Rehabilitation & Nursing Center at Everett

Rehabilitation & Nursing Center at Everett

MI Elder Abuse Free Legal ConsultationDid someone you love suffer elder abuse or neglect at Rehabilitation & Nursing Center at Everett? Our lawyers can help.

Abuse of the elderly is not acceptable and we fight hard in these types of cases. If you suspect a nursing home or caregiver has caused harm to your loved one in someone elses’ care, contact our law firm today for a free legal consultation.

Talking to us does not obligate you to anything, but we may be able to tell you if you have a claim and the value of your case. If we accept your case, you pay no fee unless we recover for you.

About Rehabilitation & Nursing Center at Everett

Rehabilitation & Nursing Center at EverettRehabilitation & Nursing Center at Everett is a for profit, 183-bed Medicare/Medicaid certified skilled nursing facility that provides services to the residents of  Revere,  Somerville, Medford, and the other towns in and surrounding Middlesex County, Massachusetts.

Rehabilitation & Nursing Center at Everett focuses on 24 hour care, respite care, hospice care and rehabilitation services.

Rehabilitation & Nursing Center at Everett

289 Elm Street
Everett, MA 02149

Phone: (617) 387-6560
Website: http://www.genesishcc.com/Everett

CMS Star Quality Rating

The Centers for Medicare and Medicaid (CMS) rates all nursing homes that accept medicare or medicaid benefits. CMS created a 5 Star Quality Rating System—1 star is the lowest rating and 5 stars is the highest—that look at three areas.

As of 2017, Rehabilitation & Nursing Center in Everett Massachusetts received a rating of 2 out of 5 stars.

Performance Area Rating
Overall Rating 2 out of 5 (Below Average)
State Health Inspections 1 out of 5 (Much Below Average)
Staffing 2 out of 5 (Below Average)
Quality Measures 5 out of 5 (Much Above Average)

Fines Against Rehabilitation & Nursing Center at Everett

The Federal Government fined Rehabilitation & Nursing Center at Everett $46,638 on February 25th, 2016, $68,983 on September 15th, 2016, and $108,940 on July 10th, 2017 for health and safety violations.

Fines and Penalties

Our Nursing Homes Abuse Injury Lawyers inspected government records and discovered Rehabilitation & Nursing Center at Everett committed the following offenses:

Failed to Hire only people with no legal history of abusing, neglecting or mistreating residents; or report and investigate any acts or reports of abuse, neglect or mistreatment of residents.

Based on observation, documentation review and staff interview, the facility staff failed to report resident to resident incidents for 2 sampled residents, (#4, #13) and 5 non-sampled residents in a total sample of 24 residents as required by the facility’s Abuse Prohibition Policy.

Findings include:

On 9/6/16, review of the clinical record for Resident #4, indicated that on 7/20/16, Resident #4 pushed Non-Sampled #5 causing him/her to fall onto his/her buttocks. As an intervention, Resident #4 was placed on 15 minute checks. On 9/9/16, at 10:45 A.M., the Director of Nurses said that she was aware of this incident and was working on the investigation. She was aware that the incident should have been reported within 5 working days. On 9/12/16 the incident report was submitted to the Department of Public Health. On 9/9/16, review of facility incident reports, indicated that on 12/11/15, Non-Sampled Resident #6 pushed Resident #13 causing a fall with cut above the left eye. As an intervention, Non-Sampled Resident #6 was to be redirected away from other residents space. On 9/12/16, at 11:00 A.M., the Director of Nurses said she was aware of this incident and was not sure why it was not reported to the Department of Public Health. On 9/12/16, at 7:30 A.M., review of the facility’s Policy labeled Abuse Prohibition, effective 3/1/05 and revised 7/25/14 indicated that one of the definitions of abuse is resident to resident altercation with the willful act of verbal, physical, mental or psychosocial harm regardless of the resident’s cognition. An investigation will be initiated immediately and reported to the state agency as identified in the regulations. The final report is due to the Department of Public Health within five business days of the incident.

On 9/12/16, at 11:00 A.M., during an interview with the Director of Nurses, she said that these incidents should have been reported to the Department of Public Health in a timely manner.

