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Inspectors wroteBased on observation, interview, and record review conducted during the Standard survey completed on 12/20/24, the facility did not store, prepare, distribute, and serve food in accordance with professional standards for food service safety. Specifically, five ([NAME] 3, [NAME] 2, Willink A, Willink C, Willink Legacy Cove) of five unit Nourishment Room refrigerators contained undated, unlabeled, and out of date food and drink items and a staff member's personal food was stored with residents' food.

Inspectors wroteBased on observation, interview and record review conducted during the Standard survey completed on 12/20/24, the facility did not ensure residents had the right to interact with members of the community and participate in community activities inside the facility for one (Resident #33) of two residents reviewed. Specifically, staff did not accommodate Resident #33's choice to attend the Resident Council Meeting on 12/17/24. The finding is: The policy and procedure titled Resident Rights and Responsibilities revised 4/2/24 documented the facility functions on the premise that the service it renders should demonstrate its belief in the dignity and worth of every individual. It is the objective of the facility to provide the Patient/Resident with optimal nursing and psychosocial care. Every effort is made by the staff to meet the Patient/Resident's individual needs and requirements. [...]

Inspectors wroteBased on interview and record review conducted during a Complaint investigation (#NY00347404) during a Standard survey completed on 12/20/2024, it was determined the facility did not protect residents from sexual abuse for two (Resident #165 and Resident #151) of seven residents reviewed. Specifically, residents who lacked ability to consent were observed undressed and in bed together. The policy and procedure titled Abuse Prohibition dated 02/2023 documented that residents have a right to be free from abuse including sexual abuse. The policy and procedure titled Abuse Prohibition Staff Responsible for Coordinating and Implementing dated 11/19/2021 documented that the Administrator is responsible for preventing abuse of the residents.

Inspectors wroteBased on observation, interview, and record review conducted during the Standard survey completed on 12/20/24, the facility did not maintain an infection prevention program designed to provide a safe, sanitary, and comfortable environment and to help prevent the development and transmission of communicable diseases and infection for one (Resident #10) of three residents reviewed. Specifically, staff placed linens soiled with urine and fecal matter and soiled incontinence briefs directly on the floor and on the resident's bed headboard and footboard while providing care. The finding is: The policy and procedure titled Incontinent Care revised 3/2022 documented to remove brief, clothing and bed linen and place on a soiled barrier. Wash perineum, anus, buttocks, abdomen, hips, and thighs. Rinse if using soap. Pat dry with a towel. [...]

Inspectors wroteBased on observation, interview, and record review conducted during the Standard survey completed on 12/20/24, the facility did not ensure each resident was offered the pneumococcal and influenza immunizations and received education regarding the benefits and potential side effects of the immunizations for two (Residents #171 and #10) of six residents reviewed. Specifically, Resident #171 was not given the influenza vaccine after their responsible party consented to the vaccination nor were they offered and educated about the pneumococcal vaccination. Additionally, Resident #10 was not given the pneumococcal vaccination after their responsible party consented to the vaccination.

Inspectors wroteBased on observation, interview, and record review conducted during a Standard survey completed on 6/28/23, the facility did not ensure that residents who receive a psychotropic medication have gradual dose reductions (GDR), unless clinically contraindicated, in an effort to discontinue these drugs for one (Resident #7) of six residents reviewed for psychotropic medication use. Specifically, there was a lack of a GDR attempt for a resident receiving an antipsychotic medication without adequate supporting evidence for its continued use. The finding is: The policy and procedure (P&P) titled Psychotropic Med Use Initiation and Gradual dose reduction dated revised 10/22 documented each resident is evaluated for the initiation/continued need of psychotropic medications and the determination of whether he/she is being maintained on the lowest effective dose. [...]

