Sharpview Residence and Rehabilitation Center

In the surveyor’s words

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

• Immediate jeopardy, isolatedF695Jul 29, 2025

  Based on observation, interview and record review, the facility failed to ensure that a resident who needs respiratory care, including tracheostomy care, is provided such care, consistent with professional standards of practice, the comprehensive person-centered care plan, and the residents' goals and preferences for 1 (CR #1) of 4 residents reviewed for tracheostomy care.-LVN A failed to provide emergency tracheostomy (surgical hole in the windpipe to assist with breathing when the usual way is blocked) reinsertion for CR #1 after the resident accidentally removed their tracheostomy on 04/27/2025. […]

• No harm, potential for more than minimal, patternF644Jul 29, 2025

  Based on observation, interview, and record review the facility failed to refer all level II residents and all residents with newly evident or possible serious mental disorder, intellectual disability, or a related condition for level II resident review upon a significant change in status assessment for 1 of 3 residents (Resident #8) reviewed for coordination of PASARR and assessments. -The facility failed to conduct the PASARR Level I assessment Form 1012-Mental Illness/Dementia Resident Review for Resident #8 until 7/24/25.-The facility failed to request, submit and coordinate the PASARR assessment and screening in the Simple LTC portal to ensure therapeutic services (physical, speech and occupational) were completed for Resident #8.This failure could place residents requiring PASARR… […]

• No harm, potential for more than minimal, patternF695Jun 14, 2024

  32422 Based on observation, interview and record review, the facility failed to ensure residents who needed respiratory care were provided such care, consistent with professional standards of practice, for oxygen therapy for two of two residents (Resident # 29 and Resident #186) reviewed for respiratory care. -The facility failed to follow the physician orders for Resident #29's oxygen administration. -The facility failed to provide tracheal care and suctioning according to professional standards for Resident #186. These deficient practices could result in the resident's not receiving the care and services ordered by the physician and a decline in health status and oxygen deprivation. […]

• No harm, potential for more than minimal, patternF759Jun 14, 2024

  Based on observation, interview, and record review, the facility failed to ensure that the medication error rate was not five percent (%) or greater. The facility had a medication error rate of 9% based on 3 errors out of 32 opportunities, which involved 3 of 9 residents (Resident #29, Resident #14 and Resident #6) reviewed for medication errors. 1. RN A did not administer Sodium Chloride (a prescription medicine used to replenish lost water and salt in your body due to certain conditions like low salt syndrome) to Resident #29 as ordered by the physician. 2. MA A did not administer Losartan Potassium ( a drug used to lower blood pressure) to Resident #14 as ordered by the Physician. 3. […]

• No harm, potential for more than minimal, patternF812Jun 14, 2024

  Based on observation and interview, the facility failed to store, prepare, distribute, and serve food in accordance with professional standards for food service safety in 1 of 1 kitchen reviewed for food procurement. 1. The facility failed to ensure expired foods were discarded. 2. The facility failed to ensure foods were labeled and dated. 3. The Facility failed to ensure food was stored in designated areas at all times. 4. The facility failed to thaw frozen ,d+[DATE] lb. rolls of frozen ground beef. These failures could place residents who ate food from the kitchen at risk of food borne illness and disease. Findings Included: Observation of the facility kitchen on [DATE] at 8:15 AM revealed the following. 1. […]