Snyder Nursing Home

Based on staff interview, clinical record review and facility document review the facility staff failed to provide evidence that Advance Care planning information was provided to residents/resident representatives upon admission and reviewed periodically. The findings included:During clinical record reviews, each clinical record reviewed was found to contain a form entitled, Advance Directives/Medical Treatment Decisions Acknowledge of Receipt which read in part, Resident Understanding Acknowledgement-Advance Directive/Medical Treatment Decision. This is to acknowledge that I have been informed in writing in a language that I understand of my rights and all rules and regulations to make decisions concerning medical care, including the right to accept or refuse medical or surgical treatment and the right to formulate and to issue advance directions to be followed should I become decisionally incapable. I understand it is my responsibility to provide to the facility copies of all pertinent documentation which verify advance directives formulated and/or issued by me for placement in my…

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 staff interviews, clinical record reviews, and facility document review, the facility staff failed to develop comprehensive care plans that included the residents code status for all current residents of the facility.The findings included:During the clinical record reviews, the survey team was unable to identify any information regarding the resident's current code status on the comprehensive care plans.On 10/27/2025 at 5:10 p.m., during an interview with Registered Nurse (RN) #2 this staff stated they did not include the residents code status on their comprehensive care plan. On 10/28/2025 at 8:20 a.m., RN #2 approached the surveyor, and stated she had updated the residents care plans to include their current code status. On 10/28/25 at 2:30 p.m., during a meeting with the Director of Nursing (DON) and Administrator the issue with the resident's code status not being care planned was reviewed. On 10/28/25 at 4:40 p.m., the DON provided the survey team with a copy of their policy with the subject Comprehensive Care Plan. This policy read in part, .Each resident will have 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 staff interview, clinical record review, and facility document review, the facility staff failed to provide a valid basis for a declination of readmission of the resident after a hospitalization with return anticipated and the facility staff failed to develop and implement an appropriate discharge process to the resident and/or resident representative for (1) one of (2) closed record reviews, Resident #45. The findings included:For Resident #45 the facility staff declined readmission following a hospital stay with a paid bed hold due to the resident electing hospice services. readmission was declined despite the facility offering individualized hospice service contracts. Resident #45's diagnosis list indicated diagnoses that included, but were not limited to, Multiple Sclerosis, Paraplegia, Osteoarthritis, Repeated Falls, Weakness, Depression, TIA (Transient Ischemic Attack), Cerebral Infarction, History of Disease of Digestive Tract, Anxiety Disorder, and Congestive Heart Failure. 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, staff interview, and clinical record review, the facility staff failed to ensure the highest practicable well-being for 2 of 16 current residents of the facility. Resident #39 and #2.The findings included:1. Resident #39 was observed with a chair alarm in place. The clinical record did not include a current provider order for a chair alarm. Resident #39's diagnoses included adult failure to thrive and muscle weakness. Section C (cognitive patterns) of Resident #39's annual minimum data set assessment (MDS) with an assessment reference date (ARD) of 10/03/25 was coded 1/1/2 to indicate Resident #39 had problems with long- and short-term memory and was moderately impaired in cognitive skills for daily decision making. Section GG0120 (mobility devices) was checked to indicate this resident used a wheelchair. Section P (restraints and alarms) was coded to indicate the resident used a bed alarm daily. Resident #39's comprehensive care plan included the focus area at risk for falls. Interventions included bed alarm. There was no intervention for a chair alarm.…

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 staff interview, clinical record review, and facility document review, the facility staff failed to maintain a complete and/or accurate clinical record for (1) of (16) sampled residents, Resident #3. The findings included:For Resident #3 the facility staff failed to accurately document the resident's fluid intake on the TAR (treatment administration record) as indicated by a medical provider order for fluid restriction. Resident #3's diagnosis list indicated diagnoses that included but were not limited to Chronic Atrial Fibrillation, Hypothyroidism, Chronic Kidney Disease-Stage 4, Chronic Obstructive Pulmonary Disease, Chronic Diastolic (Congestive) Heart Failure, and Cognitive Communication Deficit. The most recent quarterly minimum data set (MDS) with an assessment reference date (ARD) of 10/7/25, assigned the resident a brief interview for mental status (BIMS) summary score of 13 out of 15 for cognitive abilities, indicating the resident was cognitively intact. A medical provider orders with a start date of 9/15/25 read in part, .1500 mL (milliliters) fluid restriction…

