Bells Nursing And Rehabilitation Center

Based on policy review, observation, and interview, the facility failed to ensure food was stored, handled, prepared, and served under sanitary conditions, when food was found opened and undated. The census was 87 with 87 residents receiving a meal tray from the kitchen. The findings include: Review of the facility policy titled, Food Receiving and Storage, revised 11/2018, revealed .Foods shall be received and stored in a manner with safe handling practices.All foods stored in the refrigerator or freezer will be covered, labeled and dated ( use by date or open date).Other opened containers must be dated and sealed or covered during storage. Observation during the initial tour in the kitchen on 8/11/2025 at 8:50 AM, revealed the following in the walk-in refrigerator: a. 1 gallon of opened and undated mayonnaise b. 1 bag of opened and undated sliced cheese c. 1 gallon of opened and undated pickles Observation during the initial tour in the kitchen in the walk-in freezer on 8/11/2025 at 8:55 AM, revealed a box of single serve ice cream, opened and undated. During observation 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 policy review, medical record review, observation, and interview, the facility failed to report an injury of unknown origin and an allegation of misappropriation of resident property to the appropriate agencies for 2 of 3 (Resident #78 and #94) sampled residents reviewed for abuse. The findings include: 1. Review of the facility policy titled, Abuse, Neglect, Exploitation or Misappropriation-Reporting and Investigating, dated 10/28/2022, revealed .All reports of resident abuse (including injuries of unknown origin), neglect, exploitation, or theft/ misappropriation of resident property are reported to local, state and federal agencies (as required by current regulations) and thoroughly investigated by facility management. Findings of all investigations are documented and reported. If resident abuse, neglect, exploitation, misappropriation of resident property or injury of unknown source is suspected, the suspicion must be reported immediately to the administrator and to other officials 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.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on policy review, medical record review, and interview, the facility failed to perform a complete and thorough investigation for 1 of 3 (Resident #94) sampled residents reviewed for allegations of abuse. Resident #94, a severely cognitively impaired, vulnerable resident, dependent on staff for transfers was found with her right arm lodged in the opening of the armrest of the wheelchair on 7/13/2025. Later the same day staff observed bruising from her elbow to her wrist. An x-ray obtained on 7/14/2025 revealed a fracture of the right humerus (upper arm). The findings include: 1. Review of the facility policy titled, Abuse, Neglect, Exploitation or Misappropriation-Reporting and Investigating, dated 10/28/2022, revealed .All reports of resident abuse (including injuries of unknown origin), neglect, exploitation, or theft/ misappropriation of resident property are reported to local, state and federal agencies (as required by current regulations) and thoroughly investigated by facility management. Findings 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 policy review, medical record review, observation, and interview, the facility failed to ensure proper infection control practices were followed when 1 of 1 Licensed Practical Nurse (LPN R) failed to sanitize her stethoscope, failed to follow Enhanced Barrier Precautions during medication administration, when 2 of 2 Certified Nursing Assistants (CNA P and CNA Q) failed to follow Enhanced Barrier Precautions (EBP) during incontinence care, when the facility failed to ensure resident care items and equipment were labeled, contained and properly stored in resident shared bathrooms, and when 1 of 20 Certified Nursing Assistant (CNA E) directly touched residents food with her bare hands and failed to use proper hand hygiene after touching items in residents rooms during dining. The findings include: 1. Review of the facility's policy titled, Enhanced Barrier Precautions, dated August 2022, revealed .Enhanced barrier precautions (EBPs) are used as an infection prevention and control intervention to reduce 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 policy review, observation, and interview, the facility failed to maintain or enhance residents' dignity and respect during dining when 6 of 18 staff members Certified Nursing Assistant (CNA) C, CNA E, and CNA F, Hydration Aides K and Hydration Aide L, Licensed Practical Nurse (LPN) M, and Activities Tech O, failed to knock and/or announce themselves before entering a resident's room and failed to use courtesy titles when addressing residents and referring to residents. The findings include: 1. Review of the facility's policy titled, Dignity, revised 2021, revealed, Each resident shall be cared for in a manner that promotes and enhances his or her sense of well-being, level of satisfaction with life, and feelings of self-worth and self-esteem .Residents are treated with dignity and respect at all times .Staff are expected to knock and request permission before entering residents' rooms. Staff speak respectfully to residents at all times, including addressing the resident by his or her name of choice and not labeling or referring to the resident by his or her room number,…

