Vanderman Place

In the surveyor’s words

From the most serious findings on record at Vanderman Place, in the surveyor’s own words.

• Actual harm, isolatedF689Oct 25, 2022

  Based on clinical record review, facility documentation review, interviews, and policy review for one of three residents (Resident #1) reviewed for accidents, the facility failed to maintain the safety. The finding includes: Resident #1 had diagnoses that included Alzheimer's disease, polyarthritis, multisystem inflammatory syndrome, syncope (fainting or passing out) and collapse, hypo-osmolality, hyponatremia, and malignant neoplasm of the colon. The Resident Care Plan (RCP) dated 8/23/2022 identified Resident #1 had an ADL self-care deficit and poor safety awareness related to dementia and was at risk for falls. […]

• No harm, potential for more than minimal, widespreadF812May 23, 2025

  Based on the tour of the kitchen, observations, review of facility policy and staff interviews, the facility failed to ensure hair coverings were worn while in the kitchen. The facility failed to ensure food was consistently labeled and dated and expired foods were discarded. The findings included: Tour of the kitchen on 5/19/25 at 9:57 AM during the initial walk through with the Administrator identified the following: 1.an Observation on 5/19/25 at 9:57 AM of Cook#1 in the kitchen without hair covering. Interview with Cook#1 on 5/19/25 at 9:57 AM indicated hair covering should be on while in the kitchen. [NAME] #1 also indicated he/she had a hat on but forgot to put it back on when he/she reentered the kitchen. b. […]

• No harm, potential for more than minimal, patternF552May 23, 2025

  Based on review of the clinical record, review of facility documentation and staff interviews for 5 of 5 residents (Residents 24, 55, 56 and # 73) reviewed for Psychotropic medications, the facility failed to ensure informed consent for the use of a new psychotropic medication was obtained from the responsible party prior to the use of the medication. The findings included: 1. Resident #22's diagnosis included cognitive deficits following a cerebral infarction, unspecified intellectual disabilities and major depression. […]

• No harm, potential for more than minimal, patternF689May 23, 2025

  Based on clinical record reviews, observations and staff interviews for 3 of 3 (Residents #25, #63 and #78) with a history of wandering, the facility failed to ensure soiled utility on Units 1, 2, and 3 were not accessible to residents to prevent an accident.The findings included: 1. Resident #25's diagnosis includes Alzheimer's disease. Resident #25's Nursing Quarterly Evaluation dated 3/08/2025 at 11:18 AM indicated Resident #25 wanders without purpose. 2. Resident #63's diagnosis includes dementia with behavioral disturbance. Resident #63's Nursing Quarterly Evaluation dated 3/29/2025 at 7:46 PM indicated Resident #63 wanders without purpose, oblivious to needs and safety, and is confused. 3. […]

• No harm, potential for more than minimal, patternF761May 23, 2025

  Based on observations of Wings 2 and 3 and staff interviews, the facility failed to ensure the medication refrigerator was free of food items and failed to keep medication rooms clean. The facility failed to ensure a medication cart was secure and accessible to only licensed staff. The findings included: 1 a. Observation on 5/23/25 at 11:45 AM of Wing 3 medication room with LPN #5 identified the following: The bottom door shelf of the medication refrigerator was observed to have an opened 12-ounce bottle of a tan-colored drink that had a manufacturer label indicating 20 grams of protein and with vanilla cream flavor. LPN #5 indicated the drink was not an item used by the facility. There were no labels indicating if the drink belonged to a resident. […]