Spring Grove Rehabilitation and Healthcare Center

In the surveyor’s words

From the most serious findings on record at Spring Grove Rehabilitation and Healthcare Center, in the surveyor’s own words.

• Actual harm, isolatedF684Oct 29, 2024

  Complaint# NJ 174618 Based on interview, review of closed medical records, and review of pertinent facility documents, it was determined that the facility failed to ensure appropriate care was provided with no delay in treatment for a resident who sustained an injury during rehabilitation therapy on 2/23/24, complained of pain and was not assessed by a Registered Nurse until 2/25/24 (two days later), and the physician ordered an x-ray which indicated a non-displaced fracture of the medial malleolus (ankle fracture). This deficient practice was identified for 1 of 3 closed medical records reviewed (Resident #101), and was evidenced by the following: Reference: New Jersey Statutes, Annotated Title 45, Chapter 11. Nursing Board. […]

• No harm, potential for more than minimal, patternF921Mar 30, 2026

  Based on observation, interview, and review of pertinent documents, it was determined that the facility failed to maintain a clean, safe, and sanitary environment for a.) 3 of 7 linen carts in 2 of 3 nursing units (North and [NAME] units), b.) 4 of 7 resident rooms (Rooms 10, 17, 18, and 20), and c.) 1 of 2 central baths (South unit) observed during environmental tour. This deficient practice was evidenced by the following: 1.On 3/24/26 at 11:20 AM, Surveyor #1 (S #1) observed during [NAME] unit tour two linen carts parked in between room [ROOM NUMBER] with posted sign for respiratory isolation and room [ROOM NUMBER] with posted sign for contact precaution. […]

• No harm, potential for more than minimal, patternF558Oct 29, 2024

  Based on observation, interview, and review of pertinent facility documents, it was determined that the facility failed to maintain the call bell within reach of residents. This deficient practice was identified for 6 of 37 residents reviewed for accommodation of needs (Resident #70, #15, #1, #48, #13, and #86), and was evidenced by the following: a. On 10/22/24 at 10:43 AM, the surveyor observed Resident #70 in bed, with his/her eyes closed. Resident #70 did not respond to the surveyor's greeting. The surveyor observed the resident's call bell (a bell used to summon staff for assistance) was not within the Resident's reach. On 10/23/24 at 12:59 PM, the surveyor observed Resident #70 in bed with his/her eyes closed. Resident #70 did not respond to the surveyor. […]

• No harm, potential for more than minimal, patternF582Oct 29, 2024

  Based on observation, interview and record review, it was determined that the facility failed to issue the required Skilled Nursing Facility Advance Beneficiary Notice (SNF ABN) and/or the Notice of Medicare Non-coverage (NOMNC) for 3 of 3 residents (#82, #349, #348) reviewed for facility change notifications regarding insurance termination. The evidence is as follows. On 10/28/24 at 11:28 a.m., the facility presented the surveyor with a list of residents who were discharged from the facility within 6 months and were required to have received Beneficiary Notices. […]

• No harm, potential for more than minimal, patternF677Oct 29, 2024

  Complaint # NJ 172317, NJ 172237; NJ 174618; NJ 175890 Based on observation, interview, record review, and review of facility provided documentation, it was determined that the facility failed to ensure that incontinence care was provided to dependent residents in a timely manner for 7 of 8 residents (Resident #82, #199, #48, #13, #86, #24, and #14) observed for incontinence care on 2 of 4 units (North Unit and [NAME] Unit). This deficient practice was evidenced by the following: On 10/24/24 at 7:35 AM, the surveyor completed an incontinence tour on the North Unit and observed the following: a. On 10/24/24 at 7:40 AM, the surveyor accompanied by Registered Nurse (RN #1) observed Resident #82 in bed. RN #1 exposed Resident #82's incontinence brief. […]