Harbor Point Skilled Nursing

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interviews, and record review the facility failed to ensure residents had the right to exercise his or her rights as a resident of the facility and as a citizen or resident of the United States for 12 of 12 anonymous residents reviewed for resident rights.The facility failed to provide residents the rights to update their personal information and the opportunity to exercise their rights as citizens of the United States.This failure could place residents at risk of isolation and low self-worth.Findings include:During a group meeting on an undisclosed date and undisclosed time, 12 of 12 anonymous residents complained of not being able to exercise their rights as citizens of the United States during the past primary elections and the next coming elections. The Anonymous residents said they always registered to vote but were not able to vote during the past primary election. All said no one had asked them about updating their voting records. eight Eight of the 12 residents said they had a valid voter's…

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 and record review the facility failed to provide, Comprehensive assessment, care plan and preferences of each resident, an ongoing program to support resident in their choice of activities both facility's sponsored group and individual activities design to meet the interest and support the physical, mental, and psychosocial well-being of each resident, encourage both independent and interaction in the community for 12 of 12 confidential residents reviewed for activities The facility failed to provide activities to meet the residents' needs and interests on Saturdays and Sundays. This failure could place residents at risk for a decline in quality of life, social and mental psychosocial well-being.Findings includeDuring a confidential group interview with 12 alert and oriented residents on undisclosed date and undisclosed time, it was revealed that there were no activities scheduled for Saturdays and Sundays. All agreed bingo was played almost daily, but there were no incentives that motivated going to the bingo games and there were no planned outing activities 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, interview, and record review, the facility failed to store, prepare, distribute and serve food in accordance with professional standards for food service safety for 1 of 1 kitchen reviewed for food safety. 1. The facility failed to ensure the stove area was cleaned and free of food particles. 2. The facility failed to ensure one deep fryer in the kitchen was kept clean. 3. The facility failed to ensure one of 2 refrigerators in the kitchen was free from expired food products. 4. The facility failed to ensure hot food products were at recommended food temperature These failures could place residents at risk of food-borne illnesses and compromised health conditionsFindings include:Kitchen observation and interviews on 04/14/26 at 8:15AM, revealed- the deep fryers in the kitchen had dark looking grease and brown substances around the deep fryer. Between the deep fryer and the stove were food particles and a dark looking substance. [NAME] A looked at the deep fryer and said the grease was supposed to be changed last week . She said she would change the grease 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 observation, interview and record review the facility failed to ensure based on the comprehensive assessment of a resident, a resident with pressure ulcers received necessary treatment and services, consistent with professional standards of practice, to promote healing, prevent infection and prevent new ulcers from developing for 1 of 1 resident (Resident #61) reviewed for pressure ulcer. LVN A failed to cleanse the peri-wound area of stage 4 pressure ulcers for Resident #61. This failure could place residents at risk for infections, delayed healing, and further decrease in quality of life. Findings include: Record review of Resident #61's face sheet reflected a [AGE] year-old female who was admitted to the facility on [DATE] and readmitted on [DATE]. She had diagnoses which included: intracranial injury with loss of consciousness, cerebrovascular disease (a condition that affects the blood vessels that supplies the brain), Quadriplegia (Paralysis in all four limbs), gastrostomy (feeding tube inserted…

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, the facility failed to coordinate the PASRR assessment for specialized services for 1 of 3 residents (Resident #1) reviewed for PASRR coordination and assessment. The facility failed to submit a NFSS request for nursing facility specialized services in the LTC Online Portal for Resident #1's specialized services by a specific deadline. This failure could place residents with intellectual and developmental disabilities at risk for not receiving specialized PASRR services which could contribute to a decline in physical, mental, psychosocial well-being and quality of life. Finding included: Record review of Resident #1's electronic face sheet dated 07/30/25 reflected he was a [AGE] year-old male, admitted to the facility on [DATE] and readmitted of 12/29/23. His diagnoses included Cerebral palsy, dementia, unspecified severity, psychotic disturbance, mood disturbance, and anxiety, schizoaffective disorder, bipolar disorder (A serious mental illness characterized by extreme mood…

