Nick's Health Care Center

Inspectors wroteBased on interview and record review, the facility failed to protect one resident (Resident #2) from physical abuse when Resident #1 punched Resident #2 in the face to the extent hospitalization was required. The facility census was 66. The Administrator was notified on 10/20/2025 at 5:05 PM of the past noncompliance which began on 10/20/2025. The facility administration immediately separated and protected the residents from further abuse by Resident #1. Residents #1 and #2 were sent to separate hospitals for medical assessment and treatment, staff updated regarding each resident's plan of care, and all residents were interviewed and provided updated abuse and neglect information. All staff were In-serviced on the abuse and neglect policy and procedure by 10/23/25. The noncompliance was corrected on 10/23/2025. [...]

Inspectors wroteBased on observation, interview and record review, the facility failed to provide sanitary conditions when the facility failed to address a fly problem in the kitchen/dining area and failed to address walls, flooring, and doors that were in need of repair. The facility census was 69. Review of the facility's Dietary Equipment, Infection Control and Sanitation policy, revised 2/2/24, showed the Dietary Manager is responsible for assembling, organizing and maintaining the needs for the operating and cleanliness of the kitchen and all dietary equipment. Review of the facility's Pest Control Program policy, dated 5/14/24, showed it was the policy of the facility to maintain an effective pest control program that eradicates common household pests such as flies. 1. [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to maintain an effective pest control program when residents were observed with flies on them during meals, cares, and activities. The facility census was 69. Review of the facility's Pest Control Program policy, dated 5/14/24, showed it is the policy of the facility to maintain an effective pest control program that eradicates common household pests such as flies. The facility was unable to provide documentation of the last pest control services in the facility. Observation on 9/30/25 at 10:05 A.M., showed flies in the main entrance of the facility flying around residents. Observation on 9/30/25 at 12:45 P.M., showed flies landing on residents' food during the noon meal, flies on the tables where residents were eating, and flies being swatted away by residents while they ate. [...]

Inspectors wroteBased on interview and record review, the facility failed to use the correct advanced beneficiary notice of non-coverage form to notify three of three sampled residents (Residents #2, #34, and #36) of changes in coverage to items and services covered by Medicare and/or by the Medicaid State plan. The facility census was 69. Review of the facility's Medicare Advance Beneficiary and Medicare Notice, policy last revised 11/05/24, showed residents are informed in advance when changes occur to their bills. CMS (Center for Medicare/Medicaid Services) form 10055 will be provided to the resident prior to discharging from Medicare part A.1. [...]

Inspectors wroteBased on observation and interview, the facility failed to ensure laundry services were provided in a manner to ensure a safe/clean/ comfortable homelike environment, when laundry services did not return clean clothes to one Resident (Resident # 49) causing the resident to wear a hospital gown in the dining room. Additionally, failure to keep the dirty laundry caught up resulted in a strong urine odor outside the hall of the laundry room. The facility census was 69. The facility was unable to provide a policy regarding duties of the laundry.1. Observation on 9/30/25 at 10:45 A.M., showed the laundry room located outside the hallway of the dining room and a strong odor of urine on the hallway prior to entry of the dining room. Upon entry into the laundry room there were three large barrels overflowing the top, full of dirty linen and clothing. [...]

Inspectors wroteBased on interview and record review, the facility failed to honor one resident's (Resident #27) right to make choices about aspects of his/her life in the facility that were significant to the resident, when the facility failed to honor and follow through on the resident's request to transfer to a different Long Term Care (LTC) facility that would allow the resident to live closer to his/her family member. The facility census was 69. Review of the facility's Resident Rights Policy, revised 9/21/25, showed all residents have a right to a dignified existence, self-determination and communication with and access to persons and services inside and outside the facility. The facility must protect and promote the right of each resident. [...]

