Three Rivers Health and Rehabilitation Center

In the surveyor’s words

From the most serious findings on record at Three Rivers Health and Rehabilitation Center, in the surveyor’s own words.

• Immediate jeopardy, isolatedF812Aug 18, 2023

  Based on observation, interview, and record review the facility failed to ensure food items were maintained at acceptable temperature, failed to ensure employees washed hands between clean and dirty tasks and failed to obtain foods served to residents were from an approved source to prevent food borne illness. The failed practice resulted in 6 (Resident #11, #21, #30, #38, #50 and #87) residents experiencing food borne illness symptoms and had the ability to affect 93 residents who receive meals from 1 of 1 kitchen according to a list provided by the Director of Nursing on 08/17/2023 at 11:00 AM. The findings included: The situation resulted in a finding of Immediate Jeopardy. […]

• Immediate jeopardy, isolatedF689Apr 18, 2023

  Based on observation, record review, and interview, the facility failed to ensure the Van Driver safely transported a resident sitting in a wheelchair in the facility's van to prevent potential injury for 1 (Resident #1) of 13 residents who required transport in a wheelchair on the facility van in the past 2 weeks. This failed practice resulted in Immediate Jeopardy, which caused or could have caused serious harm, injury or death to Resident #1, who flipped over backwards in the wheelchair when the van accelerated out of a parking lot after failure to secure front wheels of wheelchair to J-hooks and had the potential to cause more than minimal harm to 13 residents who required wheelchairs during transport in the facility van in the past 2 weeks, as identified by the Administrator on… […]

• No harm, potential for more than minimal, widespreadF812Apr 16, 2026

  Number of residents sampled: Number of residents cited: Based on observation, interview and facility policy review it was determined that the facility failed to ensure hair restraints were consistently worn to prevent the potential for hair to contaminate resident food items in one of one kitchen observed. The findings include: During an observation on 04/14/2026 at 10:28 AM, Dietary Aide (DA) #1 was observed preparing sandwiches with a hair net covering the top part of their hair, from their ears up. There was uncovered hair out of the back of the hair net. DA #1 noticed this surveyor observing the kitchen, moved quickly to the outside door and called out to other workers requesting a hair net. […]

• No harm, potential for more than minimal, widespreadF812Aug 29, 2024

  Based on observations, interview, and record review the facility failed to ensure hand hygiene was performed properly in one of one kitchen. The findings are: On 08/27/2024 at 10:45 AM, Dietary Aide #8 donned gloves to remove the middle blade of the food processor, Dietary Aide #8 then added the pureed spaghetti to a medium rectangular steam table pan with gloves still on. Dietary Aide #8 then proceeded to put the food processor back together, she took off her gloves and did not wash hands. She then added the rest of the regular spaghetti into the food processor from a medium rectangular steam table pan. Dietary Aide #8 was observed pouring the puree spaghetti into the same steam table pan with the rest of the pureed spaghetti. […]

• No harm, potential for more than minimal, widespreadF812Apr 1, 2021

  Based on observation and interview, the facility failed to ensure leftover food items were not used as pureed food to prevent potential food borne illness for residents who received meal trays from 1 of 1 kitchen; foods stored in the freezer were covered or sealed to minimize the potential for food borne illness for residents who received meals from 1 of 1 kitchen, staff washed their hands before handling clean equipment or food items to prevent potential for cross contamination; ice machine, and ice scoop holder were maintained in a clean condition to prevent potential contamination of residents' food or beverages and hot foods were maintained at or above 135 degrees Fahrenheit on the steam table while awaiting service, to prevent potential food borne illness for residents who received… […]