Westminster Village Health & Rehab

In the surveyor’s words

From the most serious findings on record at Westminster Village Health & Rehab, in the surveyor’s own words.

• Actual harm, isolatedF689Mar 13, 2026

  Based on interview and record review, the facility failed to ensure a resident was mechanically transferred safely resulting in harm when a resident had a fall from the mechanical lift and had a left clavicle fracture and laceration to the back of the head for 1 of 3 residents reviewed for falls (Resident C). The deficient practice was corrected by 3/8/26 prior to the start of the survey and was therefore Past Noncompliance. Findings include:A Facility Reported Incident (FRI), dated 3/9/26 at 4:14 p.m., indicated Resident C had a fall during a mechanical lift transfer. Staff administered first aid and pain management and transferred the resident to the emergency room for further evaluation and treatment for a left clavicle fracture and laceration to the back of her head. […]

• No harm, potential for more than minimal, patternF812Mar 27, 2024

  Based on observation and interview, the facility failed to prepare and serve food in a sanitary manner on 3 of 3 kitchen observations. Findings include: On 3/20/24 at 9:43 a.m., during initial dietary observation. Observed the following. a. Employee 5 had a beard cover not covering all of his mustache b. Food on the steam table was uncovered c. Debris on the floor throughout food prep area d. Dark debris on the outside and inside of the food warmer. Dried dark debris on the inside and bottom of the convection oven e. Review of dishwasher temperature log indicated the documentation from 1/1/24 to 3/20/24 lacked entries of wash temperatures. […]

• No harm, potential for more than minimal, isolatedF684Jul 1, 2026

  Based on interview and record review, the facility failed to ensure that a physician was notified of STAT (immediate) lab results and a resident's change in condition related to low platelet count and increased confusion for 1 of 5 residents reviewed for hospitalization (Resident B). Findings include:During an interview on 6/25/26 at 9:22 a.m., Resident B indicated he had been sent out to the hospital a couple of times in the month of May 2026. During an interview on 6/29/26 at 3:53 p.m., Resident B indicated he could not recall how he was feeling the days prior to being sent out to the hospital, I was completely out of it. […]

• No harm, potential for more than minimal, isolatedF578Apr 28, 2025

  Based on record review and interview the facility failed to indicate the full code status of a resident upon admission to the facility according to a POST (physician's order for scope of treatment) form for 1 of 24 records reviewed. (Resident 271) Findings include: On 4/22/25 at 9:45 a.m., the medical record of Resident 271 was reviewed. The medical record indicated the resident was admitted to the facility on [DATE]. Diagnoses included, but were not limited to, infection and inflammation and inflammatory reaction due to other internal joint prosthesis (a medical device, typically an artificial joint, designed to replace or improve the function of a damaged or diseased natural joint), methicillin susceptible staphylococcus aureus infection (a bacterial infection), and hypertension (high… […]

• No harm, potential for more than minimal, isolatedF622Apr 28, 2025

  Based on interview and record review, the facility failed to ensure documentation of a resident's transfer included a progress note with pertinent information that the resident was being transferred to the hospital and the facility failed to ensure report was called to the emergency room for 1 of 1 resident reviewed for hospitalization (Resident 7). Findings include: During an interview, on 4/22/25 at 8:52 a.m., Resident 7 indicated she had been transferred to the hospital a couple of times in the last few months. Resident 7's record was reviewed on 4/23/25 at 8:59 a.m. […]