Shore Health & Rehab Center

Inspectors wroteBased on staff interview and clinical record review, the facility staff failed to develop a person-centered comprehensive care plan for 1 of 49 residents (Resident #76), in the survey sample.

Inspectors wroteBased on staff interview and clinical record review, the facility staff failed to provide care and services in accordance with professional standards for 2 of 49 residents (Resident #76 and #125), in the survey sample.

Inspectors wroteBased on observations, staff interview and clinical record review, the facility staff failed to ensure a resident with an indwelling catheter received the appropriate care and services to prevent repetitive urinary tract infections (UTIs) for 1 of 49 residents (Resident #76), in the survey sample.

Inspectors wroteBased on observations, resident interview, staff interview, clinical record review, the facility's staff failed to ensure significant medication was administered for 1 of 49 residents in the survey sample, Resident #125

Inspectors wroteBased on a resident interview, staff interview, and clinical record review the facility staff failed to treat residents with respect and dignity for 1 out of 49 residents (Resident #84) in the survey summary.

Inspectors wroteBased on observations, staff interview, resident interview and clinical record review, the facility staff failed to ensure reasonable accommodation of needs for two alert Residents (Resident # 63 and # 64) in a survey sample of 49 residents. 1. For Resident # 63, the facility staff failed to ensure the large clock on the bedroom wall was working. The room was shared with a roommate (Resident # 64) who also was alert and oriented. Resident # 63 was admitted to the facility with the diagnoses of, but not limited to, Cerebral Vascular Infarction and Aphasia. The most recent Minimum Data Set (MDS) was a Quarterly Assessment with an Assessment Reference Date (ARD) of 4/26/2024. Resident # 63's BIMS (Brief Interview for Mental Status) Score was a 15 out of 15, indicating no cognitive impairment. Review of the clinical record was conducted on 7/232024-7/26/2024. [...]

Inspectors wroteBased on resident interviews, staff interviews, and clinical record review, the facility staff failed to schedule and invite the residents and their representatives to participate in care planning for 2 of 49 residents (Resident #10 and #7), in the survey sample.

Inspectors wroteBased on a resident interview, staff interview, and clinical record review the facility staff failed to assist a resident to schedule an appointment and arrange transportation to and from the vision care center for 1 of 49 residents (Resident #84), in the survey sample.

Inspectors wroteBased on observation, interview, clinical record review and facility documentation the facility staff failed to provide respiratory care consistent with professional standards of practice for 1 Resident (#94) in a survey sample of 49 Residents.

Inspectors wroteBased on observations, staff interview, and clinical record review, the facility staff failed to demonstrate alternatives were attempted prior to installing side rails to the bed of 1 of 49 residents (Resident #76), in the survey sample.

Inspectors wroteBased on observation and staff interview the facility staff failed to properly thaw and store chicken and the facility staff failed to appropriately label and date refrigerated and un-refrigerated food items.

Inspectors wroteBased on observations, clinical record review, staff and resident interviews, the facility staff failed to provide personal hygiene to include full body showers and or whirlpools with hair washing for 4 of 41 residents (#64, #52, #19 and #53) in the survey sample.

Inspectors wroteBased on a complaint investigation, observations, staff and resident interviews and facility documentation, the facility staff failed to accurately assess and provide effective pressure relief while in sitting in a wheelchair to prevent pressure ulcers for 1 of 41 residents (Resident #64) in the survey sample.

Inspectors wroteBased on observations, staff interviews and facility documentation review the facility staff failed to remove expired medication from 1 of 6 medication carts (A-Wing).

Inspectors wroteBased on resident interview, family interview, staff interviews, and clinical record review, the facility's staff failed to act on replacing missing dentures after they were know not to be in the resident's possession for 1 of 41 residents (Resident 4), in the survey sample.

Inspectors wroteBased on observation, staff interview, and facility document review, it was determined that facility staff failed to follow infection control practices while picking up meal trays from quarantine rooms on the C-Wing.

Inspectors wrote574-C The facility staff failed to ensure postings of State Agencies were in large enough font, positioned well and accessible to facility residents. FACILITY Resident Council 03/11/21 11:39 AM Resident council was at 10:30 am and voiced concerns about missing clothing, snacks at night are not substantive even for the diabetic-I went to the A Wing refrigerator and found crackers and nabs- and [NAME] WARD, LPN stated that snacks are given with their meals at 5:00 p.m., but she works 7:00 am to 7:00 p.m I will tell [NAME] and see if she can check the kitchen. The diabetic in the group (Vera [NAME] on B wing said she gets crackers and has awaken sweating due to low blood sugar. The President stated crackers with no drink-would like fruit, yogurt, or something else. They do not offer?? Been having Council meetings even during the Pandemic. [...]

