Daybreak Nursing Center

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure all residents were kept free from possible accident hazards when the facility staff failed to monitor one resident (Resident #10) out of four sampled residents and one resident (Resident #29) outside the sample during scheduled resident smoke breaks. The facility census was 66. Review of the facility's policy titled, Smoking Policy - Residents, dated October 2023, showed:- This facility has established and maintains safe resident smoking policies;- Prior to, and upon admission, residents are informed of the facility smoking policy, including designated smoking areas, and the extent to which the facility can accommodate their smoking or non-smoking preferences;- Smoking is only allowed in designated resident areas, which are located outside of the building. [...]

Inspectors wroteBased on interview and record review, the facility failed to identify, assess, and provide supportive interventions for two residents (Residents #42 and #50) with a diagnosis of post-traumatic stress disorder (PTSD - a mental health condition triggered by a terrifying event - either experiencing it or witnessing it; symptoms may include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event) out of four sampled residents. The facility's census was 66. The facility did not provide a PTSD policy.1. Review of Resident #42's medical record showed:- admitted on [DATE]; [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to maintain a medication error rate of less than five percent (%). There were 28 opportunities with three errors made, resulting in an error rate of 10.71% for three residents (Residents #15, #31 and #59) out of five sampled residents. The facility's census was 66. Review of the facility's policy titled, Insulin Administration, last revised March 2025, showed:- Did not address insulin administration using an insulin pen. [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to provide a safe, clean, comfortable, and homelike environment. This deficient practice had the potential to affect all residents in the facility. The facility census was 65. Review of the facility's policy titled, Homelike Environment, revised February 2021, showed: - Residents are provided with a safe, clean, comfortable and homelike environment and encouraged to use their personal belongings to the extent possible; - The facility staff and management maximizes, to the extent possible, the characteristics of the facility that reflect a personalized, homelike setting which includes a clean, sanitary and orderly environment. [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to provide adequate personal hygiene for one resident (Resident #10) out of 16 sampled residents and two additional residents (Resident #2 and #57) and failed to provide showers at least twice a week for one resident (Resident #2) outside the sample. The facility census was 65. Review of the facility's policy titled, Dignity, revised February 2021, showed: - Each resident shall be cared for in a manner that promotes and enhances his or her sense of well-being, level of satisfaction with life, and feelings of self-worth and self-esteem; - Residents are treated with dignity and respect at all times; - The facility culture supports dignity and respect for residents by honoring resident goals, choices, preferences, values and beliefs; [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to store medications in accordance with accepted professional standards of practice. This deficient practice had the potential to affect all residents residing in the facility. The facility also failed to properly label medications in a safe and effective manner. The facility's census was 65. Review of the facility's policy titled, Medication Labeling and Storage, dated 2001, showed: - Medications requiring refrigeration are stored in a refrigerator located in the medication room at the nurses station or other secured location. Medications are stored separately from food and are labeled accordingly; - Policy did not address checking and the appropriate refrigerator temperatures or labeling over the counter medications with an opened date. 1. [...]

Inspectors wroteBased on observation and interview, the facility failed to store and distribute food under sanitary conditions, increasing the risk of cross-contamination and food-borne illness. These practices had the potential to affect all residents who are served food from the kitchen. The facility census was 65. 1. Observation on 10/07/24 at 2:24 P.M., of the dry food storage room showed: - A large bag of elbow pasta opened with the top of the bag twisted, not sealed and undated; - Three bags of cereal opened, undated, and one unsealed; - Opened graham cracker crumbs in a labeled box with the bag unsealed. 2. Observation on 10/07/24 at 2:25 P.M., of the storage area showed: - Two large baking sheets with black carbon build up on the sides/bottom. 3. Observation on 10/07/24 at 2:26 P.M., of a white single door residential-style stand up freezer located in the front of the kitchen showed: [...]

