Preferred Care at Old Bridge, LLC

Inspectors wroteComplaint NJ#'s 420827, 2636492Based on observation, interviews, record review and review of pertinent facility documents it was determined that the facility failed to provide appropriate assistance with toileting needs and personal hygiene care for 4 of 6 residents (Residents #5, #8, #9, and #4) reviewed for Activities of Daily Living (ADL). This deficient practice was evidenced by the following:1. On 10/23/25 at 8:45 AM, Surveyor #1 observed Resident #5 sitting in a chair by the bedside on the South Unit. Resident #5 was disheveled and unkempt. Their sneakers were heavily soiled and stained. Their facial area was covered with yellow and white flakes. Resident #5's lower extremities were swollen, covered with yellow flaky and discolored areas. The residents fitted sheet on the bed was heavily soiled and yellow stained. [...]

Inspectors wroteComplaint NJ# 420827Based on observations, interviews, record review and review of pertinent facility documents, it was determined that the facility failed to ensure that a.) resident's call bells were within reach and could be activated for assistance with their needs, and b.) resident's needs were met in a timely manner once the call bell was answered. This deficient practice was identified for 3 out of 9 residents (Resident's #4, #6 and #7) reviewed for reasonable accommodation of needs. This deficient practice was evidenced by the following: 1. On 10/23/25 at 9:20 AM, the surveyor observed Resident #6 in bed. When the surveyor inquired about the residents call bell, they stated, I do not have a call light. The resident further stated that if they required assistance, they used their wheelchair to go to the hallway to find/alert staff. [...]

Inspectors wroteComplaint#: NJ187513, NJ187972Based on interviews, closed medical record review, and review of other pertinent facility documents on 7/10/2025, it was determined that the facility failed to develop an elopement risk care plan (CP) for a resident (Resident #5) who was identified as an elopement risk. This deficient practice was identified in 1 of 4 residents reviewed for elopement risk. This deficient practice was evidenced by the following:The surveyor reviewed the closed medical record for Resident #5. According to the admission Record (AR), Resident #5 was admitted to the facility with diagnoses which included but were not limited to Diabetes, Anemia, Hyperlipidemia (high cholesterol). [...]

Inspectors wroteBased on interviews, medical record review, and review of other pertinent facility documentation on 7/10/2025 it was determined that the facility failed to follow their protocol and policy to prevent the elopement of a safety awareness impaired resident (Resident #2) who exited the facility from the rear entrance when an incoming family member entered the facility and held the door for Resident #2 to leave the facility and return to their home with staff failing to adequately supervise resident and ensure safety of its residents. This REQUIREMENT is NOT MET as evidenced by:Complaint#: [...]

Inspectors wroteBased on observation, interview, and record review, it was determined that the facility failed to ensure that all medications were administered without error of 5% or more. During the medication administration observation performed on 3/26/25, the surveyor observed three (3) nurses administer medications to five (5) residents. There were 32 opportunities, and two (2) errors were observed which calculated to a medication administration error rate of 6.25 %. This deficient practice was identified for one (1) of five (5) residents, (Resident #79), that were administered medications by one (1) of three (3) nurses. The deficient practice was evidenced as follows: On 3/26/25 at 8:10 AM, the surveyor observed the Licensed Practical Nurse (LPN #1) preparing to administer the morning medications to Resident #79. [...]

Inspectors wroteBased on observation, interview, record review, and review of pertinent facility documents, it was determined that the facility failed to a.) identify and address a severe weight loss of 7.6 pounds (lbs.) and 5.3% in one week from 9/15/22 through 9/22/22, and obtain a reweight for 1 of 4 residents, (Resident #97), b.) ensure that a resident identified as at risk for malnutrition or malnourished was comprehensively evaluated and assessed for 2 of 4 residents, (Resident #38 and #97), and c.) provide the recommended supplements to residents that experienced weight loss for 3 of 4 residents, (Resident #33, #38 and #97) reviewed for nutrition. The evidence was as follows: 1. On 3/2/23 at 11:25 AM, the surveyor observed Resident # 97 awake and seated in a wheelchair in front of the North nursing unit. At that time, the resident stated that he/she was aware of his/her weight loss. [...]

Inspectors wroteBased on observation, interview, and record review, it was determined that the facility failed to ensure the physician addressed severe weight loss for 1 of 4 residents (Resident #97) reviewed for nutrition. The evidence was as follows: On 3/2/23 at 11:25 AM, the surveyor observed Resident # 97 awake and seated in a wheelchair in front of the North nursing unit. At that time, the resident stated that he/she was aware of his/her weight loss. The surveyor reviewed the electronic and paper medical record for Resident #97. Review of the admission Record (an admission summary) included that the resident was admitted to the facility with diagnoses that included but were not limited to cerebral infarction (stroke), hemiplegia and hemiparesis (weakness of one side of the body) following cerebral infarction affecting the right dominant side, and dysphagia (difficulty swallowing). [...]

