Merwick Post Acute

Inspectors wroteComplaint: 3015011Based on interviews, record review, and review of other pertinent facility documents it was determined that the facility failed to ensure that a resident received treatment and care in accordance with professional standards of practice by a) discharging a resident with a midline catheter (long, flexible catheter inserted into larger veins of the upper arm) in place without a physician order (PO) to do so; and b) removing a resident's midline catheter after the resident was discharged at the resident's home without a PO to do so. This deficient practice was identified for 1 out of 3 residents reviewed for the discharge process (Resident #2). This deficient practice was evidenced by the following:Reference: New Jersey Statutes, Annotated Title 45, Chapter 11. Nursing Board. The Nurse Practice Act for the state of New Jersey states: [...]

Inspectors wroteComplaint: 3015011 Based on interviews, record review, and review of other pertinent facility documents it was determined that the facility failed to complete an incident report and thoroughly investigate after a resident was discharged from the facility with a midline catheter (long, flexible catheter inserted into larger veins of the upper arm) in place. This deficient practice was identified for 1 of 3 residents reviewed for the discharge process (Resident #2), and was evidenced by the following:Resident #2 was no longer at the facility. The closed medical record for Resident #2 was reviewed. A review of the admission record face sheet for Resident #2 revealed that the resident was admitted to the facility with diagnoses including but not limited to: [...]

Inspectors wroteComplaint #:3015011 Based on interviews, record review, and review of pertinent documents, it was determined that the facility failed to ensure that the medical record accurately documented the care provided to a resident who was discharged home with a midline (long, flexible catheter inserted into larger veins of the upper arm) and had it removed in their home the next day by facility staff. This deficient practice occurred for 1 of 3 residents reviewed for discharge processes (Resident #2) and was evidenced by the following:Resident #2 was no longer in the facility. A closed record review was conducted. A review of the admission record face sheet for Resident #2 revealed that the resident was admitted to the facility with diagnoses including but not limited to: [...]

Inspectors wroteComplaint #: 2680813Based on record review, staff interviews, and review of pertinent facility documentation on 12/3/2025, it was determined that the facility failed to ensure the individualized comprehensive care plan reflected a resident's current physician ordered diet. This deficient practice was identified for 3 of 3 residents (Resident #1, Resident #2, and Resident #4).

Inspectors wroteBased on observation, interview, and review of facility documents, it was determined that the facility failed to a.) sanitize, store, and maintain kitchen equipment to prevent microbial growth, b.) store, label and date potentially hazardous foods to prevent food borne illness, and c.) discard potentially hazardous food past the use by date. The deficient practice was evidenced by the following: On 4/21/2025 from 9:36 AM to 10:05 AM, the surveyor, who was accompanied by the Assistant Food Service Director (AFSD), observed the following in the kitchen: 1. In the walk-in refrigerator, there was a 5-pound container of ricotta cheese with lid ajar and opened date of 4/8/2025. The packaging indicated to use within 7 days of opening. The AFSD confirmed it needed to be discarded. 2. [...]

Inspectors wrote4.) On 4/21/25 at 10:08 AM during the initial tour of the facility, surveyor #4 observed an oxygen concentrator (a device that enriches air with oxygen by removing nitrogen) in Resident # 70's room with a nasal cannula oxygen tubing (small flexible tube with two prongs that delivers oxygen into the nose) connected to the concentrator. The nasal cannula tubing was found on the floor under the bedside table. A review of the admission Record, an admission summary, revealed that Resident #70 had medical diagnoses which included but were not limited to: Chronic Kidney Disease, contractures and hypoglycemia. [...]

Inspectors wroteBased on observation, interview, and record review, it was determined that the facility failed to treat each resident with respect and dignity in a manner that promotes his/her quality of life. This deficient practice was identified for 1 of 32 residents (Resident #123) reviewed for resident rights. Upon initial tour of the facility on 04/21/2025 at 11:15 AM, the surveyor was speaking with Resident #123 in their room with the door closed. While speaking with the resident, the door opened and Registered Nurse #1 (RN#1) attempted to enter. Resident #132 shook their head, looked at the surveyor, and stated no knock. This surveyor stated that they were speaking with the resident and RN #1 exited the room. Approximately 5 minutes later, RN #1 knocked, immediately entered the room, walked past the surveyor and began to set up wound care supplies. [...]

