Sparta Health and Rehabilitation

In the surveyor’s words

From the most serious findings on record at Sparta Health and Rehabilitation, in the surveyor’s own words.

• No harm, potential for more than minimal, patternF812Oct 9, 2022

  Based on observation, interview, and facility policy review, the facility failed to ensure all hot food items were held above 135 degrees on the steam table to prevent food borne illness. This deficient practice had the potential to effect 36 of 42 resident that receive regular or mechanical soft textured diet. Findings include: Observation on 10/8/22 at 12:45 p.m. revealed the Dietary Manager (DM) assisting with obtaining hot food temperatures on the steam table using the facility's calibrated thermometer. Steam table temperatures were obtained halfway through lunch meal service. Continued observation revealed a deep square steam table pan containing tater tots had a temperature of 130 degrees. During an interview on 10/8/22 at 12:45 p.m. […]

• No harm, potential for more than minimal, patternF656Apr 29, 2021

  Based on observation, record review, interview, patient rights documents and facility policy review, the facility failed to implement care plan interventions to prevent falls for one (Resident (R) 41). Staff failed to provide care as required per R41's care plan, including the number of staff necessary to prevent accidents during the provision of care. As a result, the resident fell from his bed to the floor on two occasions. The facility failed to ensure R41 and R22's preferences for bathing were integrated into the care plan. The facility failed to develop a comprehensive care plan for R9 regarding nutritional risk, out of a survey sample of 13 reviewed for care plans. […]

• No harm, potential for more than minimal, patternF883Apr 29, 2021

  Based on interview, record review, facility policy review, and review of the Centers for Disease Control and Prevention (CDC) guidelines, the facility failed to offer one of five residents (Resident (R) 29), and/or their representative, reviewed for pneumonia vaccinations, the opportunity for the resident to be vaccinated in accordance with CDC guidelines. The resident and/or their representatives were unable to share in clinical decision making with the medical provider as they were not given information or offered PCV13. […]

• No harm, potential for more than minimal, isolatedF677Mar 13, 2025

  Based on observation, staff interviews, record reviews, and review of the facility's policy titled Helping Avoid Nosocomial Developed Skin Breakdown, the facility failed to provide activities of daily living (ADL) care to one of 25 sampled residents (R) (R13). Specifically, the facility failed to ensure that thorough incontinence care was provided to R13. This deficient practice had the potential to place R13 at risk of developing infections, foul odor, and skin breakdown. Findings include: Review of the facility's policy titled Helping Avoid Nosocomial Developed Skin Breakdown, reviewed 4/2024, included Incontinence cleansing and skin barriers may be used for incontinence patients. […]

• No harm, potential for more than minimal, isolatedF880Mar 13, 2025

  Based on observations, record reviews, staff interviews, and a review of the facility's policies titled Hand Hygiene, and Standard Precaution/Use of PPE [Personal Protective Equipment], the facility failed to ensure infection control processes were followed during resident care for one of 25 sampled residents (R) (R13). The deficient practice had the potential to increase the potential for cross-contamination and spread of infection. Findings include: Review of the facility's policy titled Hand Hygiene, reviewed 12/27/2024, revealed the Purpose section stated, Hand Hygiene is the single most important means of preventing the spread of infection. The use of gloves does not replace hand washing. […]