Skyline Terrace Conv Home

In the surveyor’s words

From the most serious findings on record at Skyline Terrace Conv Home, in the surveyor’s own words.

• No harm, potential for more than minimal, patternF641Jul 22, 2021

  Based on staff interview, clinical record review, and facility document review, it was determined that the facility staff failed to ensure a complete and accurate MDS (minimum data set) assessment for four of 25 residents in the survey sample, (Residents #23, #46, #21, and #37). 1. The facility staff failed to complete the resident interview for Section C - Cognition, and Section D - Mood, of the 5/24/21 MDS assessment for Resident #23. 2. The facility staff failed to complete the resident interview for Section C - Cognition of the 6/23/21 MDS assessment for Resident #46. 3. The facility staff failed to attempt the interview for Section C - Cognition for Resident #21. 4. The facility staff failed to complete the interview for Section C - Cognition of the MDS for Resident # 37. […]

• No harm, potential for more than minimal, isolatedF583Oct 15, 2025

  Based on observations, and staff interview, facility staff failed to maintain the confidentiality of a resident's clinical documentation for one of 26 residents in the survey sample, Resident #4 (R4). The findings include:For R4, facility staff failed to place the amount of fluid restrictions in a confidential manner. R4 was admitted to the facility with a diagnosis that included by not limited to respiratory failure. On the most recent MDS (minimum data set), a quarterly assessment with an ARD (assessment reference date) of 08/13/2025, R4 scored 14 out of 15 on the BIMS (brief interview for mental status) score, indicating R4 was cognitively intact for making daily decisions. On 10/14/2025 at approximately 2:40 p.m. […]

• No harm, potential for more than minimal, isolatedF695Oct 15, 2025

  Based on observation, resident interview, staff interview and clinical record review, the facility staff failed to provide respiratory care and services for one of 26 residents in the survey sample, Resident #4 (R4). The findings include:For R4, facility staff failed to store the incentive spirometer (1) in a sanitary manner. R4 was admitted to the facility with a diagnosis that included by not limited to respiratory failure. On the most recent MDS (minimum data set), a quarterly assessment with an ARD (assessment reference date) of 08/13/2025, R4 scored 14 out of 15 on the BIMS (brief interview for mental status) score, indicating R4 was cognitively intact for making daily decisions. On 10/14/2025 at approximately 2:40 p.m., and 4:45 p.m. […]

• No harm, potential for more than minimal, isolatedF623Jan 31, 2023

  Based on staff interview, clinical record review and facility document review, it was determined that the facility staff failed to provide written notice of a hospital transfer to the resident and/or resident representative and the Office of the State Long-Term Care Ombudsman for one of 16 residents in the survey sample; Resident #26. The findings include: Resident #26 was transferred to the hospital on 12/7/22, however notice of the hospital transfer was not provided to the resident and/or resident representative or the ombudsman. A review of the clinical record revealed a nurse's note dated 12/7/22 that documented, Resident was observed to be lying on the floor face down right beside [their] bed .POA (power of attorney) called and updated. […]

• No harm, potential for more than minimal, isolatedF657Jul 22, 2021

  Based on resident interview, clinical record review, facility document review and staff interview, it was determined facility staff failed to revise the comprehensive care plan for one of 25 residents in the survey sample, Resident #44. The facility staff failed to revise the comprehensive care plan of Resident #44 to include the resident's participation in their pain management program in choosing between multiple ordered as needed pain medications. The findings include: Resident #44 was admitted to the facility with diagnoses [MEDICAL RECORD OR PHYSICIAN ORDER] . […]