Inspectors wroteBased on interview and record review, the facility failed to protect one Resident's (Resident #1) right to be free from abuse when Resident#2, hit Resident #1 in the face causing bodily injury to Resident #1. The deficient practice affected one out of five sampled residents. The facility census was 67. Review of the facility provided policy titled, Abuse and Neglect, dated 6/12/24 showed: -Abuse is the willful infliction of injury; -Purposefully beating, striking, wounding or injuring any resident; -The facility will identify and correct, by providing interventions, in which abuse, neglect, or misappropriation are more likely to occur; -The facility desires to prevent abuse, neglect and theft by establishing a resident sensitive and resident secure environment; [...]

Inspectors wroteBased on interviews and record review, the facility failed to protect the resident's right to be free from abuse by Resident #1, when Resident #1 struck Resident #2 in the face resulting in a bloody lip. The facility census was 64. Review of the facility's Abuse and Neglect policy, dated 6/12/24, showed: - It is the policy of this facility to report all allegations of abuse/neglect/exploitation or mistreatment, including injuries of unknown sources and misappropriation of resident property are reported immediately to the Administrator of the facility; - Abuse is the willful infliction of injury, unreasonable confinement, intimidation, or punishment with resulting physical harm, pain or mental anguish, which can include staff to resident abuse and certain resident to resident altercations; - Physical Abuse: [...]

Inspectors wroteBased on observation, interview, and document review, the facility failed to ensure the roast beef served for lunch on 10/09/2024 was not tough for 5 (Residents #4, #34, #37, #49, #58) of 5 residents who attended the resident council meeting.

Inspectors wroteBased on observation, interview, and facility policy review, the facility failed to ensure expired food items were discarded after their expiration and use-by-date, items stored in the walk-in refrigerator were sealed from potential contamination, and food items were not stored on the floor of the walk-in freezer. These deficient practices had the potential to affect all residents who received food from the kitchen.

Inspectors wroteBased on observation, interview, record review, and facility policy review, the facility failed to maintain an effective pest control for the prevention and control of flies in the facility. The deficient practice had the potential to affect all 69 resident who currently resided in the facility.

Inspectors wroteBased on interview, record review, and facility policy review, the facility failed ensure care plan meetings were conducted for 2 (Resident #15 and Resident #56) of 19 sampled residents.

Inspectors wroteBased on interview, record review, and facility policy review, the facility failed to timely report allegations of abuse to the state agency for 2 (Resident #19 and Resident #21) of 2 sampled residents reviewed for abuse.

Inspectors wroteBased on interview, record review, and facility policy review, the facility failed to develop and implement comprehensive care plans for 2 (Resident #57 and Resident #66) of 19 residents whose care plans were reviewed. Specifically, the facility failed to ensure Resident #57's comprehensive care plan addressed a diagnosis of type two diabetes mellitus and failed to develop a comprehensive care plan for Resident #66.

Inspectors wroteBased on observation, interview, and facility policy review, the facility failed to ensure the nurse staffing data was posted daily for 3 of 5 days of the survey.

Inspectors wroteBased on observation, interview, record review, and facility policy review, the facility failed to remove dead bugs and cobwebs in 1 (main dining room) of 2 dining rooms in the facility.

Inspectors wroteBased on interview, record review, and facility policy review, the facility failed to ensure a preadmission screening and resident review (PASARR) was completed when 1 (Resident #54) of 1 sampled resident reviewed for PASARR received a new mental illness diagnosis.

Inspectors wroteBased on record review and interview, the facility failed to implement their water management policy and procedures to reduce the risk of growth and spread of Legionella (bacteria that causes Legionnaires' disease, a serious type of pneumonia). The facility also failed to ensure facility staff were informed on the facility's Water Management Plan and on safe water temperatures to maintain for the hot water. The facility census was 56. Review of the CMS Quality Safety and Oversight (QSO), dated 6/2/17 and revised on 7/6/18, showed: - Facilities must have water management plans and documentation that, at a minimum, ensure each facility: Conducts a facility risk assessment to identify where Legionella (a [NAME] of pathogenic Gram-negative bacteria that includes the species L. [...]

