Sunrise Health & Rehabilitation Center

Inspectors wroteBased on observations and interviews, the facility failed to store, prepare, distribute, and serve food in accordance with professional standards for food service safety. This was observed during 2 of 2 visits conducted in the Main Kitchen.

Inspectors wroteBased on observation, interview and record review, the facility failed to correctly complete Minimum Data Set (MDS) assessments for 2 of 35 sampled residents, Resident #54 and Resident #98.

Inspectors wroteBased on observation, interviews, and record review, the facility failed to provide splints / protectors to assist in preventing contractures for 1 of 3 sampled residents reviewed for position and mobility, Resident #15.

Inspectors wroteBased on observations, interviews, and record review, the facility failed to address weight loss in a timely manner and provide nutritional interventions for 3 of 5 sampled residents reviewed for nutrition, Resident #193, Resident #7, and Resident #59.

Inspectors wroteBased on review of policy and procedure, observation, record review and interview, the facility failed to provide care and services and change the dressings for residents' Midline Intravenous (IV) catheter dressing in a timely manner, for 1 of 1 sampled resident observed, on the Locked Memory Care, G-wing, with a Midline catheter in place, Resident #23.

Inspectors wroteBased on observations, interviews, record reviews, and policy review, the facility failed to follow physicians' oxygen orders for 4 of 5 sampled residents reviewed for oxygen therapy and has the potential to affect 49 residents on oxygen therapy, Resident #38, Resident #229, Resident #108, Resident #228; failed to obtain physicians order for oxygen therapy administration for 1 of 5 sampled residents reviewed for oxygen therapy, Resident #49; and failed to follow the professional standards of practice during medication administration via an oral inhalation for 1 of 8 sampled residents for medication administration observation, Resident #54.

Inspectors wroteBased on observations, interviews, record review, and review of facility policy, the facility failed to ensure communication sheets were filled out accurately and completely for 2 of 3 sampled residents reviewed for dialysis, Resident #59 and Resident 105.

Inspectors wroteBased on observation, interview and record review, the facility failed to document the code status in the physician's orders for 1 of 35 sampled residents, Resident #6.

Inspectors wroteBased on observations, interviews and record reviews, the facility failed to maintain residents' call lights in a working manner for 2 of 35 residents in the final sample, Residents #112 and 225.

Inspectors wrote4. Resident #162 was admitted on [DATE] with diagnoses of protein-calorie malnutrition, Type 2 diabetes, and muscle weakness. The admission Minimum Data Set (MDS) dated [DATE] revealed a Brief Interview of Mental Status (BIMS) score of 02, which indicated severe cognitive impairment. In an observation conducted on 08/05/24 at 6:25 PM, Resident #162 received her dinner tray, which was placed at the side table. At 6:55 PM (30 minutes later), Staff C, Certified Nursing Assistant, was noted standing over the Resident feeding her the dinner soup. A chair was noted near Staff C, which had enough space to pull the chair near Resident #162's bed. Staff C stopped when this Surveyor walked into the room and said, She is a feeder, in front of Resident #162. [...]

Inspectors wroteBased on observations, interviews, and record review, the facility failed to provide the necessary services to maintain good nutrition (assist with feeding) for a resident who is unable to carry out activities of daily living for 1 of 8 sampled residents reviewed for nutrition (Resident #121).

Inspectors wroteBased on review of policy and procedure, interview and record review, the facility failed to assess skin in a timely manner, to identify a pressure ulcer for 1 of 7 sampled residents reviewed for facility acquired pressure ulcers, Resident #408.

Inspectors wroteBased on observations, interviews, and record review, the facility failed to monitor weights, provide appropriate nutritional interventions, and ensure that dietary interventions were followed as ordered for 2 of 8 sampled residents for nutrition (Resident #162 and Resident #98).

Inspectors wroteBased on observations, interviews and record review, the facility failed to ensure that pain management is provided to residents who require such services, consistent with professional standards of practice for 1 of 1 resident reviewed for pain (Resident #358).

