Smith Center Health And Rehab

The 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. Findings included: - On 04/14/25 at 09:00 AM, observation dietary staff in the kitchen preparing the breakfast meal. On 04/14/25 at 09:10 AM, Dietary Staff BB verified she was not a Certified Dietary Manager. Dietary Staff BB stated the facility had one resident with a pureed diet. On 04/16/25 at 01:00 PM, Administrative Staff A verified Dietary Staff BB was not certified. The facility's Food Service Staffing dated 10/2024, documented that the community will employ sufficient staff with the appropriate competencies and skills to carry out the food and nutrition services function. The qualified Dietitian would help oversee clinical nutrition and dietary services in the facility. The policy documented that if the Dietitian…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY The 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. Findings included: - On 04/14/25 at 09:00 AM in the south hall resident nourishment freezer revealed the following: 1. A frozen banquet salisbury meal with an expiration date of 12/24. 2. Two frozen Michelina's fettuccini [NAME] meals with an expiration date of 12/24. 3. A Michelina fettuccine alfredo with chicken and broccoli frozen meal with an expiration date of 12/24. 4. An undated to when opened 8 ounce…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY The 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. Findings included: - Review of R4, R6, R11, R18, and R25 clinical medical records lacked evidence the facility or the resident representative received or signed a consent to receive or informed declination for the pneumococcal vaccine PCV20. Review of R4's electronic health record revealed the resident was admitted to the facility on [DATE]. R6 had not…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

The 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. Findings included: - The Medicare ABN form informed the beneficiaries Medicare may not pay for future skilled therapy and did not provide an estimated cost to continue their services. The form included options for the beneficiary to (1) receive specified services listed, and bill Medicare for an official decision on payment. I understand if Medicare does not pay, I will be responsible for payment, but can appeal to Medicare. (2) receive therapy listed, but do not bill Medicare, I am responsible for payment for payment of services. (3) I do not want the listed services. The facility's Medicare ABN form…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY The 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. Findings included: - R18's Electronic Health Record (EHR) revealed diagnoses of dementia (a progressive mental disorder characterized by failing memory and confusion) with behavioral disturbance, delusional disorder (untrue persistent belief or perception held by a person although evidence shows it was untrue), and anxiety (mental or emotional reaction characterized by apprehension, uncertainty, and irrational fear). R18's Quarterly Minimum Data Set (MDS), dated [DATE], recorded R18 had severe cognitive impairment (problems with thinking, learning, remembering, and using judgment). The MDS recorded she required extensive staff assistance with transfers and activities of daily living (ADL). The MDS documented the resident ambulated with a…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY The 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. Findings included: - On [DATE] at 08:35 AM, observation of the facility's South Hall medication cart revealed the following: R6's Tresiba (long-acting insulin) flex pen was not labeled with an open or expired date. R23's Tresiba flex pen was not labeled with an open or expired date. On [DATE] at 08:40 AM, Administrative Nurse D verified the nurses should label and date the insulin flex pens with the date opened. Medlineplus.gov directs open, unrefrigerated Tresiba can be used within 56 days; after that time, they must be discarded. The facility's Storage of Medication policy, dated [DATE], documented the facility would store…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

The 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. Findings included: - On 08/02/23 at 07:28 AM, observation during medication administration revealed Resident (R) 28 entered the dining room. Licensed Nurse (LN) G opened the top drawer of her medication cart where R28 and R12s' medications were set up in medication cups with each resident's initials on the two separate cups. On 08/02/23 at 07:28 AM, LN G stated when she comes in to work in the morning, she pre-sets the residents medications who she know would be in the dining room at 07:00 AM. On 08/02/23 at 08:32 AM, LN G stated she should not set up residents medications ahead of time. On 08/02/23 at 08:37 AM, Administrative…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

The 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. Findings included: - On 08/01/23 at 09:53 AM, observation revealed the following in the nutrition refrigerator: An unlabeled, undated box of chicken alfredo meal, Two unlabeled, undated 15.5-ounce jars of salsa. An unlabeled, undated deli meat sandwich. A sticky brown substance in the refrigerator door in the small compartment on the left upper corner, approximately four inches (in) x two in. The refrigerator trays had numerous areas of a blackish substance which varied in size. The freezer lacked a thermometer and lacked…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

The 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. Findings included: - On 02/10/22 at 09:45 AM, observation revealed the following: The outer layer of wood peeling from eight under counter cupboards, two upper cabinets by the eyewash station, and nine drawers. The shelf above the stove had sticky gray substance. Missing mopboard, approximately 18 inches (in), below the three sink and approximately 4 feet (ft) by the steam table. On 02/10/22 at 09:45 AM, Dietary Staff (DS) BB verified the above findings. The facility's Sanitization policy, revised December 2021, documented all kitchens, kitchen areas and dining areas should be kept clean. The food services manager would be responsible for scheduling staff for regular cleaning of kitchen and dining areas. The…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

The 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. Findings included: - On 02/09/22 at 08:40 AM, observation revealed the west shower room with an unlocked cabinet. The cabinet contained a quart spray bottle of Peroxide Multi surface cleaner and disinfectant and a quart spray bottle of lemon scented disinfectant. Both spray bottles labels documented, Hazardous to humans do not ingest, can cause eye irritation. On 02/09/22 at 08:50 AM, observation revealed the north whirlpool room with an unlocked cabinet. The cabinet contained two quart spray bottles of Bio Enzymatic Odor Eliminator and one quart spray bottle of Peroxide Multi surface cleaner and disinfectant. The three bottles labels…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY The 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. Findings included: - R140's Electronic Medical Record (EMR) documented R140 had diagnoses of hemiplegia (paralysis of one side of the body), hemiparesis (muscular weakness of one half of the body), pain in right knee, and reduced mobility. R140's Quarterly Minimum Data Set, (MDS) dated [DATE], documented the resident had short- and long-term memory problems and severe impaired cognition. The MDS documented R140 required total staff assistance with locomotion off unit and extensive staff assistance with the rest of his activities of daily livings (ADLs). The MDS documented R140 had no skin issues. R140's Hemiplegia/Hemiparesis…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.