Bronte Health and Rehab Center

Inspectors wroteBased on interview and record review, the facility failed to report the results of an investigation in accordance with State Law within 5 working days of the incident for 1 of 2 incidents (Resident #1) reviewed for reporting. The Administrator failed to report the results of an investigation alleging neglect, after Resident #1 had an unwitnessed fall resulting in fracture, within 5 days to the State Survey Agency. This failure could affect residents if alleged violations are verified, and appropriate corrective actions are not taken.

Inspectors wroteBased on observation, interview, and record review, the facility failed to develop and implement a comprehensive person-centered care plan for each resident, consistent with the resident rights that included measurable objectives and timeframes to meet a resident's medical, nursing, and mental and psychosocial needs that were identified in the comprehensive assessment, for 1 of 4 Residents (Resident #1) reviewed for care plans. The facility did not develop and implement a comprehensive person-centered care plan that implemented an intervention to prevent falls for Resident #1's fall. This failure could place residents with falls at risk for further falls and injuries.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure residents who were unable to carry out activities of daily living received necessary services to maintain good personal hygiene for 1 of 2 residents (Residents #2) reviewed for ADL care. The facility failed to provide incontinence care to Resident #2 every 2 hours and as needed. This failure could place residents who were dependent on staff for ADL care at risk for loss of dignity, risk for infections and a decreased quality of life.

Inspectors wroteBased on observation, interview, and record review the facility failed to update the care plan after quarterly assessment was completed for 1 of 3 residents (Resident #1) reviewed for care plans. The facility failed to update the care plan as there were no interventions to prevent falls added to the care plan for Resident #1's fall sustained on 2.6.26. This failure could place residents at risk of not receiving the necessary care or services and having personalized plans developed to address their needs.

Inspectors wroteBased on observation, interview, and record review, the facility failed to remove expired items, store, prepare, distribute and serve food in accordance with professional standards for food service safety for 1 of 1 kitchen reviewed for food and nutrition services.1. The facility failed to ensure expired items were disposed of properly. 2. The facility failed to ensure pans, strainers, pitchers, cooking and serving utensils, and measuring cups were covered; not open to air.3. The facility failed to ensure drawers, containing cooking and serving utensils and plastic lids, were clean and without food crumbs in the bottom.4. The facility failed to reseal food items that were opened.5. The facility failed to ensure food was frozen or discarded after 48 hours (2 days) after preparation per facility policy.6. The facility failed to ensure foods were labeled properly. [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to store all drugs and biologicals in locked compartments in the facility's only treatment cart. The facility failed to ensure RN C secured the facility's only treatment cart when it was left unattended. This failure could place residents at risk for drug diversion or accidental ingestion.

Inspectors wroteBased on interviews and record review, the facility failed to incorporate the recommendations from the PASARR level II determination and the PASARR evaluation report into a resident's assessment, care planning, and transitions of care for 1 (Resident #1) of 2 residents reviewed for PASRR. The facility failed to submit a complete and accurate request for NFSS in the LTC online portal within 20 days after the IDT meeting. This failure could place residents who were PASRR positive at risk of not getting the PASARR services for a better quality of life and could lead to a decline in health. Record review of Resident #1's face sheet dated 7.16.25 revealed a [AGE] year-old female who was admitted to the facility on 2.10.25 with diagnoses that included: [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure each resident received adequate supervision and that the resident environment remained as free of accident hazards as possible for 2 of 5 residents (Resident #13 and Resident #42) reviewed for accidents and supervision. The facility failed to ensure Resident #42 did not have hazardous chemicals in her room unattended. Resident #42 had two bottles of nail polish remover in her room. The facility failed to ensure the staff used a gait belt when walking back from the shower with Resident #13. These failures placed residents at risk of injury due to not being supervised and placed at risk of accidents/hazards.

Inspectors wroteBased on observation, interview, and record review, the facility failed to maintain an infection prevention and control program designed to provide a safe, sanitary, and comfortable environment to help prevent the development and transmission of communicable diseases and infections for two (Resident #12 and #28) of 3 residents reviewed for incontinent care in that; CNA A failed to change her gloves once they became contaminated during incontinent care for Resident #12. CNA C failed to change her gloves once they became contaminated during incontinent care for Resident #28. These failures could place resident's risk for cross contamination and the spread of infection.

Inspectors wroteBased on observations, interview, and record review the facility failed to ensure that nurse aides were able to demonstrate competency in skills and techniques to provide nursing and related services for 1 of 3 residents (Resident #28) by 1 of 4 certified staff (CNA C) reviewed for competent staff, in that: CNA C failed to change her gloves once they became contaminated during incontinent care for Resident #28. These failures could place residents at risk for not receiving nursing services by adequately trained and certified aides and could result in a decline in health and infection.

Inspectors wroteBased on interview, and record review, the facility failed to ensure that all alleged violations involving abuse were reported immediately, but not later than 2 hours after the allegation is made, if the events that cause the allegation involve abuse or result in serious bodily injury, or not later than 24 hours if the events that cause the allegation do not involve abuse and do not result in serious bodily injury to other officials (including to the State Survey Agency and adult protective services where state law provides for jurisdiction in long-term care facilities) in accordance with State law for 2 of 5 residents (Resident #1, Resident #2) reviewed for abuse. The facility failed to report alleged violations related to abuse to HHSC. The facility failed to notify a law enforcement agency of allegations of abuse. This failure could place the residents at risk of sexual abuse.

