St Clare Manor Nursing and Rehabilitation

In the surveyor’s words

From the most serious findings on record at St Clare Manor Nursing and Rehabilitation, in the surveyor’s own words.

• Immediate jeopardy, isolatedF609Feb 8, 2024

  Based on interviews and record reviews, the facility failed to ensure an allegation of possible sexual abuse was reported immediately, but not later than 2 hours after the allegation was made, to the facility Administrator and to the State Survey Agency for 1 (#1) of 3 (#1, #2, and #3) residents reviewed for sexual abuse. S3NP and S5FMD failed to notify the facility's Administrator after a sexually transmitted disease was found in Resident #1's microscopic urine sample while residing in the hospital. This deficient practice resulted in an Immediate Jeopardy situation on 01/15/2024 when S3NP and S5FMD were made aware Resident #1, a nonverbal resident with Flaccid Hemiplegia, tested positive for Trichomonas, a sexually transmitted disease. […]

• Immediate jeopardy, isolatedF841Feb 8, 2024

  Based on interviews and record reviews, the Medical Director failed to fulfill her responsibility for the implementation of resident care policies by failing to notify S1ADM and S4DON after being made aware of a sexually transmitted disease for 1 (#1) of 3 (#1, #2, and #3) residents reviewed for sexual abuse. This deficient practice resulted in an Immediate Jeopardy situation on 01/15/2024 when S3NP and S5FMD were made aware Resident #1, a nonverbal resident with Flaccid Hemiplegia, tested positive for Trichomonas, a sexually transmitted disease. S3NP and S5FMD failed to notify S1ADM and S4DON of Resident #1's positive Trichomonas urine test from 01/13/2024. […]

• No harm, potential for more than minimal, widespreadF880Feb 2, 2023

  Based on observations, interviews and record review, the facility failed to maintain an infection prevention and control program designed to provide a safe, sanitary, and comfortable environment and to help prevent the development and transmission of communicable diseases and infections by failing to ensure: 1. Staff practiced appropriate hand hygiene and glove use during the provision of perineal and catheter care for 2 (#21 and #29) of 3 (#21, #29, and #87) residents reviewed for urinary tract infections; and, 2. […]

• No harm, potential for more than minimal, patternF761May 6, 2026

  Based on observations and interviews, the facility failed to ensure drugs and biologicals used in the facility were stored in accordance with currently accepted professional principles by failing to ensure:Resident rooms were free of loose and unlabeled pills for 1 (Resident #145's room) of 6 resident rooms observed during medication administration; andMedication carts were free of loose and unlabeled pills for 2 (Med Cart 1 and Med Cart 2) of 3 medication carts reviewed.Findings: Review of the facility's Storage of Medications policy, dated November 2020, revealed the following, in part:Policy:The facility stores all drugs and biologicals in a safe, secure, and orderly manner.2. […]

• No harm, potential for more than minimal, patternF847Apr 3, 2024

  Based on interviews and record review, the facility failed to ensure residents understood the binding arbitration agreement signed on admission or were given the right to rescind the agreement within 30 calendar days for 3 (#89, #101, and #267) of 3 (#89, #101, and #267) residents reviewed for arbitration. Findings: Review of the facility's form titled Admission Agreement on page 13 of 35 revealed an arbitration agreement was included in the Admission Agreement. This agreement revealed in part, the following: Binding Arbitration Provision. -If the parties to this agreement do not wish to include the following arbitration provision please indicate so by marking an X through the provision. […]