Belmont Manor

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, medical record review, policy review and interview, the facility failed to ensure residents were free from restraints. This affected two residents (#21 and #46) of three residents reviewed for restraints. The facility did not identify any residents having restraints. The census was 51. Findings include: 1. Medical record review revealed Resident #21 was admitted on [DATE] with diagnoses including non-traumatic brain dysfunction, Alzheimer's disease, pneumonia, thyroid disorder, arthritis, hip fracture, psychotic disorder, and unsteadiness on feet. Review of the annual Minimum Data Set 3.0 (MDS) assessment dated [DATE] revealed Resident #21 was severely impaired for daily decision-making, and did not use restraints, chair alarms or a chair to prevent rising. Review of the Full Year Therapy Screen dated 2024 revealed on 02/27/24, 05/16/24 and 08/08/24 Resident #21 was dependent for wheelchair mobility and walking was not attempted due to medical condition/safety. Review of the electronic…

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 medical record review, observation, and interview, the facility failed to ensure the comprehensive assessments were accurate related to alarms, falls and psychotropic medications. This affected one resident (#46) of 18 residents reviewed for comprehensive assessments. The census was 51. Findings include: Medical record review revealed Resident #46 was admitted on [DATE] from the community with diagnoses including non-Alzheimer's dementia, anxiety, major depressive disorder and diabetes mellitus type 2. Review of the electronic Physician Orders dated July 2024 revealed resident was ordered a self-releasing seat belt and a pressure sensitive alarm at all times except while in wheelchair. The resident also received a PRN (as needed) Haldol (antipsychotic) 1 milligram on 07/04/24 for anxiety. a. Review of the quarterly Minimum Data Set 3.0 (MDS) assessment dated [DATE] revealed Resident #46 was severely impaired for daily decision-making and sustained one fall with no injury . Review of the Fall…

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 medical record review and interview, the facility failed to ensure residents were provided a written summary of the baseline care plan. This affected one resident (#106) of 18 residents reviewed for care planning. Findings include: During an interview on 08/05/24 at 9:51 A.M., Resident #106 stated she did not recall receiving a summary of her baseline care plan. Review of Resident #106's medical record revealed an admission date of 07/20/24. Diagnoses included muscle wasting and atrophy, hypokalemia, pain, age-related physical debility, hypothyroidism, cervical disc degeneration, right artificial knee joint, bilateral hearing loss, angina pectoris, depression, hypertension, hyperlipidemia, osteoarthritis, thyroid disorder, squamous cell carcinoma of skin, and anxiety disorder. Review of the baseline care plan dated 07/20/24 revealed there was an area at the bottom of the second page for a resident or representative to sign indicating they received a copy of the resident's medication list and a copy of the baseline care plan. Instead of a signature there was a note written…

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 medical record review and interview, the facility failed to develop and implement care plans to maintain a resident's highest practicable well-being. This affected one resident (#46) of 18 residents reviewed for care plans. The census was 51. Findings include: Medical record review revealed Resident #46 was admitted on [DATE] with diagnoses including non-Alzheimer's type dementia, anxiety, breast cancer and arthritis. a. Review of the admission Fall Risk assessment dated [DATE] revealed Resident #46 was at moderate risk for falls. Further review revealed no evidence a care plan was developed between 03/04/24 and 06/05/24 to prevent falls. Review of the Nursing Notes dated 06/05/24 revealed Resident #46 had sustained a fall. This was the first documented fall for the resident. b. Review of the admitting History and Physical dated 02/06/24 and the electronic Diagnosis List revealed Resident #46 had health conditions/diagnoses including diabetes mellitus, breast cancer, arthritis, constipation 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.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, medical record review, policy review and interview, the facility failed to ensure proper positioning of residents during meals on the secured unit. This affected three residents ( #21, #25 and #46) of 14 residents on the secured unit. The census was 51. Findings include Medical record review revealed Resident #46 was admitted on [DATE] with diagnoses including non-Alzheimer's type dementia. Medical record review revealed Resident #21 was admitted on [DATE] with diagnoses including non-traumatic brain dysfunction, Alzheimer's disease and history of pneumonia. Medical record review revealed Resident #25 was admitted on [DATE] with diagnoses including non-traumatic brain dysfunction and non-Alzheimer's type dementia. Observations of meal service on the secured unit revealed the following: a. On 08/05/24 at 12:01 P.M., observation revealed State Tested Nurse Aide (STNA) #105 and #108 distributed the lunch meals to residents on the secured unit. After distribution, STNA #108 sat at one 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, record review, policy review, and interview, the facility failed to ensure dependent residents received nail and oral care. This affected two residents (#22 and #49) of two residents reviewed for activities of daily living. Findings include: 1. Review of Resident #22's medical record revealed a 03/09/24 admission with diagnoses including encounter for fitting and adjustment of urinary device, pressure ulcer of right lower back, encounter for palliative care, retention of urine, cerebral infarction, dementia, osteomyelitis of vertebra, need for assistance with personal care, and anxiety. Review of a Significant Change Minimum Data Set (MDS) dated [DATE] for initiation of hospice care included the resident was severely impaired for daily decision making, dependent for personal hygiene, dependent on rolling in bed, had bilateral lower leg functional impairment, and had a Stage IV pressure ulcer (Full-thickness skin and tissue loss with exposed or directly palpable fascia, muscle, tendon,…

