Swanton Valley Rehabilitation and Healthcare Cente

In the surveyor’s words

From the most serious findings on record at Swanton Valley Rehabilitation and Healthcare Cente, in the surveyor’s own words.

• Immediate jeopardy, isolatedF689Jun 9, 2025

  Based on review of the medical record, observation, resident interview, staff interview, review of the facility policy, review of documentation on the National Institute of Health (NIH) website, and review of Public Safety Network guidance, the facility failed to ensure the residents environment remained as free from accident hazards as possible when one resident (#11) continued to use vape pens (an electronic device that uses a battery to heat up a special liquid into an aerosol that users inhale) in the presence of oxygen. […]

• Actual harm, isolatedF600Jun 1, 2022

  Based on medical record review, staff interview, review of Self-Reported Incidents (SRIs), and review of facility policy, the facility failed to address and implement interventions for a resident (#75) with physical behaviors directed towards staff and residents. Resident #75 admitted to the facility on [DATE] with a history of physical behaviors directed towards others. On 05/20/22, Resident #75 punched a staff member in the chest. No care plan or interventions were implemented, and behaviors continued. This resulted in resident-to-resident physical abuse on 05/23/22 when Resident #75 hit Resident #22 on the back of her head for an unknown reason. Shortly after the incident with Resident #22, Resident #75 than pushed Resident #20, causing her to fall and hit her head. […]

• No harm, potential for more than minimal, widespreadF812Dec 5, 2024

  Based on observation and staff interview the facility failed to ensure dishes were cleaned and properly stored. This had the potential to affect 75 residents who received food from the kitchen. The facility identified one resident (#52) who received no food by mouth. The facility census was 76. Findings include: Observation on 12/02/24 at 8:12 A.M. of the kitchen revealed no designated storage area for clean cups, bowls, plates or trays. The clean clear bowls and adaptive equipment were stored on a rack in the dish room, cups were stored on the drink carts, trays were stored at the end of the steam table and opaque soup bowls were stored in racks under the steam oven. Observation on 12/03/24 at 9:58 A.M. […]

• No harm, potential for more than minimal, widespreadF727Feb 8, 2024

  Based on staff schedule review, staff interview, review of the facility assessment the facility failed to maintain the services of a registered nurse for at least eight consecutive hours a day, seven days a week as required. This had the potential to affect all 84 residents currently residing in the facility. The facility census was 84. Findings include: Review of the nursing staff information and staff schedule from 01/29/24 to 02/04/24 revealed no registered nurses (RN) were present working in the facility on 02/03/24 and 02/04/24. […]

• No harm, potential for more than minimal, widespreadF812Feb 8, 2024

  Based on observation, staff interview, review of cleaning list, and review of policy, the facility failed to ensure a clean and sanitary kitchen, ensure all food items were dated when opened and contained used by dates. This had the potential to affect all 84 residents who received food from the kitchen. The facility census was 84. Findings include: Observation during the tour of the kitchen on [DATE] between 8:27 A.M. and 9:00 A.M., of the kitchen revealed a buildup of a black substance on around the baseboards of the kitchen, a dirty microwave with a variety of dried color splatter, dried patterns of dried substances on a variety of metal shelving, including a dried white splatter on the cart containing boxes of foil and plastic wraps and an air conditioner in the window next to the… […]