Teresian House Nursing Home Co Inc

In the surveyor’s words

From the most serious findings on record at Teresian House Nursing Home Co Inc, in the surveyor’s own words.

• Immediate jeopardy, isolatedF689Dec 23, 2021

  Based on observation, medical and facility record review, video footage, and staff interview during a recertification and abbreviated survey (Case # NY 505) the facility failed to provide adequate supervision for one (Resident #216) of 8 residents reviewed for accidents. Specifically, on 12/3/21 at 11:30 AM the facility failed to provide Resident #216, who was severely cognitively impaired, with supervision. Subsequently, Resident #216 was able to exit the building through a coded/locked door off the unit and 2 sets of alarmed doors exiting the facility for over two hours. Both alarmed doors were disabled by facility staff. […]

• No harm, potential for more than minimal, patternF759Nov 8, 2024

  Based on observation, record review, and interviews conducted during a recertification survey, the facility did not ensure that its medication error rate did not exceed 5% for 1 (Resident #77) of 4 residents observed during a medication pass for a total of 25 observations. This resulted in a medication error rate of 24%. This is evidenced by: The facility's Policy and Procedure titled Administering Medications, last reviewed 3/16/2023 and Last Revision: 11/5/2024, documented medications were administered in a safe and timely manner, and as prescribed. Policy Interpretation and Implementation #2: medications may be administered within (1) hour before or after prescribed times. […]

• No harm, potential for more than minimal, patternF760Nov 8, 2024

  Based on observation, record review, and interviews conducted during a recertification survey, the facility did not ensure that residents were free of any significant medication errors for 2 (Resident #s 88 and 144) of 2 resident reviewed. Specifically, (a.) on 6/27/2024 Resident #88 received medications that were prescribed for another resident; (b.) on 11/02/2024 and 11/03/2024 Resident #144 did not receive a medication as prescribed. Additionally, there was no documented evidence that physician was notified, and that Resident #144 was monitored for side effects. […]

• No harm, potential for more than minimal, patternF812Dec 23, 2021

  Based on observation, record review, and staff interview during the recertification survey, the facility did not store, prepare, distribute, and serve food in accordance with professional standards for food service safety. The sanitizing chemical in the final rinse of low temperature automatic dishwashing machines are to be within a specific range, and food preparation and serving areas are to be kept clean. Specifically, the automatic dishwashing machine chemical sanitizing final rinse was too concentrated, and the unit kitchens required cleaning. This is evidenced as follows. When checked on 12/19/2021 at 9:14 AM, the concentration of sanitizing chemical in the final rinse of the automatic dishwashing machine final rinse was 200 parts per million of available chlorine (ppm). […]

• No harm, potential for more than minimal, isolatedF609Nov 8, 2024

  Based on interviews and record review during the recertification survey and an abbreviated survey (Case #NY00346710), the facility did not ensure that (a.) all alleged violations of resident abuse, neglect, exploitation, or mistreatment, including injuries of unknown source, were reported immediately but not later than 2 hours after the allegation was made, if the events that cause the allegation involve abuse or resulted in serious bodily injury, to the administrator of the facility and to other official (including the State Survey Agency and adult protective services where state law provided for jurisdiction in long-term care facilities) in accordance with State law through established procedures; and (b.) reported the results of all investigations to the administrator or their… […]