Failed to provide a safe, clean, comfortable and homelike environment.

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, staff and resident interview, the facility failed to provide a clean, comfortable and homelike environment on four of four resident occupied units. These included resident bedrooms, dining areas, outdoor space and hallways throughout the building (Main 1, Main 2, Plunkett and Leavitt 1)

Findings include:

During Environmental tours on 9/7/16 at 9:30 A.M., on 9/7/16 at 1:36 P.M., on 9/9/16 from 7:15 A.M. to 7:25 A.M., on 9/9/16 from 9:02 A.M. to 9:52 A.M., and on 9/9/16 from 2:30 P.M. to 2:32 P.M., and during an Extended Survey on 9/15/16 from 8:30 A.M. to 11:21 A.M. the following were observed.

1. For Main 1, the facility failed to provide a clean comfortable and homelike environment in 16 of 16 rooms, the television rooms, the shower area and the Clean Utility Closet. The television room had walls with peeling paint, the furniture had holes in them, the table’s veneer was scratched off, leaving unfinished wood exposed and there was a geri-chair with a pile of stacked wheel chair leg rests.

Room M102 occupied by 3 women, had a malodorous smell, the walls had patched holes that were not painted and peeling paint throughout the room. Shared bathroom for M103 and M105 observations revealed a broken towel rack and silver tape covering the pipe under the sink. Room M103 revealed the blinds in the window were broken, the door was scratched and worn of paint and there were white patches on the walls that were not painted to match the room. The wooden foot boards were worn of veneer and had exposed wood.

Shared bathroom for M104 and M102 revealed dead insects in the light casing and a sink drain pop-up missing in the bathroom. Room M104 had a surge protector with multiple electrical cords plugged into it, broken window blinds and the tile floors were cracked throughout the room. Room M105 had white patched walls that did not match the color of the room. Shared bathroom for M106 and M108 revealed exposed pipes and a rusted out baseboard radiator.

Room M106 had no curtains on the window, there were exposed nails on the wall and scratched, peeling paint on the walls. Shared bathroom for M107 and M109 had missing tiles on the walls, duct tape on the floor to hold down laminate flooring which was peeling up. The toilet had rust around the bottom where the toilet met the floor.

Room M107 had chipped paint and holes on the walls. Room M108 had a surge protector with multiple electric cords plugged into it. The foot board to the bed had worn veneer with exposed wood on it. Room M109 did not have a curtain for the window and there was a gap between the air conditioning unit and the window, allowing exposure of the outdoor elements to the resident occupied unit.

Room M111 had patched holes on the walls and there was a hole in the wall that was not patched. The molding on the ground was missing on the wall behind the bedroom door. Room M112 revealed a hole in the corner of the room where Resident #6 said the mice come out of the walls and into their living space. Room M112 also revealed cut wires exposed on the wall in occupied patient space.

Shared bathroom for M112 and M114 had dead insects in the light casing.

Room M113 had chipped and peeling paint on the walls and the window frames.

Room M114 had a missing wooded bumper board, with exposed, unpainted wall. There were electrical cords plugged in above bed over the resident’s head.

Shared bathroom for rooms M115 and M117 observations revealed a broken towel rack, a rusted heating vent, ceiling paint chipped and peeling, and there were dead insects in the light casing.

Room M115 had patched holes in the walls, not painted to match the rest of the walls. There were screws sticking out of the wall and the closet doors were not affixed to a runner and they were sticking out at the ground.

Room M116 observations revealed paint on the walls that was bubbling and peeling. There was a surge protector plugged into the wall with multiple electric cords plugged into it. Room M117 had a stained, peeling and patched ceiling, the heating vent had patched plaster around it and a hole in the wall above the radiator.

M118 had patched walls that did not match the paint in the room. There was a strip of plastic covering electrical wires, to the right of bed A, that had a chipped section of paint. There appeared to be a black, porous substance on the wall where the paint is chipped.

The shower curtain on Main 1 community shower had a brown, dirty substance smeared on the bottom of the curtain. Another shower stall is used as storage space for durable medical equipment.

The clean utility room on Main 1 had a sink with no faucet. The eye was station was set up without proper plumbing for the drainage of the wash water. The nourishment room had a window open and there was no screen in the window, allowing exposure of the outdoor elements to the resident occupied unit.

