Jml Care Center Inc

Inspectors wroteBased on interview and record review, the facility failed to ensure up to date pneumococcal immunizations were offered and/or administered after consent had been obtained for 4 out of 5 Residents (#7, #5, #48, and #99) reviewed for immunizations.

Inspectors wroteBased on interview and record review, the facility failed to offer the COVID-19 2025/2026 vaccination when it became available to 4 out of 5 Residents (#7, #5, #48, and #99) reviewed for immunizations.

Inspectors wroteBased on document review and interview, the facility failed to notify the Health Care Proxy (HCP- health care agent designated by the resident when competent who has the authority to consent for health care decisions when a resident has been declared, by a physician, not to be competent to make his/her own health care decisions) in a timely manner when the Resident was found ingesting pieces of a Styrofoam plate resulting in a need to alter the plan of care to reduce the risk of reoccurrence, for one Resident (#8), out of a total sample of 19 residents.

Inspectors wroteBased on document review and interviews, the facility failed to ensure that individualized, comprehensive care plans were reviewed and revised for one Resident (#8), out of 19 sampled residents. Specifically, the facility failed to ensure the care plan was revised to reflect removal of all non-food items from meal tray after the Resident was found ingesting a Styrofoam plate.

Inspectors wroteBased on observation, document review, and interview, the facility failed to establish and maintain an infection prevention and control program designed to provide a safe, sanitary, and comfortable environment for two Residents (#104 and #120), out of a total sample of 19 residents. Specifically, the facility failed to:1. Ensure the correct personal protective equipment (PPE) was used when staff provided care and services for Resident #104 who was on isolation precautions for COVID-19; and2. Adhere to standard infection control practices including hand hygiene in between glove changes and practices on disinfecting the hub connector during connecting or flushing the peripherally inserted central line catheter (PICC) for Resident #120.

Inspectors wroteBased on observation, interview, and record review, the facility failed to develop and implement an individualized, person-centered care plan to meet the physical, psychosocial, and functional needs for four Residents (#40, #48, #84, and #33), out of a total sample of 19 residents. Specifically, the facility failed to ensure a comprehensive care plan was developed: 1. For Resident #40, to address the use of antidepressant medication (used to treat obsessive compulsive disorder) that identified target behaviors, individualized, measurable non-pharmacological interventions and measurable goals of treatment; 2. For Resident #48, to address the use of antianxiety, antidepressant, and antipsychotic medication that identified target behaviors and individualized, measurable non-pharmacological interventions and measurable goals of treatment; 3. [...]

Inspectors wroteBased on observation and interview, the facility failed to provide an environment that was free from accidents and hazards on three of three units. Specifically, the facility failed: 1. For the Naushon Unit, to ensure that medicated treatment supplies and an unlocked treatment cart in the Clean Utility Room were accessible only to licensed staff; 2. For the Nobska Unit, to ensure that: a. medicated treatment supplies and an unlocked treatment cart in the Clean Utility Room were accessible only to licensed staff, and b. the daily supply closet door was locked and not accessible to residents; 3. For Resident #33, (Nobska Unit) that sharps were properly placed in the sharps container to decrease the risk of needlestick injuries and exposure to bloodborne pathogens; and 4. [...]

Inspectors wroteBased on record review and interview, the facility failed to ensure three Residents' (#33, #40, and #48) drug regimen was free from unnecessary psychotropic medications, out of a total sample of 23 residents. Specifically, the facility failed: 1. For Resident #33, to adequately identify and monitor target behaviors related to his/her antipsychotic use; 2. For Resident #40, to adequately monitor for potential side effects of fluvoxamine (antidepressant used in the treatment of obsessive-compulsive disorder); and 3. For Resident #48, to adequately monitor for potential side effects for the use of Ativan (antianxiety), Depakote (anticonvulsant used as a mood stabilizer), Escitalopram (antianxiety), Remeron (antidepressant), Zyprexa (antipsychotic), and Strattera (norepinephrine reuptake inhibitor (SNRI) used to treat attention deficit hyperactivity disorder).

Inspectors wroteBased on record review and interview, the facility failed to ensure the Resident Representative was notified of a fall for one Resident (#48), out of a total sample of 19 residents. Specifically, the facility failed to ensure the activated Health Care Proxy (health care agent designated by the resident when competent who has the authority to consent for health care decisions when a resident has been declared, by a physician, not to be competent to make his/her own health care decisions) was notified of one fall resulting in a large bruise.

Inspectors wroteBased on interview and record review, the facility failed to report an allegation of physical abuse to the State Agency (SA) within the mandated timeframes as required for one Resident (#13), out of a total sample of 19 residents.

