Excel Care At The Pines

Based on observation, interview and record review, it was determined that the facility failed to provide the necessary respiratory care and services for 1 of 2 residents (Resident # 16) reviewed. This deficient practice was evidenced by the following:A review of the admission Record (admission summary) indicated that Resident #16 was admitted to the facility with the diagnoses that included but was not limited to chronic obstructive pulmonary disease (COPD) and acute respiratory distress syndrome. A review of the quarterly Minimum Data Set (MDS), an assessment that facilitates a resident's care, dated 1/26/26, indicated that Resident #16 scored 14 out of 15 on the Basic Interview of Mental Status (BIMS) which indicated that the resident was cognitively intact. The MDS also indicated that Resident #16 was independent with all aspect of activities of daily living (ADLs). On 3/30/2026 at 11:29 AM, during initial tour, the surveyor was unable to observe Resident #16 in their room. Review of the Electronic Medical Record (EMR) revealed that the resident was on continuous oxygen (O2). 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.

Based on observation, interview, record review, and document review, it was determined that the facility failed to provide sufficient nursing staff to ensure all residents reached their highest practical wellbeing by failing to: a) provide timely incontinence care to 2 out of 8 residents (Resident #1 and #36) reviewed for Activities of Daily Living, and b) provide sufficient nursing staff for 4 of 4 weeks of staffing prior to the recertification survey date of 4/6/2026 . This deficient practice was evidenced by the following:On 4/2/2026 at 9:15 AM, the surveyor conducted an incontinence tour with Licensed Practical Nurse/Nursing Supervisor (LPN/NS) #1 on the third floor. Resident #36 was observed lying in bed. When Resident #36 was asked if their incontinence brief was clean and dry, they stated that it was wet and they needed to be changed. They added that they had been wet since 5 AM. They further stated that at 5 AM that morning, they asked their assigned Certified Nursing Assistant (CNA) to change them, but the CNA left the room and never returned to change them.At that time,…

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.

Based on observation and interview, it was determined that the facility failed to ensure that the daily Nursing Home Resident Care Staffing Report was posted and displayed in the front lobby. This deficient practice was identified on 1 of 1 main entrance and was evidenced by the following: On 4/6/2026 at 10:15 AM, the surveyor observed the facility's Nursing Home Staffing Report Form dated 4/2/2026, posted on the receptionist's desk in the front main lobby. On 4/6/2026 at 10:20AM, the surveyor interviewed the Licensed Nursing Home Administrator (LNHA) who stated that he posts the schedule out front so that visitors and patients know what the staffing is like. He added that on Fridays, he preprints the staffing reports for Saturdays and Sundays and places them in the stand behind Friday's report. He further stated that the supervisor was responsible for posting the staffing report in his absence and adjusting it, if there were any call outs. He acknowledged that the daily staffing should be accurate and posted daily. A review of the facility's Staffing policy, dated 5/1/2025, failed…

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.

Based on observation, interview, record review, and review of other pertinent facility documents, it was determined that the facility failed to ensure 1.) a resident received a Renal-Regular Double Portions diet for a lunch meal in accordance with physician orders, and 2.) a resident received a Regular Diet with small portion starches, double portions of entree and vegetable; provide extra sandwich with lunch and dinner in accordance with physician orders. This deficient practice was identified for 2 of 3 residents reviewed for nutrition (Resident #7, #18). This deficient practice was evidenced by the following: 1.) On 3/30/2026 at 10:29 AM, during the initial tour, the surveyor observed Resident #18 lying in bed. Resident #18 had oxygen in place and stated to the surveyor that he/she did not feel well and stated, sick. On 3/31/2026 at 10:53 AM, the surveyor reviewed the electronic medical record (EMR) for Resident #18. A review of the admission Record revealed that Resident #18 was admitted to the facility with the following but not limited to diagnoses: Anemia, acute respiratory…

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.