Throughout the Main 1 unit, the halls have peeled and chipped paint, missing molding. The hand rail on the wall in between room M11 and the elevator is loose from the wall. The hand rail across from room M117 is loose from the wall, and the hand rail across from room M118 is loose from the wall. Posing risk for resident injury.

The small sitting area across from room M116 had unopened milk cartons stored on the shelf on the wall, the walls had chipped and peeling paint and the tables had worn veneer on the tables with exposed wood.

The floor at the entrance to the Leavitt unit is uneven and poses risk for resident accident.

2. For Leavitt 1, the facility failed to provide a clean comfortable and homelike environment in 11 of 11 rooms, the shower area (shared with Main 1) and the Janitor’s Closet.

Observations of Leavitt 1 throughout the Survey and during extended survey revealed a dark, narrow hallway with resident rooms on both sides of the hall. The wallpaper on the hallway walls was torn and tattered throughout the unit. There was a hole in the wall outside of the dining room door. There were white hole patches on the wall that have not been finished to match the rest of the wall color. The doorways to resident bedrooms and to the dining area are have chipped and scuffed paint on the frames. The floor tiles do not match and some areas have gaps exposing black dirty subflooring. On 9/9/16 between 9:00 A.M. to 9:17 A.M., at 2:30 P.M. and during the Extended Survey on 9/15/16 at 10:21 A.M. through 11:09 A.M. observation of the resident occupied area revealed the following:

Dead insects in the light casings in 6 of 6 shared resident bathrooms on the unit. The Janitor’s Closet was unlocked and stored cleaning chemicals were left in the closet, posing a risk for resident injury/harm. The resident bathroom in the entrance hallway had a missing drain stopper and chipped paint on the walls.

Bathroom in L101/102 ceiling had a brown stain and paint peeling from the ceiling, 5 toothbrushes available for resident use, all in the toothbrush holder, without resident identifiers on them to prevent residents from using one another’s toothbrush, and wet, soiled towels on the ground in between the sink and the toilet. The door to enter the bathroom revealed it was scraped and scuffed up the door and the door knob.

Room L101 had resident belongings piled up from the floor, in a disorganized, unkempt manner. There was an electric cord displayed across the floor. And the ceiling paint was chipped and peeling. Room L101 also had two holes in the wall next to bed B. and there was a bedside table with drawer off of the hinges. There was a door to the hallway on Leavitt 2 in this bedroom, that was blocked with resident belongings and no longer had a door knob on it. The floors were cracked and there were gaps in the floor where tiles were missing pieces of them.

Bedroom L102 had curtains stuck up the rods and broken slats in the plastic blinds. There was a telephone jack pulled away from the wall with wires exposed. There was a door at the foot of bed A that connected to room L103 that had a bureau blocking the egress. The air conditioner was installed using plywood, black tape and plexi-glass. Room L103 had white patched holes on the walls. There were black insects flying in the room, laminate rippling up on bureau and exposed electrical wires. A brown insect with many legs was moving across the bedroom floor during observation on 9/15/16. There was a door connecting to room L102 that had a bureau blocking the egress. Bedroom L104 revealed a bureau with a taped up broken corner. The ceiling paint was chipping and flaking. There was a door connected to room L103 that had a bureau blocking the egress.

Room L105 had a profuse scent of urine and the floor tiles are cracked. There was a mouse trap on the window sill. the paint on the window sill was peeled and cracked. There was a draw hanging from a bureau in this room as well. (There is not a room L106 or L107 on the unit.)

Room L108 had a bedside table with drawer off of the hinge. In between two beds, there were two shelving units blocking a door that leads to the hallway to Main 1. the door was slightly ajar. Posing risk to resident sleeping on bed to the left of the shelving units. Bathroom shared by L108 and L109 had tiles loose on the wall, soiled linens on the floor by the toilet, a brown substance smeared on the door jam, a drain pop-up missing from the sink.

