Wellington Health And Rehab

The facility reported a census of 43 residents, and one main kitchen. Based on observation, record review and interview the facility failed to prepare and serve food under sanitary conditions to prevent the potential for food borne bacteria. This placed the residents at risk for food borne illnesses. Findings included:- Observation of the kitchen and food storage areas on 08/24/25 at 09:40 AM revealed the following areas of concern:Walk-In Cooler:A white Styrofoam cooler on the top shelf, with no date and no label, contained several rolled-up items in foil. Dietary Staff CC opened one of the foil packets and reported it was hot dogs from a facility picnic the previous Thursday.Free-standing freezer:One bag of cooked bacon with no date or label.One brown bag in a zip lock bag with no date or label.One bag of sealed French fries with no date.One bag of hash browns unsealed.One bag of ready-to-bake chocolate chip cookies with no date or label.During an interview on 08/24/25 at 10:10 AM, Dietary Staff CC reported that all food items required an open date and were required to be sealed…

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 reported a census of 43 resident. The sample included 12 residents with three residents sampled for accidents. Based on observation, interview, and record review, the facility failed to complete a thorough root cause analysis to identify causative factors and/or failed to implement the care planned interventions to prevent further falls for Resident(R) 38 and R28. This deficient practice placed the residents at risk for further falls and associated injuries. Findings included- R38's Electronic Health Record (EHR) documented diagnoses which included dementia (a progressive mental disorder characterized by failing memory and confusion), a history of falling, and muscle weakness. R38’s 03/25/25 Annual Minimum Data Set (MDS) documented a Brief Interview for Mental Status (BIMS) score of six, which indicated severely impaired cognition. The MDS documented R38 required supervision with most activities of daily living (ADLs), except set up for wheelchair mobility, bed mobility, and upper dressing. The MDS…

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 reported a census of 43 resident. The sample included 12 residents with two residents sampled for pain management. Based on observation, interview, and record review, the facility failed to monitor, treat and provide interventions including medication and non-pharmacological measures to manage Resident (R) 28's pain in accordance with his goals and preferences. This deficient practice placed the resident at risk for unmanaged pain, a decline in function and impaired quality of life. Findings included- R28's Physician Orders dated 08/20/25, documented diagnoses of neuromuscular dysfunction of the bladder (dysfunction of the urinary bladder caused by a lesion of the nervous system,) hypertension (high blood pressure), type 2 diabetes (DM-when the body cannot use glucose, not enough insulin is made, or the body cannot respond to the insulin), anxiety disorder (mental or emotional disorder characterized by apprehension, uncertainty, and irrational fear), psychosis (any major mental disorder…

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 reported a census of 43 resident; there were 12 residents in the sample. Based on observation, interview and record review the facility failed to maintain an infection program related to. Enhanced Barrier Precautions (EBP- infection control interventions designed to reduce transmission of resident organisms which employ targeted gown and glove use during high contact care) when providing dressing changes on a abdominal peritoneal dialysis (a home-based treatment for kidney failure that uses the patient's own abdominal lining as a filter to remove waste and excess fluid from the blood) catheter for Resident (R) 2. This placed the resident at risk for infection. Findings included:- R2's Physician Orders in the Electronic Medical Record (EMR) dated 08/19/25 revealed the following diagnoses: chronic kidney disease stage five (a condition where the kidneys gradually lose their ability to filter waste products from the blood) and type two diabetes (DM-when the body cannot use glucose, not enough insulin…

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 reported a census of 40 residents with 12 residents included in the sample. Based on observation, interview, and record review, the facility failed to ensure good infection control techniques for residents in the facility by the failure to change gloves and perform hand hygiene when going from soiled to clean while providing wound care for one resident, Resident (R18), and while providing incontinent care on residents and the failure to disinfect the full body mechanical lift after use on R7 who required use of the lift for transfers. Findings included: - Observation on 10/31/23 at 02:20 PM revealed Certified Nursing Assistant (CNA) E and CNA F entered R7's room. Both staff donned (applied) gloves. CNA E first took a tissue and wiped a large amount of mucous from the resident's left nostril. Staff pulled R7's covers down and the disposable brief the resident wore was untaped and pulled down in front. CNA E used wet wipes and spray cleaner to clean the resident's genital area in front, then both CNAs repositioned the resident, and CNA E proceeded to use wipes and spray…

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 reported a census of 40 residents with 12 selected for review. Based on observation, interview, and record review, the facility failed to accurately complete the Minimum Data Set (MDS) for one sampled resident, Resident (R)35, related to the use of the resident's continuous positive airway pressure (CPAP, a non-invasive mechanical ventilator that provides respiratory support to decrease the work of breathing) machine. This placed the resident at risk for uncommunicated care needs. Findings include: - The 02/27/23 Electronic Health Records (EHR) documented R35 had the following diagnoses that included echinococcus granulosis infection of the lung (a parasitic infection that causes cysts and tumor-like growths), malignant neoplasm (cancer) of the lower respiratory tract (lung) and pneumonitis (inflammation of lung tissue) due to inhalation of solids and liquids. The 09/28/23 admission Minimum Data Set (MDS) documented a Brief Interview for Mental Status (BIMS) score of 15, indicating intact cognition.…