Inspectors wroteBased on observation and interview, it was determined the facility failed to maintain the resident's living environment in a clean, sanitary, and homelike manner that included a wall-mounted call device input (Resident #13) and soap dispensers (Resident #17 and #49). This deficient practice was identified for 2 of 4 nursing units observed for environment. This deficient practice was evidence by the following: 1. During the initial tour of the facility on 4/21/25 at 10:16 AM, the Surveyor #1 observed a call device input system taped to the wall above the resident's bed in room [ROOM NUMBER] bed #2. On 4/22/25 at 9:15 AM, the surveyor interviewed Resident #13's family member that stated that the call device input box had been taped to the wall for at least a month and that the Maintenance Department was aware of it and waiting on a new system to replace it. [...]

Inspectors wroteBased on interview and record review, it was determined that the facility failed to transmit a Minimum Data Set (MDS) in accordance with federal guidelines. This deficient practice was identified for 2 of 2 residents reviewed for resident assessment (Resident #9 and Resident # 147). This deficient practice was evidenced by: The MDS is a comprehensive federal mandated process for clinical assessment of all residents that should be completed and submitted to the Quality Measure System. The facility must electronically transmit the MDS no later than 14 days after assessment being completed. After transmitting of the MDS, it will generate a quality measure to enable a facility to monitor the residents decline and progress. The following residents were identified that the MDS were not transmitted timely: 1. Resident #9: [...]

Inspectors wroteBased on observation, interview, and pertinent facility documentation, it was determined that the facility nursing staff failed to document on the Treatment Administration Record (TAR) to indicate that treatments were administered according to the Physician Orders (PO) and acceptable standards of clinical practice in accordance with the New Jersey Board of Nursing Statutes. The deficient practice was identified for 1 of 41 residents (Resident #49). This deficient practice was evidenced by the following: Reference: New Jersey Statutes, Annotated Title 45, Chapter 11. Nursing Board The nurse practice act for the State of New Jersey states; [...]

Inspectors wroteBased on observation, interview, and review of pertinent facility documentation, it was determined that the facility failed to A). store oxygen equipment in a sanitary manner B.) develop a comprehensive care plan for a resident receiving oxygen therapy and a resident who self suctioned; C.) label and date oxygen tubing according to professional standards and failed to obtain a physician order for a resident receiving oxygen therapy. This deficient practice was identified in 3 of 4 residents (Resident #70; Resident #152; Resident #472) reviewed for respiratory care and was evidenced by the following: [...]

Inspectors wroteBased on observation, interview, record review, and review of facility documentation, it was determined that the facility failed to ensure accurate accountability of controlled drugs to prevent loss or diversion. The deficient practice was identified for 1 of 5 medication carts inspected. This deficient practice was evidenced by the following: On 04/23/2025 at 09:59 AM, the surveyor inspected the Luxor Unit medication cart in the presence of the Registered Nurse #1 (RN#1). A review of the shift-to-shift Narcotic and Controlled Drug Count Verification Record, (NCDCVR) which is used in healthcare settings to track the administration and accountability of controlled substances, revealed missing signatures for the following dates and shifts: [...]

Inspectors wroteComplaint # NJ00158378 Based on observation, interview, record review, and review of pertinent facility documentation, it was determined that the facility failed to a.) follow a physician's order to obtain weekly weights for 1 of 5 residents (Resident #251) investigated for nutrition b.) notify a physician of a resident's medication refusal for 1 of 4 residents (Resident #254) investigated for accidents c.) follow a physician's order (PO) to notify if a resident's blood sugar fell below 100 for 1 of 30 residents (Resident #58) reviewed for medications d.) enter a progress note related to an unwitnessed fall for 1 of 4 residents (Resident #58), investigated for accidents and incidents and e.) document the administration of medication on the resident's electronic medication administration record (eMAR) for 1 of 30 residents (Resident #292) reviewed. [...]