Room L109 had rodent feces in a resident clothing armoire on the bottom of the furnishing and mixed in the resident’s personal belongings. Rodent feces’ was also observed on the floor around the armoire and the small bureau to the left of the armoire. The bedroom closet had a gap between it and the floor. Inside the closet were piles of clothing in bags and on the ground were rodent feces throughout. The paint on the walls was chipping and there were dead insects in the overhead light. The floors had cracked and peeled tiles.

Bathroom in L111/L110 had a cracked wall, with exposed drywall and missing tile to the right of the mirror. Room L110 was cluttered and the wall to the right of bed A had dirty lines, and there was a brown substance smeared on the wall. The window sill had cracked and peeled paint. Room L111 revealed holes above the bed and on the wall.

Room L112 had no door on the hinge from the bedroom to the hallway. Wall paint was chipped and the ceiling paint was chipped and peeling. Room L113 had peeling ceiling paint and there was a window open, without a screen in the window, allowing exposure of the outdoor elements to the resident occupied unit. 3. For Main 2, the facility failed to provide a clean comfortable and homelike environment in 7 of 16 rooms, the shower area and the Clean Utility Closet.

Observation of the Main 2 Unit on 9/9/16 9:43A.M. through 9:52 A.M. revealed the following:

The shower room had a ceiling vent hanging down from the ceiling. The clean utility room smelled of a strong malodorous scent and the eyewash station on the wall was inoperable. Room M202 had a cracked bedroom window. There was an air conditioning unit in the window, held in with cork board and silver tape. Bathroom – Room M203 had a low, mismatched toilet, with a replacement toilet paper holder with exposed wall around it.

Room M204 windows were covered in a white, cloudy film and unable to be seen out of. There was a piece of dry wall nailed into the wall to the right of bed 204C bed. Room M206 had a cracked bedroom window and windows were covered in a white, cloudy film and unable to be seen out of. There was an electrical surge protector in the room with electronics plugged into it on the bureau in the middle of the room. Room M207 had a window with white, cloudy film and was unable to be seen out of. There was another window that was open and did not have a screen in it, allowing exposure of the outdoor elements to the resident occupied area, posing a risk for resident injury. The window was unable to be shut.

Room M208 had a bed with a broken foot board with finish removed, exposing wood revealing splinters that pose a risk for resident injury. There was an electric heater in the closet.

Room M209 had an air conditioner in the window being installed with a broken, jagged edge piece of plexi-glass and a cork board. The plexi-glass was not flush to the casing, allowing exposure of the outdoor elements to the resident occupied unit and posing a risk for resident injury.

Room M218 had wooden molding torn from the wall with exposed nails on the wall. There was a floor mat that was torn and tattered.

4. For the Plunkett Unit, the facility failed to provide a clean comfortable and homelike environment in 16 of 16 rooms, the dining room, halls and the shower area. Observation of the Plunkett unit on 9/9/16 from 9:26 A.M. – 9:29 A.M. and during Extended Survey on 9/15/16 from 12:17 P.M. through 1:06 P.M. revealed the following: The window at the end of the hallway by room 310 was open and there was no screen, allowing exposure of the outdoor elements to the resident occupied unit. The wall paper around the window was peeled from the wall.

Room 301 had cracked and chipped paint on the ceilings and the walls, cracked floor tiles, a hole in the wall behind the opened door, a cracked light casing in the bathroom, the linoleum in the bathroom floor was cracked and peeling, the molding in the bathroom was peeled from the wall.

Room 302 had a bureau with a leg that was bent leaving the bureau to lean to the back left, the walls were scratched and had chipped paint. Room 303 had walls with scraped and chipped paint, the ceiling had chipped and peeling paint. The curtain was rolled up and tucked into the rod. Room 304 was void of any home like decor. The walls were baron and the bed linens a plain white coverlet.

Room 305 had walls with chipped and scraped paint, the curtains rolled up into the curtain rod. A bedside table by bed C had a drawer handle hanging off, foot boards had scraped veneer and exposed wood. The bathroom had a towel down on the ground under the sink. There was flooring lifted from the floor and there was a black, porous substance on the wall. Room 306 had scraped paint on the walls. The bathroom had a missing drain pop-up in the tub, the floor had cracks in it.

