South Pointe Rehabilitation and Care Center

In the surveyor’s words

From the most serious findings on record at South Pointe Rehabilitation and Care Center, in the surveyor’s own words.

• Immediate jeopardy, isolatedF600Mar 3, 2025

  On 02/27/25, an Immediate Jeopardy (IJ) situation was determined to exist related to the facility's failure to protect Resident #12 from mental and physical abuse. On 02/25/25 at 3:02 p.m., Resident #12 was interviewed and stated on 01/23/25 at 6:00 p.m. a person came to door 2 (hall 200) pounding on the door. Resident #12 stated CMA #1 let this person in and they immediately staring cussing and making a move to hit CMA #1. Resident #12 stated they took off down towards them and asked the unknown person what they were doing. Resident #12 stated the person took two swings at them and on the second swing hit them on the face. Resident #12 stated it hurt like the [NAME]. Resident #12 stated ever since then, I don't feel safe. Resident #12 stated, It could happen again. […]

• Immediate jeopardy, isolatedF689Mar 3, 2025

  On 02/25/25, an Immediate Jeopardy (IJ) situation was determined to exist related to the facility's failure to ensure safety and supervision for Resident #4 who smoked. On 02/24/25 at 5:40 p.m., Resident #7 was observed in the outside courtyard smoking area without staff present. Resident #7 was observed to remove a cigarette, lit it with a match, and began to smoke. Resident #7 stated they had only been at the facility for a week. Resident #7 stated they smoked whenever they wanted to and kept their own cigarettes and matches. A Smoking Policy, dated 11/06/24, read in part, The facility shall maintain safety for residents who request to Smoke, as well as for those who do not. […]

• Actual harm, patternF693Jun 22, 2021

  Based on observation, record review, and interviews, it was determined the facility failed to: ~ assess and document gastrostomy tube feeding residual amounts prior to providing additional tube feedings; ~ record and monitor daily intake and output amounts for a resident receiving bolus tube feedings; and ~ assess, monitor and intervene for nausea and vomiting for a resident receiving bolus tube feedings for one (#80) of three sampled residents who were reviewed for the use of a gastrostomy tube. The facility identified ten residents who had a gastrostomy tube. Resident #80 experienced nausea and vomiting for a period of two months prior to being hospitalized on [DATE]. […]

• Actual harm, isolatedF600Oct 25, 2024

  Based on observation, record review and interview, the facility failed to ensure residents were free of neglect for one (#3) of four sampled residents reviewed for neglect. Resident #3 took a water pitcher from the medication cart and proceed down the hall. Resident #2 blocked Resident #3 from leaving down the hall and ended up grabbing Resident #3 on the shoulders and base of the neck forcefully pushing them to the ground. Resident #3 sustained a fractured hip requiring surgery. CNA #1 was present and did not intervene to protect Resident #3 from Resident #2. The DON identifed 13 residents who resided on hall 600 memory care unit. […]

• Actual harm, isolatedF689Jan 17, 2024

  Based on observation, record review, and interview, the facility failed ensure interventions were in place, new intervention were implement after a fall, and staff were aware of fall interventions for two (#156 and #11) of four sampled residents reviewed for accident hazards. Resident #156 had 16 falls over six months. The last fall resulted in Resident #156 sustaining a facial laceration, head contusion, and loosing a tooth. The DON identified 181 residents resided in the facility. […]