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, the facility failed to provide pharmaceutical services to include procedures that assured the accurate administration of all drugs to meet the needs of each resident for 15 of 44 residents ( CR # 1, CR # 2, Resident # 3, Resident # 4, Resident # 5, Resident # 6, Resident # 7, Resident# 8, Resident # 9, Resident # 10, Resident # 11, Resident # 12, Resident # 13, Resident # 14, and Resident # 15) reviewed for pharmacy services. The facility failed to ensure medications that were scheduled three and four times daily were administered at their scheduled times, resulting in medications being administered with only 2-4 hours between doses for Residents (CR # 1, CR# 2, Resident # 3, Resident # 4, Resident #5, Resident # 6, Resident # 7, Resident #8, Resident # 9, Resident # 10, Resident # 11, Resident # 12, Resident # 13, Resident # 14, and Resident # 15). The facility failed to ensure medications were administered timely between 7/22/2024 and 7/31/2024 which resulted…

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, interviews, and record review, the facility failed to store, prepare, distribute, and serve food in accordance with professional standards for food service safety in 1 of 1 kitchen reviewed for kitchen sanitation. The facility failed to ensure that expired food products were discarded. The facility failed to ensure that the oven vent above the cooking stove was free of grease buildup. These failures could place residents at risk for food-borne illness. Findings Included: Observation and interview of the kitchen on 12/12/23 at 9:00AM, revealed the oven vent hood above one of one cooking stove had grease buildup on the vent hood. The Dietary Manager said she would call the servicing company for cleaning. She looked at the vent hood and said the last time it was clean was June of 2023. Observation 12/12/23 at 9:05 AM of the dry good s storage revealed 6 cartons of 48 oz of thicken sweetened tea with manufactured date of used by 12/09/23. The Dietary Manager said she had just received the products from the food supply company. She took all 6 expired products out 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 observations, interviews, and record reviews, the facility failed to ensure that a resident who needed respiratory care was provided with such care, consistent with professional standards of practice for 1 (Resident #23) of 2 residents reviewed for respiratory care, in that: The facility failed to ensure Resident #23 had a physician's order for oxygen (O2). This deficient practice could place residents who used oxygen incorrect or inadequate respiratory support and could result in a decline in health. Findings Included: Record review of Resident #23's Face Sheet (undated) revealed she was a [AGE] year-old female who was admitted to the facility on [DATE] and readmitted on [DATE]. Resident #23's diagnoses included moderate persistent asthma (airways became inflamed, narrow and swell produced extra mucus which made it difficult to breath) with acute exacerbation (person's respiratory symptoms significantly worsen), heart failure (chronic condition in which the heart does not pump as well as it should),…

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, the facility failed to provide a safe, functional, sanitary, and comfortable environment for 23 (100- hall) of 59 residents reviewed for environmental concerns in that: The facility failed to provide a clean shower on 100-hall for the residents. This failure placed residents at risk of living in an unsafe, unsanitary, and uncomfortable environment. Findings included: Observation on 12/21/2023 at 3:11p.m., revealed CNA B used a code to open the door to the shower room on hall 100. Observation on 12/21/2023 at 3:12p.m., revealed black substance that resembled mold, along the walls at the bottom of the shower. There was black substance at the bottom of the wall near the bathroom door. There was rust on the shower rails. The shower floors were filled with dirt. In an interview on 12/21/2023 at 3:15p.m. CNA D said housekeeping was responsible for cleaning the showers. She said there were no showers in the resident's rooms. She said the shower did not look clean. She said she never told anyone the shower was dirty because she did not…

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 the facility failed to ensure that all alleged violations involving abuse, neglect, exploitation, or mistreatment, including injuries of unknown source and misappropriation of resident property, are reported immediately, but not later than 2 hours after the allegation was made for 1 (Resident #1) of 5 residents reviewed for reporting of alleged violations. The facility failed to report to the state agency, incidents of neglect regarding a possible injury and fracture to the Resident #1's left elbow, after a fall in her room that occurred on 10/14/2023. The possible fracture to the left elbow was not reported to the state until 10/16/2023 which was two days after the incident occurred. This failure could place facility residents at risk of injury of unknown origin, abuse, and neglect. Findings included: Observation on 12/6/23 at 11:04 a.m. with Resident #1, revealed her sitting in a wheelchair near the nurse's station. A CNA pushed her wheelchair into her 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.