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, medical record review, and interview, the facility failed to implement physician orders for tubigrips (tubular bandages that provide light to moderate compression) to address edema. This affected one resident (#27) of 24 residents screened for edema (swelling). Findings include: Review of Resident #27's medical record revealed diagnoses including edema, hypertension, and type two diabetes mellitus. Resident #27 had a physician order dated 04/12/24 to apply tubigrips to both legs to be worn at all times except during hygiene as tolerated. An annual Minimum Data Set (MDS) assessment dated [DATE] revealed Resident #27 was cognitively intact. Documentation on the electronic task bar indicated Resident #27 had tubigrips worn on 08/05/24 at 5:59 A.M. and refused on 08/05/24 at 9:47 A.M. Observation of Resident #27 on 08/05/24 at 3:35 P.M. revealed both of Resident #27's feet were swollen. Resident #27 stated she used to wear compression stockings but did not know where they were. Resident #27 had…

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, medical record review, missing item log review, policy review and interview, the facility failed to ensure visual appliances i.e. eyeglasses were readily available for resident use. This affected one resident (#21) of two resident reviewed for communication-sensory. The census was 51. Findings include: Medical record review revealed Resident #21 was admitted on [DATE] with diagnoses including cataracts, glaucoma or macular degeneration, non-traumatic brain dysfunction and Alzheimer's disease. Review of the care plan: Communication Problem dated 10/26/20 revealed Resident #21 vision was adequate as she will name things across the room, has glasses that she chooses not to wear at all times but staff was to encourage her to wear her glasses. Review of the Eye Care evaluation dated 01/17/24 revealed resident with severe cataracts, hyperopia and presbyopia (refractive errors that cause blurry close-up vision) in both eyes. Resident declined new prescription glasses and spectacle prescription for…

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, record review and interview, the facility failed to ensure pressure relieving measures were in place as ordered. This affected one resident (#34) of three residents reviewed for pressure ulcers. Findings include: Review of Resident #34's medical record revealed a 06/27/24 admission with diagnoses including pressure induced deep tissue damage of sacral region, systemic lupus erythematosus, age related osteoporosis with current pathological fracture, urinary incontinence, fracture of neck of right femur, joint replacement surgery, anemia, type 2 diabetes with polyneuropathy,, hyperglycemia,, vitamin D deficiency, depression, paroxysmal vertigo of right ear, hypertension, atrial fibrillation, peripheral vascular disease, panlobular emphysema, gastroesophageal reflux disease, duodenal ulcer, constipation, lack of coordination, repeated falls, cognitive communication deficit, fracture of one right rib, need for assistance with personal care, artificial left hip joint and cerebral infarction. The resident had a fall on 07/10/24 with fracture of right hip. 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, record review, policy and interview, the facility failed to ensure restorative services were initiated, assessed, reviewed and revised if needed. This affected three residents (#12, #21, and #46) of four residents reviewed for positioning, mobility and limited range of motion. Findings include: 1. Review of Resident #12's medical record revealed a 10/16/19 admission with diagnoses including Parkinson disease, end stage renal disease, Tourette's disorder, schizoaffective disorder, rheumatoid arthritis, neuromuscular dysfunction of bladder, benign prostatic hyperplasia with lower urinary tract symptoms, and moderate intellectual disability. The resident had a plan of care initiated 04/28/22 for impaired self performance of bed mobility, Related to rheumatoid arthritis, Parkinson;s disease, age related osteoporosis, osteoarthritis, and dementia with behavioral disturbance. Interventions included 01/20/23 assistance with placement of soft palm guard to both hands at ALL times EXCEPT for meals &…