Room 307 had a strong odor of urine. There was no screen in the window that was open, allowing exposure of the outdoor elements to the resident occupied unit. The floors were buckled and scraped in areas. The wall molding in between closets was missing leaving wall exposed and unfinished. The foot boards veneer was scraped with exposed wood on the beds. The walls had chipped paint on them.

Room 308 had brown dirt and grime on the window blinds, the walls had molding and sheet rock missing, the bathroom floor had missing pieces. Room 309 had molding missing from the walls, paint chipping from the walls, a hole in the wall. The resident’s tray on his chair was dirty and had dried cereal in the cups of the tray. There was a build up of old food and liquids around the edges of the cup space and the edge of the tray.

Room 310 had dirty, soiled privacy curtains, the paint on the walls was chipped. the bathroom floor had peeling linoleum.

Room 311 had peeled veneer on the foot boards, with exposed wood. The floor tiles were torn and mis-matched. The trash barrel was rusty in the bathroom.

Room 312 had a light fixture in the bathroom hanging from the ceiling. The room was void of any homelike decor.

Room 313 had chipped and scraped paint on the walls, the base-board heat was rusted and there was a hole in the window sill.

Room 314 had chipped and scraped paint on the walls and the foot board had worn veneer with exposed wood on them.

Room 315 had a door that was not finished. The resident’s in the room refused surveyor entry.

Room 316 had closet doors that were not on the runner and were loose from the floor, the molding was peeled off the wall at the entrance, the floor tiles were scraped and cracked. The shower room had one shower stall filled with stored durable medical equipment. The floor of this shower stall was covered in dark grime. The second shower stall had two drain pipes that did not have the drain covers on them. The drain covers were removed and placed in opposite sides of the shower’s tiled floor. One drain hole had a white, film over it. There was caulking and debris around the drain hole. The other drain hole had caulking all around the drain hole. The ceiling had rippling in the tiles and the bathroom had holes in the floor. There were also dirty towels thrown in the corner of the bathroom floor.

Observation of the sharps container in the Plunkett shower room revealed a blue razor sticking out of the top of it. This is an unlocked shower room, the razor available to all residents who reside on this unit, posing a risk for resident injury/harm. The clean utility room, which was to be locked, was not locked and it had a pool of fluid on the floor.

The resident bathroom across from room 203 had a hole in the faucet, a soiled wet face cloth and a missing toilet paper rack. The wallpaper in the hall under the activity calendar is torn and stapled onto the wall. The dining room had dead insects in 3 of 4 lights, and the 4th light fixture didn’t work. the tables were worn of the veneer and there was exposed wood on them. The ceilings were chipped and patched up.

On 9/7/16 at 10:30 A.M., the group meeting took place and it was revealed that the facility has a problem with rodents and bugs. More than half of the resident’s participating in the group discussed the fact the rodent’s come out at night and they are in the resident bedrooms and in the dining rooms on the units. They also discussed the black flying insects everywhere. They said they are not fruit flies, but bigger and very black. Resident’s also said that about 60 resident’s between Main 1 and Leavitt 1 share a 2 shower bathroom. They said that the showers are dirty and unkempt. The shower curtains are torn and have, what appears to the resident’s, to be feces on them. The residents said they do not feel clean when they are in the shower. The group meeting also revealed that the Plunkett Unit showers had drains with missing covers and were in disrepair and dirty. More than half of the resident’s participating in the group meeting said that the outdoor space is inadequate. They said that only a portion of it is available to them and it is not a desirable area to sit. The space is layed in brick and there is a picnic table and pots of dead plants throughout. Resident #19 said she hasn’t stepped on grass in months. Resident’s said they rarely are able to leave and that they feel like prisoners in the facility. They offer outings for activities, but not many people fit in the transportation van, so they have to wait a long time to be able to go out unless they have family to do this for them. Other’s are unable to go in the van because their handicaps make it inaccessible.

Observation of the outdoor space on 9/7/16, at 1:00 P.M. revealed that the space provided is off of the ground level dining area, under an overhang. There is a barrier to keep resident’s from going up to the second level of the area. The space is dark and not a homelike environment. There are dead flowers/plants in pots around the edge of the upper level and one on the lower level. The area is not maintained and swept free of debris. There is a picnic table in the corner and limited seating otherwise.

