Alaris Health at Hamilton Park

Inspectors wroteBased on observation, interview, and record review, it was determined that the facility failed to ensure the resident's primary physician (MD) accurately dated their physician progress notes (PPN) during their visit to ensure the resident's current medical regimen was up to date. This deficient practice was observed for 1 of 33 residents (Resident #129). This deficient practice was evidenced by the following: On 3/7/25 at 10:10 AM, the surveyor observed Resident #129 sitting in a wheelchair inside the day room, unable to answer the surveyor's inquiry. On 3/7/25 at 10:28 AM, the surveyor reviewed the electronic Medical Record (eMR)/ hybrid medical record (paper and electronic) of Resident #129, which revealed the following: [...]

Inspectors wroteREPEAT DEFICIENCY Based on interviews and record reviews, it was determined that the facility failed to accurately code the Minimum Data Set (MDS), an assessment tool used to facilitate the management of care, in accordance with federal guidelines for 1 of 33 residents (Residents #32) reviewed for accuracy of MDS coding. This deficient practice was evidenced by the following: On 3/7/25 at 9:58 AM, the surveyor observed Resident #32 in bed awake, able to answer the surveyor's inquiry. On 3/12/25 at 8:25 AM, the surveyor reviewed the electronic Medical Record (eMR)/ hybrid medical record (paper and electronic) of Resident #32, which revealed the following: [...]

Inspectors wroteBased on observation, interview, and record review, it was determined that the facility failed to follow a Physician's Order (PO) in accordance with professional standards of practice for 2 of 3 residents (Resident #156 and #67) reviewed for oxygen therapy. The deficient practice was evidenced by the following: Reference: New Jersey Statutes Annotated, Title 45. Chapter 11. Nursing Board. The Nurse Practice Act for the State of New Jersey states: The practice of nursing as a registered professional nurse is defined as diagnosing and treating human responses to actual and potential physical and emotional health problems, through such services as case-finding, health teaching, health counseling, and provision of care supportive to or restorative of life and wellbeing, and executing medical regimens as prescribed by a licensed or otherwise legally authorized physician or dentist. Reference: [...]

Inspectors wroteBased on observation, interview, and record review, it was determined that the facility failed to establish appropriate infection control practices for environmental cleaning for 1 of 33 residents (Resident #40). This deficient practice was evidenced by the following: On 3/12/25, at 9:45 AM, the surveyor observed Resident #40 awake inside the room with the head of the bed elevated with a tube feeding (TF) (nutrition received through a flexible tube surgically inserted into the stomach) formula hanging on a pole at a rate of 65 ml/hr. (milliliters per hour). The surveyor observed a splash of creamy substance on the suction canister lid and the feet of the feeding pole. On 3/12/25 at 9:58 AM, the surveyor interviewed the Registered Nurse (RN), who stated she did not observe the splashed milk onto the lid of the suction canister and the feeding pole feet. [...]

Inspectors wroteBased on interviews, record review, and policy review, the facility failed to ensure a potential allegation of physical abuse by staff was reported timely to the State Survey Agency (SSA) when a resident sustained an injury during incontinence care for one of three residents reviewed for abuse (Resident (R) 5) out of 27 sampled residents. This failure increased the risk of other vulnerable residents being physically abused.

Inspectors wroteBased on interviews, record review, and policy review, the facility failed to protect other residents by suspending the alleged perpetrator during the investigation for one of three residents reviewed for abuse (Resident (R) 5) out of 27 sampled residents. This failure increased the risk of other vulnerable residents being physically abused.

Inspectors wroteBased on record review, interview, and facility policy review, the facility failed to ensure one (Resident (R) 13) out of three residents reviewed for pressure ulcers had timely assessments and monitoring of the pressure ulcers out of a total sample of 27 residents. This had the potential for the pressure ulcer to worsen and delay treatment.

Inspectors wroteBased on record review, interview, and review of the Centers for Disease Control and Prevention (CDC) guidelines, the facility failed to ensure indwelling urinary catheter care was completed and urinary output was monitored as ordered for one of three residents (Resident (R) 8) reviewed for catheter care out of a total sample of 27 residents. This had the potential for the resident to be susceptible for a urinary tract infection (UTI) and possible fluid status issues.

Inspectors wroteBased on record review, interview, review of the Centers for Disease Control and Prevention (CDC) guidance criteria for wound infections, and facility policy review, the facility failed to ensure one of one resident (Resident (R) 13) reviewed for antibiotic stewardship out of a total sample of 27 residents had documentation to support the resident met the criteria before being prescribed an antibiotic for a wound infection. This had the potential to cause the resident to be prescribed an antibiotic that was potentially unnecessary.