Inspectors wroteBased on interview, and record review the facility failed to have sufficient nursing staff with the appropriate competencies and skills sets to provide nursing and related services to assure resident safety and attain or maintain the highest practicable physical, mental, and psychosocial wellbeing for 5 (Residents #1, #2, #3, #4, and #5) of 10 residents reviewed for staffing concerns on the memory care unit. 1. The facility failed to ensure there were sufficient staff to ensure Resident #1 did not sustain falls while on the memory care unit. 2. The facility failed to ensure there were sufficient staff to ensure Residents #1-#5 had the proper assistance per the resident's required assistance. These failures placed residents at risk of not getting needed care and services, a decrease in quality of care and quality of life and/or injury.

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure residents on psychotropic drugs had the correct diagnosis in place for 1 of 4 residents (Resident #1). The facility failed to ensure that Resident #1 should not have received antipsychotic (ABH gel), without the proper diagnosis in place. This failure could affect residents who received medications in the facility and put them at risk for adverse consequences such as impairment or decline in an individual's mental or physical condition or functional or psychosocial status.

Inspectors wroteBased on, interviews, and record reviews, the facility failed to ensure hospitality aides with the supervision of a CNA can care for resident's needs, as identified through resident assessments, and described in the plan of care for 1 of 4 Residents (Resident #1) in that: 1. The facility failed to ensure CNA C supervised hospitality aide HA B in assisting Resident #1 to the toilet. These deficient practices affect residents who require assistance from trained staff which could contribute to possible adverse reactions.

Inspectors wroteBased on observation, interview, and record review, it was determined the facility failed to accurately assess a resident for risk of entrapment from bed rails, prior to use for one (Resident #1) of 4 sampled residents. Resident #1 had quarter bed rails in use, when there was no side rail assessment completed. This failure had the potential to cause injury to a resident for improper use of bed rails.

Inspectors wroteBased on observation, interview, record review, the facility failed to ensure each resident received adequate supervision to prevent accidents for 1 of 11 resident (Resident #1) reviewed for accidents. The facility failed to supervise Resident #1 to prevent falls. This failure could place residents who required supervision at risk for falls.

Inspectors wroteBased on observation, interview, and record review the facility failed to store, prepare, distribute, and serve food in accordance with professional standards for food safety in the facility's only kitchen. 1. The facility failed to ensure food items remain covered during distribution on the hallways. 2. The facility failed to ensure that the dish machine reached the appropriate temperature for sanitization. 3. The facility failed to ensure expired food items were discarded by their expiration date. This failure could affect residents by placing them at risk for contamination by foodborne illness.

Inspectors wroteBased on observation, interview, and record review the facility failed treat each resident with respect and dignity in a manner and in an environment that promotes maintenance or enhancement of his or her quality of life, recognizing each resident's individuality for three of seven residents (Residents #6, #15, and #40) reviewed for residents rights, in that: Staff on the secured unit did not serve residents at the same table at the same time. CNA D stood over residents while feeding Residents #40, Resident #15, and Resident #6 who were sitting in their seats. This failure puts residents at risk of feeling embarrassed, infantilized, dehumanized, or stigmatized due to their need for assisted dining.

Inspectors wroteBased on interview and record review, the facility failed to ensure residents had the right to be free from abuse for 2 of 3 residents (Resident #22 and Resident #36) reviewed for abuse. 1. The facility failed to prevent Resident #22 and Resident #36 from verbal abuse from CNA F. This failure could result in verbal abuse to the residents, fear, and isolation.

Inspectors wroteBased on observation, interview, and record review the facility failed to provide pharmaceutical services, including procedures that assure the accurate acquiring, receiving, dispensing, and administering of all drugs and biologicals, to meet the needs of each resident for 1 of 3 Medication Carts and 1 Medication Storage Rooms reviewed for pharmacy services. 1. The facility failed to ensure Medication Cart #1 did not include expired Calcium Carbonate (antacid). 2. The facility failed to ensure the Medication Storage Room did not contain expired Cimetidine (antacid), Allergy Relief tablets and Acetaminophen Suppositories. 3. The facility failed to maintain proper temperature in the medication refrigerator in the medication room. [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to maintain an infection prevention and control program designed to provide a safe, sanitary, and comfortable environment to help prevent the development and transmission of communicable diseases and infections for 3 of 5 residents (Resident #6 Resident #and #94) reviewed for infection control. LVN A failed to clean scissors during wound care for Resident #94 between dirty and clean dressings. CNA D and CAN E did not wash their hands or change gloves between dirty and clean during incontinent care (Resident #6). CNA D touched Resident #40's food with her bare hands MA C put her bare, unwashed hands into a medication crushing bag These failures could place resident's risk for cross contamination and the spread of infection.

Inspectors wroteBased on observation, interview, and record review, the facility failed to respect the resident's right to personal privacy for 2 of 12 residents (Resident #6 and #15) reviewed for privacy issues in that: CNA E and CNA J failed to pull the curtain all the way around during Resident #6's ADL care. This failure could cause residents to feel uncomfortable, disrespected, and possible exposure to anyone passing by.

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure each resident received adequate supervision and assistance devices to prevent accidents for 1 of 3 residents (Resident #15) reviewed for accident hazards/supervision, in that: CNA E failed to complete a one-person gait belt transfer safely for Resident #15. These failures could place residents at risk for injuries.