On 9/9/16 at 12:00 P.M., interview with the Nursing Home Administrator took place to discuss the maintenance program and to discuss environmental tour. The NHA said that the Maintenance man keeps a log of his maintenance work and does environmental tours every day. He was asked about the use of tape to fix broken furniture, wrap pipes, and install air conditioning units and boards screwed into walls to cover holes and the windows that were open with no screens, wouldn ‘ t shut and had a white, cloudy film on them. The NHA was unable to explain why these were not fixed properly and also said that the plan was to have the windows fixed. There was no time frame mentioned as to when they would be fixed, nor was there an estimate for the work that was supposed to be done. There was no explanation as to how the environmental problems are revealed other than the logs that the nurses use to inform maintenance of their concerns.

On 9/12/16 at 7:15 A.M., an interview with Resident #19 and Resident #20 took place. Both live on Main 1 in room M103. Resident #19, who admitted in 2/2016 and scored a 15 out of 15 on his/her Brief Interview for Mental Status evaluation, revealing that he/she is cognitively intact,said that he/she shouldn’t have to lower his/her standards to live here due to the environmental conditions. Resident #20, admitted ,[DATE] 13 out of 15 on his/her Brief Interview for Mental Status evaluation, revealing that he/she is cognitively intact said he/she was taught to be thankful for the roof over his/her head, but this is not a nice place to live. Both residents are working with social services for discharge planning.

On 9/15/16 at 2:00 interview with the administrator took place. When asked why the floors tiles are cracked and mis-matched, he said that there is asbestos in the flooring and if they pull it up, they will need to have an abatement performed to remove all of the asbestos and that is a large undertaking.

Failed to provide housekeeping and maintenance services.

Based on observation and staff interivew, The facility failed to provide sufficient and effective housekeeping and maintanance services necessary to maintain a sanitary, orderly and comfortable environment throughout the facility.

Findings include:

Please reference F252 and F371 evidencing throughout the facility physical plant maintenance and repairs, cleaning, pest control management needing to be addressed. In addition the following was also observed.

An Environmental tour of Main 2 was conducted on 9/8/16 from 9:30 A.M. to 10:20 A.M., and 9/15/16 from 9:45 A.M., 12:00 P.M. during an extended survey revealed the following: Sunroom: cracked tiles below the window with sharp edges, black substance top window frame, broken shade, dirty ceiling vent, unfinished patch on the wall, chipped paint on the wall.

Hallway: the entire length of the hallway with areas of chipped, scraped paint, cove base between 207 and 209 loose and coming free from the wall. Shower room: resident equipment stored in 3 of 4 showers, 1 shower without stored items had a shower curtain with brown fecal stains, the ceiling vent was loose from the ceiling and hanging down into the shower area, tattered curtain with frayed edges covering the window.

Linen closet doorknob loose. Dayroom: chair with ripped cushion, window with a cloudy film preventing clear viewing outside, no screen in the windown, frayed cord to activate emergency call system.

Resident rooms:

Room 202: Door to bathroom with gauges in the paint, light fixture in bathroom with black particles inside, bathroom drain missing pop-up and with rust color surrounding,

Room 203: Dirty, grimy window impairing ability of residents of room to look out the window and to view sunlight. Insulation hanging down from top of window, corkboard covering area above air conditioning unit, footboard with missing veneer exposing wooden splinters and sharp edges able to cause injury, tub drain missing pop-up and surrounded by rust colored material, wall to left of soap dispenserwith holes and exposed sheetrock.

Room 204: Dirty, grimy window impairing ability of residents to look out the window and view sunlight, strips on floor next to bed peeling exposing sharp edges, light fixture with black particles resting inside, wooden bumper behind b bed with paint missing exposing wooden splints and sharp edges able to cause injury, piece of sheetrock screwed into the wall behind c bed, plaster off of wall by door exposing sheetrock with black porous material showing, wall behing a bed gauged with sheetrock exposed, bathroom tub drain with rust colored material surrounding drain,

Room 205: Dirty, grimy window impairing ability of residents to look out the window and view sunlight, no screen, hole in wall under b bed, b bed with bedside with exposed particle board with sharp edges, hole in wall by the foot of a bed.