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 follow physician's preventive measures order for wounds for 1 of 16 (Resident #43) sampled residents reviewed for physician orders. The findings include: Review of the medical record revealed Resident #43 was admitted on [DATE], with diagnoses including Alzheimer's, Diabetes, Stage 3 Pressure Ulcer of Sacral, Stage 4 Pressure Ulcer Left Lateral Leg, and Unstageable Left Heel. Review of the Care Plan dated 1/20/2024 revealed .returned from recent hospital stay with a stage II to sacrum .Implement pressure ulcer treatment per MD order .03/26/24 [3/26/2024]: Stage III to sacrum resolved as of this date .Stage III to sacrum reopened as of this date. To be treated per MD orders . Review of the quarterly Minimum Data Set (MDS) dated [DATE], revealed Resident #43 was moderately impaired for daily decision making, and had 1 stage 3 pressure ulcer and 3 deep tissue injury. Review of the Physician's Orders dated 3/28/2024, revealed .apply…

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 policy review, medical record review, and interview, the facility failed to ensure the residents oxygen tubing and humidifier bottle was dated for 2 of 4 (Resident #54 and #224) reviewed for oxygen. The findings include: 1. Review of the facility's policy titled, Oxygen Administration, dated 4/2014, revealed The purpose of this procedure is to provide guidelines for safe oxygen administration .Before administering oxygen, and while the resident is receiving oxygen therapy .Oxygen tubing should be replaced weekly as well as humidifier bottles .should be labeled with a resident identifier and dated . 2. Review of the medical record revealed #54 was admitted on [DATE], with diagnoses including Parkinson's, Heart Failure, and Chronic Obstructive Pulmonary Disease Review of the annual Minimum Data Set (MDS) dated [DATE], revealed #54 had a Brief Interview for Mental Score (BIMS) score of 13, indicating the resident had intact cognition, and was not coded for oxygen. Review of the care plan dated 4/8/2024,…

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 policy review, observation, and interview, the facility failed to ensure a safe, sanitary, and comfortable environment for 4 of 60 (Resident #1, #32, #39, and #173) resident rooms observed. The findings include: 1. Review of the facility's policy titled, Cleaning and Disinfection of Environmental Surfaces, Resident-Care Items, Equipment and Other Items, Revised 8/2010, revealed, .Walls, blinds, and window curtains in resident areas shall be cleaned when these surfaces are visibly contaminated or soiled . Review of the facility's Housekeeping and Laundry Service Cleaning Schedule, revealed, .Shift .First .Ceiling .Vents, Light Fixtures, Cubicle Curtains/Tracks .Cleaning Schedule .Weekly . 2. Observation in Resident #32's room on 6/17/24 at 9:40 AM, 11:33 AM, at 2:46 PM, and on 6/18/2024 at 8:10 AM, revealed a dark brown stain at the bottom of the middle divider privacy curtain that separates the A bed from the B bed. 3. Observation in Resident #39's on 6/17/24 at 9:52 AM, 2:43 PM, 3:47 PM, and on 6/18/2024 at 8:49 AM, revealed dark brown stains at various places on 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 policy review, observation, and interview, the facility failed to maintain or enhance resident dignity and respect when 4 of 26 (Certified Nursing Assistant (CNA) #1 and CNA #9, Licensed Practical Nurse (LPN) #1, and the Activities Director) staff members observed during dining failed to knock, announce or introduce themselves when entering a resident's room and failed to use courtesy titles to address residents. The findings include: 1. Review of the facility's policy titled Dignity, revised 2/2021, revealed, Each resident shall be cared for in a manner that promotes and enhances his or her sense of well-being level of satisfaction with life and feelings of self-worth and self-esteem .The facility culture supports dignity and respect for residents .Residents are treated with dignity and respect at all times .Staff are expected to knock and request permission before entering resident's rooms .Staff speak respectfully to residents at all times, including addressing the resident by his or her name of choice .not labeling . Review of the facility's .Resident Rights Policy,…