Complaint #NJ184191/394091 Based on observations, interviews, and record review, it was determined that the facility failed to document treatments administered to a resident on the electronic Treatment Administration Record (eTAR) for 1 of 4 residents reviewed for professional standards of nursing practice (Resident #2). This deficient practice was evidenced by the following: Reference: New Jersey Statutes Annotated, Title 45. Chapter 11. Nursing Board. The Nurse Practice Act for the State of New Jersey states: The practice of nursing as a registered professional nurse is defined as diagnosing and treating human responses to actual and potential physical and emotional health problems, through such services as case-finding, health teaching, health counseling, and provision of care supportive to or restorative of life and wellbeing, and executing medical regimens as prescribed by a licensed or otherwise legally authorized physician or dentist.According to the facility admission Record, Resident #2 was admitted to the facility with diagnoses which included: atherosclerotic heart…

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.

Based on observation, interview, and review of other facility documentation, it was determined that the facility failed to handle potentially hazardous foods and maintain sanitation in a safe and consistent manner to prevent food borne illness. This deficient practice was evidenced by the following: On 11/12/2024 at 09:32 AM, the surveyor, accompanied by the Food Service Director (FSD), observed the following in the kitchen: 1. On a lower shelf a one (1) gallon container of Deli Mustard was dated received 11/21/22. The mustard had a manufacturer's BEST BY date of 10/25/23. On interview the FSD agreed that the mustard was expired and should have been removed from stock. The FSD then removed the mustard from storage. 2. On a lower shelf in the walk-in freezer two (2) bags of frozen French fries were removed from their original container. The French fries had no dates. The FSD told the surveyor that all products should be dated when removed from the original container. In addition, an apple pie on a middle shelf was removed from its original container and had no dates. 3. On a middle…

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 C/O # NJ 168401, NJ# 174304 Based on observation, interview and review of other facility documentation, the facility failed to ensure the facility was maintained in a safe, clean and homelike environment. This deficient practice was identified for 2 of 3 units, 2nd and 3rd floor and was evidenced by the following: 1. On 11/14/24 at 08:29 AM the surveyor conducted an interview and observation with Resident #70 while he/she was lying in bed. The sheet covering the mattress was observed to have holes in it at the lower end of the bed towards the foot board and exposed the mattress underneath. Resident #70 expressed to the surveyor that he/she would prefer a sheet that did not have holes. On 11/15/2024 at 09:28 AM the surveyor observed room [ROOM NUMBER]. The surveyor observed that the C-bed bottom dresser drawer was broken, with the right side of the drawer face hanging on the floor. Resident who occupied D-bed was not present in the room at time of observation. The surveyor observed several flies around D-bed and…

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.

Based on observation and interview, it was determined that the facility failed to make State of New Jersey inspection results in a place readily accessible to facility residents. This deficient practice was evidenced by the following: On 11/12/2024 at approximately 9:00 AM, the surveyor observed the state survey results binder in the facility reception area upon entry. The results were on top of the receptionist desk in a black plastic binder. During the Resident Council Meeting on 11/13/2024 at approximately 10:30 AM, 4 of 4 alert and oriented residents in attendance stated to the surveyor that they were not aware of the location of State Survey results. The residents indicated that they would like to be able to have access to the results upon completion of the survey. On 11/13/2024 at 11:01 AM, after completion of the Resident Council meeting, the surveyor again observed the State Survey results binder on the lobby receptionist desk. The binder was clearly labeled and visible, however, it was determined that residents could not easily access the results without asking for staff…

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.

NJ 173880 Based on observation, interview, review of the medical record and review of other facility documentation, it was determined that the facility failed to notify a physician of a resident's blood sugar levels exceeding the established parameters (Resident #173) in accordance with professional standards of practice. This deficient practice was identified for 1 of 1 residents reviewed for insulin usage. This deficient practice was evidenced by the following: Reference: New Jersey Statutes Annotated, Title 45. Chapter 11. Nursing Board. The Nurse Practice Act for the State of New Jersey states: The practice of nursing as a registered professional nurse is defined as diagnosing and treating human responses to actual and potential physical and emotional health problems, through such services as case finding, health teaching, health counseling, and provision of care supportive to or restorative of life and wellbeing, and executing medical regimens as prescribed by a licensed or otherwise legally authorized physician or dentist. Reference: New Jersey Statutes Annotated, Title 45,…

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.

