Southridge Specialty Care

In the surveyor’s words

From the most serious findings on record at Southridge Specialty Care, in the surveyor’s own words.

• Immediate jeopardy, patternF760Sep 26, 2024

  Based on observation, staff, resident and physician interview along with the facility policy/procedure, the facility failed to prevent a significant medication error from occurring. On 9/16/24, during the morning medication pass, a Certified Medication Aide took Resident #1 and Resident #2 oral medications in clear plastic medication cups into the room in one hand and proceeded to sit down Resident #2 medications on the bedside table and then proceeded to go to Resident #1 bedside table and sat them down. Resident #1 received Resident #2 medications for which resulted in Resident #1 becoming lethargic and difficult to arouse during a morning activity. […]

• Actual harm, isolatedF697Nov 5, 2024

  Based on observation, record review, facility policy review, resident, staff, and physician interviews, the facility failed to thoroughly assess and follow through on interventions to maintain Resident #1's highest practical physical well being and function for 1 or 5 residents reviewed (Resident #1). Resident #1 experienced unnecessary pain, due to grossly decayed and non-restorable teeth. Resident #1 reported mouth pain in July 2024. She saw a dentist in August 2024. The dentist referred her to the University dental office at her appointment on 8/16/24. The facility failed to arrange an appointment. Resident #1 continued to have oral pain and saw the dentist again on 9/4/24. At this time, the dentist ordered to send Resident #1 to the University Hospital emergency room . […]

• Actual harm, isolatedF689Dec 27, 2022

  Based on observations, interviews, and record review, the facility failed to ensure 1 out of 3 residents was transferred properly per the resident's Care Plan (Resident #1). The facility failed to provide assistance of 1 Nursing Staff to transfer the resident in and out of the facility's transport van, resulting in a fall with injury. An untrained driver attempted to transfer Resident #1 into the van when her leg gave out. The facility reported a census of 74 residents. Findings Include: A Minimum Data Set (MDS) Assessment Tool dated 8/1/22, documented that Resident #1's diagnoses included history of fracture, arthritis and diabetes. Resident #1 documented with a Brief Interview for Mental Status (BIMS) score of 15 out of 15, indicating intact cognition. […]

• No harm, potential for more than minimal, patternF725Jul 15, 2026

  Based on clinical record review, resident interview, staff interview and policy review, the facility failed to provide adequate staffing to meet the needs of the residents in a timely manner when call lights were activated for 11 of 17 residents reviewed (Resident #'s 1, #4, #7, #10, #18, #19, #22, #45, #52, #59 and #67). The facility reported a census of 79 residents. Findings include: 1. Resident #22's Minimum Data Set (MDS) dated [DATE] documented a Brief Interview for Mental Status (BIMS) score of 15, indicating intact cognition. […]

• No harm, potential for more than minimal, patternF806Jul 15, 2026

  Based on observations, resident interviews, staff interviews, and policy review, the facility failed to offer meal items as requested for 5 of 10 residents receiving room trays (Residents #18, #22, #17, #4, and #7). The facility reported a census of 79. Findings include:The facility's Traditional Diet Menu for Week 1 dated 3/13/26 listed the Sunday Lunch desert as cherry pie. On 7/12/26 at 12:45 PM, Resident #18 did not receive cherry pie or coffee with their lunch room tray. Both items were listed on the meal ticket. On 7/12/26 at 1:35 PM, Resident #22 did not receive cherry pie with their lunch room tray. Staff returned with a replacement pie but Resident #22 elected not to accept as they desired ice cream was well. The resident commented they could only receive 1 dessert item per meal. […]