Inspectors wroteBased on observations, interviews, and record review, the facility failed to provide food that accommodates resident preferences and appealing options of similar nutritive value to residents who choose not to eat food that is initially served or who request a different meal choice for 2 of 8 residents sampled for nutrition (Resident #88 and Resident #172).

Inspectors wroteBased on interview, observation, and record review the facility failed to effectively communicate, and educate Staff regarding fluid restriction, failed to ensure supervision, communication, and education of a resident about the allowable amount of liquids for fluid restriction, and failed to document the amount of provided liquid per shift based on the guidelines of a medically prescribed order for fluid restriction for 1 of 1 sampled resident (Resident # 172).

Inspectors wrote2. Record review for Resident #96 revealed the resident was admitted to the facility on [DATE] with diagnoses that included: Diabetes, Major Depressive Disorder, and Anxiety Disorder. Review of the Minimum Data Set (MDS) for Resident #96 dated 05/06/23 revealed in Section C the resident had a Brief Interview of Mental Status (BIMS) score of 15 indicated the resident had an intact cognitive response. During an observation conducted on 05/14/23 between 11:00 AM to 1:00 PM the exterior door located at the East end of E-wing unit was opened 15 times with a very loud alarm sounding each time the door was opened. An interview was conducted on 05/14/23 at 12:59 PM with Resident #96 who was awake and lying in her bed. When asked if the East E-wing exterior door alarm disturbs her, she said sometimes it does at night. It happens so often that I do not jump every time it goes off like I used to. [...]

Inspectors wroteBased on observation, interview, and record review, it was determined that the facility failed to prepare pureed foods in a safe and proper form for 7 of 31 sampled residents on puree diets (Residents #83, #110, #114, #120, #132, 135, and #248) and failed to provided thickened liquids as per physician order for Resident #120.

Inspectors wroteBased on interview and record review the facility failed to conduct appropriate infection surveillance testing of staff for Covid-19 in accordance with national standards and facility's policy during current outbreak of Covid-19.

Inspectors wroteBased on observations, interviews, and record reviews, the facility failed to provide dining in a dignified manner during multiple observations conducted on Unit G (lockdown unit).

Inspectors wroteBased on observations, interviews and record review, the facility failed to secure residents' records for 3 of 45 sampled residents (Residents #9, #34, and #83).

Inspectors wroteBased on observation, interview, and record review, it was determined based on their comprehensive assessment that the facility failed to provide necessary care, services and adaptive eating equipment to maintain independence in self feeding for 2 (Resident' #75, and #83) of 11 residents sampled for nutrition review.

Inspectors wroteBased on observation, interview, and record review, the facility failed to assist during dining for 2 of the 2 sampled residents reviewed for Activities of Daily Living (ADLs) (Resident #68 and Resident #142).

Inspectors wroteBased on interview, record review and facility policy review, the facility failed to follow through with physician's order for blood sugar monitoring for 1 of 1 resident reviewed (Resident #162), and facility failed to provide wound care as ordered for 1 of 2 residents reviewed for wound care (Resident #167).

Inspectors wroteBased on interview and record review the facility failed to ensure that residents are seen by a physician at least every 60 days for 2 residents reviewed for physician's services (Resident #69 and #145).

Inspectors wroteBased on observation, interview, record and policy review, the facility failed to store and dispose of medication in a secure manner affecting 2 of 7 residents observed during medication administration (Residents #46 and #116).

Inspectors wroteBased on observation, interview, and record review, it was determined that the facility failed to prepare pureed foods by methods that conserve nutritive value, flavor, and appearance that potentially affected 7 of 31 residents with physician ordered Pureed Diet (Residents #83, #110, #114, #120, #132, 135, and #248).

Inspectors wroteBased on observation, interview, and record review, it was determined that the facility failed to follow physician orders for 2 (Resident's 147 and #248) of 2 residents with physician ordered Fluid Restriction diets (Residents #142 and #248).