South Peninsula Hospital LTC

In the surveyor’s words

From the most serious findings on record at South Peninsula Hospital LTC, in the surveyor’s own words.

• No harm, potential for more than minimal, widespreadF812Aug 23, 2024

  Based on observations, interview, and record review the facility failed to ensure storage and preparation of food in accordance with professional standards for food service safety for 24 residents (#1, #2, #3, #4, #5, #6, #7, #8, #9, #10, #11, #12, #13, #14, #15, #16, #17, #18, #19, #20, #21, #23, #24, #25) out of 25 residents who received meals from the kitchen. This failed practice placed all residents at risk to receive contaminated food and placed these 24 residents at risk of foodborne illnesses. […]

• No harm, potential for more than minimal, widespreadF804May 12, 2023

  Based on observation, interview, and record review, the facility failed to ensure food was served at a palatable temperature. This failed practice had the potential to place all residents, based on a census of 25, at risk for poor nutrition due to foods served outside of palatable temperatures. Findings: During an observation beginning in the main kitchen on 5/8/23 at 12:20 PM, Cook #1 placed all the food from the steam table onto a cart and delivered the food to the Long-Term Care (LTC) kitchen. Upon reaching the LTC kitchen he/she washed his/her hands, put on gloves, prepared a pail of bleach water, wiped the steam table and placed the pans from the cart onto the steam table. He/she removed gloves, sanitized his/her hands and put on new gloves. […]

• No harm, potential for more than minimal, patternF567Sep 12, 2025

  .Based on record review and interview, the facility failed to ensure that interest earned on residents' trust accounts was correctly credited to the residents' accounts. This failure affected 23 of 26 residents reviewed (Residents #1, 2, 3, 4, 5, 6, 7, 9, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 24, 25, and 26). The facility did not apply the interest earned to either the residents' actual account balances or to their account statements. As a result, residents and/or their representatives were not given timely or accurate information about the interest accrued in their personal funds.Findings:.Past non-compliance: The last standard recertification survey was conducted on 8/23/24. During the Recertification survey conducted on 9/12/25 past noncompliance was identified at F567. […]

• No harm, potential for more than minimal, patternF609Nov 17, 2021

  Based on interview, and record review the facility failed to report allegations of abuse to the Administrator and State Survey Agency (SSA) immediately, but not later than two hours; and failed to report findings of their investigations within five working days of the allegations for four of four sampled residents reviewed for abuse/neglect (Resident #1, Resident #2, Resident #3, and Resident #117). This failed practice placed the residents at risk for potential abuse and/or neglect. […]

• No harm, potential for more than minimal, patternF610Nov 17, 2021

  Based on facility policy review, record review, and interview the facility failed to ensure allegations of abuse and/ or neglect were thoroughly investigated, and a 5-Day investigation report was submitted to the State Agency for three of four sampled residents reviewed for abuse and/or neglect (resident #s 1, 2 and 3). The failure to complete a thorough investigation of potential abuse and/or neglect and report the resulting investigation to the State Agency, places residents at risk of harm from abuse and/or neglect. Findings: Review of the facility's policy titled Abuse, Neglect, Exploitation, and Misappropriation of Property- Identifying, Reporting, and Investigating revised 12/21/2020, revealed, . Procedure: II. Management of Suspected Abuse. C. An alleged violation of abuse . […]