Inspectors wroteComplaint # NJ 154800, NJ 154946, NJ 158378 Based on observation, interview, record review, and review of facility-provided documentation, it was determined that the facility failed to a.) ensure that incontinence care was provided to dependent residents in a timely manner for 7 of 9 residents (Resident #3, #25, #103, #75, #48, #95, and #127) observed for incontinence care on 2 of 4 units ([NAME] and Luxor 1) and b.) provide nail care to residents that required extensive assistance from the staff for activities of daily living (ADLs) for 2 of 4 residents, (Resident #127 and #75) reviewed for ADLs. This deficient practice was evidenced by the following: 1. On 11/15/23 at 12:46 PM, during an interview with the surveyor, RN/UM #2 and LPN #2 identified residents as being dependent on staff for care. [...]

Inspectors wroteComplaint #NJ00155975; NJ00158378; NJ00154946; NJ154800 Based on observation, interview, record review, and review of pertinent documentation, it was determined that the facility failed to provide adequate staff to ensure all residents were provided with timely: a.) incontinent care, and b.) nail care for residents that required extensive assistance for activities of daily living (ADLs). This deficient practice occurred for 7 of 9 residents reviewed for incontinence care (Resident #3, #25, #103, #75, #48, #95 and #127 on 2 of 4 units ([NAME] and Luxor 1) and for 2 of 4 residents, (Resident #38 and #218) reviewed for ADLs and was evidenced by the following: Refer to F677E Reference: New Jersey Department of Health (NJDOH) memo, dated 1/28/21, Compliance with N.J.S.A. [...]

Inspectors wroteBased on observation, interview, record review, and review of facility documentation, it was determined that the facility failed to maintain infection control standards and procedures to address the risk of infection transmission by failing to: a.) follow appropriate hand hygiene practices for 4 of 5 staff observed and b.) handle and store linens and resident's garbage in accordance with facility policy. This deficient practice was evidenced by the following: 1. On 11/13/23 at 1:50 PM, the surveyor observed Registered Nurse (RN) #1 don (put on) a disposable gown, and gloves and entered room [ROOM NUMBER] which had signage indicating the resident was on transmission-based precautions. On 11/13/23 at 1:55 PM, the surveyor observed RN #1 preparing to exit room [ROOM NUMBER], RN #1 doffed (took off) her gown and gloves and exited the room. [...]

Inspectors wroteComplaint #NJ00156125 Based on interview, record review, and review of pertinent documents, it was determined that the facility failed to report an allegation of abuse to the New Jersey Department of Health (NJDOH) for 1 of 5 residents reviewed for investigations and was evidence by the following: A review of Resident #296's admission Record Face Sheet (an admission summary) reflected that the resident was admitted to the facility with diagnosis which included ileostomy (surgery where the small intestines is diverted through an opening of the abdomen), multiple sclerosis (a chronic disease of the central nervous system) and depression. A review of Resident #296's admission Minimum Data Set (MDS), an assessment tool, dated 6/16/22, revealed the resident had a Brief Interview for Mental Status (BIMS) score of 15 out of 15 indicating the resident was cognitively intact. [...]

Inspectors wroteBased on observation, interview, and record review, it was determined that the facility failed to develop and implement a comprehensive person-centered care plan. This deficient practice was identified for 1 of 30 residents (Resident #124) reviewed for care plans and evidenced by the following: On 11/13/2023 at 12:47 PM, the surveyor observed Resident #124 with an unidentifiable mass on the forehead. The surveyor also observed that there was blood on the bedsheets. The surveyor reviewed the medical record for Resident #124: A review of the admission Record face sheet (an admission summary) reflected that the resident was admitted to the facility with diagnosis that included displaced fracture of surgical neck of left humerus and schizophrenia. [...]

Inspectors wroteBased on observation, interview, record review, and review of other pertinent facility documents, it was determined that the facility failed to consistently complete the dialysis communication form for one (1) of two (2) residents, (Resident # 239) reviewed for dialysis. This deficient practice was evidenced by the following: On 11/17/23 at 10:01 AM, the surveyor observed the resident seated in a wheelchair in their room. Resident #239 stated that he/she goes to dialysis on Mondays, Wednesdays, and Fridays. A review of Resident #239's admission record reflected that the resident was admitted to the facility with diagnoses which included but were not limited to: acute kidney failure, osteomyelitis of the vertebra (infection of the bone), and low back pain. [...]

