Aristacare At Whiting

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observations, documentation review, and interviews on 8/12/2025 and 8/13/2025 in the presence of the Regional Director of Maintenance (RDM) and the Maintenance Director (MD), it was determined that the facility failed to ensure that all devices used to identify call bell notifications were properly functioning in accordance with State Operations Manual (SOM) Appendix PP Subsection 483.90(g). This deficient practice had the potential to affect all residents and was evidenced by the following:An observation on 08/12/2025 at 10:05 AM revealed the call station pull cord closest to the toilet in room [ROOM NUMBER] was wrapped around the grab bar, prohibiting the station from being activated. When the cord was unwrapped and tested, it failed to initiate a call. The call station for Bed A in the same room did not function when activated. An observation at 10:10 AM revealed the master call station at the second floor nursing station reading 324 CALL FAIL. In an interview at 10:11 AM the MD stated that he was…

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 03/18/2024 from 9:18 AM to 9:45 AM, the surveyor, accompanied by the Food Service Director (FSD), toured the kitchen and observed the following: In the walk-in freezer, the surveyor observed a spinach quiche, two packages identified by the FSD as pulled pork, and a pie with no labels or dates. The FSD stated that there should be a use by label if out of the package. He further stated that the above referenced items were not correct. A review of facility provided policy titled Labeling and Dating System Protocol rev 5/23/23, revealed All fresh and frozen foods must be dated with the date it was received into the kitchen, unless it has a Purveyor shipping label on it. Also included was All food in freezer storage - 6 months. N.J.A.C. 18:39-17.2(g)

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview and review of facility documentation, it was determined the facility failed to maintain a comfortable and homelike environment for resident rooms on 3 of 3 nursing units of the facility observed (1 East, 2 East, and 2 West). The evidence of this deficient practice includes: 1.) On 03/18/2024 from 9:33 AM to 11:41 AM, during the initial tour of the 2 [NAME] nursing unit, the surveyor made the following observations: The vinyl wall covering in resident room [ROOM NUMBER] behind bed B was partially removed and pulled away falling off the wall. room [ROOM NUMBER] the plastic/vinyl wall bumper behind bed A was broken with pointed edges. The bath tub in room [ROOM NUMBER] contained brown and grey stains and the overflow plate was covered with a white crusty material. The wall behind bed A in room [ROOM NUMBER] had an approximately 12 inch by 4 inch area with gouges missing paint and revealing the bare drywall. room [ROOM NUMBER] had four holes approximately one inch in diameter in 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 interview, review of Nursing Staffing Report sheets and facility provided documents, it was determined that the facility failed to ensure a Registered Nurse (RN) worked 7 days a week for at least 8 consecutive hours a day for 5 of 51 days reviewed under the Sufficient and Competent Nurse Staffing Task. The deficient practice was evidenced by the following: A review of the Nurse Staffing Reports completed by the facility for the weeks of 07/10/2022 through 07/16/2022, 01/08/2023 through 01/14/2023, 03/10/2024 through 03/16/2024 revealed the facility had no RN coverage for all shifts on 07/16/2022, 01/08/2023, 01/14/2023, 03/10/2024, and 03/16/2024. A review of the facility provided schedules for those dates did not reveal any RN coverage. Additionally, facility provided schedules for 07/17/2022 and 03/17/2024. 07/17/2022 did not reveal any RN coverage. The schedule for 03/17/2024 revealed the Director of Nursing was present in the facility however the resident census on that day was 136. On 03/26/2024 at 1:40 PM during an interview with the surveyor, the Director of Nursing…

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 record review, it was determined that the facility failed to ensure the accountability of the narcotic shift count logs were completed in accordance with facility policy. The deficient practice was identified on 2 of 4 medication carts reviewed (1 East Low side cart and 2 [NAME] High side cart) during the Medication Storage Task. The deficient practice was evidenced by the following: On 03/19/2024 at 10:05 AM during an interview with the surveyor, Licensed Practical Nurse (LPN) # 4 said that narcotic shift count logs are to be completed by two nurses (the incoming and outgoing nurses) at the same time once they confirm an accurate count of the narcotics (opium, opium derivatives, and their semi-synthetic substitutes) in the medication cart. She also confirmed that shift count logs should not be missing any documentation or signatures. Further, she said that the inventory sheet should be filled out when she prepares to administer a narcotic. At that time, the surveyor, in the presence of LPN 4, reviewed the 1 East low side medication cart Narcotic…

