Saunders Medical Center

In the surveyor’s words

From the most serious findings on record at Saunders Medical Center, in the surveyor’s own words.

• Actual harm, isolatedF684Jun 14, 2021

  Licensure Reference Number 175 NAC 12-006.09D Based on record review and interview, the facility failed to identify a change in condition and complete an assessment for a resident that had an air hunger episode that required hospitalization for 1 resident (Resident 18). The facility census was 48. Findings are: An interview on 06/07/21 at 04:36 PM with the Resident's representative reported Resident 18 had been admitted to the hospital and the hospital had removed 8 pounds of fluid. The reporter relayed the staff had been informed multiple times of the concern for Resident 18, related to a change in the resident's condition. […]

• No harm, potential for more than minimal, widespreadF923Apr 15, 2026

  Licensure Reference Number 175 12-007.04 (D) The facility failed to ensure resident bathroom ventilation was functional in eight resident rooms (rooms 102, 105, 107, 114, 119, 121, 204, and 206 ) out of eight resident rooms sampled. The facility census was 53 at the time of the survey. Findings are: An observation on 4.13.2026 during the initial screening at 8:00 AM, the resident bathroom ventilation was not functioning in rooms 102, 105, 107, 114, 119, 121, 204, and 206 when checked with a one-ply tissue. An observation on 4.14.2026 at 8:10 AM, the resident bathroom ventilation was not functioning in rooms 102, 105, 107, 114, 119, 121, 204, and 206 when checked with a one-ply tissue. […]

• No harm, potential for more than minimal, widespreadF886Jun 14, 2022

  Based on record reviews and interviews, the facility failed to ensure measures in place were followed to prevent the potential spread of Covid-19 (a mild to severe respiratory illness that is contagious and caused by a coronavirus) related to staff screening logs not being completed as outlined on the screening log and unvaccinated staff not meeting the requirement of testing twice weekly. FINDINGS ARE: An interview with the facility Administrator on 6/14/22 at 08:10 AM revealed the facility had no current positive Covid-19 cases amongst staff or residents. […]

• No harm, potential for more than minimal, patternF812Jun 14, 2022

  LICENSURE REFERENCE NUMBER 175 NAC 12-006.11E Based on observation, interview and record review; the facility failed to ensure food was stored in a manner to prevent the potential for food borne illness related to food being undated and vegetables being wilted and brown in color in the walk-in cooler and walk-in freezer. This had the potential to affect all residents. The facility census was 50. FINDINGS ARE: An observation on 6/14/22 at 10:14 AM of the kitchen walk-in cooler/refrigerator and walk-in freezer revealed produce of lettuce, onions and a head of cauliflower which were in plastic bags, wilted and browning in color and not dated, a container of cherries which had been opened but not dated, and a box of frozen hamburgers in an opened bag which was not resealable and had no opened… […]

• No harm, potential for more than minimal, isolatedF641Apr 15, 2026

  License Reference Number 175 NAC 12.006.09(B)(iii)Based on record review and interviews, the facility failed to accurately code a Minimum Data Set (MDS- a comprehensive assessment of each resident's functional capabilities used to develop a resident's plan of care) reflected that antipsychotic (medication used to manage psychosis including hallucinations, delusions and agitation) was being given. This affected 1 (Resident 41) out of the five sampled residents. The facility census was 53 at the time of survey.Findings are:Record review of Resident 41's Quarterly MDS dated [DATE] revealed the following:-resident was admitted on [DATE]-Brief Interview for Mental Status (BIMS- a test used to get a quick snapshot of a resident's cognitive function, scores from 0-15, the higher the score, the… […]