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, medical record review, fall investigation review, policy review and interview, the facility failed to implement interventions and complete accurate investigations to prevent further falls. This affected one resident (#46) of three residents reviewed for accidents. The census was 51. Findings include: Medical record review revealed Resident #46 was admitted on [DATE] with diagnoses including non-Alzheimer's type dementia, anxiety and arthritis. Review of the quarterly MDS 3.0 assessment dated [DATE] revealed Resident #46 was severely impaired for daily decision-making and had one fall without injury since the last assessment. Review of the quarterly MDS 3.0 assessment dated [DATE] revealed Resident #46 was severely impaired for daily decision-making, required extensive assistance with transfers, bed mobility of two persons, had two or more falls with no injury, had received therapy services and did not use any alarms or restraints. Review of the admission Fall Risk assessment dated [DATE]…

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, record review, policy review, and interview, the facility failed to ensure treatment and care was provided as ordered for a resident with a history of urinary tract infections and urinary catheter. This affected one resident (#6) of one resident reviewed for urinary catheter. Findings include: Review of Resident #6's medical record revealed an admission on [DATE] with diagnoses including flaccid neuropathic bladder, neurogenic bladder, retention of urine, history of urinary tract infections, urinary incontinence, atherosclerosis of native arteries of right leg with ulceration of heel and midfoot, peripheral vascular disease and type 2 diabetes. The resident had a positive urinary tract infection from Escherichia Coli >100,000 on 05/18/23 and was treated with Keflex. A positive urinary tract infection from Escherichia Coli on 12/12/23 was treated with Levoquin. The resident returned from the hospital on [DATE] with an indwelling urinary catheter due to retention and urinary tract infection.…

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 medical record review, observation and interview, the facility failed to ensure a resident with a significant weight loss received medications, supplements and routine meals. This affected one resident (#46) of two residents reviewed for nutrition. The census was 51. Findings include: Medical record review revealed Resident #46 was admitted on [DATE] with diagnoses including non-Alzheimer's dementia, anxiety, major depressive disorder, breast cancer and diabetes mellitus type 2. The resident's admission weight was 110.6 pounds (#). Review of the Nutritional Sheet Version 1.5 revealed: -dated 03/04/24 revealed resident weight 110.6# with a BMI of 21.6 indicating a healthy weight. Tolerating diet with intakes averaging 86% with no chewing or swallowing difficulties. Dietitian to follow and address nutrition concerns as appropriate. -dated 06/13/24 revealed resident weight 112.2# with a BMI of 21.9 indicating a healthy weight. , no significant weight loss. Tolerating diet with intakes averaging 65% with no…

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 medical record review, medication guide review,policy review, and staff interview, the facility failed to provide monitoring for side effects with the use of a psychoactive medication. This affected one resident (#46) of three residents reviewed for unnecessary medications. Findings Include: Medical record review revealed Resident #46 was admitted on [DATE] from the community with diagnoses including dementia, anxiety, major depressive disorder and diabetes mellitus type 2. Review of the quarterly MDS 3.0 assessment dated [DATE] revealed Resident #46 was severely impaired for daily decision-making with diagnoses including diabetes mellitus. Review of the electronic Physician Orders dated 07/10/24 revealed to start Rexulti (antipsychotic) 0.5 milligrams one tablet daily. Review of the July and August 2024 Medication Administration Record revealed Resident #46 had received Rexulti daily since 07/11/24. Review of the medical record revealed no baseline AIMS (Abnormal Involuntary Movement Scale) assessment…

