Towers Nursing Home

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure residents was provided the required assistance with eating resulted in poor intake, however, the resident met identified weight services in the facility with reasonable accommodations of resident's needs and preferences except when to do so would endanger the health and safety of the resident or other residents for 1 of 6 residents ( Resident # 1 ) reviewed for nutrition. The facility failed to provide Resident #1 with supervision and assistance during meal service on 06/11/2026. This failure could place residents at risk of dehydration and malnutrition.

Inspectors wroteBased on interview and record review the facility failed to establish and 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 in response to one (Resident #1) of three Residents with unknown COVID 19 status. The facility failed to appropriately screen and test Resident #1 for signs, symptoms, and exposure of COVID-19. This failure placed residents at risk of exposure to COVID-19, which could result in illness, and hospitalization.

Inspectors wroteBased on interview and record review, the facility failed to ensure that residents received care, consistent with professional standards of care to prevent development or promote wound healing for one (Resident #1) of three residents reviewed for pressure ulcers. The facility failed to provide treatments on 03/19/2026 and 03/25/2026 to a pressure ulcer on Resident #1 buttocks. This failure could place residents at risk for worsening pressure ulcers leading to discomfort, pain, and potential infections.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure a resident with indwelling catheter received the appropriate care and services to prevent urinary tract infections for 1of 3 residents (Resident #2) reviewed for indwelling urinary catheters. The facility failed to ensure Resident #2's urinary drainage bag tubing and bag were kept from touching and resting on the floor. This failure could place residents with indwelling catheters at risk of developing infections.

Inspectors wroteBased on interviews and record reviews the facility failed to ensure comprehensive care plans were reviewed and revised by the interdisciplinary team after each assessment, including both the comprehensive and quarterly review assessments, for 1 (Resident #01) reviewed care plans. The facility failed to update the comprehensive care plan to reflect Resident #01 received IV fluids for dehydration. This failure could have placed residents at risk of not having their needs identified and met.

Inspectors wroteBased on observations, interviews, and record review the facility failed to ensure the residents received services in the facility with reasonable accommodation of each resident's needs for 2 (Resident # 27 and Resident #30) out of 8 residents reviewed for call lights. The facility failed on 07/29/2025 to ensure Resident # 27 and Resident #30's call light was within reach to use. This failure could affect all residents who needed assistance and could result in needs not being met.

Inspectors wroteBased on observation, interview and record review the facility failed to ensure a resident who was unable to carry out activities of daily living received the necessary services to maintain good nutrition, grooming, and personal and oral hygiene for two of eight residents (Resident# 30 and Resident # 65) reviewed for ADL care. The facility failed on 07/29/2025to ensure Resident #30, and Resident #65's fingernails were cleaned. This failure could place residents at risk of not receiving services or care, diminished quality of life, and decreased self-esteem.

Inspectors wroteBased on observation, interview, and record review the facility failed to establish and 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 and follow accepted national standards for two of six residents (Resident #10 and Resident #93) reviewed for infection control practices. The facility failed to ensure: MA B followed good nursing practices when preparing medications to prevent cross contamination of oral medications for Resident #93 on 07/30/2025 when MA B failed to perform hand hygiene and don gloves prior to touching Resident #93's medications with contaminated, ungloved hands. [...]

Inspectors wroteBased on interviews and record review, the facility failed to ensure residents were free of any significant medication errors for one (Resident #1) of four residents reviewed for medication errors. The facility failed to ensure Resident #1's glucose was monitored, and insulin was administered regularly from 07/21/24 - 08/02/24. She was sent to the ER on [DATE] with a glucose level of 649 and a diagnosis of DKA. The noncompliance was identified as PNC. The IJ began on 08/02/24 and ended on 08/09/24. The facility had corrected the noncompliance before the survey began. This deficient practice could place residents at risk of not receiving the intended therapeutic benefit of the medications and supplements, worsening or exacerbation of chronic medical conditions, and hospitalization.

Inspectors wroteBased on interview, observation, and record review the facility failed to ensure that the residents environment remained as free of accident hazards as was possible for one (Resident #45) of thirty-three residents reviewed for hazards. The facility failed to ensure that Resident #45 was assisted by two care providers during peri-care resulting in her rolling out of the bed onto the floor and sustaining facial lacerations. This failure could place residents at risk of accidents and injury. Findings Include: Review of Resident #45's Face Sheet dated 06/05/2024 reflected an [AGE] year-old female admitted to the facility on [DATE] with the following diagnosis: [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to store, prepare, distribute, and serve food under sanitary conditions in the facility's only kitchen reviewed for sanitation. The facility failed to date a box of bananas in the dry storage area which contained a banana that was open and rotted. The facility failed to ensure that no food products or food product boxes were stored on the floor in the facility's walk-in refrigerator and freezer. The facility failed to ensure that a food product in the freezer was in a sealed bag to prevent direct exposure to air. The facility failed to discard of food products that were past indicated use by dates per facility policy. These failures could place residents at risk of cross contamination, loss of nutritional value, and foodborne illness.

Inspectors wroteBased on interview and record review the facility failed to establish an infection prevention and control program that must include, at a minimum, an antibiotic stewardship program that includes antibiotic use protocols and a system to monitor antibiotic use for 2 (Residents #94 and Resident #28) of 3 residents reviewed for infection control A) The facility failed to follow the antibiotic stewardship recommendations for Resident #94. B) The facility failed to follow the antibiotic stewardship recommendations for Resident #28 This deficient practice could place residents receiving antibiotics at risk for unnecessary antibiotic use, inappropriate antibiotic use and increased antibiotic-resistant infections.

Inspectors wroteBased on record review and interviews the facility failed to complete preadmission screening for a resident with a mental disorder. The facility failed to review and correct a PASSR evaluation for Resident #45 . This failure could result in the resident not receiving correct and approved treatments, medications and quality of life enhancements.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure a resident who is unable to carry out activities of daily living (ADL) received the necessary services to maintain good grooming and personal hygiene for 1 of 8 residents, in that: Resident 29 was not provided fingernail care. This failure affected one resident and could place her at risk of infection and diminished self-esteem.

Inspectors wroteBased on observation, interview, and record review the facility failed to administer parenteral fluids consistent with professional standards of practice and in accordance with physician orders, the comprehensive person-centered care plan, and the resident's goals and preferences for Resident #6. The facility failed to assess and properly label Resident #6's peripheral intravenous catheter (PIV) This failure could place residents at risk of infection, infiltration, and not receiving appropriate PIV care.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure that a resident who needs respiratory care, is provided such care, consistent with professional standards of practice for 2 (Resident #65 and Resident #81) of 8 residents reviewed for respiratory care. A) The facility failed to ensure that Resident #65's oxygen tubing with nasal cannula was changed out every seven days. The facility failed to ensure that Resident #65's Nebulizer tubing and mask, which included the nebulizing chamber (unit into which liquid medicine is converted into aerosol or mist by the pressurized air pumped through the tubing), was replaced every seven (7) days and bagged. The facility further failed to ensure that the air filter on Resident #65's air concentrator filter was free of dust and debris. [...]