San Jose Healthcare & Wellness Center

In the surveyor’s words

From the most serious findings on record at San Jose Healthcare & Wellness Center, in the surveyor’s own words.

• Actual harm, isolatedF684Oct 11, 2023

  Based on observation, interview, and record review the facility failed to ensure to transfer the resident's body to the referred mortuary (a funeral home, where dead bodies are kept before burial or cremation) within four hours after Resident 1 expired at the facility. This failure has caused significant emotional distress for three of three sampled residents (Resident 2, 3, and 4). Findings: Review of Resident 1's undated face sheet (a document that gives a resident's information at a quick glance) indicated, Resident 1 was admitted to facility on [DATE] with diagnoses including acute and chronic respiratory failure (a condition in which the respiratory system is unable to provide an adequate supply of oxygen or to remove carbon dioxide efficiently), adult failure to thrive (a condition… […]

• No harm, potential for more than minimal, patternF700Mar 7, 2025

  Based on observation, interview, and record review, the facility failed to ensure the proper use of side or bed rails (adjustable rigid bars attached to the side of a bed) for six of 11 residents (31, 33, 35, 37, 42, and 49) when: 1. Residents 31, 33, and 35 did not have care plan for siderails; 2. Residents 42 and 49 did not have a physician's order for the use of siderails and care plan for siderails; and 3. Resident 37 did not have a consent and a physician's order for the use of siderails, and care plan for siderails. These failures had the potential to place the residents at risk of entrapment and injury. Findings: During an observation on 3/4/25 at 11:47 a.m., Residents 31, 33, 35, 37, 42, and 49 had bilateral siderails. […]

• No harm, potential for more than minimal, patternF802Mar 7, 2025

  Based on observation, interview, and record review, the facility failed to ensure the kitchen staff competently carried out the functions of the food and nutrition services department according to facility policy and standards of practice when kitchen staff did not correctly demonstrate how to test the dish machine sanitizer. This failure had the potential to place 51 residents who consumed food from the kitchen at risk for exposure to contaminants in food that may lead to food borne illness. Findings: During a kitchen observation and interview on 3/4/25 at 1:09 p.m. with the Registered Dietician (RD), Dietary Manager (DM), and Dietary [NAME] (DC), DC tested the sanitizer of the facility dish machine. […]

• No harm, potential for more than minimal, patternF812Mar 7, 2025

  Based on observation, interview and record review, the facility failed to ensure safe and sanitary conditions were maintained in the kitchen for food preparation equipment and food storage methods, according to standards of practice and facility policy when: 1. Foods were stored unlabeled and/or past used-by date; and 2. Sink drainage pipe with buildup within the inner lining. These failures had the potential for food contamination, resulting in food borne illnesses for 51 residents who consume food from the kitchen. Findings: 1. […]

• No harm, potential for more than minimal, patternF880Mar 7, 2025

  Based on observation, interview, and record review, the facility failed to ensure staff followed proper infection control procedures when: 1. Licensed Vocational Nurse D (LVN D) did not wash or sanitize hands before checking Resident 21's vital signs (blood pressure [BP], pulse, and oxygen saturation [SpO2], which measures the amount of oxygen in the blood); 2. Certified nursing assistant C (CNA C) did not wash or sanitize her hands before feeding Resident 40; licensed vocational nurse A (LVN A) and registered nurse F (RN F) did not wash or sanitize their hands before opening the plate lids to check the residents' meals on the meal tray; and 3. […]