Silver Creek Nursing and Rehabilitation

Inspectors wroteBased on observation, interview, and record review, the facility failed to store, prepare, distribute, and serve food in accordance with professional standards for food service safety for 1 of 1 facility reviewed for food and nutrition services.1.-The facility failed to ensure an overhead ceiling vent in the main kitchen area was cleaned2. The facility failed to ensure a side wall vent in the main kitchen area was cleaned3. The facility failed to ensure overhead lighting in the main kitchen area was repaired.4. The facility failed to ensure overhead lighting in the dish room area was repaired5. [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to maintain an infection prevention and control program designed to provide a safe, sanitary and comfortable environment and to help prevent the development and transmission of communicable diseases and infections for 1 of 1 laundry areas, 1 of 5 facility hallways (300 hall), and 3 of 6 residents (Residents #37, #191, and #78) reviewed for infection control. 1. The facility failed to ensure clean linen in the laundry area was stored in a method to reduce the risk of contamination.2. The facility failed to ensure PPE was readily available to staff caring for residents identified as requiring EBP in the 300 hallway.3. The facility failed to ensure staff members were following TBP procedures and donning PPE when providing high contact care for Residents #37, #191, and #78. [...]

Inspectors wroteBased on observations, interviews, and record review, the facility failed to provide a safe, functional, sanitary, and comfortable environment for residents, staff, and the public for 2 of 5 resident hallways (100 and 500 hallways) and 2 of 2 shower room (West and East Wing shower rooms) reviewed for environmental concerns in that:1-The facility failed to clean a bathroom ceiling vent in room [ROOM NUMBER].2-The facility failed to replace a bathroom light bulb and repair a piece of bathroom floor molding in room [ROOM NUMBER].3-The facility failed to clean a bathroom vent in room [ROOM NUMBER].4-The facility failed to replace a bedroom side wall light in room [ROOM NUMBER].5-The facility failed to clean a ceiling vent and and sprinkler head on the [NAME] Wing shower room.6-The facility failed to clean the ceiling vents and replace light bulbs in the East Wing shower room. [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure a resident with pressure ulcers received necessary treatment and services, consistent with professional standards of practice, to promote healing, prevent infection and prevent new ulcers from developing for 1 of 4 residents (Resident #13) reviewed for pressure ulcers. The facility failed to implement the repositioning schedule indicated in Resident #13's comprehensive care plan. This failure could place residents at risk of hindered healing of the residents with existing pressure ulcers or lead to the development of additional skin injuries.

Inspectors wroteBased on observation, interview, and record review, the facility failed to provide nutritional and hydration care and services to each resident, consistent with the resident's comprehensive assessment for 1 of 4 residents (Resident #39) reviewed for nutrition. The facility failed to assess and document the restricted fluid intake for Resident #39, as ordered by the physician. This failure could place residents at risk of impaired cardiovascular function, impaired breathing, and decreased quality of life.

Inspectors wroteBased on observation, interview, and record review, the facility failed to enact a policy regarding use and storage of foods brought to residents by family and other visitors to ensure safe and sanitary storage, handling, and consumption, for 1 (Resident # 33) of 3 residents reviewed, in that:Resident # 33's personal refrigerator located in her room observed on 06/29/2025, revealed food items, with no date and no label. This failure could place residents at risk of foodborne illness due to consuming foods which might be spoiled.

Inspectors wroteBased on interviews and record reviews the facility failed to ensure all alleged violations involving abuse, neglect, exploitation, or mistreatment, including injuries of unknown sources are reported not later than 24 hours to the administrator of the facility and to other officials, including to the State Survey Agency in accordance with State law through established procedures, for 1 of 3 Residents (Resident #1) reviewed for Abuse, in that: The facility did not report an allegation of abuse not later than 24 hours to the State Survey Agency (HHSC) when Resident #1 fell off the bed. This deficient practice could affect any resident and could contribute to further abuse.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure that each resident received adequate supervision and assistive devices to prevent accidents for 1 of 3 residents (Resident #1) reviewed for accidents. The facility failed to ensure CNA A provided adequate supervision and assistance devices for Resident #1 when CNA A failed to use two staff during incontinent care on 03/14/2025 resulting in Resident #1 falling off the bed. The non-compliance was identified as past non-compliance. The noncompliance began on 3/14/25 and ended on 3/16/25. The facility had corrected the non-compliance before the survey began. This failure could lead to injury or death to residents.

Inspectors wroteBased on observations, interviews, and record review, the facility failed to provide a safe, functional, sanitary, and comfortable environment for residents, staff, and the public on 4 (Hallways 100, 200, 400, 500) of 5 resident hallways reviewed for environmental concerns. The facility failed to replace dirty ceiling tiles and clean rusted air vents on halls 100, 200, 400, and 500. These failures could place residents at risk of a diminished quality of life due to exposure to an environment that was unpleasant and unsafe.