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 policy review, medical record review, observation, and interview, the facility failed to ensure 1 of 1 (Resident #41) was free from the use of restraints. The findings include: Review of the facility's policy titled, Use of Restraints, dated 2008, revealed, .If the resident cannot remove the device in the same manner in which the staff applied it .that device is considered a restraint .Restrained individuals shall be reviewed regularly (at least quarterly) to determine whether they are candidates for restraint reduction, less restrictive methods of restraints, or total restraint elimination . Review of the medical record revealed Resident #41 was admitted to the facility on [DATE] with diagnoses of Alzheimer's Disease, Dementia, Heart Failure, and Depression. Review of the Care Plan revealed Resident #41 was not care planned for the use of a merri-walker (a type of adaptive equipment that is a combination of a wheelchair and a walker and has a safety belt and latch lock). Review of a Physician's Order…

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 policy review, medical record review, observation, and interview, the facility failed to monitor oxygen administration for 1 of 2 residents (Resident #51) reviewed for respiratory services. The findings include: Review of the facility's policy titled, Oxygen Administration, dated 10/2010, revealed, .Verify that there is a physician's order for this procedure .start the flow of oxygen at the rate prescribed by the physician . Review of the medical record revealed Resident #51 was admitted to the facility on [DATE] with diagnoses of Chronic Respiratory Failure, Chronic Obstructive Pulmonary Disease, Schizoaffective Disorder, Anxiety and Pain. Review of the Progress Notes dated 2/24/2023 revealed, .Respiratory Note: .3Lpm [3 liters per minute] BNC [by nasal cannula] . Review of the Physician's Order dated 2/28/2023, revealed, .CONTINUOUS OXYGEN AT 2 L/MIN [2 liters per minute] .NASAL CANNULA TO KEEP SATS [oxygen saturations] > [greater than] 92 % [percent] every shift for SHORTNESS OF BREATH . Review 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.

Based on policy review, observation, and interview the facility failed to ensure medications were properly stored and secured when opened controlled medications that are subject to abuse were found outside of separately locked, permanently affixed compartments for storage in 2 of 8 (East Hall Medication Storage Room and [NAME] Hall Medication Storage Room) medication storage areas. The findings include: 1. Review of the facility's policy titled, Storage of Medications, dated 9/2019, revealed, .The facility shall store all drugs and biologicals in a safe secure and orderly manner .Compartments (including drawers, cabinets, rooms .) containing drugs .shall be locked when not in use . 2. Observation in the East Hall Medication Storage Room on 2/28/2023 at 3:41 PM, revealed the following controlled medications that were not in separately locked, permanently affixed compartments: a. Lorazepam (a controlled medication used for the treatment of anxiety) 0.5 milligrams (mg) 94 tablets b. Alprazolam (a controlled medication used for the treatment of anxiety) 0.25 mg 30 tablets c.…

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 policy review, observation, and interview, the facility failed to ensure food was served under sanitary conditions when 3 of 26 staff members (Housekeeper #1, Activities Director, and Registered Nurse (RN) #1) failed to perform proper hand hygiene during meal service. The findings include: Review of the facility's policy dated 3/2020, titled, Hand Hygiene Guidelines, revealed, .This facility considers hand hygiene the primary means to prevent the spread of infections .All personnel shall follow the hand washing/hand hygiene procedures to help prevent the spread of infections to other .residents .Use an alcohol-based hand rub containing at least 62% [percent] alcohol; or, alternatively, soap .and water for .Before and after direct contact with residents .After contact with objects .in the immediate vicinity of the resident .Before and after eating or handling food .Before and after assisting a resident with meals . Observation in the main Dining Room on 2/27/2023 beginning at 11:07 AM, revealed Housekeeper #1 delivered a lunch meal tray to Resident #38, moved her wheelchair,…

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.