Stonebridge Health Rehab

In the surveyor’s words

From the most serious findings on record at Stonebridge Health Rehab, in the surveyor’s own words.

• Immediate jeopardy, isolatedF697Feb 14, 2025

  Based on observation, interview and record review, the facility failed to ensure that pain management was provided to residents who required such services, consistent with professional standards of practice, the comprehensive person-centered care plan, and the residents' goals and preferences for 1 of 5 (Resident #195) residents reviewed for pain. The facility failed to provide scheduled Morphine and Tramadol for Resident #195 from 02/07/2025-02/09/2025 which resulted in mental anguish and untreated pain. An IJ was identified on 02/11/2025. The IJ template was provided to the facility on [DATE] at 04:56 PM. […]

• Actual harm, isolatedF697Apr 23, 2026

  Based on observation, interview, and record review, the facility failed to ensure that pain management was provided to residents who require such services, consistent with professional standards of practice, the comprehensive person-centered care plan, and the residents' goals and preferences for 1 of 8 residents (Resident #16 reviewed for pain.The facility failed to ensure Resident #16 received pain management to the fullest extent possible, resulting in her experiencing pain on 04/22/2026. This failure placed residents at risk of uncontrolled pain. Findings included:Record review of the undated face sheet for Resident #16 reflected a [AGE] year-old female admitted to the facility on [DATE]. […]

• No harm, potential for more than minimal, widespreadF812Feb 14, 2025

  Based on observation, interview, and record review the facility failed to store, prepare, distribute, and serve food in accordance with professional standards for food safety in the facility's only kitchen. The cook was not wearing hair restraints while in the kitchen. The cook did not practice appropriate hand washing prior to preparing and cooking food. The cook did not wash hands or wear gloves when moving from one operation to another. The DA did not wash hands or wear gloves when moving from one operation to another. Non-dietary staff, CNA entered the kitchen without hair restraint. Non-dietary staff did not wash hands. The DM improperly cleaned the thermometer while checking holding temperatures of foods prior to meal service. […]

• No harm, potential for more than minimal, widespreadF812Oct 7, 2022

  Based on observation, record review, and interview, the facility failed to prepare and serve food in accordance with professional standards for 1 of 1 kitchen reviewed for food service safety, in that: 1. The shelve unit below the steamer had visible dust and dirt particles. 2. The two (2) ceiling vents in the dish room measuring approximately one (1) foot by one foot were dirty with noticeable dust build-up. The side wall in the dish room measuring approximately two (2) feet by 2 feet was dirty with chipped paint. 3. The ceiling overhead light in front of the three (3) pan sink with four (4) fluorescent bulbs did not have a light cover on. 4. […]

• No harm, potential for more than minimal, patternF761Feb 14, 2025

  Based on observations, interviews, and record review, the facility failed to ensure drugs and biologicals were stored and labeled in accordance with currently accepted professional principles for 1 of 1 medication storage room and 2 of 3 medication carts. A) The facility failed to ensure expired supplies and medications were removed from the medication storage room. B) The facility failed to ensure expired supplies and medications were removed from the nurses' medication cart for 400 hall. […]