Cherry Hill Rehabilitation & Healthcare Center

Inspectors wroteBased on observation, interview, the facility's policy for Menus, the facility's Meal Guide Report for Week 3, the facility's Recipe Report for Pudding Parfait, and the facility's chart for scoop size and capacity; the facility failed to ensure Pureed Lasagna and Chocolate Pudding Parfait were served in the portion sizes as indicated on the menu for Tuesday, 12/13/2022. This had the potential to affect 67 of 97 residents receiving meals from the kitchen. Findings Include: The facility's policy for Menus, dated 6/2017, included the following: Policy: Menus are planned to meet the nutritional needs of the residents in accordance with the Recommended Dietary Allowances of the Food and Nutrition Board of the National Research Council, National Academy of Sciences. The facility shall provide residents with a nourishing, palatable, well balanced diet that meets daily nutritional needs . [...]

Inspectors wroteBased on interviews, medical record review, and a review of a facility policy titled, Change in Medical Condition of Residents, the facility failed to ensure that Resident Identifier (RI) #18's sponsor/family was notified when RI #18's medication, Oxcarbazepine was increased on 08/16/2022. This deficient practice affected RI #18; one of one sampled resident reviewed for notification. Findings Include: A review of facility's policy titled, Change in Medical Condition of Residents, with an effective date of 02/01/2004, documented, .Notification of . legal representative, or interested family member, should occur promptly, according to federal regulations, when there is a change in the resident's condition. A need to alter treatment . [...]

Inspectors wroteBased on interview, record review and a facility policy with the subject, Resident Assessment Instrument, the facility failed to ensure a quarterly resident Minimum Data Set (MDS) assessment instrument was transmitted within the required timeframes. This affected Resident Identifier (RI) #61, one out of two residents investigated for resident assessments. Findings Include: A facility policy with the subject, Resident Assessment Instrument, with a revision date of 10/2013, revealed, . PURPOSE: Residents are assessed, using a comprehensive assessment process, in order to identify care needs and to develop a plan of care. PROCESS: . V. MDS Version 3.0 Quarterly Assessment . b) Quarterly assessments are due at least every 92 days, and at a minimum, three quarterly assessments and one comprehensive assessment is required in each twelve-month period. XI. [...]

Inspectors wroteBased on observation, interviews, record reviews and a review of the Long-Term Care Facility Resident Assessment Instrument (RAI), the facility failed to ensure Resident Identifier (RI) #79 and RI #90 had a care plan for Foley catheters. This deficient practice affected RI #79 and RI #90, two of four residents sampled for catheters. Findings Include: A review of the Long-Term Care Facility Resident Assessment Instrument 3.0 User's Manual Version 1.17.1 dated October 2019 revealed, . Chapter 4 Care Area Assessment Process and Care Planning . 4.7 . The care plan is driven not only by identified resident issues and/or conditions but also by a resident's unique characteristics, strengths and needs. Develops and implements an intradisciplinary care plan based on the assessment information gathered throughout the RAI process, with necessary monitoring and follow-up; . [...]

Inspectors wroteBased on observation, interviews, record review the facility failed to ensure the feeding tube containers for Resident Identifier (RI) #79 were labeled appropriately. This deficient practice affected RI #79; one of three residents sampled receiving tube feedings. Findings Include: RI #79 was admitted to the facility on [DATE] and readmitted on [DATE] with a diagnosis to include Dysphagia following Cerebral Infarction. RI #79's December 2022 Physician's Orders documented, Jevity at 20 CC/HR (cubic centimeter/hour) with flush of 25 CC/HR x 23 HRS. On 12/12/2022 at 9:36 AM, RI #79 was observed lying in bed with head elevated, feeding hanging and machine beeping. The feeding containers were not labeled. On 12/12/2022 at 9:54 AM, an interview was conducted with Employee Identifier (EI) #9, Licensed Practical Nurse (LPN). EI #9 admitted feeding bags/bottles were not labeled. [...]

Inspectors wroteBased on record review, and interview, the facility failed to ensure Resident Identifier (RI) #6's Nebulizer Treatments were administered in accordance with the physician's orders. This deficient practice affected RI #6, one of three residents sampled for respiratory care. Findings Include: RI #6 was admitted to the facility on [DATE] and readmitted on [DATE] with a diagnosis of Chronic Respiratory Failure. RI #6's November 2022 Physician Orders documented, Albuterol Sul (sulfate) 2.5 Mg/3ML (milligram/milliliter) SOLN (solution) -give 3ML Nebulizer treatment every 6 hours. RI #6's November's e-MAR (electronic medication administration record) documented, Albuterol Sul 2.5MG/3 ML SOLN-give 3ML Nebulizer Treatment every 6 hours . Order date 10/25/22. [...]

Inspectors wroteBased on observation, interviews, record review and review of a facility policy Diagnostic Testing Services, the facility failed to ensure a laboratory specimen was picked up timely after orders were received on 12/10/22. This affected one of one resident to which a Urine specimen was observed in the Specimen refrigerator on 12/13/22. Findings Include: A review of a facility policy titled Diagnostic Testing Services with an effective date of February 1, 2004, revealed . PURPOSE: Each resident has the right to receive diagnostic services, in a timely manner, to meet his/her needs for diagnosis, treatment and prevention. Resident Identifier (RI) #48 was admitted to the facility on [DATE] and readmitted on [DATE] with a diagnosis of Type 2 Diabetes Mellitus without complications. A review of a handwritten Physician's order dated 12/10/22 revealed ' Urine albumin - creatine ratio Diabetes . [...]

Inspectors wroteBased on observations, interviews, and a facility policy titled Urinary Catheter Care, the facility failed to ensure Resident Identifier (RI) #79's catheter bag was not touching the floor on 12/12/2022. This deficient practice affected one of two residents observed with catheters. Findings Include: A facility Policy titled, Urinary Catheter Care, with an effective date of 02/01/2004, documented, .Process: . i) Catheter tubing and drainage bags are kept off the floor to prevent contamination . RI # 79 was admitted to the facility on [DATE] and readmitted on [DATE] with a diagnosis to include Retention of Urine. RI #79's December's Physician's Orders documented: Catheter for Urinary Retention. On 12/12/2022 at 9:35 AM, RI #79's catheter bag was observed hanging from bed frame and touching the floor. [...]

Inspectors wroteBased on observation, interview and review of the facility policy, FOOD FROM OUTSIDE SOURCES, the facility failed to ensure food brought into the facility from friends and family was labeled with each resident's name or date on which the food was received and stored, as well as the date it should be discarded. This involved the residents' refrigerator on the [NAME] Wing nursing station, one of two Nursing Units observed.