Riverside Nursing and Rehabilitation Center

In the surveyor’s words

From the most serious findings on record at Riverside Nursing and Rehabilitation Center, in the surveyor’s own words.

• Immediate jeopardy, widespreadF880Feb 14, 2022

  Based on observations, staff interviews, interview with the Local Health Department (LHD), review of medical records, review of the facility census, review of a list of Coronavirus Disease 2019 (COVID-19) positive residents, review of the facility's floor plan identifying COVID-19 positive rooms, review of facility's infection surveillance, review of a list of new admissions, review of facility policies, review of the Centers for Disease Prevention and Control (CDC) recommendations, and review of Centers for Medicare and Medicaid (CMS) recommendations, the facility failed to implement effective and recommended infection control practices to prevent the spread of infectious disease and move COVID-19 positive residents out of rooms or units with COVID-19 negative residents. […]

• Immediate jeopardy, isolatedF689Sep 2, 2025

  Based on review of medical records, interviews with staff, residents, and family, review of video footage from electronic monitoring device, and policy review, the facility failed to provide adequate supervision to prevent two cognitively impaired residents (#49 and #160) from continuing to engage in sexually aggressive behaviors in the female resident's room (#160). This resulted in Immediate Jeopardy and the potential for serious, physical, mental, and/or psychosocial negative outcomes for two residents (#49 and #160) when the facility failed to supervise and intervene to prevent Resident #49 from entering Resident #160's room and engaging in sexual activity. On 04/28/25, Resident #49 entered Resident #160's room numerous times throughout the day. […]

• Actual harm, isolatedF689Apr 9, 2025

  THE FOLLOWING DEFICIENCY REPRESENTS AN INCIDENT OF PAST NONCOMPLIANCE THAT WAS SUBSEQUENTLY CORRECTED PRIOR TO THIS SURVEY. Based on medical record review, staff interviews, review of facility investigation, and review of facility policy, the facility failed to ensure a resident was properly transferred from the bed to the wheelchair. This resulted in Actual Harm when Resident #04 was transferred without the use of a Hoyer (mechanical lift) by Certified Nursing Assistant (CNA) #200 and the resident sustained a left femoral head fracture requiring hospital admission and surgical repair. This affected one (#04) of three residents reviewed for accidents. The census was 169. Findings include: Review of Resident #04's medical record revealed an admitted [DATE]. […]

• Actual harm, isolatedF689Jul 31, 2024

  Based on medical record review, review of the facility investigation, resident interview, staff interview, and review of the facility policy, the facility failed to provide appropriate supervision and assistance with resident transfers which resulted in Actual Harm on 06/03/24 when Resident #66 was transferred out of a shower chair into bed by two staff members without the use of a Hoyer lift as ordered, resulting in the resident sustaining a fracture to the left humerus during the transfer. This affected one (Resident #66) of three residents reviewed for accidents. The facility census was 169 residents. Findings include: Review of the medical record for Resident #66 revealed an admitted [DATE] with a diagnosis of hemiplegia and hemiparesis following cerebral infarction. […]

• Actual harm, isolatedF773Jul 27, 2021

  Based on medical record review, physician interview, review of the facility policy, and review of the hospital records, the facility failed to ensure laboratory (lab) values were obtained and interventions were implemented for a resident with subtherapeutic levels of an anti-[CONDITION(S)] medication. This resulted in actual harm when Resident #146 was hospitalized for a breakthrough [CONDITION(S)] related to subtherapeutic levels and required a loading dose of the anti-[CONDITION(S)] medication. This affected one (#146) of three residents receiving anti-[CONDITION(S)] medications. The facility census was 154. Findings include: Review of the medical record for Resident #146 revealed the resident was readmitted to the facility on [DATE]. diagnoses [MEDICAL RECORD OR PHYSICIAN ORDER] . […]