Skilled Nursing at Pine Village

In the surveyor’s words

From the most serious findings on record at Skilled Nursing at Pine Village, in the surveyor’s own words.

• No harm, potential for more than minimal, widespreadF812Aug 29, 2025

  Based on observation and interview it was determined that the facility failed to ensure the kitchen and remote food service pantry were maintained in a clean and sanitary manner to prevent the spread of potential infection and food borne illness. The deficient practice was evidenced by the following:On 08/25/2025 at 8:59 AM, the surveyor toured the food service pantry with a Dietary Aide (DA) who stated the meals were brought up to the pantry from the main kitchen, and served via the pantry. The DA confirmed the dish machine located in the pantry was also utilized to wash the lunch and dinner dishes. […]

• No harm, potential for more than minimal, patternF609Aug 29, 2025

  Based on interview and record review it was determined that the facility failed to report an injury of unknown origin to the New Jersey Department of Health (NJDOH) for 1 of 3 residents reviewed for accident and incidents (Resident #22).This deficient practice was evidenced by the following:Refer to F610 On 8/25/25 at 9:30 AM, the surveyor observed Resident #22 in bed. When the surveyor inquired regarding their care, Resident #22 informed the surveyor that they had an accident with the lift machine and their Representative would be able to elaborate on the incident later. […]

• No harm, potential for more than minimal, patternF610Aug 29, 2025

  Based on interview, record review, and review of pertinent documents, it was determined that the facility failed to ensure a thorough and complete investigation was conducted, and documented for an injury of unknown origin to ensure a) when a resident reported they were hurt during a mechanical lift transfer while in the bathroom, experienced pain, and b) was diagnosed with a left clavicle fracture, to determine the root cause and implement interventions to prevent recurrence. This deficient practice occurred for 1 of 3 residents reviewed for accidents and incidents (Resident #22) and was evidenced by the following: On 8/25/25 at 9:30 AM, the surveyor observed Resident #22 in bed. […]

• No harm, potential for more than minimal, patternF686Aug 29, 2025

  Based on observation, interview, and record review, it was determined that the facility failed to: a.) ensure wound care was done in accordance with professional standards of practice, and b) staff were trained and followed infection control measures during wound care to prevent potential infection. This deficient practice was identified for 1 of 2 residents reviewed with pressure ulcers (Resident # 2) and was evidenced by the following: On 8/25/25 at 7:58 AM, the surveyor inquired about Resident#2's wound and the nurse confirmed that Resident #2 was admitted with a stage 3 sacral pressure ulcer. The surveyor informed the LPN that she would observe the wound care on the next day. […]

• No harm, potential for more than minimal, patternF880Aug 29, 2025

  Based on observation, interview and document review, it was determined that the facility failed to ensure infection surveillance was implemented during a Covid-19 outbreak to limit the spread of a virus and prevent the spread of potential infections ensuring that a.) staff performed hand hygiene prior to serving meals and b.) residents were provided with opportunities to wash their hands prior to dining. This deficient practice was evidenced by the following: During the initial tour of the facility on 8/24/25 at 8:00 PM, the surveyor observed signage posted at the entrance door for all to wear a mask prior to entering the facility. […]