Sienna Skilled Nursing & Rehabilitation

In the surveyor’s words

From the most serious findings on record at Sienna Skilled Nursing & Rehabilitation, in the surveyor’s own words.

• Actual harm, isolatedF690Apr 28, 2025

  Based on observation, medical record review, interview, and policy review the facility failed to ensure urinary catheter care was provided and failed to assess the resident's urinary status and condition when the resident experienced no urinary output for two days and minimal output the third day resulting in transfer to the hospital for treatment of a clogged urinary catheter. This affected three residents (#14, #66, and #80) of three residents reviewed for urinary catheters. Actual Harm occurred on 02/12/25 when the facility failed to provide timely and necessary indwelling urinary catheter care to Resident #80 resulting in increased pain and the resident being transferred to the hosptial. […]

• No harm, potential for more than minimal, widespreadF804Feb 9, 2026

  Based on temperature logs, policy and interview, the facility failed to consistently monitor food and drink serving temperatures. This affected all but one Resident #15 who did not receive nutrition from the kitchen. The census was 80.Findings include: Tour of the kitchen was on 2/5/26 at 8:19 A.M. Review of the food temperature log revealed the following:On 01/23/26 there were no coffee temperatures recorded for the dinner meal.On 01/28/26 there were no food or drink temperatures recorded for dinner.On 01/29/26 there were no food or drink temperatures documented for breakfast or lunch.On 01/30/26 there were no food or drink temperatures documented for the whole day.On 01/31/26 there were no food or drink temperatures for the dinner meal recorded.On 02/01/26 there were no food or drink… […]

• No harm, potential for more than minimal, widespreadF812Aug 11, 2025

  Based on observation, staff interview and facility policy review the facility failed to store food in a sanitary manner. This had the potential to affect all 79 residents residing in the facility, as the facility identified zero residents with an order for nothing by mouth (NPO). The facility's census was 79. Findings Include: During the initial kitchen tour conducted on 08/04/25 from 8:30 A.M. to 8:50 A.M. observations revealed in the dry food/canned food storage three cans of 66.5 ounces (oz) of tuna each were dented along the seal and stored in the main storage area for resident foods to be used for meal preparation. […]

• No harm, potential for more than minimal, widespreadF804Mar 20, 2025

  Based on observation, taste tray, food temperature, policy review, and interview, the facility failed to prepare food to enhance texture and serve at an appetizing temperature. This affected all 83 of 83 residents in the facility. The facility census was 83. Findings include: Observation of the lunch tray line took place on 03/20/25 at 11:41 A.M. [NAME] #94 was wearing gloves and had hair and beard coverings. When asked if temperatures were obtained he stated he already took the temperatures and motioned toward a binder. Observation revealed the lids were off the chaffing dishes on the steam table. Dietary #94 plated the dining room trays. They were sent to the dining room in an open to air cart. Interview on 03/20/25 at 12:10 P.M. until 12:20 P.M. […]

• No harm, potential for more than minimal, widespreadF812Mar 20, 2025

  Based on observation and interview, the facility failed to ensure food was stored, prepared and held under sanitary conditions. This affected all 83 of 83 the residents in the facility The facility census was 83. Findings include: Observation of the kitchen on 03/20/25 at 11:29 A.M. revealed the shelf above the cooking surface of the cooktop and top of the steamer were dirty with brown debris, dusty and a greasy, sticky film. The fronts of the silver refrigerators, freezers, ovens, oven handles were sticky, smeared with dried food and fingerprinted. The Ansel system above the cooktop was dusty. The linoleum type squares on the floor were soiled, dull, dirty with stains, yellowed, and cracked. […]