Solaris Healthcare Celebration

In the surveyor’s words

From the most serious findings on record at Solaris Healthcare Celebration, in the surveyor’s own words.

• Immediate jeopardy, isolatedF689Oct 22, 2021

  Based on observation, interview and record review, the facility failed to conduct accurate elopement risk evaluations to identify and implement appropriate interventions for elopement risk to prevent a physically and cognitively impaired resident from exiting the facility; and failed to respond to an exit door alarm in a timely manner and conduct a thorough search for a missing resident, for 1 of 5 residents reviewed for elopement, of a total sample of 8 residents, (#3). These failures contributed to the elopement of resident #3 and placed her at risk for serious injury/impairment/death. […]

• No harm, potential for more than minimal, widespreadF812May 23, 2024

  Based on observations, staff interview, cleaning schedule, and policy and procedure review, the facility failed to maintain food safety standards, such as ensuring food employees used beverage containers that prevented contamination from hands; resident Time/Temperature Control for Safety (TCS) food was not stored too long under refrigeration; ensure that food and non-food contact surfaces were clean to sight and touch; bathrooms used by food employees were equipped with handwashing signage; ensure that exposed food, clean equipment and clean utensils were protected from contamination from non-Food and Nutrition Services staff unrestrained hair; and clean equipment and utensils were stored in a clean and dry location and protected from splash. […]

• No harm, potential for more than minimal, patternF561May 23, 2024

  Based on observation, interview, and record review, the facility failed to honor resident's rights to choose their bathing preference for 1 of 3 residents reviewed for choices, of a total sample of 47 residents, (#17). Findings: Review of the medical record revealed resident #17 was admitted to the facility on [DATE] from a skilled nursing facility. His diagnosis included cervical disc disorder, syncope and collapse, difficulty in walking, ataxic gait, major depressive disorder, muscle weakness, and need for assistance with personal care. Resident #17's Annual Minimum Data Set (MDS) with an assessment reference date of 4/08/24 revealed the resident scored 13 out of 15 on the Brief Interview for Mental Status which indicated he did not have any cognitive impairment. […]

• No harm, potential for more than minimal, patternF623May 23, 2024

  Based on interview and record review, the facility failed to provide written Notification of Transfer or Discharge forms to the residents or their representative for 3 of 3 residents reviewed for hospitalization , of a total sample of 47 residents, (#51, #64 and #117). Findings: 1. Resident #51 was admitted to the facility on [DATE] with diagnoses including cerebral infarction, gastrointestinal hemorrhage, chronic respiratory failure, type 2 diabetes, chronic obstructive pulmonary disease, Alzheimer's Disease, and cerebrovascular disease. Review of resident #51's medical record revealed she was transferred to the hospital on 3/17/24 due to hypokalemia and on 4/03/24 due to gastrointestinal bleeding. Resident #51 returned to the facility following each hospital transfer. […]

• No harm, potential for more than minimal, patternF680May 23, 2024

  Based on interview and record review, the facility failed to employ a qualified professional to serve as the Activity Director. Findings: On 5/23/24 at 3:37 PM, during a Background Screening review with the Human Resources (HR) Director, the HR Director reported the Activity Director was hired on 1/23/24. A review of the Activity Director's Background Screening revealed she had worked for an Assisted Living Facility (ALF) for 1 year and 8 months prior to her employment date. The HR Director reviewed the Activity Director's personnel file and stated she was unable to locate certification for the Activity Director. […]