Based on observation, interview, medical record review and review of other facility documentation, it was determined that the facility failed to implement infection control measures for the handling and storage of respiratory equipment for 1 of 4 residents (Resident #70) reviewed for respiratory care. This deficient practice was evidenced by the following: On 11/12/2024 at 10:56 AM, during the initial tour of the facility the surveyor observed that Resident #70 was not present in the room. The surveyor observed a nebulizer mask placed on top of the nebulizer machine while not in use. The mask was uncovered and exposed to contamination. On 11/14/2024 at 08:25 AM Resident #70 was observed lying in bed. The surveyor observed Resident #70's nebulizer mask not in use and placed in the opened top drawer of the bedside table. The surveyor asked Resident #70 if he/she had received a nebulizer treatment this AM, and the resident responded not yet. The surveyor asked if the last treatment he/she had received was last night and the resident confirmed that they last received a nebulizer…

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.

Based on observation, interview and review of other facility documentation, it was determined that the facility failed to follow appropriate infection control practices and perform proper hand hygiene (HH) a.) during medication administration task on 1 of 4 units, the ventilator unit for 2 of 7 resident (Resident #3 and Resident #61) and b.) follow appropriate infection control practices and perform hand hygiene during tracheostomy care (a surgical procedure that creates an opening in the neck to provide an airway and remove secretions from the lungs) for 1 of 1 residents reviewed for Ventilator/Trach. This deficient practice was evidenced by the following: 1. During medication pass on the ventilator unit on 11/13/2024 at 9:45 AM, the surveyor observed the following: a.) Licensed Practical Nurse (LPN #1) administered medication to Resident #3 via the J tube (a soft, plastic tube that's surgically inserted into the small intestine to provide nutrition and medicine). LPN #1 disconnected the piston syringe used to administer the medications and reconnected feeding tube and turned tube…

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 Based on observation, interview and review of other facility documentation, it was determined that the facility failed to provide a A.) sanitary and orderly environment for 3 of 39 rooms on the second floor and various areas on the 3rd floor and B.) a homelike dining atmosphere for 2 of 2 floors, 2nd and 3rd. This deficient practice was evidenced by the following: A.) On 8/14/2023 at 9:44 AM, during the initial tour of the facility, Surveyor #1 entered room [ROOM NUMBER]. A strong odor of urine emanated inside the room. Surveyor #1 observed a floor stain that appeared to be dried, brown liquid. On 8/14/2023 at 10:19 AM, during the initial tour of the facility, Surveyor #1 entered room [ROOM NUMBER]. A strong odor of urine emanated from the room. On 8/15/2023 at 11:31 AM, Surveyor #1 entered room [ROOM NUMBER]. A strong odor of urine continued to emanate from the room. At that time, Resident #27 who resides in the room told the surveyor that he/she was not wet with urine. On 8/16/2023 at 8:38 AM, Surveyor #1…

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.

Based on observation, interview, and review of other facility documentation, it was determined that the facility failed to handle potentially hazardous foods and maintain sanitation in a safe and consistent manner to prevent food borne illness. This deficient practice was evidenced by the following: On 8/15/2023 from 8:25 to 9:03 AM, the surveyors, accompanied by the Food Service Director (FSD) and Regional Manager (RM), observed the following in the kitchen: 1. On a middle shelf in the walk-in refrigerator a sheet pan contained 17 defrosted house shakes. The shakes had no pull date or manufacturer expiration date. The RM stated that the shakes are good for 14 days after pulling from freezer to defrost. The RM agreed that there was no way to determine how long the house shake supplements were in the refrigerator. 2. On an upper shelf, an unopened gallon of whole milk had a best if used by date of 07/19/23. The FSD removed the expired gallon of milk to the trash. 3. On an upper shelf in the walk-in freezer (2) boxes covered with clear plastic contained frozen biscuits, according to…

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.