Inspectors wroteBased on observation, interview and record review, it was determined that the facility failed to complete a Significant Change in Status Assessment (SCSA) Minimum Data Set (MDS), an assessment tool used to facilitate the management of care for 1 of 27 residents reviewed, Resident #63, as evidenced by the following: The MDS is a comprehensive federal mandated process for clinical assessment of all residents that should reflect the health status of each resident to provide the best quality of care. On 3/2/23 at 12:07 PM, the surveyor observed Resident #63 in bed, with eyes closed. The surveyor also observed that Resident #63 was using a Low Air loss mattress (a specialized pressure relieving mattress used to treat pressure sores). On 3/2/23 at 12:24 PM, the surveyor reviewed the hybrid medical records of Resident #63. [...]

Inspectors wroteBased on observation, interview, and record review, it was determined that the facility failed to accurately complete the Minimum Data Set (MDS) in accordance with federal guidelines. This deficient practice was identified for 2 of 31 residents (Resident #147, Resident #63) reviewed. The deficient practice was evidenced by the following: The MDS is a comprehensive federal mandated process for clinical assessment of all residents that should reflect the health status of each resident to provide the best quality of care. 1. On 3/13/23 at 11:04 AM, the surveyor reviewed the discharged medical records for Resident #147. The resident was admitted to the facility on [DATE] with diagnosis that included but was not limited to Acute Respiratory Failure with Hypoxia, Hypertension, and Type 2 Diabetes Mellitus. [...]

Inspectors wroteBased on observation, interview, and record review, it was determined that the facility failed to follow professional standards of practice by not administering a current Physician's Order (PO) for 1 of 5 residents reviewed (Resident #109). This deficient practice was evidenced by the following: Reference: New Jersey Statutes Annotated, Title 45, Chapter 11. Nursing Board. The Nurse Practice Act for the State of New Jersey states: The practice of nursing as a licensed practical nurse is defined as performing tasks and responsibilities within the framework of casefinding; reinforcing the patient and family teaching program through health teaching, health counseling and provision of supportive and restorative care, under the direction of a registered nurse or licensed or otherwise legally authorized physician or dentist. [...]

Inspectors wroteBased on observation, interview, and record review, it was determined that the Consultant Pharmacist (CRPh) failed to identify and/or report medication irregularities, which resulted in the administration of Lacosamide (Vimpat) 100 mg (used to treat seizures) inconsistent with the manufacturer recommendations. This deficient practice was identified for 1 of 7 residents (Resident #81) reviewed during medication administration observation. This was evidenced by the following: On 3/6/23 at 8:56 AM, the surveyor observed the Licensed Practical Nurse (LPN) crush medications in preparation for administration to Resident #81 that included Lacosamide 100 mg with directions 1 tablet two times a day. [...]

Inspectors wroteBased on observation, interview, and record review, it was determined that the facility failed to maintain complete and readily accessible medical records. This deficient practice was identified for 1 of 2 hospice residents reviewed, Resident #100, and was evidenced by the following: On 2/28/23 at 12:48 PM, the Licensed Practical Nurse assigned to the resident informed the surveyor that Resident #100 was on hospice care. On 3/6/23 at 12:29 PM, the surveyor interviewed the Registered Nurse/Unit Manager (RN/UM) to determine how often the hospice nurse visits the resident. The RN/UM responded, it varies. The RN/UM showed the surveyor the area in the resident's physical chart where the hospice visiting notes were located. On 3/6/23 at 1:16 PM, the surveyor reviewed the hybrid medical records for Resident #100. [...]

Inspectors wroteBased on observation, interview, and record review, it was determined that the facility failed to adhere to accepted standards of infection control practices for the proper storage of a urinary drainage bag for Resident #116. This deficient practice was identified for 1 of 2 residents who were reviewed for infection control practices. This deficient practice was evidenced by the following: On 2/28/23 at 11:18 AM, the surveyor observed Resident #116 in bed with eyes closed. The surveyor also observed that the resident had a urinary catheter tube (a tube used to empty the bladder and collect urine into a drainage bag) with a drainage bag evident on the side of the bed. The drainage bag was in a privacy bag that was on the floor. The surveyor reviewed Resident #116's Electronic Medical Record: [...]

Inspectors wroteBased on observation, interview, and record review, it was determined that the facility failed to follow a physician's order for monitoring a resident's blood glucose. This deficient practice was noted for 1 of 2 residents observed for blood glucose monitoring, Resident # 77. The deficient practice was evidenced by the following: Reference: New Jersey Statutes Annotated, Title 45, Chapter 11. Nursing Board. The Nurse Practice Act for the State of New Jersey states: The practice of nursing as a licensed practical nurse is defined as performing tasks and responsibilities with in the framework of case finding; reinforcing the patient and family teaching program through health teaching, health counseling and provision of supportive and restorative care, under the direction of a registered nurse or licensed or otherwise legally authorized physician or dentist. [...]