Room 206: Dirty, grimy window, shade broken, screen incorrect size exposing open spaces that insects could enter, damage to wall on right of window sill in bathroom, exposed sheetrock in bathroom wall to right of hand soap dispenser, bathroom door with gauges in paint, a bed footboard with missing veneer exposing splinters, b bed footboard with missing veneer exposing splinters, b bed bedside table with missing veneer exposing particle board with sharp edges, wall behind b bed board missing paint with exposed splinters and sharp edges, hole in wall behind a bed, board behind c bed with missing paint and a chunk of wood exposing splints and sharp edges.

Room 207: Dirty, grimy window, condensation between window panes, cracked window, no screen on the window, corkboard above air conditioner, bathroom tub with rust colored material around drain, caulking at base of tub with brown material, footboard with missing veneer exposing wood with splinters, bedside table missing hardward so unable to open drawer, wall above b bed with multi colored stains, bedside table missing veneer exposing sharp edges, wall above c bed with area of missing paint exposing sheetrock

Room 208: c bed length of bed impeding bathroom door from opening all the way, c bed footboard with missing veneer and chunk of wood exposing splinters and sharp edges,

Room 209: Dirty, grimy window, no screen on the window, crack in the window, plexiglass covering above air conditioning cracked with sharp edges, no knob on closet door, bedside table with cracked top corner exposing particle board and sharp edges, window sill missing paint exposing wood with sharp edges and splinters,

Room 211: Dirty, grimy window, rust colored bathroom vent, bathroom light fixture with black particles inside, door to room with chipped paint exposing wood and sharp edges, tile under window loose from the floor, bedside table with missing veneer exposing particle board and sharp edges, drawers would not close.

Room 213: Mouse droppings swept into a pile, duct tape holding toilet tank cover to toilet tank, toilet paper holder broken, b bed footboard cracked down the center, bureau with missing veneer exposing particle board and sharp edges, door to room with gauge missing exposing a sharp edge, purple and green multi colored stains on wall to right of lightswitch, shade off of roll, no screen.

Room 214: Heating vent in bathroom with rust colored material, bathtub with rust colored material around drain, bathroom sink with rust colore material in drain, screen incorrect size exposing open spaces that insects could enter., light fixture with black particles inside, b bed bedside table with hardware not affixed to one side so hanging down loosely, cracked electrical outlet plate above a bed

Room 215: Miniature toilet, toilet tank cover did not fit onto tank, mismatched with white cover and blue tank, cracked electrical cover behind dresser, heating vent with metal fibers exposed, gauges in wall behind bed exposing sheetrock.

Room 217: Window cracked, no screen, multiple areas of walls with damaged paint, unfinished patching and exposed sheetrock, door to room with missing paint exposing splinters and sharp edges.

Roo 218: Screen incorrect size exposing open spaces that insects could enter, wood falling off wall behind bed with sharp screws exposed, dead plant on bathroom window sill, heating vent with rust colored material, b bed bedside table with missing veneer exposing particle board and sharp edges, b bed bedside table also missing hardware so drawer cannot be opened, c bed with holes in linen, c bed bedside table drawers would not stay closed, wooden board with missing paint and chunk of wood exposing splinters and sharp edges, b bed footboard with missing veneer exposing splinters and sharp edges, vent behind b bed with rust colored areas, bathroom light fixture with black particles inside Room 219: no screen in the bathroom, missing tile in bathroom, rust colored vent in bathroom, toilet tank cover turned upside down. During the extended survey on 9/15/16, the following observations were made and interviews held: At 8:30 A.M., the maintenance employee entered the conference room and a cart holding various records requested by the survey team. Surveyor #1 noticed at that time that there were several visible mouse droppings all inside the cart, which also held a towel with visible mouse droppings entwined in it.