Based on observation, interview, record review and review of pertinent facility documents, it was determined that the facility failed to provide reasonable accommodation of resident needs specifically by failing to ensure call devices were in reach of 2 of 6 residents (Residents #68 and Resident #23) reviewed under the Environmental Task. The deficient practice was evidenced by the following: A.) On 8/14/2023 at 9:44 AM, during the initial tour of the facility, Surveyor #1 observed Resident #68 asleep in bed. At that time, Surveyor #1 observed the call device on the floor adjacent to the bed. On 8/15/2023 at 11:33 AM, Surveyor #1 observed Resident #68 asleep in bed. At that time, Surveyor #1 observed the call device on the floor adjacent to the bed. On 8/16/2023 at 8:40 AM, Surveyor #1 observed Resident #68 asleep in bed. At that time, Surveyor #1 observed the call device on the floor adjacent to the bed. On 8/17/2023 at 9:56 AM, Surveyor #1 observed Resident #68's call device on the floor adjacent to the bed. On the same date at 11:45 AM, Surveyor #1 in the company of 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.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview, and review of pertinent facility documents, it was determined that the facility failed to ensure a resident's environment is free from accident hazards specifically by having unattended, unpackaged medications left in 2 of 2 rooms reviewed for Accidents. The deficient practice was evidenced by the following: On 8/14/2023 at 9:46 AM during the initial tour of the facility, the surveyor observed two tablets and one capsule left on the night stand between two resident beds in room [ROOM NUMBER]. On 8/16/2023 at 9:26 AM, the surveyor again observed two tablets and one capsule left on the night stand between two resident beds in room [ROOM NUMBER]. At that time, the surveyor showed Licensed Practical Nurse (LPN #1) the tablets and capsule. LPN #1 stated that she believed one of the tablets may be Eliquis (medication used to thin blood). LPN #1 was unsure if the tablet and capsule belonged to a specific resident in room [ROOM NUMBER]. On 8/18/2023 at 9:35 AM while in room [ROOM…

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.

Based on observation, interview, record review and review of other facility documentation, it was determined that the facility failed to identify and monitor a resident's hemodialysis (the clinical purification of blood by dialysis, as a substitute for the normal function of the kidney) treatment access site. This deficient practice was identified for 1 of 1 residents reviewed for dialysis (Resident #161) and was evidenced by the following: According to the admission Record Resident # 161 was admitted to the facility with diagnoses including but not limited to: End Stage Renal Disease. According to the most recent Minimum Data Set (MDS) an assessment tool used to facilitate care, dated 8/09/2023 revealed Resident #161 had a Brief Interview for Mental Status score of 15/15 indicating Resident #161 was cognitively intact. The MDs section O indicated the Resident received dialysis while a resident. A review of the Physician Order summary on 8/14/2023 did not include a physician order to monitor the dialysis access site. There was no documentation in the medical record that Resident…

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 Based on observation, interview, record review, and review of pertinent facility documentation, it was determined that the facility failed to use appropriate precautions to store respiratory equipment in order to prevent the risk of infection, specifically by not containing a bilevel positive airway pressure (BiPAP) mask and a continuous positive airway (CPAP) mask in the appropriate manner increasing the risk of potential infection. The deficient practice was evident for 2 of 7 residents (Resident #21, #6) reviewed for Respiratory Care. The deficient practice was evidenced by the following: On 08/16/2023 at 09:35 AM while inside Resident #21's room, the surveyor observed a mask connected to a BiPAP machine left on top of a night stand adjacent to the resident's bed. The mask was not contained in a bag and left exposed to the environment. The top of the nightstand contained a variety of items including but not limited to a dentures container, container of margarine/butter, batteries, and a cellular phone. On…

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.

Based on interview and review of other facility documentation, it was determined that the facility failed to ensure 2 of 5 Certified Nursing Assistants ( CNA #2 and CNA #3) received 12 hours of education annually. This deficient practice was evidenced by the following: The surveyor requested five (5) random CNA education files for the year 2022. A review of a facility form titled 2022 In-Service Log revealed the following; CNA #2 completed 11.5 hours. CNA #3 completed 8.5 hours. During an interview with the surveyor on 8/21/2023 at 1:09 PM, the Director of Nursing (DON) said the CNA should have 12 hours of education annually. When asked what topics are required to be covered, the DON responded we have a list. She further said yes, Resident rights, abuse and neglect, Infection Control should be included. The surveyor asked who is responsible to ensure the CNA completes 12 hours of education annually and the DON replied Human Resources tracks to ensure they (CNA's) are getting 12 hours. A review of a facility policy titled Staff education with a Plan date of 02/01/2022 revealed under…

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.