Rest Haven Health Care Center

In the surveyor’s words

From the most serious findings on record at Rest Haven Health Care Center, in the surveyor’s own words.

• Immediate jeopardy, isolatedF600Jan 6, 2026

  Based on interview and record review, facility staff failed to ensure one resident (Resident #1) remained free from sexual abuse, when staff found Certified Nurse Assistant (CNA) A in the resident's bed with his/her pants around his/her ankles, resident's pants and underwear off. CNA A admitted he/she sexually assaulted the resident. The facility census was 62.The administrator was notified on 01/06/26 of a past non-compliance immediate jeopardy (IJ) which occurred on 01/04/26. The administrator immediately began an investigation and began in-servicing all staff on abuse and neglect who were on duty and continued in-servicing staff not on duty prior to their shifts. The IJ was corrected on 01/04/26. 1. […]

• Actual harm, isolatedF689May 12, 2026

  Based on observation, interviews and record review, facility staff failed to ensure one resident (Resident #1) remained free from accidents, when Licensed Practical Nurse (LPN) A heated water in a microwave and gave it to the resident, the resident spilled the hot water on him/herself, which resulted in a burn injury to the resident's legs. Facility staff failed to prevent one resident (Resident #2) from falling, when staff assisted the resident with one staff member and rolled the resident to his/her side during care and the resident fell from his/her bed. The facility's census was 53.The administrator was notified on 05/12/26 of past Non-Compliance which occurred on 05/08/26. […]

• No harm, potential for more than minimal, widespreadF812Jan 6, 2026

  Based on observation, interview and record review, facility staff failed to store food in a manner to prevent potential contamination and outdated use. Facility staff failed to ensure the dish washing machine operated according to manufacturer's instructions to adequately prevent cross contamination of kitchen wares. Facility staff failed to perform hand hygiene as often as necessary, using approved techniques, to prevent cross-contamination. The census was 64.1. Review of the facility's Resident Food: Storage and Sharing policy, revised 09/16/2024, showed the purpose of the policy is to ensure resident food storage is safe with sanitary storage, handling and consumption. […]

• No harm, potential for more than minimal, widespreadF880Mar 6, 2025

  Based on observation, interview, and record review, facility staff failed to use appropriate infection control procedures to prevent the spread of bacteria or other infectious causing contaminants when facility staff failed change and/or store oxygen and nebulizer tubing in a manner to prevent the spread of bacteria for three residents (Resident #1, #18, and #35) out of three sampled residents. Facility staff failed to maintain proper infection control practices for three residents (Resident # 13, #18 and #25) out of four sampled residents catheters.Facility staff failed to perform appropriate hand hygiene, and glove changes during wound care for one resident (Resident #2) out of two sampled residents. […]

• No harm, potential for more than minimal, widespreadF882Mar 6, 2025

  Based on interview and record review, the facility staff failed to designate one or more individuals with specialized training in Infection Prevention and Control (IPC) as the Infection Preventionist (IP) for the facility's infection prevention and control program. The census was 52. 1. Review of the facility's Infection Preventionist Policy, revised 03/05/2025, showed the facility will employ one or more qualified individuals with responsibility for implementing the facility's infection prevention and control program. 2. During an interview on 03/05/25 at 2:43 P.M., the Chief Nursing Director said they do not currently have an infection preventionist (IP). […]