Preferred Care at Wall

Inspectors wroteBased on observation, interview, and review of pertinent facility documents, it was determined that the facility failed to store food in accordance with professional standards for food service safety related to storage height and temperature monitoring. This deficient practice was evidenced by the following:1.) On 06/11/26 at 10:04 AM, the surveyor toured the kitchen with the Food Service Director (FSD). When touring the dry food storage area, boxed items were observed being stored less than 18 inches from the ceiling. The surveyor observed painted lines on the wall which indicated a measurement of 18 inches from the ceiling. During an interview at that time, the FSD stated that items in the dry food storage area should be kept more than 18 inches from the ceiling as a matter of fire safety in the kitchen. [...]

Inspectors wroteBased on observation, interview, and review of pertinent facility documentation, it was determined that the facility failed to maintain a homelike environment that was clean, safe, and sanitary. This deficient practice was identified for 1 of 3 Units (200 Unit) and was evidenced by the following: On 06/12/26 at 9:25 AM, the surveyor observed a white sign posted on the bathroom door of room [ROOM NUMBER] on the 200 Unit that read, Do Not Use Sink Out of Service. The bathroom sink was actively dripping water. A black trashcan, and a pink basin had been placed beneath the sink to collect the leaking water. Both containers were overflowing, resulting in water accumulation on the bathroom floor. [...]

Inspectors wroteBased on observation, interview, record review, and review other facility documentation, it was determined that the facility failed to properly secure medications for 1 of 26 residents (Resident #2) sampled. This deficient practice was evidenced by the following: On 06/11/26 at 10:24 AM, the surveyor observed Resident #2 was not in his/her room, but there were medications left on the resident's dresser - an umeclidinium bromide inhaler, a fluticasone propionate nasal spray, an albuterol sulfate nebulizer solution and a budesonide nebulizer solution. On 06/11/26 at 10:26 AM, the surveyor interviewed Registered Nurse (RN) #1 who stated that medications should be secured in the medication cart when not in use. The RN further stated that she did not have any residents on her assignment that were allowed to self-administer medications. [...]

Inspectors wroteComplaint: NJ186923, NJ186877 Based on observation, interviews, medical record review, and review of other pertinent facility documentation on 6/04/2025 and 6/09/2025, it was determined that the facility failed to ensure a resident's movement in and out of bed was not restricted. The Certified Nursing Assistant (CNA) placed a floor mat against the right quarter side rail that extended to the foot of the bed. The CNA then placed a bedside tray table and wheelchair against the floor mat to hold it in place along the right side of the bed. This restricted the resident's ability to move legs on the right side of the bed. This deficient practice was identified for 1 of 3 sampled residents ( Resident #2) and was evidenced by the following: [...]

Inspectors wroteBased on observation, interview, and record review, it was determined that the facility failed to a.) maintain kitchen equipment in a clean and sanitary manner and b.) maintain pantry equipment in a clean and sanitary manner on 3 of 3 units. The evidence was as follows: On 2/19/25 at 9:31 AM, the surveyor toured the kitchen in the presence of the Food Service Director (FSD) and observed the following: 1. The stand mixer was covered with a clear plastic bag which indicated that it was clean. The FSD removed the bag and the connecting bearing that holds the mixer attachment had hard dried white sediment on it. The FSD was able to wipe it off with a gloved hand. The FSD acknowledge it was not properly cleaned. 2. The can opener blade was worn, discolored, and had a rolled pointed edge. [...]

Inspectors wroteBased on observation, interview, and record review it was determined the facility failed ensure a Preadmission Screening and Resident Review (PASARR) was completed accurately for a newly admitted resident. This deficient practice was identified for 1 of 2 residents reviewed for PASARR (Resident #9), and was evidenced by the following: On 2/19/25 at 11:10 AM, during the initial tour of the facility, Resident #9 was observed in the day room. A review of the admission Record face sheet (an admission summary) indicated Resident #9 had medical diagnoses which included but were not limited to; diabetes (high blood sugar), respiratory conditions due to smoke inhalation, bipolar disorder, schizophrenia, and heart failure. [...]

Inspectors wroteBased on observation, interview, and review of pertinent facility documents, it was determined the facility failed to revise an individual comprehensive care plan (ICCP) with the resident's personal preference for incontinence care and the need for incontinence briefs. This deficient practice was identified in 1 of 9 residents observed for incontinence care (Resident #35), and was evidenced by the following: On 2/19/25 at 9:55 AM, during initial tour of the facility, the surveyor accompanied by the Certified Nursing Aide (CNA), observed incontinence care for Resident #35. The surveyor observed that the resident had an adult incontinence brief on with a pull-up incontinence brief on top. At that time, the CNA informed the surveyor that it was the resident's preference to wear two incontinence briefs. [...]

Inspectors wroteBased on observation, interview, record review, and review of pertinent documentation, it was determined that the facility failed to ensure that proper incontinence care was provided to dependent residents. This deficient practice was identified for 1 of 9 residents observed for incontinence care (Resident #43), and was evidenced by the following: On 2/19/25 at 9:55 AM, during initial tour of the facility, the surveyor accompanied by the Certified Nursing Aide (CNA), observed incontinence care for Resident #43. The surveyor observed that the resident had an adult incontinence brief on with a pull-up incontinence brief on top. The surveyor asked the resident if they had a preference to be double briefed, and the resident shrugged their shoulders indicating they did not know. [...]

Inspectors wroteBased on observation, interview, and the review of pertinent facility documentation, it was determined that the facility failed to a.) provide supportive rational for starting a new antianxiety medication and b.) document targeted behaviors for a resident on psychoactive medication. This deficient practice was identified for 1 of 3 residents reviewed for psychoactive medication use (Resident #88), and was evidenced by the following: A review of the admission Record face sheet (admission summary) indicated that Resident #88 was admitted to the facility with the diagnoses which included but was not limited to; dementia and unspecified psychosis not due to a substance or known psychological condition. A review of the comprehensive Minimum Data Set (MDS), an assessment tool dated 12/26/24, reflected that Resident #88 had severe cognitive impairment and did not exhibit any behaviors. [...]

Inspectors wroteBased on observation, interview, and review of pertinent facility documents, it was determined that the facility failed to ensure Enhanced Barrier Precautions (EBP) were maintained while providing direct resident care in accordance with infection control standards of practice and facility policy. The deficient practice was identified for 1 of 9 residents observed for incontinence care (Resident #105), and was evidenced by the following: A review of Resident #105's admission Record face sheet (admission summary) indicated that the resident was admitted to the facility with dementia and rheumatoid arthritis (RA). A review of the most recent quarterly Minimum Data Set (MDS), an assessment tool dated 12/12/24, indicated that the resident had severe cognitive impairment and required maximum assistance with all aspects of activities of daily living (ADLs). [...]

Inspectors wroteBased on observation, interview, and review of pertinent facility documents, it was determined that the facility failed to a.) maintain multiuse food-contact surface cutting board in a manner to prevent microbial growth; b.) store, label, and date potentially hazardous foods to prevent food-borne illness; and c.) perform hand hygiene in accordance with infection control standards. This deficient practice was evidenced by the following: On 1/13/23 at 9:14 AM, the surveyor toured the kitchen with the Food Service Director (FSD) and observed the following: 1. In the walk-in refrigerator, one opened container of ricotta cheese. The container was not labeled when opened or when to use by. The packaging indicated best quality is three days. The FSD acknowledged the container was not labeled when opened or when to discard. 2. In the reach-in refrigerator, seven health shakes not dated; [...]