Milford Health and Rehabilitation Center

Inspectors wroteBased on review of the clinical record and facility documentation, and interviews for one resident (Resident #1) reviewed for accidents, the facility failed to ensure staff notified the State Agency timely when a new fracture of indeterminate age was identified.

Inspectors wroteBased on review of the clinical record, facility documentation, facility policy, and interviews for one resident (Resident #1) reviewed for accidents, the facility failed to ensure a thorough investigation was completed timely after an injury of unknown origin was identified.

Inspectors wroteBased on review of the clinical record, facility policy and interviews for 2 of 4 residents (Resident #2 and Resident #16) reviewed for nutrition, the facility failed to ensure a significant weight loss of 18.6 pounds (lbs.) in 31 days was identified timely for Resident #2 which resulted in a delay of Resident #2 receiving a nutritional supplement and failed to ensure nutritional supplements were administered per physician orders for a resident with significant weight loss of 20.4 lbs. in 6 months for Resident #16.

Inspectors wroteBased on observations, interviews, review of clinical records, and facility policy for 2 of 2 residents (Resident #3 and Resident #16) reviewed for dialysis, the facility failed to ensure an emergency dialysis kit was at the bedside per policy (Resident #3) and for Resident #16, failed to document/tally Resident #16's actual fluid intake and failed to ensure administration of medication per physician orders.

Inspectors wroteBased on review of the clinical record, facility documentation, facility policy and interviews for 1 of 4 residents (Resident #2) reviewed for nutrition, the facility failed to ensure timely notification to the physician, dietician, and responsible party of a significant weight loss resulting in a delay in providing nutritional supplements and for the only sampled resident (Resident #68) reviewed for constipation/diarrhea, the facility failed to notify the Advanced Practice Registered Nurse (APRN) of loose stools for Resident #68 who was on a laxative.

Inspectors wroteBased on interviews and review of the clinical record for the only sampled resident reviewed for laboratory results (Resident #84), the facility failed to ensure required blood work was completed in the time frame required prior to the resident's appointment.

Inspectors wroteBased on review of the clinical record, facility policy, and interviews for 1 of 2 residents (Resident #11) reviewed for positioning, the facility failed to apply bilateral hand splints per physician orders.

Inspectors wroteBased on observation, interviews, and facility policy for 1 of 6 resident units (unit C1), the facility failed to ensure egress pathways remained free of obstructions. Observation of unit C1 on 2/18/26 at 6:32 AM noted 4 wheelchairs blocking both sides of an exit door (which totally obstructed the entrance to the exit door) that directly leads to a vestibule with 3 doors, one leading to an outside exit, one to a stairwell and one to a janitor's closet. An interview with Nurse Aide (NA) # 6 on 2/18/26 at 6:35 AM noted that the wheelchairs in front of the exit door were recently cleaned by her and were in the hallway to dry. NA #6 stated she did not place the wheelchairs there and was unsure of how they were moved or by who, however she identified the wheelchairs were usually left in the hallway to dry after cleaning but usually were pushed to one side as to not block the exit door. [...]

Inspectors wroteBased on observations, review of the clinical record, facility policy and interviews for 1 of 3 residents (Resident #1) reviewed for skin conditions, the facility failed to implement enhanced barrier precautions (EBP) for a resident with a chronic pressure ulcer and a chronic diabetic wound.

Inspectors wroteBased on review of the clinical record, facility documentation, facility policy, and interviews for one (1) of three (3) residents (Resident #1) reviewed for injury of unknown origin, the facility failed to report an injury of unknown origin to the state agency within the required time frame.

Inspectors wroteBased on review of the clinical record, facility policy, and interviews for 1 of 3 residents (Resident #52) reviewed for Activities of Daily Living (ADL's), the facility failed to maintain proper fingernail hygiene and care.

Inspectors wroteBased on the tour of the Dietary Department, staff interview, facility documentation and facility policy, the facility failed to ensure the Dietary Department consistently labeled opened dry food with the date opened and expiration dated and failed to ensure canned goods identified an expiration date.

Inspectors wroteBased on review of the clinical record, facility policy, and interviews for 1 of 4 residents (Resident #89) reviewed for nutrition, the facility failed to notify the provider of weight loss.

Inspectors wroteBased on interviews and review of the clinical record for 1 of 5 residents reviewed for unnecessary medications, the facility failed to ensure Resident #1's abnormal laboratory results were addressed.

Inspectors wroteBased on interviews, review of the clinical record, and facility policy, for 2 of 7 residents (Resident #3 and Resident #26) reviewed for Preadmission Screening and Resident Review (PASARR), the facility failed to notify the state mental health authority promptly after a new psychiatric diagnosis.

Inspectors wroteBased on staff interview and review of 1 of 2 Nurse Aide (NA #3) personnel files, the facility failed to complete a yearly performance review.

Inspectors wroteBased on observation, review of facility documentation, review of facility policy, and interviews during a review of the facility's medication storage and reconciliation program in 1 of 2 medication rooms, the facility failed to appropriately store and reconcile a discontinued controlled substance (narcotic).

Inspectors wroteBased on observation, review of the clinical record, review of facility documentation, review of facility policy, and interviews for one sampled resident (Resident # 418) reviewed for Discharge Planning, the facility failed to provide diabetic education and teaching.

Inspectors wroteBasedonreviewoftheclinicalrecord reviewoffacilitydocumentation reviewoffacilitypolicyandinterviewsforoneoftwosampledresidents(Resident#44) reviewedforactivitiesofdailyliving thefacilityfailedtoprovidenecessaryservicestomaintainpersonalhygiene Thefindingsinclude Resident#44 haddiagnosesthatincludedschizoaffectivedisorder majordepressivedisorder hemiplegiaandhemiparesisfollowingacerebrovascularaccidentandatraumaticbraininjury TheannualMDSassessmentdated11/09/2021 identifiedResident#44 wascognitivelyintact hadnonotedbehaviors requiredextensiveassistancewithbedmobilityandpersonalhygieneandrequiredtotalassistanceforbathing Thecareplandated11/19/21 identifiedResident#44 hadanADLselfcareperformancedeficitwithinterventionsthatincluded showertwotimesaweekonWednesdayonthe7AM3PMshiftandFriday3PM11PMshift residentrequiresassistanceofonestaffwithbathingshowering [...]

Inspectors wroteBased on observation, review of the clinical record, review of facility documentation, review of facility policy, and interviews for one sampled resident (Resident #5) who utilized oxygen, the facility failed to ensure physician's orders were in place for the use of oxygen.

Inspectors wroteBased on review of the clinical record, review facility documentation, review of facility policy, and interviews for one sampled resident (Resident #1) reviewed for resident assessment, the facility failed to complete a quarterly assessment in a timely manner.