Quaker Hill Manor

Inspectors wroteThe facility reported a census of 47 residents. Based on observation, record review, and interview, the facility failed to prepare and serve food under sanitary conditions, to the residents of the facility, and to prevent the potential for food borne bacteria in one of one kitchen.

Inspectors wroteThe facility reported a census of 47 residents with 12 residents sampled, including one resident reviewed for dignity. Based on observation, interview and record review, the facility failed to show respect and dignity to one Resident (R)30, when the resident sat with her bare legs, including her upper thighs, exposed.

Inspectors wroteThe facility reported a census of 47 residents; the sample included 12 residents including two residents reviewed for hospitalization. Based on interview and record review, the facility failed to provide Resident (R)15 and R1, and/or their representative, a written notification explaining the purpose of the discharge.

Inspectors wroteThe facility identified a census of 47 residents. The sample included 12 residents. Based on observation, interview, and record review, the facility failed to revise Resident (R) 1's Care Plan with the interventions to address a diagnosis of cancer or the cancerous lesions. Findings Included:- R1's Electronic Medical Record (EMR) revealed the following diagnoses of lung cancer, respiratory failure, and chronic obstructive pulmonary disease (COPD- a progressive and irreversible condition characterized by diminished lung capacity and difficulty or discomfort in breathing). R1's 10/09/2025 Quarterly Minimum Data Set (MDS) documented a Brief Interview for Mental Status (BIMS) of 15, indicating intact cognition. The MDS recorded R1 had dressing treatments. R1 had a diagnosis of cancer. [...]

Inspectors wroteThe facility reported a census of 47 residents; there were 12 residents sampled, including one resident reviewed for activities of daily living (ADL). Based on observation, interview and record review, the facility failed to provide oral care for Resident (R)30, who was dependent on staff for oral hygiene.

Inspectors wroteThe facility identified a census of 47 residents, with 12 residents sampled, including one resident reviewed for non-pressure skin issues, and one resident reviewed for constipation. Based on record review, interview and observation, the facility failed to monitor skin issues for Resident (R)30 and failed to administer as needed (PRN) medication and assess for constipation for R19.

Inspectors wroteThe facility reported a census of 47 residents; the sample included 12 residents selected for review. Based on observation, interview, and record review, the facility failed to ensure Resident(R) 4's call light remained in reach to prevent falls for R4. The facility further failed to ensure R45 had wheelchair pedals when staff propelled him in the wheelchair.

Inspectors wroteThe facility identified a census of 47 residents. The sample included 12 residents with five reviewed for unnecessary medications. Based on interview and record review, the facility failed to follow physician orders regarding blood pressure monitoring for Resident (R) 5's blood pressure medication when staff administered the medication despite R5's blood pressure being lower than the ordered parameters.

Inspectors wroteThe facility reported a census of 47 residents. The sample included 12 residents. Based on observation, interview and record review, the facility failed to use adequate hand hygiene when caring for residents.

Inspectors wroteThe facility reported a census of 47 residents. Based on observation, record review and interview, the facility failed to display posted staffing information which contained the required data including the actual nursing hours worked for the 47 residents who resided in the facility.

Inspectors wroteThe facility reported a census of 47 residents. The sample included 12 residents. Based on interviews, record reviews and observation, the facility failed to ensure a safe, homelike environment in all areas of the facility including those used by visitors and staff and the floor in one of one kitchen. This deficient practice created a risk for impaired safety and cleanliness.

Inspectors wroteThe facility reported a census of 44 residents. Based on observation, record review, and interview, the facility failed to prepare and serve food under sanitary conditions, to the residents of the facility appropriately to prevent the potential for food borne bacteria.

Inspectors wroteThe resident reported a census of 44 residents. Based on observation, interview, and record review, the facility failed to provide a safe, functional, sanitary, and comfortable environment for residents and staff.

Inspectors wroteThe facility reported a census of 44 residents with 14 residents selected for review which included three residents reviewed for choices. Based on observation, interview, and record review, the facility failed to ensure bathing opportunities, per the residents' preferences, for two Residents (R)30 and R36, of the three residents reviewed for choices.

Inspectors wroteThe facility reported a census of 44 residents with 14 residents selected for review. Based on observation, interview and record review, the facility failed to develop a comprehensive care plan to include one Resident (R)26's use of Estrace (a female hormone) for inappropriate sexual behaviors.

Inspectors wroteThe facility reported a census of 44 residents with 14 residents sampled, including two residents reviewed for Activities of Daily Living (ADL). Based on observation, interview, and record review, the facility failed to provide oral care for one dependent Resident (R)35.

Inspectors wroteThe facility reported a census of 44 residents with 14 residents selected for review which included five residents reviewed for unnecessary medications. Based on interview and record review, the facility failed to clarify the diagnoses for a medication for one Resident (R)26 of the five residents reviewed for medications.

Inspectors wroteThe facility reported a census of 37 residents with 13 selected for review, including two residents reviewed for self-determination/choices. Based on observation, record review, and interview, the facility failed to honor one of the two residents bathing preferences, Resident (R)17, who requested baths on Saturdays so she was ready for church on Sundays.

Inspectors wroteThe facility reported a census of 37 residents with 13 selected for review. Based on observation, record review, and interview, the facility failed to review and revise the care plan for two sampled residents, Resident (R)17 with bathing preferences/choices and R21 with interventions post falls to prevent further fall occurrences.

Inspectors wroteThe facility reported a census of 37 residents with 13 selected for review including three residents reviewed for accidents. Based on observation, interview, and record review the facility failed to follow planned fall interventions and implement a new and/or appropriate intervention for one of the two residents, Resident (R)21, to prevent occurrence of additional falls for this resident with multiple falls.