Inspectors wroteBased on observation, record review, and interviews, the facility failed to provide a safe, clean, comfortable and homelike environment for all residents of the facility, when the staff did not keep rooms clean, floors throughout the building clean and in good repair, doors and walls in all the hallways and in resident rooms scuffed with missing paint, and an overall un-cleanliness about the building which affected all of the facility's residence halls, and all common areas of the facility. The facility census was 66. Review of the facility deep cleaning and daily cleaning policy dated 2/26/21, showed: - It is the purpose of this policy to ensure rooms are clean. 1. Observation on 3/27/23 at 10:45 A.M., showed: - On the 100 hall, room [ROOM NUMBER] missing baseboards in the entire resident room exposing sheetrock and old paint. [...]

Inspectors wroteBased on observations, interviews, and record review, the facility failed to assure residents have the right to file grievances in writing; the right to file grievances anonymously; the contact information of the grievance official with whom a grievance can be filed, that is, his or her name, business address (mailing and email) and business phone number; a reasonable expected time frame for completing the review of the grievances, the right to obtain a written decision regarding his or her grievance. This had the ability to affect all residents. The facility census was 66. Review of the facility grievance policy titled,, Grievance Policy -Residents, dated 9/17/21, showed: -Facility wants to hear and address any concern of a resident. A resident or their legal representative can bring concerns to a staff member, the resident concern group, or call the compliance hotline. [...]

Inspectors wroteBased on record reviews and interview the facility failed to ensure they completed a check of the employee disqualification list (EDL), Criminal Background Check (CBC) and/or the Nurse Aide (NA) Registry prior to allowing four of 19 sampled staff to have contact with residents. The facility census was 66. Review of the facility provided policy, Screening-Applicant, Employee, Volunteer and Vendor dated 5/9/22 showed: -Human Resources (HR) department will conduct pre-employment screens on applicants to determine whether the applicant has committed a disqualifying crime, is an excluded provider of any Federal or state healthcare programs, is eligible to work in the United States and if applicable is duly licensed or certified to perform the duties of the position for which they applied. HR will conduct the following screens on potential employees prior to hire: [...]

Inspectors wroteBased on observations, interview, and record review, the facility failed to ensure staff developed and updated care plans consistent with resident's specific conditions and needs which affected two of twelve sampled residents (Resident #41 and #61). The facility census was 66. 1. Review of Resident #41's quarterly Minimum Data Set (MDS), a federally mandated assessment, dated 3/24/23, showed: -Diagnoses included hyponatremia (a condition where sodium levels in your blood are lower than normal often due to too much water in the body which dilutes sodium levels), Parkinson's disease, and traumatic brain injury. Review of care plan, dated 3/7/23 showed: [...]

Inspectors wroteBased on observation, record review and interview, the facility failed to prevent tissue injury to both feet, by allowing the underside of the right great toe area to re-open, and the tops of toes on the left foot to show skin injury where the skin peeled back from the nail to the first knuckle of the second, third, and fourth toes rubbing against his shoes. This affected one resident (Resident #61) of sampled 18 residents. The facility census was 66. Review of the facility's skin assessment policy dated 2/26/21 showed: - The purpose of the policy is to ensure that all residents are being assessed for skin integrity concerns weekly. 1, Review of the resident #61's most current care plan dated on 1/17/23, showed: - No specific nursing interventions to address the residents risk for skin concerns to his/her feet. [...]

Inspectors wroteBased on interview and record review, the facility failed to ensure four of four randomly selected Certified Nurse Aides (CNA) received the required annual 12 hour resident care training. The census was 66. The facility failed to provide any education records for staff. Review of the CNA individual service records, showed the following: -CNA A hired 4/24/19, with zero hours of in-service education; -CNA B hired 10/20/20, with zero hours of in-service education; -CNA E hired 4/20/22, with zero hours of in-service education; -CMT A hired 6/11/21, with zero hours of in-service education. During an interview on 3/30/21 at 2:17 P.M., the Administrator said inservices were not as often as he would like. He would keep a record of any education completed in the facility. He does not have any records of education. Relias is used for training as well and they send a report to the facility. [...]

