Elderwood at Liverpool

Inspectors wroteBased on interviews and record review during the recertification survey, the facility did not ensure that views, grievances, or recommendations voiced by residents during Resident Council group meetings were considered, acted upon, and responded to with a rationale for nine (9) of nine (9) anonymous residents present at the resident group meeting and one additional resident interviewed (Resident #17). Specifically, nine (9) anonymous residents at the resident group meeting and one additional resident interviewed (Resident #17) stated they did not receive responses to topics or concerns addressed in prior Resident Council meetings. Additionally, there was no documented evidence that the residents' voiced concerns were investigated, and rationales or responses were provided to the residents.

Inspectors wroteBased on observations, record review, and interviews during the recertification survey, the facility failed to ensure a safe, clean, comfortable, and homelike environment for one (1) of three (3) resident floors (Second floor) reviewed. Specifically, the Second floor hallway carpet was unclean with stains and dirt debris; room [ROOM NUMBER] smelled of urine; and room [ROOM NUMBER] D's bathroom had a broken light bulb.

Inspectors wroteBased on observations and interviews during the recertification survey, the facility failed to follow proper sanitation practices to prevent outbreak of illness in one (1) of one (1) main kitchen. Specifically, expired sanitizer testing strips were used to test sanitizer strength in the three-bay sink; and a cloth was used to dry dishes and silverware as they came out of the dish machine.

Inspectors wroteBased on interviews, observations, and record review during the recertification survey, the facility failed to develop and implement a baseline care plan that included the minimum healthcare information necessary to properly care for a resident within 48 hours of their admission for one (1) of one (1) resident (Resident #97) reviewed. Specifically, Resident #97 was admitted from the hospital with an arm sling recommended by a specialist and there was no physician order or care plan for the use of the arm sling.

Inspectors wroteBased on observations, record review, and interviews during the recertification survey, the facility failed to ensure residents received care consistent with professional standards of practice to prevent pressure ulcers and promote healing of pressure ulcers for one (1) of three (3) residents (Residents #16) reviewed. Specifically, Resident #16's wound care was not completed as ordered and a vascular consult was not ordered as recommended by the wound care provider.

Inspectors wroteBased on observations, record review, and interviews, the facility failed to ensure drugs and biologicals were stored in accordance with currently accepted professional standards for one (1) of four (4) medication carts (1st floor North medication cart). Specifically, the 1st floor North medication cart contained an opened lidocaine (anesthetic) vial and opened insulin pens with no documented opened dates.

Inspectors wroteBased on observations and interviews during the recertification survey, the facility failed to ensure garbage and refuse was disposed of properly for one (1) of one (1) dumpster observed. Specifically, the area around the dumpster located outside near the kitchen was not maintained to prevent attraction and harborage of pests.

Inspectors wroteBased on observations, record review, and interviews during the recertification survey the facility failed to establish and maintain an infection prevention and control program designed to provide a safe, sanitary, and comfortable environment and to help prevent the development and transmission of communicable diseases and infections for one (1) of four (4) residents (Resident #48) reviewed. Specifically, Resident #48 was on transmission-based precautions (contact precautions) and Registered Nurse #16 was observed not wearing appropriate personal protective equipment while administering medications or practicing hand hygiene to prevent the spread of infection.

Inspectors wroteBased on record review and interviews during the recertification survey, the facility did not provide the appropriate liability and appeal notices to Medicare beneficiaries for one (1) of three (3) residents (Resident #208) reviewed. Specifically, Resident #208 remained in the facility after discontinuation of Medicare Part A, and the facility did not provide a Skilled Nursing Facility Advance Beneficiary Notice of Non-Coverage (Centers for Medicare and Medicaid Services-10055) for Medicare Part A as required.

Inspectors wroteBased on observation, record review, and interview during the recertification survey conducted 2/21/2024-2/27/2024, the facility did not ensure food was stored, prepared, distributed, and served in accordance with professional standards for food service safety in 2 of 3 food preparation and storage areas (the main kitchen and the third floor kitchenette). Specifically, the walls and ceiling in the main kitchen dish machine area were unclean, the walls behind the three bay sink were unclean and there was expired and undated food in the main kitchen dry food storage room and the third floor kitchenette.

Inspectors wroteBased on observation, record review, and interviews during the recertification survey conducted 2/21/2024 - 2/27/2024, the facility did not establish and maintain an infection prevention and control program designed to provide a safe, sanitary, and comfortable environment and to help prevent the development and transmission of communicable diseases and infections for 1 of 4 residents (Resident #82) reviewed and for the facility's Legionella (a bacteria that can cause Legionnaires' disease) water management program. Specifically, staff did not wear required personal protective equipment or take off personal protective equipment appropriately when caring for Resident #82 who was on transmission-based precautions. Additionally, the facility's annual Legionella assessment was not completed in 2022 and the annual review of the Legionella program was not completed in 2021 and 2022.

Inspectors wroteBased on observations, record review, and interviews during the recertification and abbreviated (NY00312902 and NY00317893) surveys conducted 2/21/2024-2 /27/2024, the facility did not ensure residents received treatment and care in accordance with professional standards of practice, the comprehensive person-centered care plan, and the resident's choices for 1 of 1 resident (Resident #67) reviewed. Specifically, licensed practical nurse #12 administered a wound treatment to Resident #67's foot that was not consistent with the physician ordered treatment.

Inspectors wroteBased on observation, record review, and interviews during the recertification survey conducted 2/21/2024-2/27/2024, the facility did not ensure that pain management was provided to residents who required such services consistent with professional standards of practice for 1 of 1 resident (Resident #143) reviewed. Specifically, Resident #143's physician ordered pain patch was not administered and was documented as administered by licensed practical nurse #3.

Inspectors wroteBased on observation and interview during the recertification survey conducted 2/21/2024 - 2/27/2024, the facility did not ensure each resident received and the facility provided food and drink that was palatable, flavorful, and at an appetizing temperature for 2 of 2 meals reviewed (2/22/2023 and 2/23/2023 lunch meals). Specifically, food was not flavorful and was not served at palatable and appetizing temperatures.

Inspectors wroteBased on observation, record review, and interview during the recertification survey conducted 2/21/2024-2/27/2024, the facility did not maintain an effective pest control program so that the facility was free of pests in the main kitchen. Specifically, the main kitchen had fruit flies.

Inspectors wroteBased on observation, record review and interview during the recertification survey conducted 10/18/21-10/21/21, the facility failed to post in a place readily accessible to residents, and family members and legal representatives of residents, the results of the most recent survey of the facility conducted by Federal or State surveyors. Specifically, the facility did not post the Life Safety Code survey results from the 5/17/19 federal recertification survey.

Inspectors wroteBased on observation, interview, and record review during the recertification and abbreviated survey (NY00277317) conducted from 10/18/21 through 10/21/21, the facility failed to ensure each resident receives and is provided food and drink that is palatable, attractive, and at a safe and appetizing temperature for 2 of 2 meals (breakfast and lunch) reviewed. Specifically, sampled breakfast and lunch meals were not served at palatable or appetizing temperatures. This is evidenced by: The facility Meal Service Audit Form dated 4/2018 documented taste, temperature, quantity, and appearance of the meal should be enjoyed. The form did not document acceptable food temperatures. During an interview on 10/18/21 at 11:49 PM, Resident #346 stated the hot food was cold. During an interview on 10/18/21 at 12:19 PM, Resident #94 stated the food was cold by the time they were served their meals. [...]