Smith Center Health and Rehab

Inspectors wroteThe facility had a census of 37 residents. The sample included 13 residents. Based on observation, record review, and interview, the facility failed to provide the services of a full-time Certified Dietary Manager for the 37 residents who resided in the facility and received their meals from the kitchen. This placed the residents at risk for inadequate nutrition.

Inspectors wroteThe facility had a census of 37 residents. The sample included 13 residents. Based on observation, record review, and interview, the facility failed to store food by professional standards for food service safety in the nourishment refrigerator located in the south hall. The facility failed to cover two fluorescent light fixtures in one of one dining room. This placed the residents, who received their food items from the south nourishment refrigerator/freezer, at risk for foodborne illness. This also placed the residents who ate in the facility's dining room at risk of getting foreign objects in their meals.

Inspectors wroteThe facility had a census of 37 residents. The sample included 13 residents, with five residents reviewed for immunizations, Resident (R) 4, R6, R11, R18, and R25, to include pneumococcal (a disease that refers to a range of illnesses that affect various parts of the body and are caused by infection) vaccinations. Based on record review and interviews, the facility failed to offer, or obtain an informed declination or a physician-documented contraindication for the pneumococcal PCV20 vaccination per the latest guidance from the Centers for Disease Control and Prevention (CDC). This placed the residents at risk for pneumococcal infection and related complications.

Inspectors wroteThe facility had a census of 37 residents. The sample included 13 residents, with three residents reviewed for the Center for Medicare and Medicaid Services (CMS) Beneficiary Liability notices. Based on record review and interview, the facility failed to provide the correct CMS Form 10055, Advanced Beneficiary Notice (ABN), to the resident or their representative for Residents (R)15, R21, and R140. This placed the residents at risk for uninformed decisions regarding skilled services.

Inspectors wroteThe facility had a census of 37 residents. The sample included 13 residents. Based on interview and record review, the facility failed to notify the State Long-term Care Ombudsman (LTCO) of Resident (R)18's discharge to the hospital. This placed R18 at risk for impaired rights.

Inspectors wroteThe facility had a census of 37 residents. The sample included 13 residents. Based on observation, interview, and record review, the facility failed to label Resident (R)6 and R23s' insulin (a hormone that lowers the level of glucose in the blood) flex pens with a started/opened date or a use by date. This deficient practice placed the affected residents at risk for ineffective medications.

Inspectors wroteThe facility had a census of 37 residents. Based on observation, interview, and record review, the facility failed to submit complete and accurate staffing information through Payroll Based Journaling (PBJ) as required. This deficient practice placed the residents at risk for unidentified and ongoing inadequate nurse staffing.

Inspectors wroteThe facility identified a census of 35 residents with three residents reviewed for accidents. Based on record review, observation, and interview, the facility failed to provide a safe environment free from preventable accidents for Resident (R) 1. On 01/15/25 at approximately 09:20 AM, Certified Nurse Aide (CNA) M and CNA N transferred R1 from his wheelchair to his recliner using a Hoyer (total body mechanical lift) lift. The CNAs used the lift to suspend R1 into the air due to limited space in R1's room. CNA M turned around to position R1's recliner for R1 to sit in, turned back around to assist R1 into the recliner, and the right top lift sling strap dislodged and R1 slid out of the lift sling onto the floor. R1 hit the right side of his head and came to rest on his right side. The facility transferred R1 to the hospital where they diagnosed the resident with a fractured neck. [...]

Inspectors wroteThe facility had a census of 36 residents. The sample included 12 residents. Based on observation, interview, and record review, the facility failed to store and administer medications in a safe manner for one of two medication carts and the facility failed to discard an expired bottle of melatonin (supplement used to treat sleeping problems) in one of two medication rooms. This placed the residents at risk to receive expired supplements and medication errors.

Inspectors wroteThe facility had a census of 36 residents. The sample included 12 residents. Based on observation, record review, and interview, the facility failed to store food in accordance with professional standards for food service safety for the residents who resided in the facility and received food from the nutrition refrigerator, when staff failed to label and date food items kept in the nutrition refrigerator. The facility staff failed to assess and record freezer temperatures for the nutrition freezer. This placed the affected residents at risk for foodborne illness.

Inspectors wroteThe facility had a census of 36 residents. The sample included 12 residents. Based on observation, record review, and interview, the facility failed to ensure the number of nursing (licensed and unlicensed) staff and actual hours worked was posted for all four days of the onsite survey.

Inspectors wroteThe facility had a census of 43 residents. The sample included 12 residents. Based on observation, record review, and interview, the facility failed to distribute and serve food in accordance with professional standards for food service safety in one of one facility kitchen. This placed the 43 residents who received food from the facility kitchen at risk for foodborne illness.

Inspectors wroteThe facility had a census of 43 residents. The sample included 12 residents. Based on observation, interview, and record review, the facility failed to maintain an environment free of accident hazards for two of two shower/whirlpool rooms when the facility failed to adequately secure harmful chemicals. This placed five cognitively impaired, independently mobile residents residing in the facility at risk for harm or injury related to avoidable hazards.

Inspectors wroteThe facility had a census of 43 residents. The sample included 12 residents, with one reviewed for change of condition. Based on observation, record review, and interview, the facility failed to notify Resident (R) 140's representative when staff ripped off his loose toenail during a transfer. This placed R140 at risk for uninformed treatment decisions and/or delayed wound care treatments.