The Gables of Pelham Skilled Nursing & Rehab

Inspectors wroteBased on observations, interviews, and review of the facility policy, the facility failed to ensure foods that are stored in the freezer, refrigerators and dry food storage were appropriately sealed, labeled and dated with a use by date and/or discarded after the manufacturer's expiration date. In 2 of 2 Kitchens, 1of 2 Freezers, 1 of 2 Refrigerators and 1 of 1 Dry Foods Storage. Review of the facility's policy titled Food Receiving and Storage last revised July 2024 revealed, Foods shall be received and stored in a manner that complies safe food handling practices. 7) Dry foods that are stored in bins will be removed from original packing, labeled and dated (use by date). Such food will be rotated using a first in - first out system. 8. All foods stored in the refrigerator or freezer will be covered, labeled and dated ( use by date) . 14. C. [...]

Inspectors wroteBased on review of facility policy, record reviews, observation and interviews, the facility failed to assess a resident for safe self-administration of medication for 1 of 1 resident, Resident (R) 34 reviewed for self-administration of medication. Review of the facility policy titled, Self-Administration of Medication last revised February 2021, states, Residents have the right to self-administer medications if the interdisciplinary team has determined that it is clinically appropriate and safe for the resident to do so.1. As a part of the evaluation comprehensive assessment, the interdisciplinary team (IDT) assesses each resident's cognitive and physical abilities to determine whether self-administering medications is safe and clinically appropriate for the resident. 3. [...]

Inspectors wroteBased on review of facility policy, observations and interviews, the facility failed to ensure that expired medications and biologicals were removed from the refrigerator in 1 of 1 medication storage rooms. Review of the facility policy titled Medication Labeling and Storage last revised February 2023, states 2. The nursing staff is responsible for maintaining medication storage and preparation areas in a clean, safe, and sanitary manner. 3. If the facility has discontinued, outdated or deteriorated medications or biologicals, the dispensing pharmacy is contacted for instructions regarding returning or destroying these items. During an observation of the medication storage room on 07/22/25 at 12:25 PM, the following was observed:1. 1 dose of Covid 19 Vaccine with an expiration date of 05/09/252. 12 doses of Influenza Vaccine Adjuvanted with an expiration date of 04/24/253. [...]

Inspectors wroteBased on review of facility policy, manufactures instructions, observations and interviews, the facility failed to: 1. Ensure the safe handling and preparation of meals when during meal preparation a metal can lid was noted in a pan of cooked desert 2. Follow appropriate infection control practices during medication administration when Licensed Practical Nurse (LPN)1 failed to clean the top of the insulin syringe before administration of insulin. 1. Review of the facility's policy, titled Food Preparation and Service, last revised November 2022, revealed, Food and nutrition services employees prepare, distribute and serve food in a manner that complies with safe food handling practices. [...]

Inspectors wroteBased on manufacturer's recommendation, review of the facility policy, record review, and interviews, the facility failed to ensure Resident (R)1 was free from chemical restraints, when it was identified that R1 was administered Haloperidol Deaconate (Haldol) for exit seeking, entering patient rooms. The medication was not ordered for an approved indication of use. On 02/07/25 at 2:20 PM, the State Agency (SA) determined that the facility's non-compliance with one or more federal health, safety, and/or quality regulations has caused or was likely to cause serious injury, serious harm, serious impairment, or death. On 02/07/25 at 2:23 PM, the Administrator was notified that the facility's failure to have systems in place to monitor for chemical restraints constituted Immediate Jeopardy (IJ) at F605. On 02/10/25 at 9:37 AM, the facility provided an acceptable IJ Removal Plan. [...]

Inspectors wroteBased on review of the facility policy, record review, and interviews, the facility failed to ensure that adequate supervision was in place to prevent Resident (R)1 from eloping from the facility. On 12/17/24 at approximately 9:33 PM, R1 was found outside of an exit door on the C-Unit of the facility. Licensed Practical Nurse (LPN)1 stated that they heard the alarm sounding off from another unit and felt cold air coming from the door while walking down the hallway. R1 was observed outside of the door in his wheelchair and stated that he was picking berries from the bush. On 12/17/24 at approximately 9:33 PM, the weather was 54 degrees Fahrenheit (F). On 02/05/25 at 7:34 PM the Administrator was electronically notified that the failure to ensure Resident (R)1 was free from accidents/hazards related to a succesful elopement on 12/17/24 constituted Immediate Jeopardy (IJ). [...]

Inspectors wroteBased on review of the facility policy, interviews, and record review, the facility failed to implement their policy, Abuse Prevention Program to provide protection for the identified resident (Resident (R)4) for 1 of 3 residents reviewed for abuse.

Inspectors wroteBased on policy review, observation, and interview, the facility failed to ensure that 1 of the 2 dumpsters were kept closed to keep pests out and/or to keep the garbage contained in the dumpsters. The facility also failed to ensure the area around the dumpster was clean and free of debris and failed to ensure the other dumpster was clean. This failure had the potential to cause insects and rodents near the dumpster, which could potentially be a health hazard.

Inspectors wroteBased on interview, record review, and policy review, the facility failed to notify the resident representative in a timely manner, for an accident with change of condition for 1 resident Resident (R) 24 of 6 residents reviewed for falls/accidents.

Inspectors wroteBased on policy review, record review, observations and interviews, the facility failed to ensure that 2 residents, Resident (R)14 and R22, of 3 residents reviewed for provision of activities of daily living (ADL) out of a total sample of 12 residents, received appropriate grooming, specifically related to the removal of facial hair. Failure to remove facial hair for a resident could result in a decrease in body image, depression, and isolation.