Inspectors wroteBased on interview and record review, conducted during a Standard survey completed 6/28/23, the facility did not ensure the resident has a right to a safe, clean, comfortable, and homelike environment. The facility did not exercise reasonable care for the protection of resident's property from loss or theft for one (Resident #43) of 3 reviewed. Specifically, Resident #43 reported to the facility in February 2023 that their cell phone went missing during a room change from one unit to another. The facility did not investigate and follow up on the missing property report.

Inspectors wroteBased on interview and record review conducted during a Complaint Investigation (NY00310847) during a Standard survey completed on 6/28/23, the facility did not ensure that residents, residents' representative, and the Office of the State Long Term Care Ombudsman receive a written notice of transfer or discharge must be made by the facility at least 30 days before the resident is transferred or discharged . Specifically, three (Residents #221, 220, 219) of four, their representatives, and the New York State Ombudsman office did not receive a written transfer or discharge notices 30 days prior to being transferred to another facility.

Inspectors wroteBased on observation, interview, and record review conducted during a Standard survey completed on 6/29/23, the facility did not ensure that each resident who was unable to carry out Activities of Daily Living (ADL's) received the necessary services to maintain grooming and personal hygiene for one (Residents #7) of four residents reviewed for ADL's. Specifically, Residents #7 had dark thick debris under their fingernails.

Inspectors wroteBased on observation, interview, and record review during the Standard survey completed on 6/28/23, the facility did not operate and provide services in compliance with all applicable Federal, State, and local laws, regulations, and codes. Specifically, the facility was not in compliance with Section 915 of the 2020 Fire Code of New York State, which requires carbon monoxide detection in buildings with fuel-burning appliances and on-going preventative maintenance of carbon monoxide detectors. This affected three ([NAME], [NAME], Willink) of three resident use buildings. The finding is: The policy and procedure called, Carbon Monoxide Detectors, effective 5/2019, documented carbon monoxide detectors shall be installed, tested and cleaned as per manufacturer's recommendations. [...]

Inspectors wroteBased on observation, interview, and record review conducted during a Standard survey completed on 8/11/21, the facility did not maintain all essential mechanical, electrical, and patient care equipment in a safe operating condition. Specifically, one ([NAME]) of two kitchens in use had issues with sub-optimal dish machine water temperatures for proper cleaning and sanitizing of dishes.

Inspectors wroteBased on observation, interview, and record review conducted during the Standard survey completed on 8/11/21, the facility did not ensure that each resident who is unable to carry out Activities of Daily Living (ADL's) receives the necessary services to maintain grooming and personal hygiene. Specifically, one (Resident # 205) of four residents reviewed for ADL's had long jagged fingernails. The finding is: A facility policy and procedure (P&P) titled Activities of Daily Living dated 3/20 documented that each resident will receive, and the facility will provide the necessary care and services to attain or maintain the highest practicable physical, mental, and psychosocial well-being, consistent with the resident's comprehensive assessment and plan of care. [...]

Inspectors wroteBased on observation, interview, and record review conducted during a Standard survey completed on 8/11/21, the facility did not ensure that residents receive treatment and care in accordance with professional standards of practice and the comprehensive person-centered care plan for one (Resident #6) of six residents reviewed for non-pressure related skin issues. Specifically, a nurse did not complete the wound treatment as ordered by the physician and there was a lack of hand hygiene and glove change, during wound treatment. The finding is: The facility policy and procedure (P&P) titled Physician Orders effective 3/1/20 documented it shall be facility policy to assure that medication/treatment orders are implemented accurately, timely, and in accordance with the Health Code of the State of NY and Federal Government agencies. [...]

Inspectors wroteBased on interview and record review conducted during a Standard Survey completed on 8/11/21, the facility did not ensure that each resident receives an accurate assessment, reflective of the resident's status at the time of the assessment for five (Residents #'s 14, 60, 88, 205 and 210) of forty residents reviewed for Minimum Data Set 3.0 (MDS, a resident assessment tool) accuracy. Specifically, the facility did not ensure that the MDS Assessments accurately reflected the residents' status.