Inspectors wroteBased on interview and record review, the facility failed to maintain clinical records in accordance with accepted professional standard and practices that are complete and accurately documented for 7 (#1, #2, #3, #4, #5, #6 #8) of 8 residents reviewed for treatment administration. The facility failed to ensure the treatment administration records (TAR) for Residents #1, #2, #3, #4, #5, #6, and #8 reflected that the administration of the treatment orders were accurately documented. This deficient practice could place residents receiving treatments at risk for not receiving appropriate care.

Inspectors wroteBased on observation, interviews, and record review, the facility failed to ensure that residents received treatment and care in accordance with professional standards of practice for 1 (Resident #2) of 8 residents reviewed for quality of care. 1) The facility failed to ensure LVN C labeled and dated Resident #2's wound treatment dressing after completing wound care on 08/25/24. 2) The facility failed to ensure LVN C followed Resident #2's physician order for wound treatment. These failures could affect residents who receive wound care treatments by placing them at risk for receiving inadequate treatments resulting in the worsening of wounds.

Inspectors wroteBased on observations, interviews, and record review, the facility failed to maintain an infection control program designed to ensure enhanced barrier precaution procedures were followed by staff in direct care of 1 resident (Resident #2) of 8 reviewed for infection control in that: The facility failed to ensure Resident #2 had a sign on the room door indicating Resident #2 required enhanced barrier precautions per the facility's policy. The deficient practice could place the staff and residents at risk for infection.

Inspectors wroteBased on and biologicals were stored properly for 2 of 6 medication carts (400 hall medication cart, 100 hall nurse medication cart). 1. An expired bottle of medication was stored in the drawer of the 400-hall medication cart . 2. The medication cart assigned to hall 100 had a loose pill. This failure could place residents at risk of not receiving prescribed medications as ordered, receiving medications that were less effective or have altered composition, and drug diversions.

Inspectors wroteBased on observations, interviews, and record review, the facility failed to store, prepare, distribute, and serve food in accordance with professional standards for food service safety in 1 of 1 kitchen reviewed for dietary services. The facility failed to ensure foods were processed and pureed under sanitary conditions. These failures could place residents at risk for food contamination and foodborne illness.

Inspectors wroteBased on interview and record review, the facility failed to immediately consult the resident's physician and notify the resident's responsible party when there was a need to alter treatment significantly for 1 of 5 residents (Resident #1) reviewed for notification of changes in that: The facility failed to consult Resident #1's primary physician and inform the responsible party prior to placing an indwelling urinary catheter in Resident #1. This deficient practice could affect residents and place them at risk for untimely and inappropriate care leading to injury and or death.

Inspectors wroteBased on interview, and record review, the facility failed to ensure incontinent care was provided in accordance with appropriate treatment and service practices to prevent urinary tract infections and to restore continence to the extent possible for 1 of 5 residents (Resident #1) reviewed for incontinent care and catheter care, in that: Resident #1 had an indwelling urinary catheter inserted without a physician's order. This deficient practice could place residents at-risk for infection due to improper care practices.

Inspectors wroteBased on observation, interviews and record review, the facility failed to store, prepare, distribute and serve food in accordance with professional standards for food service safety for 1 of 1 kitchen reviewed for sanitation in that: 1. Three 35-ounce bags of cereal in plastic bags opened and in plastic bags that were open. 2. One bag of macaroni noodles opened not labeled dated twisted at the top but not completely closed. 3. One 16-ounce bag of potato chips with no open date. 4. One 30-ounce Mexican style dehydrated beans, opened and partially used, with no open date or expirations date. 5. One box or grits opened and not completely sealed with no open date. 6. One package of hot dog buns partially covered with a green powdery substance varying in shades of green, covering approximately ninety percent of the remaining buns in the package. [...]

Inspectors wroteBased on interview and record review, the facility failed to ensure that residents who required dialysis received such services, consistent with professional standards of practice for 1 of 1 resident (Resident #27) reviewed for dialysis in that: The facility did not maintain communication, coordination and collaboration with the dialysis facility for Resident #27. This deficient practice could affect residents who received dialysis treatments and place them at risk for complications and not receiving proper care and treatment to meet their needs.

Inspectors wroteBased on observations, interviews, and record reviews, the facility failed to ensure that the menus were followed for 1 of 2 meals observed in that:

Inspectors wroteBased on observation, interviews and record reviews, the facility failed to establish and maintain an infection control program designed to provide a safe, sanitary, and comfortable environment and to help prevent the development and transmission of communicable diseases and infections for one resident (#71) of 4 observed for infection control in that: CNA D failed to follow infection control requirements while performing incontinent care for Resident #71. This deficient practice could place residents at risk for infection.