Inspectors wroteBased on observation, interviews, and review of other facility documentation, it was determined that the facility failed to provide a sanitary environment for residents, staff, and the public by failing to keep the garbage compactor free of garbage and debris. On 11/13/23 at 9:59 AM, the surveyor, in the presence of the Food Service Supervisor (FSS) toured the kitchen and the designated garbage area and observed the following: There was garbage debris that included food, gloves, cups, paper products, plastic bags, and card board surrounding the garbage compactor. The FSS stated that the area should have been clean by the maintenance, housekeeping, and dietary departments. On 11/20/23 at 2:19 PM, the surveyor met with the Licensed Nursing Home Administrator (LNHA) and was informed of the findings. [...]

Inspectors wroteBased on observation, interview, record review, and review of pertinent facility documentation, it was determined that the facility failed to: a.) obtain the appropriate physician orders for the care of a resident with a tracheostomy, b.) appropriately label and date oxygen tubing, c.) obtain a physician's order for the use of oxygen and continuous positive airway pressure (CPAP) and d.) failed to follow their facility's policy and procedure for the use and storage of oxygen and respiratory equipment. This deficient practice was identified for 3 of 3 resident's, (Resident #81, Resident #94 and Resident #140), reviewed for respiratory care for 1 of 2 residents, (Resident #145) reviewed for closed medical records. The deficient practice was evidenced by the following: 1. On 12/1/21 at 11:16 AM, the surveyor observed Resident # 81 in bed sleeping. [...]

Inspectors wroteBased on observation, interview and record review, it was determined that the facility failed to maintain complete, accurate and readily accessible medical records. This deficient practice was identified for 1 of 30 residents reviewed (Resident #37) for a period of 7 months and was evidenced by the following: On 12/01/21 at 11:33 AM, during the initial tour of the facility, the surveyor observed Resident #37, seated in a wheelchair in the resident's room. Resident #37 had three complaints: swollen feet, poor vision with missing eyeglasses, and missing dentures. Review of the resident's medical record revealed the following information: [...]

Inspectors wroteBased on observation, interview, and record review, it was determined that the facility failed to ensure a.) appropriate infection control practices were followed in accordance with the Center for Disease Control guidance (CDC) and facility guidelines for 2 of 2 housekeeping staff observed on 1 of 4 nursing units and b.) Transmission-Based Precautions (TBP) were followed for 1 of 11 residents (unsampled resident #1) on TBP's on 1 of 4 nursing units and c.) proper handwashing technique for 3 of 4 nurses during the medication pass on 3 of 4 units. The evidence was as follows: According to the U.S. CDC guidelines for Hand Hygiene in Healthcare Settings Hand Hygiene Guidance, updated 1/30/20, included Healthcare personnel should use an alcohol-based hand rub or wash with soap and water for the following clinical indications: [...]

Inspectors wroteBased on observation, interview, record review, and review of pertinent facility documentation it was identified that the facility failed to offer a resident the influenza and pneumonia vaccination. This deficient practice was identified for 1 of 5 residents, (Resident #74) reviewed for vaccination status and was evidenced by the following: On 12/01/2021 at 11:42 AM, the surveyor observed Resident #74 lying in bed on an air mattress reading a book that was written in the resident's native language. At that time, the surveyor attempted to interview the resident and the resident stated that his/her English was not so good. The surveyor reviewed Resident #74's medical record. [...]

Inspectors wroteBased on observation, interview, record review and review of other facility documents, it was determined that the facility failed to maintain the call bell within reach of 1 of 28 residents (Resident #91) reviewed. This deficient practice was evidenced by the following: On 12/01/21 at 12:30 PM, during the initial tour of the facility, the surveyor observed Resident #91, whose room was located towards the end of the hallway, far from the nurse's station. Resident #91 was out of bed and seated in a Geri-chair in his/her room. The resident was leaning to the left side with no pillows or cushions on the Geri-recliner for comfort and proper positioning. When asked, Resident #91 stated, in a very soft voice, that he/she was very uncomfortable. The resident was not in reach of the call bell, which was wrapped around a bar on the bed frame to the left of the resident's Geri-recliner. [...]

