The Blossoms at van Buren Rehab and Nursing Center

In the surveyor’s words

From the most serious findings on record at The Blossoms at van Buren Rehab and Nursing Center, in the surveyor’s own words.

• Immediate jeopardy, isolatedF689May 2, 2023

  Based on record review and interview, the facility failed to ensure adequate supervision and monitoring was provided to prevent elopement for 1 (Resident #1) of 3 (#1, #2 and #3) case mix residents who were at risk for elopement, as evidenced by a failure to develop and implement interventions and staff training to ensure that cognitively impaired residents who resided in the facility were closely monitored and their whereabouts accounted for when a facility door alarm sounded. This failed practice resulted in Non-Compliance at the level of Immediate Jeopardy, which caused injury and harm for Resident #1, who eloped from the facility, was missing for approximately 4 hours, fell into a ditch, sustained multiple injuries, and became Hypothermic due to exposure. […]

• No harm, potential for more than minimal, widespreadF727Jan 27, 2023

  Based on interview, and record review, the facility failed to ensure there was Registered Nurse (RN) coverage for at least 8 consecutive hours per day, 7 days a week. The findings are: 1. On 01/25/23 at 2:30 PM, the Surveyor asked the Human Resource (HR) Coordinator to provide the license for the Director of Nursing (DON) and the Assistant Director of Nursing (ADON). The HR Coordinator stated, We do not currently have a DON or ADON. The Surveyor requested the Minimum Data Set (MDS) Coordinator's license and the other RN's license who were at the facility when the MDS Coordinator was not. The HR Coordinator went into the Administrator's Office to ask the Administrator who the RN was when the MDS Coordinator was not at the facility. […]

• No harm, potential for more than minimal, widespreadF732Jan 27, 2023

  Based on observation and interview, the facility failed to ensure staffing schedules for Nursing staff and Certified Nursing Assistants (CNAs) were posted in a prominent area that was readily accessible to residents and visitors in 1 of 1 facility. The findings are: 1. On 01/23/23 at 7:50 PM, a sign in a case on the wall on the 200 Hall documented, Schedule is now posted in the Battery Room!!! 2. On 01/25/23 at 3:20 PM, the Social Service Director informed the Surveyor where the Battery Room was located. The signage on the door stated, Therapy Tub, and the door was locked. Upon entry, the staff schedule for the Nurses and CNAs was on the wall inside. 3. On 01/25/23 at 3:30 PM, the Surveyor asked the Administrator who was responsible for posting the required staff information. […]

• No harm, potential for more than minimal, widespreadF812Jan 27, 2023

  Based on observation, and interview, the facility failed to ensure foods stored in the kitchen area and in the freezer were covered, sealed and dated to minimize the potential for food borne illness for residents who received meals from 1 of 1 kitchen; failed to ensure 1 of 1 ice machine was maintained in a clean and sanitary condition to prevent potential contamination of residents' beverages and failed to ensure dietary staff washed their hands before handling clean equipment or food items to prevent potential food borne illness for residents who received meals from 1 of 1 kitchen. These failed practices had the potential to affect 55 residents who received meals from the kitchen (total census: 57), as documented on a list provided by the Dietary Supervisor on 01/25/23 at 8:22 AM. […]

• No harm, potential for more than minimal, widespreadF947Jan 27, 2023

  Based on interview, and record review, the facility failed to ensure Certified Nursing Assistants (CNAs) were provided with the required in-service training to ensure they were prepared and competent with the skills required to meet the needs of the residents of 1 of 1 facility. The findings are:. 1. On 01/25/23 at 2:30 PM, the Human Resource (HR) Coordinator informed the Surveyor that the CNAs were provided a minimum of 12 units of in-service training annually by the facility. 2. On 01/25/23 at 4:00 PM, the Surveyor requested the in-service training for Abuse/Neglect/Exploitation, Resident Rights, Dementia Care, Infection Control, Communication, Behavioral Health, and Special Resident Needs such as Pain, Trach Care, Medication Side Effects, Hospice, and Changes in Condition. […]