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 reported a census of 40 residents with 12 selected for review. Based on observation, interview, and record review, the facility failed to develop a person-centered comprehensive care plan for Resident (R)35, related to the use of the resident's continuous positive airway pressure (CPAP, a non-invasive mechanical ventilator that provides respiratory support to decrease the work of breathing) machine. This placed the resident at risk for uncommunicated care needs. Findings include: - The 02/27/23 Electronic Health Records (EHR) documented R35 had the following diagnoses that included echinococcus granulosis infection of the lung (a parasitic infection that causes cysts and tumor-like growths), malignant neoplasm (cancer) of the lower respiratory tract (lung) and pneumonitis (inflammation of lung tissue) due to inhalation of solids and liquids. The 09/28/23 admission Minimum Data Set (MDS) documented a Brief Interview for Mental Status (BIMS) score of 15, indicating intact cognition. R35 required limited or extensive assistance of two staff for all cares except eating…

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 reported a census of 40 residents with 12 residents selected for review. Based on observation, interview, and record review, the facility failed to address edema (swelling resulting from an excessive accumulation of fluid in the body tissues) for Resident (R) 140's lower extremities. This deficient practice had the potential to place R140 at an increased risk for development of additional medical problems. Findings included: - R140's Electronic Medical Record (EMR) included a diagnosis of congestive heart failure (CHF - a condition with low heart output and the body slowly becomes congested with fluid), localized edema and diabetes mellitus, type 2 (DM2 - when the body cannot use glucose, not enough insulin is made, or the body cannot respond to the insulin). The 10/23/23 admission Minimum Data Set (MDS), documented a Brief Interview for Mental Status (BIMS) score of 12, indicating moderately impaired cognition. No behaviors documented with rejections of cares. R140 received a diuretic (a class of medications used promote the formation and excretion of urine) medication…

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 reported a census of 34 residents. Based on record review and interview, the facility failed to ensure ongoing antibiotic stewardship to ensure appropriate antibiotic use. Findings included: - Review of the notebook containing a log of infection tracking for January 2022, revealed a Physician Order, dated 01/05/22, instructed staff to administer to resident (R)24, Cephalexin (anantibiotic) 500 milligrams (mg), twice a day, for urinary tract infection, but lacked culture results. This resident's medical record lacked the IDT (Inter Departmental Team) assessment for antibiotic use compliance utilizing assessment tools such as Loeb's ( a criteria with a minimum set of signs and symptoms which when met indicate that the resident likely has an infection and antibiotics may be indicated) or McGeer's criteria (a tool used for identification of symptoms of infection for antibiotic use.) Review of the infection tracking log for February 2022, revealed two unsampled residents admitted to the facility from acute care on antibiotics for urinary tract infections, but 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.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY The facility reported a census of 34 residents with 15 residents sampled, including two residents reviewed for accidents. Based on observation, interview, and record review, the facility failed to ensure appropriate safety measures were used while staff ambulated Resident (R)133. The resident fell and received a skin tear to the resident's right wrist. Findings included: - Resident (R)133's electronic medical record (EMR), under the Med Diagnosis tab, included: congestive heart failure (CHF) -a condition with low heart output and the body becomes congested with fluid) and altered mental status (an abnormal state of alertness or awareness). The admission Minimum Data Set (MDS), dated [DATE], documented the resident had a Brief Interview for Mental Status (BIMS) score of nine, indicating moderately impaired cognition. He required limited assistance of one staff for walking in his room. His balance was not steady and he was only able to stabilize with staff assistance. He had no impairment in functional range of…

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 reported a census of 34 residents with 15 residents sampled, including one Resident (R)23 reviewed for bowel and bladder. Based on observation, interview, and record review, the facility failed to toilet this dependent resident, as care planned. Findings included: - The Physician Order Sheet (POS), dated 04/08/22, documented Resident (R)23 had diagnoses of cognitive deficit (failing memory) and type II diabetes mellitus (when the body cannot use glucose, not enough insulin made or the body cannot respond to the insulin). The annual Minimum Data Set (MDS), dated [DATE], documented the resident had a Brief Interview for Mental Status (BIMS) score of seven, indicating severe cognitive impairment. The resident required extensive assistance of two staff for toileting. She was incontinent of bladder and frequently incontinent of bowel. The Urinary Incontinence and Indwelling Catheter Care Area Assessment (CAA), dated 03/22/22, documented the resident relied on the staff for toileting and proper perineal…

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.