Inspectors wroteBased on interview and record review, the facility did not provide medically related social services to attain the highest practicable physical, mental, and psychological well being of each resident when they failed to obtain resident's eye glasses following his/her eye appointment. This affected three of twelve sampled residents (Resident #15, #56, and #61). The facility census was 66. Review of the facilities resident rights policy, dated and retrieved from corporate on 3/29/23, showed: - The purpose of the resident rights policy was to prevent harm to the residents. - There was no mention of the social service role in the facility - There was no policy for social services provided 1. Review off Resident #56's quarterly MDS, dated [DATE], showed: -Cognitively intact -Wore corrective lenses Review of resident's care plan, dated 8/6/21, showed: [...]

Inspectors wroteBased on interview and record review, the facility failed to ensure residents remained free from unnecessary drugs when the facility failed to ensure they attempted a gradual dose reduction (GDR) in an effort to discontinue psychotropic drug (medications used to treat mental illness by causing an effect on the chemical makeup of the brain and nervous system) use, unless clinically contraindicated for three of twelve sampled residents (Resident #34, #51, and #60). The facility census was 66. Review of the facility policy titled Medication Administration and Monitoring, dated 9/17/21, showed: -Each resident's drug regimen will be reviewed monthly by a licensed pharmacist. Any irregularities or concerns will be given to the physician and the Director of Nursing (DON). All pharmacy consultant recommendations will be addressed and followed up by nursing or the physician. [...]

Inspectors wroteBased on observation and interview, the facility failed to provide meals served at an appetizing temperature by failing to do temperature checks on all foods being served from the steam table. The facility census was 66. Facility did not provide requested food temperature policy. 1. Observation on 3/28/23 at 11:03 A.M. showed: -Dietary Aide (DA) A temperature checked ribs in the oven, reading 123.5 Fahrenheit (F) -Thermometer placed on steam table, not cleaned. Observation on 3/28/23 at 11:26 A.M. showed: -Staff removed fries from the oven and placed them on the steam table by DA A -DA A checked the temperature of the pork loin 179 F., and used an alcohol wipe to clean the thermometer. -DA A asked DA B to write down temperatures for him/her. Temperatures included fries 189.3 F., cabbage 208 F., riblets 175 F. , sweet potatoes 185 F., and pork loin 179 F. [...]

Inspectors wroteBased on observation, record review and interview, the facility failed to prepare and serve food in accordance with professional standards for food service safety when staff failed to label and date food when it was opened, did not keep a clean kitchen, failed to monitor sanitizer levels for the sanitizer buckets and ensure staff washed their hands as often as necessary to keep their hands clean. The facility census was 66. Review of the facility policy, dietary receiving and storing food and supplies, revised 10/12/21, included: Food Storage: -Food items will be stored, thawed, and prepared in accordance with good sanitary practice. -All products shall be dated upon receipt or when they are prepared. Use Date shall be marked on all food containers according to the timetable -Leftovers shall be dated according to the leftovers policy. Raw Meat: [...]

Inspectors wroteBased on interview and record review, the facility failed to develop a comprehensive, data-driven quality assessment and assurance (QAA) activities and a quality assurance performance improvement (QAPI) program that focused on outcomes of care and quality of life when they failed to provide documentation and evidence of its ongoing QAA/QAPI program. The facility census was 66. The facility did not provide a policy for their QAA/QAPI process. The facility did not provide QAA committee information. The facility did not provide a QAPI plan. Record review of QAPI meeting sign in sheets showed: -The facility medical director did not participate in meetings; -On 12/2/22 showed participation from the Administrator, Director of Nursing (DON), Nurse Practitioner, Dietary Manager, MDS Coordinator, Therapy, Nursing, Environmental Services, and Social Services. [...]

Inspectors wroteBased on interview and record review, the facility failed to establish an infection prevention and control program that included an antibiotic stewardship (a set of commitments and actions designed to optimize the treatment of infections while reducing the adverse events associated with antibiotic use) program that included antibiotic use protocols and a system to monitor antibiotic use. This deficient practice had the potential to affect all residents in the facility. The facility census was 66. The facility did not provide an Antibiotic Stewardship policy. 1. Record review of the facility's blank, undated and unsigned Antibiotic Stewardship form, showed the facility had not developed or implemented an Antibiotic Stewardship Program that should include: [...]