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, staff interview, clinical record review, and facility document review, the facility staff failed to review and revise the comprehensive person-centered plan of care for 3 of 14 residents in the survey sample, Residents #10, #18, and #22. The findings included: 1. For Resident #10, the facility staff failed to revise the comprehensive person-centered care plan following the development of an unstageable pressure injury. Resident #10's diagnosis list indicated diagnoses, which included, but not limited to Alzheimer's Disease, Hemiplegia and Hemiparesis following Cerebral Infarction, Type 2 Diabetes Mellitus, and Chronic Congestive Heart Failure. The most recent annual minimum data set (MDS) with an assessment reference date (ARD) of 5/16/23 assigned the resident a brief interview for mental status (BIMS) summary score of 8 out of 15 indicating the resident was moderately cognitively impaired. A review of Resident #10's clinical record revealed a report entitled Weekly Pressure Ulcer Progress Report indicating a 1 cm x 1 cm unstageable wound was identified to 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 staff interview and clinical record review, the facility staff failed to follow the providers orders for 1 of 14 residents, Resident #20. The findings included: For Resident #20, the facility staff failed to administer the medication Metoprolol per the providers orders. Resident #20's diagnoses included, but were not limited to hypertension, atrial fibrillation, and congestive heart failure. Section C (cognitive patterns) of Resident #20's quarterly MDS assessment with an assessment reference date (ARD) of 07/12/23 included a brief interview for mental status (BIMS) score of 14 out of a possible 15 points. Resident #20's clinical record included an order for Metoprolol 50 mg take 1 tablet by mouth every day for hypertension hold if systolic is less than 90 AND diastolic less than 60. A review of Resident #20's medication administration records for August 2023 revealed that Licensed Practical Nurse (LPN) #1 held Resident #20's Metoprolol for a blood pressure of 106/68 on 08/20/23 for the administration time of 8:00 a.m. Resident #20's comprehensive care plan included 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, resident interview, staff interview, interviews with local health department staff, clinical record review, and facility document review, the facility staff failed to maintain an infection prevention program for preventing and controlling infection and communicable diseases during an identified outbreak of COVID-19. Facility staff failed to follow facility policy and procedure and CDC (Centers for Disease Control and Prevention) guidance related to cohorting COVID-19 positive and untested, asymptomatic residents together when vacant rooms were available creating the likelihood of the resident being exposed to and contracting COVID-19 for 1 of 29 current residents residing in the facility, Resident #18. Facility staff failed to follow CMS (Centers for Medicare and Medicaid Services) and CDC guidance related to performing COVID-19 testing for exposed residents and staff following residents testing positive for COVID-19 on [DATE] and [DATE]. At the time of the survey, two (2) residents were…

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 staff interview and review of facility documents, the facility staff failed to conduct COVID-19 testing for asymptomatic staff based on the county positivity rate for 30 of 60 staff members. The findings included: The facility staff failed to conduct routine COVID-19 testing for asymptomatic staff members based on the county positivity rate for staff members that have not previously tested positive. At the time of the survey, there were no residents or staff positive for COVID-19. Testing totals in the facility indicated a cumulative total of 24 COVID-19 positive residents with three (3) deaths and a cumulative total of 30 positive staff members. On 2/09/21 at 2:15pm during the Entrance Conference with the survey team, the administrator stated the facility is testing staff based on signs and symptoms only. Survey team requested the current county COVID-19 positivity rate, administrator stated the current rate for the City of (name omitted) is 6.7% and the facility considers themselves to be in the low range for testing. Administrator stated they are using the VDH (Virginia…

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 clinical record review, staff interview, and facility document review, the facility staff failed to ensure residents with pressure ulcers receive necessary treatment to promote healing as evidenced by failure to follow physician's orders for 1 of 14 residents, Resident #8. The findings included: For Resident #8, the facility staff failed to follow physician's orders for treatment to a stage II pressure area to the left buttock on 2/08/21 and 2/09/21. Resident #8's diagnosis list indicated diagnoses, which included, but not limited to Alzheimer's Disease with Late Onset, Psychotic Disorder with Delusions due to Known Physiological Condition, Type 2 Diabetes Mellitus without Complications, Muscle Weakness Generalized, and Unspecified Urinary Incontinence. The quarterly MDS (minimum data set) with an ARD (assessment reference date) of 12/15/20 coded the resident as being severely impaired in cognitive skills for daily decision making with short term and long term memory loss in section C, Cognitive Patterns. Resident #8 was coded as being totally dependent on staff for bed…

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.