Inspectors wroteBased on observations and staff interview, it was determined that the facility staff failed to maintain an effective pest control system potentially affecting all residents in the facility.

Inspectors wroteBased on information obtained during the Resident Council Meeting, observations and interviews, the facility staff failed to display advocacy agencies addresses, and telephone numbers in a manner the residents could utilize which could potentially affect resident's who utilize wheelchairs.

Inspectors wroteBased on staff interviews, facility documentation review and clinical record review the facility staff failed send a copy of the Bed-Hold Policy upon discharge/transfer for 4 of 47 resident's (Resident #10, #47, #59 and #93) after being transferred to the local hospital.

Inspectors wroteBased on observations and staff interview, the facility staff failed to ensure a two compartment deep fryer was clean and properly sanitized potentially affecting residents in the survey sample.

Inspectors wroteBased on staff interviews, clinical record review and facility documentation review the facility staff failed to send a copy of the Resident's Care Plans to include their goals for 3 of 47 residents in the survey sample (Residents #10, #47 and #93) after being transferred and admitted to the hospital.

Inspectors wroteBased on resident record review, staff interviews and facility document review, the facility failed to notify the Office of the State Long-Term Care Ombudsman in writing of hospital discharges for 2 of 47 residents (Resident #10 and #93) in the survey sample.

Inspectors wrote2. The facility staff failed to ensure Resident #88's, MDS with an Assessment Reference Date (ARD) of 06/15/19 was coded correctly under Section N (Medications) for the use of insulin and injections. Resident #88 was admitted to the facility on [DATE]. Diagnosis for Resident #88 included but not limited to Type II Diabetes Mellitus. The current Minimum Data Set (MDS), a quarterly assessment with an Assessment Reference Date (ARD) of 06/15/19 coded the Resident #88 with a 12 out of a possible score of 15 on the Brief Interview for Mental Status (BIMS) indicating moderate cognitive impairment. Further review of Resident #88's quarterly MDS with an ARD of 06/15/19 was coded 0 for receiving injections and insulin. The section N on the MDS under medications received read as follows: [...]

Inspectors wroteBased on resident interview, staff interviews, and clinical record review, the facility staff failed to coordinate a recommendation dated 2/8/2018, for a Pre-admission Screening and Resident Review (PASARR) level II determination for 1 of 47 residents (Resident #26), in the survey sample.

Inspectors wroteBased on observations, clinical record review and staff interviews, the facility's staff failed to develop a baseline care plan within 48 hours to include use of heels float boots for 1 of 47 residents in the survey sample (Resident #207).

Inspectors wroteBased on observations, resident interview, staff interview, and clinical record review the facility's staff failed to obtain physician's orders for 2 of 47 residents in the survey sample, Resident #206 and #207.

Inspectors wroteBased on observations, staff interviews, resident interview and clinical record review the facility staff failed to ensure 1 of 47 residents in the survey sample, Resident #86, was provided ADL (Activities of Daily Living) care to include removal of facial hair.

Inspectors wroteBased on observations, resident interview, staff interview, and clinical record review the facility staff failed to provide necessary respiratory care and services for 1 of 47 residents (Resident #206), in the survey sample for *Continuous Positive Airway Pressure (C-PAP).

Inspectors wroteBased on information obtained during the Sufficient and Competent Nurse Staffing task, the facility staff failed to staff a Registered Nurse (RN) for at least 8 consecutive hours a day, 7 days a week which could potentially affect all residents. The facility staff failed to staff a RN for at least 8 consecutive hours a day on 12/23/18 and 1/1/19.

Inspectors wroteBased on observation, and staff interview, the facility staff failed to dispose of medications in a timely manner.

Inspectors wroteBased on observations, staff interviews and facility documentation review the facility staff failed to ensure house stock Artificial Tears eye drops was labeled to identify the specific resident for whom it was prescribed for 1 of 47 resident's in the survey sample (Resident #158); and failed to remove expired biological's from the Storage Room on B-Unit.

Inspectors wroteBased on staff interview and clinical record review, the facility staff failed to follow physician orders to obtain a *Hemoglobin A1C once every three months for 1 of 47 residents in the survey sample, Resident #27.

Inspectors wroteBased on observations, staff interviews and clinical record review the facility staff failed to ensure infection control practices were followed during wound care for 1 of 47 resident's in the survey sample, Resident #87.