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 record review, it was determined that the facility failed to ensure required monthly visits by the Consultant Pharmacist (CP) for the months of November 2023, December 2023, and January 2024. This irregularity was identified for 3 of 3 residents reviewed for CP review, Residents #63, #83, and #27. This deficient practice was evidenced by the following: 1.) On 03/21/24 at 11:37 AM, the surveyor reviewed the CP progress notes. During review it was identified that the CP reviewed Resident #63 medications January 2023 through October 2023 every month. There was no available documentation for November 2023, December 2023, or January 2024. A review of the admission Record for Resident #63 indicated the resident had medical diagnoses which included but were not limited to hypertension (high blood pressure), anxiety disorder, and intellectual disabilities. Review of the annual Minimum Data Set (MDS), an assessment tool dated 01/20/24 revealed the resident had a Brief Interview 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 Based on observation, interview, and record review it was determined that the facility failed to notify the resident and/or resident representative in writing of the reason for transfer or discharge to the hospital for 3 of 3 residents reviewed for hospitalization Residents #43, #129, and #230. This deficient practice was evidenced by the following: 1.) On 03/20/24 the surveyor reviewed the Electronic Medical Record (EMR) which indicated Resident #129 was admitted to the facility for short term rehabilitation. Further review showed there was a Discharge/Return Anticipated Minimum Data Set (MDS), an assessment tool completed on 12/22/23 following a transfer to the hospital for right shoulder pain. Review of the admission Record indicated Resident #129 had medical diagnoses which included but were not limited to the following: acute respiratory failure, kidney disease, and anxiety. The surveyor reviewed the most recent MDS which revealed the resident had a Brief Interview of Mental Status of 3, meaning 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 interviews, review of medical records, and other facility documentation, it was determined that the facility failed to electronically transmit the Minimum Data Set (MDS, an assessment tool), within 14 days of completing the resident's assessment. This deficient practice was identified for 1 of 1 unsampled resident, (Resident # 95) reviewed in the Resident Assessment Task for MDS record over 120 days old. On 03/20/2024 the surveyor reviewed the MDS history in the electronic medical record which revealed: Resident #95 was discharged on 10/26/2023. Resident #95's discharge MDS was completed on 12/27/2023. The history indicates that Resident #95's discharge MDS was transmitted on 03/18/2024. On 03/21/2024, the surveyor interviewed the MDS Coordinator (MDSC), who stated that the discharge MDS on Resident #95 should've been completed within 14 days of discharge and transmitted within one week after completion. She also stated, it's late and the MDSs are usually transmitted once they're completed, this one got missed. Review of facility provided policy MDS Submission Timeframes…

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 interview and record review it was determined the facility failed to conduct a new Preadmission Screening and Resident Review (PASRR) level 1 assessment after a resident was newly diagnosed with a mental illness. This deficient practice was identified in 1 of 3 residents reviewed for PASRRs (Resident #71) and was evidenced by the following: On 03/19/2024 the surveyor reviewed Resident #71's Electronic Medical Record (EMR) which included review of the PASARR level 1 completed on 08/09/2022 which was negative and marked no for any diagnoses of mental illness. Review of the admission Minimum Data Set (MDS), an assessment tool, dated 07/06/2022, indicated a Brief Interview of Mental Status (BIMS) score of 15/15, indicating intact cognition and review of section I did not include any psychiatric diagnoses. A review of the Quarterly MDS dated [DATE], indicated bipolar disorder and psychotic disorder noted in Section I. A review of the Quarterly MDS dated [DATE], indicated bipolar disorder and psychotic…

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 observations, interview, and review of facility documentation it was determined that the facility failed to 1. Obtain physician orders for a resident's discharge home, 2. follow physicians' orders during medication observation and 3. follow physician orders by obtaining an air mattress for a resident at risk for pressure ulcers. This deficient practice was identified for 3 of 29 residents reviewed (Resident #61, #96 and #128) and was evidenced by the following: Reference: New Jersey Statues, Annotated Title 45, Chapter. 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 or 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 well-being, and executing a medical regimens as prescribed by a licensed or otherwise legally authorized…

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 pertinent facility documents, it was determined that the facility failed to accurately label multidose medications to facilitate the consideration of precautions and safe administration. The deficient practice was observed for 1 of 4 medication carts (2 [NAME] High Side) reviewed under the Medication and Storage Task. The deficient practice was evidenced by the following: On 03/19/2024 at 10:33 AM, the surveyor in the presence of Licensed Practical Nurse (LPN) # 2 observed the 2 [NAME] High Side medication cart. At that time, the surveyor observed the following: 1 opened Artificial Tear bottle. The bottle was not dated when it was opened. 1 opened Spiriva (treats asthma and chronic obstructive pulmonary disease) handheld inhaler. The inhaler was not dated when it was opened. 3 opened Lantaprost 0.005% ophthalmic solution eye drops. The bottles were not dated when they were opened. 1 opened Dorzolamide hydrochloride and Timolol maleate ophthalmic solution eye drops. The bottle was not dated when they were opened. At this time, during an…