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 record review and interview, the facility failed to ensure an as needed antianxiety medication had a 14 day stop date, and an antipsychotic medication had behaviors documented and an indication for use. This affected two residents (#22 and #46) of five residents reviewed for unnecessary medication. The facility census was 51. Findings include: 1. Review of Resident #22's medical record revealed a 03/09/24 admission with diagnoses including encounter for fitting and adjustment of urinary device, pressure ulcer of right lower back, encounter for palliative care, retention of urine, cerebral infarction, dementia, osteomyelitis of vertebra, need for assistance with personal care, and anxiety. Review of a Significant Change MDS dated [DATE] for initiation of hospice care included the resident was severely impaired for daily decision making, dependent for personal hygiene, dependent on rolling in bed, had bilateral lower leg functional impairment, and had a Stage IV pressure ulcer (full-thickness skin 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.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on record review and interview, the facility failed to ensure an accurate medical record. This affected two residents (#22 and #46) of 19 residents reviewed. The facility census was 51. Findings include: 1. Review of Resident #22's medical record revealed a 03/09/24 admission with diagnoses including encounter for fitting and adjustment of urinary device, pressure ulcer of right lower back, encounter for palliative care, retention of urine, cerebral infarction, dementia, osteomyelitis of vertebra, need for assistance with personal care, and anxiety. Review of a Significant Change MDS dated [DATE] for initiation of hospice care included the resident was severely impaired for daily decision making, dependent for personal hygiene, dependent on rolling in bed, had bilateral lower leg functional impairment, and had a Stage IV pressure ulcer (full-thickness skin and tissue loss with exposed or directly palpable fascia, muscle, tendon, ligament, cartilage or bone in the ulcer. Slough and/or eschar may be visible.…

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 review of infection control logs, observation, policy and interview, the facility failed to ensure catheter care met professional standards and patterns of infection were identified. This affected one resident (#6) of three residents reviewed for indwelling catheters. Findings include: 1. Review of the June 2024 infection control log indicated four urinary tract infections (UTIs) were recorded with all acquired after admission. Three of the four UTIs had ecoli (microorganism) recorded as the results on the culture. All three of the residents with ecoli in their urine resided on the same unit (B hall) with the onset dates recorded as 06/30/24. On 08/06/24 at 2:19 P.M., during interview, Registered Nurse (RN) #522 (Infection Control Preventionist) stated she had not identified any patterns while completing the infection surveillance. After discussing the three residents who resided on the same unit having an onset on 06/30/24 and all having ecoli identified on the culture results, RN #522 stated she recognized there had been a pattern. 2. Observation of catheter care 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.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on medical record review and interview, the facility failed to ensure antibiotic orders were reviewed with the resident's attending physician when there was inadequate information to support the presence of an infection and an antibiotic was not in daily use without consultation with a specialist. This affected two residents (#9 and #15) of 24 residents screened for infections. Findings include: 1. Review of Resident #9's medical record revealed diagnoses including calculus of the kidney and kidney cyst. A nursing note dated 04/30/24 at 12:40 P.M. indicated Resident #9 complained of pain in the testes area and pain while urinating. An order was received to send Resident #9 to the emergency room (ER) for evaluation. The physician was notified Resident #9 had bright red intermittent blood coming from his penis. A progress note dated 04/30/24 at 2:04 P.M. indicated Resident #9 was being transported to the ER. A nursing note dated 05/01/24 at 1:30 A.M. revealed Resident #9 returned from the ER with orders for…

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 resident interview, medical record review, fall investigation review and staff interview the facility failed to implement fall interventions as ordered. This affected one (Resident #37) of three residents reviewed for accidents. The census was 40. Findings included: On 08/15/22 at 11:17 A.M., interview with Resident #37 revealed a fall last month during care with a staff member, and she slid off her bed and was lowered to the ground by the staff member. Review of Resident #37's medical record revealed an admission date of 01/27/21 with diagnoses that included Parkinson's disease and difficulty walking. Review of Resident #37's Minimum Data Set (MDS) 3.0 quarterly assessment with a reference date of 04/22/22 indicated Resident #37 had an independent cognition level and required two staff members for assistance with transfers. Review of Resident #37's nurse's notes revealed on 07/09/22 Resident #37 slid off the bed when sitting on the edge of the bed being assisted by staff with morning care. Review of the fall investigation completed following the fall on 07/09/22 revealed 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 Based on record review and interview, the facility failed to ensure weights were obtained as ordered for Resident #16. This affected one (Resident #16) of two residents reviewed for weights. The facility census was 40. Findings include: Review of the medical record for Resident #16 revealed an admission date of 06/28/22 with diagnoses including dementia, depression and diabetes mellitus. Review of the physician's order dated 06/28/22 for Resident #16 revealed an order for monthly weights. Review of the admission weight for Resident #16 revealed she weighed 107.1 pounds on 06/29/22. Review of the plan of care for Resident #16 dated 07/12/22 revealed she was underweight with a low body mass index. The staff were to weigh the resident per their policy and notify the physician of significant weight changes. Review of the nutritional assessment dated [DATE] revealed the most recent weight the facility had obtained was on 06/29/22 and was 107.1 pounds. Interview on 08/16/22 at 1:21 P.M. with Dietitian #500 verified…

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.