Inspectors wroteBased on observation, interview and a review of facility documents, it was determined that the facility failed to a.) maintain kitchen floors and baseboards in a sanitary manner and in good repair and b.) provide clean, sanitary floor mats in 3 of 4 resident rooms on 1 wing of 1 Nursing Unit (Grace Garden Unit 2, high side hallway). This deficient practice was evidenced by the following: 1. On 12/01/21 at 09:42 AM, during the initial tour of the kitchen in the presence of the Account Manager (AM), the surveyor observed the following: a.) There was an accumulation of dirt along the floor to wall junctures throughout the kitchen and dish room. There was some debris behind the double ovens. Most notably, the kitchen floor was severely worn in several areas near the cooking equipment and throughout the dish room. [...]

Inspectors wroteBased on interview, record review, and review of other pertinent facility documentation, it was determined that the facility failed to clarify a Physician's Orders (PO) for code status (the type of emergent Cardio Pulmonary Resuscitation treatment a person would receive if their heart or breathing were to stop). This deficient practice was identified for 1 of 30 residents, (Resident #36) reviewed for code status related to professional standards of nursing practice and was evidenced by the following: Reference: New Jersey Statutes Annotated, Title 45. Chapter 11. Nursing Board. The Nurse Practice Act for the State of New Jersey states: [...]

Inspectors wroteBased on observation, interview, record review, and review of pertinent facility documentation it was determined that the facility failed to provide Activity of Daily Living (ADL) care to dependent residents. This deficient practice was identified for 2 of 2 residents, (Resident #8 and Resident #21) reviewed for ADLs and was evidenced by the following: 1. On 12/01/2021 at 10:22 AM, the surveyor observed Resident #8 lying in bed. The surveyor observed that the fingernails on both hands extended approximately ¼ inch above his/her fingertips. On 12/06/2021 at 12:35 PM, the surveyor observed the resident lying in bed. The resident's left hand was observed to be curled inward. The surveyor further observed that the resident's fingernails extended approximately ¼ inch above his/her fingertips on both hands. [...]

Inspectors wroteBased on observation, interview, record review, and review of facility documentation, it was determined that the facility failed to apply a physician ordered splinting device to a resident with contractures (a permanent tightening of the muscles, tendons, skin, and nearby tissues that cause the joints to shorten and become stiff). This deficient practice was identified for 1 of 5 residents's (Resident #21) reviewed for position and mobility and was evidenced by the following: On 12/01/2021 at 11:07 AM, the surveyor observed Resident #21 lying in bed with his/her hands resting on his/her lap. The surveyor observed that both resident's hands were contracted, and the resident was not wearing a splinting device on his/her hands. On 12/02/2021 at 12:23 PM, the surveyor observed the resident in his/her room being fed lunch by the Certified Nursing Aide (CNA). [...]

Inspectors wroteBased on observation, interview, record review, and review of pertinent facility documentation, it was determined that the facility failed to a.) accurately assess a new admission weight for a resident; b.) follow and obtain weekly weights for 4 weeks as per facility's weight schedule for newly admitted residents in accordance with facility policy and procedure and c.) obtain a re-weight in a timely manner for 1 of 5 residents (Resident #53) reviewed for nutrition. This deficient practice was evidenced by the following: On 12/1/21 at 11:34 AM, the surveyor observed Resident #53 was on contact precautions. The resident was in bed awake and speaking with his/her physician inside the resident's room. On 12/3/21 at 10:55 AM, the surveyor observed the resident in bed awake with oxygen in use at 3 liters per minute via nasal cannula and wearing eyeglasses. [...]

Inspectors wroteBased on observation, interview, record review, and review of pertinent facility documentation, it was identified that the facility failed to provide a resident with their quarterly Personal Needs Allowance (PNA) statement. This deficient practice was identified for 1 of 30 residents, (Resident #76) reviewed for accounting and records of personal funds. The deficient practice was evidenced by the following. On 12/06/2021 at 12:28 PM, Resident #76 was observed seated in a wheelchair in the main dining room on the long-term care unit on the first floor. The resident stopped the surveyor and requested if the surveyor could help him/her obtain the money that was entitled to him/her every month from the facility. The resident further stated that he/she thought the allowance was $52.00 a month. [...]