Watsontown Rehabilitation and Nursing Center

In the surveyor’s words

From the most serious findings on record at Watsontown Rehabilitation and Nursing Center, in the surveyor’s own words.

• Actual harm, isolatedF689Jun 4, 2024

  Based on observation, closed clinical record review, review of facility documents, and staff interview, it was determined that the facility failed to to provide the services necessary to prevent accidents resulting in multiple sustained fractures for one of five residents reviewed resulting in actual harm (Resident CR1). Findings include: Closed clinical record review for Resident CR1 revealed a nursing note dated [DATE], at 9:09 PM noting the resident was being turned by a nurse aide and rolled off the bed onto the floor. It was noted the resident had a left dorsal head bump and complaints of severe left hip pain. […]

• Actual harm, isolatedF600Dec 11, 2023

  Based on observation, clinical record review, review of facility documents, and resident and staff interview, it was determined that the facility failed to protect the rights of a resident to be free from neglect by not providing the services necessary to avoid actual harm related to a fracture on one of two nursing units (Upper level, Resident 1). Findings include: An observation of Resident 1 on December 11, 2023, at 12:16 PM revealed the resident sitting in a wheelchair in front of his bed. A brace was observed on his right leg. When Resident 1 was asked why he was wearing the brace on his leg he stated, one person, (as he held up one finger), tried to put me in bed and didn't use the disc thing. Resident 1 stated it was immediate pain. […]

• Actual harm, isolatedF689Jul 10, 2023

  Based on closed clinical record review, review of facility documentation, and staff interview, it was determined that the facility failed to implement interventions and assure equipment was in working order to prevent accidents for one of six residents reviewed resulting in harm with a fracture (Resident 1). This deficiency is cited as past non-compliance. Findings include: Closed clinical record review for Resident 1 revealed the resident was admitted to the facility on [DATE], from the hospital emergency room . […]

• No harm, potential for more than minimal, widespreadF812Dec 17, 2021

  Based on observation and staff interview, it was determined that the facility failed to store food items in a safe and sanitary manner in the facility's main kitchen. Findings include: Observation during the initial tour of the facility's main kitchen with Employee 5 (Dietary Manager) on December 14, 2021, at 8:45 AM revealed a dry storage area that had several cans of tomato juice with a powdery substance accumulated on the top of the cans. There were two open loaves of bread with no open date noted on them. There were large cooking pans stored upside down that had white, flaky debris accumulated on them. There were large coffee filters on a bottom shelf that were open to air with dark colored, coffee-ground like debris accumulated on the top filter. […]

• No harm, potential for more than minimal, patternF656Mar 13, 2026

  Based on review of facility policy, clinical records, and staff interviews, it was determined that the facility failed to develop person-centered care plans related to safe positioning during meals for 19 of 32 residents (Residents R2, R3, R4, R5, R6, R7, R8, R9, R10, R11, R12, R13, R14, R15, R16, R17, R18, R19, and R20).Findings include: Review of the facility, Comprehensive Care Plan Policy dated 6/4/25, indicated the comprehensive, person-centered care plan describes the services that are to be furnished to attain or maintain the resident's highest practicable physical, mental, and psychosocial well-being. Review of the clinical record indicated Resident R2 was admitted to the facility on [DATE]. […]