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 provide a sanitary environment for residents, staff, and the public by failing to keep the garbage container area free of garbage and debris. This deficient practice was evidenced by the following: On 03/18/2024 during initial kitchen tour with the Food Service Director (FSD), the surveyor observed debris and trash around the dumpster area. The FSD stated that housekeeping was responsible for this area. He also stated that it was Monday and he guessed nobody had gotten out there as of that time. On 03/21/2024 at 12:28 PM the surveyor noted debris and trash in the area behind the dumpster area. On 03/25/2024 at 12:44 PM the surveyor interviewed the Director of Housekeeping who stated that housekeeping, maintenance and the kitchen are all in charge of the parking lot. He was shown a photo of the dumpster area and stated that they should go further than just the parking lot. A review of facility provided policy Sanitation: Dumpster/Garbage Disposal, dated November…

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 1.) implement appropriate transmission-based precautions specifically by applying precautions to a room that contained a resident with a potentially infectious disease for 1 of 1 resident (Resident #6) and 2.) failed to perform effective hand hygiene for a minimum of twenty seconds. The deficient practices were identified for 1 of 1 resident (Resident # 6) reviewed for Transmission-Based Precautions under the Infection Control task and 2 of 3 nurses observed during the Medication Administration task . The deficient practices were evidenced by the following: 1.) A review of Resident # 6's admission Record located in the Electronic Medical Record (EMR) revealed that on 03/18/2024, he/she was diagnosed with unspecified diarrhea. A review of Resident # 6's Order Summary Report located in the EMR revealed that on 03/18/2024 a, C DIFF DNA RT-PCR(STOOL) (test to determine the presence of clostridium difficile; a potentially deadly bacteria in the stool)…

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 # NJ#156705 Based on interview and review of facility documents on 11/30/23, it was determined that the facility failed to ensure a Registered Nurse (RN) worked for at least eight consecutive hours a day for 8 of 28 days reviewed. This deficient practice was evidenced by the following: Review of the Nurse Staffing Reports completed by the facility for the weeks of 07/17/22 through 07/23/22, 07/31/22 through 08/06/22, 11/12/23 through 11/18/23 and 11/19/23 through 11/25/23, revealed that the facility had no RN coverage for all shifts on 07/17/22, 07/31/22, 08/02/22, 08/03/22, 08/06/22, 11/18/23, 11/19/23 and 11/24/23. During a telephone interview with the surveyor on 12/01/23 at 11:00 am, the surveyor inquired about RN staffing in the building. The Licensed Nursing Home Administrator (LNHA) stated, Yes, there should be at least one RN in the building. During a follow-up telephone interview with the surveyor on 12/01/23 at 2:17 pm, the LNHA confirmed that there was no RNs in the building on the aforementioned dates. The LNHA further stated, No RNs were available to come into…

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 Complaint #: NJ#156370 Based on interviews, medical record review, and review of other pertinent facility documents on 11/30/23, it was determined that the facility staff failed to consistently document on the Point of Care (POC) Legend Report the Activities of Daily Living (ADL) status and care provided to a resident. The deficient practice was identified for Resident #4, 1 of 5 residents reviewed for documentation and was evidenced by the following: The surveyor reviewed the closed record for Resident #4: According to the admission Record, Resident #4 was admitted on [DATE], with medical diagnoses that included but were not limited to: lack of coordination, abnormalities of gait and mobility, seizures, and depression. Review of the discharge Minimum Data Set (MDS), an assessment tool used to facilitate the management of care, dated 07/14/22, indicated Resident #4's cognition was severely impaired. The MDS also indicated the resident required set-up help for ADLs. Review of Resident #4's POC Legend Report 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.

