Whittier Westborough Transitional Care Unit

In the surveyor’s words

From the most serious findings on record at Whittier Westborough Transitional Care Unit, in the surveyor’s own words.

• No harm, potential for more than minimal, widespreadF882May 16, 2024

  Based on interviews, the facility failed to ensure its staff designated an Infection Preventionist (IP) who had completed specialized training in infection prevention and control prior to assuming the role of IP at the facility. Specifically, the facility designated an IP who had not completed specialized training in Infection Prevention and Control before assuming the IP role and continued to work as the designated IP at the facility. Findings include: During an interview on 5/15/24 at 7:54 A.M., the Director of Nurse (DON) said that the facility had a designated IP (Nurse #1) who has been an IP in the facility for two years and would provide proof of specialized training. […]

• No harm, potential for more than minimal, patternF880May 16, 2024

  Based on observations, interviews, and policy review, the facility failed to maintain an infection prevention and control program designed to help prevent the potential transmission of communicable diseases and infections within the facility for four Residents (#80, #121, #124, and #126), out of a total sample of 17 residents. Specifically, the facility failed to clean and disinfect multi-use equipment after use between Resident #126 and Resident #80 and who were on Enhanced Barrier Precaution (an infection control strategy that uses personal protective equipment (PPE) to reduce the spread of multidrug-resistant organisms between residents) prior to using the same equipment on two other Residents (#121 and #124). […]

• No harm, potential for more than minimal, isolatedF580May 2, 2025

  Based on interview, and record reviews, the facility failed to notify the Physician of a significant change in condition for one Resident (#60) out of a total sample of nine residents. Specifically, the facility failed to notify Resident #60's Physician of a significant weight loss prior to his/her discharge from the facility. Findings include: Review of the facility policy titled, Weighing and Measuring, dated June 2022 and revised November 2024, included but was not limited to: -Residents are weighed and measured per the following protocol to provide a baseline and an on-going record of the resident's body weight: *To determine and monitor nutritional status and medical condition. -Residents are weighed: >On admission. >Weekly for the first 4 weeks after admission. […]

• No harm, potential for more than minimal, isolatedF658May 2, 2025

  2. Review of the facility policy titled Psychotropic (medication that effects mental processes, emotions or behaviors) Medication Management and Informed Consent, dated April 2014 with revision date of March/2025, included but was not limited to: -Psychotropic medications shall not be administered to a resident without an informed written consent. -Documentation of Informed Consent is required for any medication that is used in the treatment of a psychiatric diagnosis or symptoms. This includes drugs to treat depression, anxiety disorders, attention deficit/hyperactivity disorders or other psychiatric indications. -The written informed consent shall be kept in the resident's medical record. -Behaviors or symptoms will be monitored and documented each shift. […]

• No harm, potential for more than minimal, isolatedF689May 2, 2025

  Based on observations, interviews, and record reviews, the facility failed to provide an environment free from accidents and hazards related to the storage of medications for one Resident (#63) out of a total sample of nine residents. Specifically, for Resident #63, the facility failed to: -safely and properly store prescribed topical medications when the medications were left within reach at the Resident's bedside, and he/she had a diagnosis of Dementia, putting the Resident at risk of inappropriately accessing and using the medications. […]