombudsman) regarding the arbitration process and/or outcome of the arbitration settlement. This had the potential to affect all 79 residents residing in the facility. […]

• No harm, potential for more than minimal, widespreadF880Jun 11, 2025

  Based on observation, medical record review, staff interview, review of infection control tracking logs and COVID-19 tracking logs, review of the Centers for Disease Control and Prevention documents, and review of facility policies, the facility failed to adequately track infections within the facility and failed to ensure infection control measures were maintained related to obtaining blood glucose levels and proper hand hygiene after resident contact and glove use. This had the potential to affect all 79 residents residing in the facility. The census was 79. Findings included: 1. […]