Based on observation, interview, and review of pertinent facility documents, it was determined that the facility failed to consistently document catheter urinary output according to the physician orders. This deficient practice was identified for 1 of 1 resident reviewed for urinary catheters (Resident #11) and was evidenced as follows: On 11/23/21 at 10:15 AM, the surveyor observed Resident #11 lying in bed. The resident stated he/she had a urinary catheter bag (used to empty the bladder and collect urine in a drainage bag) and that staff would empty it, but he/she would also have to remind the staff to empty his/her urinary catheter bag when necessary. The surveyor reviewed the medical record for Resident #11. A review of the admission Record face sheet (an admission summary) reflected that the resident was admitted to the facility in March 2018, with diagnoses which included: neuromuscular dysfunction of bladder/neurogenic bladder (lacks bladder control due to brain, spinal cord, or nerve problems), urinary tract infection and altered mental status. A review of the most recent…

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 record review it was determined the facility failed to ensure a.) an accurate ordering, receiving and administration of narcotic medications that required Federal narcotic acquisition forms (DEA 222 form) were completed with sufficient detail to enable accurate reconciliation; b.) accurately document the administration of controlled medications; c.) ensure Narcotic Shift Count logs were completed in accordance with facility policy; and d.) maintain a system of record keeping that ensures an accurate inventory of controlled medications. This deficient practice was identified for 5 of 7 DEA 222 forms reviewed and 3 of 4 medication carts reviewed. The evidenced was as follows: On 12/1/21 at 11:59 AM, the surveyor reviewed the facility provided DEA 222 forms which revealed the facility did not complete Part 5 of the form (number received and date received), as instructed to on the reverse of the DEA 222 form. The inaccuracies were identified on the following order forms: #210697903, #210697905, #210697909, #210697910, #210697913. On 12/1/21 at 12:15…

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 and interview it was determined that the facility failed to ensure that corridors were equipped with firmly secured handrails on each side. The deficient practice was identified on 1 of 3 nursing units (Second Floor) and evidenced by the following: On 12/6/21 beginning at 8:25 AM, the surveyor in the presence of the facility's Maintenance Director (MD) toured the Second Floor nursing unit (Memory Impaired Unit). During the tour, the surveyor observed three (3) areas in the corridors that had no hand rails for residents to utilize in the following locations: 1. At 9:01 AM, the surveyor observed next to Resident room [ROOM NUMBER] a six (6) feet long section of corridor wall with no handrail and across by stairwell #5 was a three (3) feet long section of wall with no handrail. At this time, the MD informed the surveyor that there used to be an imitation kitchen area with cabinets on the wall for the memory impaired residents, but the facility removed it. 2. At 9:15 AM, the survey observed next…

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 record review it was determined that the facility failed to follow physician's orders and administer medication based on pain scale level parameters for the prescribed medication oxycodone (a medication to treat severe pain) in accordance with professional standards of practice. The deficient practice was identified for 1 of 4 residents (Resident #115) reviewed for pain management. 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 licensed practical nurse is defined as performing tasks and responsibilities with in the framework of case finding; reinforcing the patient and family teaching program through health teaching, health counseling and provision of supportive and restorative care, under the direction of a registered nurse or licensed or otherwise legally authorized physician or dentist. This deficient practice was evidenced by the following: On 11/23/21 at 11:16 AM, the surveyor observed Resident #115 who was sitting up in…

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 record review it was determined the facility failed to ensure that all drugs and biologicals used in the facility were stored in accordance with professional standards and manufacturer's instructions. This deficient practice was identified for 3 of 4 medication carts and 1 of 2 mediation rooms inspected and was evidenced by the following: 1. On 11/29/21 at 8:41 AM, the surveyor in the presence of the Registered Nurse/ Infection Preventionist (RN/IP) observed Nursing Unit 2 West's medication storage room. The medication refrigerator in the storage room contained one open multidose vial of Flucelvax (an injectable flu vaccine medication). The medication box was dated 11/5/21, the medication vial was not dated when it was opened. At this time, the surveyor interviewed the RN/IP who stated that this medication was good for 30 days and the vial should be dated once opened, and then proceeded to remove the medication from storage for disposal. On 11/29/21 at 8:54 AM, the surveyor in the presence of Licensed Practical Nurse (LPN #1) observed Nursing…

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 facility documentation it was determined the facility failed to maintain the ice machine chute to prevent microbial growth and food borne illness. This deficient practice was identified in the main kitchen and was evidenced by the following: On 11/22/21 at 09:55 AM, the surveyor toured the kitchen in the presence of the Food Service Director (FSD). The surveyor asked to see the cleaning log for the ice machine and who was responsible to clean and maintain the ice machine. The FSD replied that he cleaned it, and maintenance sometimes cleaned. The surveyor reviewed the cleaning log which indicated that the last date the ice machine was cleaned was 8/16/21. Prior to 8/16/21, the log was signed as cleaned monthly from January 2021 to August 2021. The FSD informed the surveyor that he had cleaned it in September and October but just never signed the log. At this time, the surveyor asked the FSD to wipe the inside of the ice machine chute where the ice drops from. The FSD took a white paper towel and wiped the inside of the ice machine chute.…

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.