Inspectors wroteBased on interview, and record review, the facility failed to maintain an effective pest control program. This had the potential to affect all residents in the facility. The facility's census was 65. Review of the facility's policy titled, Pest Control, revised May 2008, showed: - The facility shall maintain an effective pest control program; - This facility maintains an on-going pest control program to ensure that the building is kept free of insects and rodents; - Pest control services are provided by a contracted pest control company; - Maintenance services assist, when appropriate and necessary, in providing pest control services. Review of the most recent pest control invoices showed no details of the areas of concern or what treatment was provided. During an interview on 10/10/24 at 1:04 P.M., Resident #34 said he/she saw four or five spiders in his/her room. [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to provide a safe, clean and comfortable homelike environment. This deficient practice had the potential to affect all residents in the facility. The facility census was 53. Review of the facility's policy titled, Maintenance Service, revised December 2022, showed: - Maintenance shall be provided to all areas of the building, grounds, and equipment; - The maintenance department is responsible for maintaining the buildings, grounds, and equipment in a safe and operable manner at all times; - Functions of maintenance personnel include maintaining the building in good repair and free from hazards and providing routinely scheduled maintenance service to all areas. Observation on 05/16/23 at 10:47 A.M., and 05/17/23 at 11:18 A.M., of the 100 Hall showed: [...]

Inspectors wroteBased on interview and record review, the facility failed to complete a significant change Minimum Data Set (MDS) (a federally mandated assessment tool completed by the facility) assessment for one resident (Resident #18) out of three sampled residents. The facility's census was 53. Review of the facility's policy titled, Comprehensive Assessments, dated March 2022 showed: - Significant change in status assessment is a comprehensive assessment for a resident that must be completed when the interdisciplinary team (IDT) (a group of health care professionals from diverse fields who work in a coordinated effort toward a common goal for a resident) has determined that a resident meets the significant change guidelines for either major improvement or decline. 1. Review of Resident #18's medical record showed: [...]

Inspectors wroteBased on interview, observation and record review the facility failed to provide resident rights information on how to formally file a complaint to the Department of Health and Senior Services (DHSS) about the care they were receiving. This deficient practice had the potential to affect all residents in the facility. The facility census was 53. Review of the facility's policy titled, Resident Rights, revised February 2021, showed: - Employees shall treat all residents with kindness, respect and dignity; - Federal and state laws guarantee certain basic rights to all residents of the facility; - Be free from abuse, neglect, misappropriation of property, and exploitation; - Communication with and access to people and services, both inside and outside the facility; [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to store and distribute food under sanitary conditions, increasing the risk of cross-contamination and food-borne illness. These deficient practices had the potential to affect all residents. The facility census was 53. Review of the facility's policy titled, Sanitization, revised November 2022, showed: - The food service area is maintained in a clean and sanitary manner; - All utensils, counters, shelves, and equipment are kept clean, maintained in good repair and are free from breaks, corrosions, open seams, cracks, chipped areas that may affect their use or proper cleaning; - All equipment, food contact surfaces and utensils are cleaned and sanitized using heat or chemical sanitizing solutions. Observations on 05/16/23 at 10:02 A.M., 05/16/23 at 02:04 P.M., and 05/17/23 at 09:18 A.M., of the kitchen area showed: [...]

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure a dumpster was closed at all times and maintained to keep pests out and/or to keep the garbage contained in the dumpster. The facility census was 53. Review of the facility's policy titled, Sanitization, revised November 2022, showed: - All kitchens, kitchen areas and dining areas are kept clean, free form garbage and debris, and protected from rodents and insects; - Garbage and refuse containers are in good condition, without leaks, and waste is properly contained in dumpsters/compactors with lids (or otherwise covered); - Areas used for garbage disposal are free from odors and waste fats, and maintained to prevent pests. Observations on 05/16/23 at 8:33 A.M., and 05/16/23 at 9:03 A.M., of the outside trash dumpster located near the maintenance shed showed: - The dumpster lid opened; [...]