Inspectors wroteBased on record review and interview, the facility failed to ensure staff provided the resident and/or their representative with a summary of the baseline care plan for one Resident (#291), out of a total sample of 19 residents. Specifically, the facility failed to provide the Resident with a written summary of the baseline care plan and document receipt of the information within the Resident's clinical record.

Inspectors wroteBased on observation, interview, and record review, the facility failed to provide respiratory care consistent with professional standards of practice for one Resident (#50), out of a total sample of 19 residents. Specifically, the facility failed to ensure a physician's order was obtained for the administration of oxygen (O2).

Inspectors wroteBased on record review and interview, the facility failed to ensure two Residents (#33, #67), out of a total sample of five residents reviewed for immunization, were screened for eligibility to receive the recommended pneumococcal vaccination, were educated on the benefits and potential side effects of the vaccine and were offered and administered (if applicable) the vaccine in a timely manner. Specifically, the facility failed to ensure Residents #33 and #67 were offered the Pneumococcal Conjugate Vaccine (PCV-a vaccine that helps protect against diseases caused by pneumococcal bacteria) at the time of admission or shortly thereafter, putting the Residents at risk for developing facility acquired pneumonia.

Inspectors wroteBased on record review and interview, the facility failed to accurately complete the Minimum Data Set (MDS) assessment for three Residents (#70, #6, #33), out of 19 sampled residents. Specifically, the facility failed: 1. For Resident #70, to ensure the MDS assessment was accurately coded for dialysis; 2. For Resident #6, to ensure the MDS assessment was accurately coded for hospice; and 3. For Resident #33, to ensure the MDS assessment was accurately coded for a diagnosis of dementia.

Inspectors wroteBased on interviews and record review, the facility failed to ensure five Residents (#84, #6, #76, #47, #31), in a sample of 19 residents, had been seen by a physician every 60 days and had the required visits alternated between the Physician and the Nurse Practitioner (NP).

Inspectors wroteBased on observations, interviews, and policy review, the facility failed to store and serve food in accordance with professional standards for food safety in three out of three nourishment kitchens. Specifically, the facility failed to properly label and date opened beverages and maintain safe and clean equipment.

Inspectors wroteBased on interviews, policy review, and observations, the facility failed to have information on how to file a grievance in resident care and public areas and have forms accessible, so residents and/or visitors were able to anonymously notify the facility of their concerns.

Inspectors wroteBased on observation, interviews, and policy review, the facility failed to ensure all drugs and biologicals were secured in locked compartments with only authorized personnel having access. Specifically, the facility failed: 1A. For Resident #212, to ensure prescription medicated treatment powder and cream were not left unattended in the Resident's room, and B. For Resident #51, to ensure a bottle of vitamin supplement and a prescription cream were not left unattended in the Resident's room; and 2. To ensure staff kept the Medication Cart locked when not in use or under direct supervision of the nurse.

Inspectors wroteBased on interview, policy review, and record review, the facility failed to implement a person-centered care plan for the use of multiple psychotropic medications for one Resident (#54), out of a total sample of 17 residents.

Inspectors wroteBased on observation, interview, and record review, the facility failed to consistently implement the nutritional care plan interventions for one Resident (#23), out of a total sample of 17 residents, resulting in a gradual progressive weight loss.

Inspectors wroteBased on interview, policy review, and record review, the facility failed to ensure each resident's drug regimen was free from unnecessary psychotropic drugs without adequate monitoring for one Resident (#54), out of a total sample of 17 residents. Specifically, the facility failed to monitor for side effects of multiple psychotropic medications and to implement behavioral interventions in an effort to discontinue these drugs.

Inspectors wroteBased on observation, interview, and policy review, the facility failed to maintain and consistently implement an infection prevention and control program to provide a safe, sanitary, and comfortable environment and to help prevent the development and potential transmission of communicable diseases and infections for one Resident (#208). Specifically, the facility failed to ensure Enhanced Barrier Precautions (EBP), including gown and glove use were consistently implemented during care.

Inspectors wroteBased on observation, interview, and document review, the facility failed to maintain an infection prevention and control program to help prevent the potential transmission of a communicable disease when the facility was experiencing an outbreak of COVID-19 infections. Specifically, the facility failed to: 1. Ensure proper COVID-19 outbreak testing procedures were implemented for two of two facility staff reviewed (Staff #1, Staff #2); and 2. Ensure staff followed infection control guidelines for doffing (taking off) personal protective equipment (PPE) when exiting a COVID-19 positive resident's room.