Inspectors wroteBased on interview and record review, it was determined that the facility failed to timely transmit a resident's Minimum Data Set (MDS), an assessment tool used to facilitate the management of care in accordance with federal guidelines. This deficient practice was identified for one (1) of 28 residents, (Resident #87) reviewed for the timely transmission of MDS's and was evidenced by the following: The MDS is a comprehensive federal mandated process for clinical assessment of all residents that has to be completed and submitted to the Quality Measure System. The facility must electronically transmit the MDS up to 14 days of the 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. [...]

Inspectors wroteBased on observation, interview, record review and review of pertinent facility documents, it was determined that the facility failed to develop a comprehensive, person-centered care plan for residents with nutritional concerns, weight loss and malnutrition. This deficient practice was identified for 2 of 27 residents reviewed for comprehensive care plans (Resident #33 and #264), and was evidenced by the following: 1. On 2/22/23 at 12:13 PM, the surveyor observed Resident #33 in his/her room seated in a wheelchair in front of the lunch tray on an overbed table. The resident stated that he/she had not eaten lunch yet and the plate was covered with a domed lid. The surveyor reviewed the electronic and paper medical record for Resident #33. [...]

Inspectors wroteBased on observation, interview and review of pertinent facility documents, it was determined that the facility failed to ensure the safe and appetizing temperatures of food and drink served to the residents. This deficient practice was identified by 4 of 5 residents, who during the 2/27/23, Resident Council group meeting stated that hot foods were received cold, and confirmed during the lunch time meal service on 3/3/23, on 1 of 3 nursing units (South) tested for food temperatures by two surveyors, and was evidenced by the following: On 2/22/23 at 9:54 AM, the surveyor conducted an initial tour of the kitchen with the Food Service Director (FSD). During the tour, the surveyor observed that the department had a functioning plate warmer and a method to heat the plate liners to assist in maintaining hot food temperatures during tray delivery to the residents. [...]

Inspectors wroteBased on observation, interview and record review, it was determined that the facility failed to: a.) administer breakthrough pain medication in a timely manner when a resident visually and verbally exhibited signs of unmanaged pain during movement, b.) ensure the same resident was appropriately assessed and pre-medicated for breakthrough pain prior to performing wound care and activities of daily living, and c.) place a pressure-relieving gel seat cushion to the chair when out of bed to offload pressure and reduce pain associated with the resident's full thickness tissue loss pressure ulcer. This deficient practice was identified for 1 of 3 residents reviewed for pain management (Resident #25). The evidence was as follows: On 3/2/21 from 11:28 AM to 11:57 AM, the surveyor observed that Resident #25 was in bed on an air mattress. [...]

Inspectors wroteBased on observation, interview, and review of pertinent facility documents, it was determined that the facility failed to ensure: a.) a medication used to treat low blood pressure (Midodrine) was administered in accordance with the hold parameters prescribed by the physician which occurred for 19 different nurses over a period of six months, and b.) the accurate documentation of a resident's skin condition in accordance with professional standards of nursing practice. This deficient practice was identified for 3 of 22 residents reviewed for professional standards of practice (Resident #10, #25, and #77). 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 documents, it was determined that the facility failed to ensure: a.) the application of a positioning wedge in accordance with a resident's Physical Therapy recommendations and the individualized care plan, b.) the application of multipodus boots in accordance with a resident's discharge physical therapy recommendations, restorative mobility program and physician orders, c.) the individualized care plan had a measurable goal for the resident's range of motion limitations and that the care plan was developed for the resident's Restorative Nursing Program with the multipodus boots. This deficient practice was identified for 1 of 2 residents reviewed for restorative programming (Resident #25). The evidence was as follows: On 3/2/21 at 11:57 AM, the surveyor observed Resident #25 in bed on an air mattress. [...]

Inspectors wroteBased on observation, interview and record review, it was determined that the facility failed to ensure that the Consultant Pharmacist recommendations regarding the use of a medication to treat low blood pressure (Midodrine) were acted upon in a timely manner when the medication was identified to not be administered in accordance with the physician prescribed hold parameters for a period of six (6) months. This deficient practice was identified for 2 of 6 residents reviewed for Consultant Pharmacist reviews (Resident #10 and #77), and was evidenced by the following: 1. On 3/10/21 at 9:03 AM, observed Resident #10 in bed awake, at that time the surveyor interviewed Resident #10 regarding his/her medication regimen. The resident expressed that he/she had no concerns. The surveyor reviewed the medical record for Resident #10. [...]

Inspectors wroteBased on observation, interview, record review, and review of pertinent facility documents, it was determined that the facility failed to ensure: a.) the appropriate disposition of a Scheduled-IV controlled drug (Tramadol), and b.) appropriately sign for the destruction of the Tramadol for 2 of 2 opportunities for medication destruction for 1 of 8 residents reviewed for medications management (Resident #25). This deficient practice was identified for 2 of 2 nurses on 3/10/21, and was evidenced by the following: On 3/10/21 at 8:38 AM, the surveyor observed Resident #25 awake in bed on an air mattress. The resident stated to the surveyor that he/she had pain in the back-side. The resident was only able to elaborate on the location of the pain, and not the type, severity, duration or other possible causes of the pain. [...]