Scotland Manor Health and Rehabilitation Center

In the surveyor’s words

From the most serious findings on record at Scotland Manor Health and Rehabilitation Center, in the surveyor’s own words.

• No harm, potential for more than minimal, patternF812May 25, 2023

  Based on observations and staff interviews, the facility failed to 1) label and date opened items in 2 kitchen refrigerators (refrigerator #1 located in the stock room, and refrigerator #2 located near the tray line counter) and the kitchen wall freezer located in the stock room and 2) failed to remove expired items from the residents' refrigerator, failed to label and date food items in the residents' refrigerator, and keep 1 of 1 freezer used for residents' personal food items, free from ice build-up. The findings included: 1. During an observation of the kitchen on [DATE] at 10:14 am with the cook the following items were observed: a. […]

• No harm, potential for more than minimal, patternF867May 25, 2023

  Based on observations and staff interviews, the facility's Quality Assessment and Assurance (QAA) Committee failed to maintain implemented procedures and monitor interventions the committee put in place following the recertification survey conducted on [DATE]. This was for a recited deficiency on the current recertification and complaint survey in the area of food procurement, store, prepare, and serve in a sanitary manner. The continued failure during two surveys shows a pattern of the facility's inability to sustain an effective QAA program. […]

• No harm, potential for more than minimal, patternF812Jan 7, 2022

  Based on observations, policy review and staff interview the facility failed to prevent cross contamination by one of one staff who failed to wear a beard net during meal service. The findings included: A review of the Next Level Hospitality Services policy, under Staff Attire policy statement reads as: It is the center policy that all Dining Services employees wear approved attire for the performance of their duties. Action Steps: 1. The Dining services Director ensures that all staff members have their hair off the shoulders, confined in a hair net or cap, and facial hair properly restrained. During the meal observation on 1/06/22 at 11:36 AM the dietary manager was observed taking the meal temperatures. […]

• No harm, potential for more than minimal, isolatedF685Nov 20, 2025

  Based on observation, record review, and interviews with the resident, staff, and Medical Director, the facility failed to follow up with an audiologist's (a medical professional that specializes in the diagnosis, evaluation and treatment of hearing disorders) recommendation for ear wax removal for 1 of 1 resident reviewed for hearing difficulties (Resident #21).The findings included:Resident #21 was admitted to the facility on [DATE] with diagnoses which included stroke. The Minimum Data Set (MDS) quarterly assessment dated [DATE] revealed Resident #21 had moderate cognitive impairment. […]

• No harm, potential for more than minimal, isolatedF695Nov 20, 2025

  Based on observation, record review, and staff interviews, the facility failed to follow physician orders to change oxygen supplies, which included the nasal cannula, for 1 of 1 resident reviewed for respiratory care (Resident #21). The findings included:Resident #21 was admitted to the facility on [DATE] with diagnoses which included chronic obstructive pulmonary disease (COPD). The Minimum Data Set (MDS) quarterly assessment dated [DATE] revealed Resident #21 had moderate cognitive impairment. Resident #21 was coded for supplemental oxygen use. […]