An interview was held with the maintenance employee at that time. He said he has been employed by the facility overall for the past year and a half. He said last year the facility had a full time maintenance Director, another full time maintenance employee and a part time maintenance employee. He said that the maintenance Director left 3 months ago and since then that there has been no Maintenance Director in the facility. He has been mostly working by himself. Only recently did another employee, who he oversees, join to assist him part-time in maintaining the building. In addition, another worker was also recently brought in part-time to do some maintenance work in the evenings. The maintenance employee further said he was aware of mice infestation throughout the building and that a Pest Control company comes in to treat various areas. He said he spends a lot of his time with the pest control employee when he is in the building and when doing so, he is unable to get any of the other ongoing and required work done in the building. He said that at this time he performs general rounds in the facility. He said that mice are on all the units and hide in the baseboard heating elements. In addition, he said that painting is something he wants and needs to do throughout the building but he does not as he does not have the time to do it. Finally, he was asked if he had a budget in which to work with. He said he did not.

Interviews were held with the Administrator throughout the day. Maintenance logs and environmental logs were requested for review. Maintenance logs were reviewed on the nursing units and they did not include any information that environmental rounds were conducted and problem areas were identified by maintenance and corrected. Further interview with the maintenance employee revealed he did not have the time to do so. Environmental logs also lacked identified problem areas.

Review of Pest Control reports written over the past 12 month period on all 4 Units often had the following documentation written in: Pest sighted and number/Location sighted: No Reports. The facility did not have a preventative maintenance program in place. In addition, written budget information for the maintenance department was repeatedly asked of the Administrator. He did not provide any written information or give any specific information pertaining to the facility’s maintenance budget program.

Failed to store, cook, and serve food in a safe and clean way

Based on observation, document review and staff interview, the facility failed to store, prepare, distribute and serve food under sanitary conditions in the main kitchen and two out of four kitchenettes.

Findings include:

On 9/08/16 at 10:00 A.M., the kitchen sanitation tour was initiated with the Food Service Supervisor (FSS). The area behind the refrigerator/freezer area was observed to have a rodent trap containing 2 live but dying mice moving on top of the trap. Directly behind the trap was a tiled wall with at least 3 wall tiles missing, exposing holes in the wall where rodents could enter. In addition, an additional 3 wall tiles were loose and not firmly in place, also exposing visible space in the wall where rodents could enter. The FSS said that he kills mice every other day in the kitchen. He said he pulled 2 mice out of the trap 2 days ago. He further said that the pest control worker recently pulled out 6 mice from the kitchen and another 5 mice in the dishroom. He said the pest control company comes into the kitchen 2-3 times a month and checks all the traps and treats the areas with a spray.

Although the facility is using a pest control company, the facility’s response and the Pest Controls ongoing treatment plan over a 12 month period has been ineffective. Please refer to F469

In addition to mice infestation, the following was observed:
* 15 floor tiles were missing from the kitchen floor
* The wall area behind the 3 part sink had open space that exposed a large hole
* A 41 inch by 4 1/2 inch sticky plastic item was seen lying loosely against the wall covering up an area next to the reach-in refrigerator/freezer. When the Surveyor peeled away the loosely placed plastic item from the wall, several tiles were observed missing from where the tiled wall met the floor, exposing open space to where rodents could enter. The FSS said the pest control worker had recently put the item there to cover up the exposed area.
* The grease trap was observed leaking.
* The hot water in the prep sink for vegetable had been shut off and was not working.
* The sink in the janitor’s closet was pulled away from the wall and the water had been shut off. The FSS said that the sink became inoperable yesterday. A pail was observed under the sink collecting water. In addition, a wet mop was observed in a bucket with a fruit fly buzzing around.
* The coffee machine’s handles were soiled with brown residue. A mound of crumbs were observed right underneath and behind the machine.
* The inside of the convection oven was heavily stained with greased on dark brown substances. The inside doors were also heavily stained with greased on dark brown substances. The steel racks had a heavy carbon build-up and were blackened in color (the convection oven was cited in last year’s survey letter and the facility’s plan of correction indicated that it had been corrected on 11/01/15).
* Dozens of wet trays were observed stored on top of one another on a cart. Standing water was observed inside the cart. An interview was held with the Diet Aide using the trays at that time. She said the wet trays had been stacked onto the cart by the dishwashing staff and she brought the cart into the kitchen to use. She said she was unaware the trays needed to be dry before using them.
* A basket holding adaptive utensils were stored wet on a table.
* The microwave stored clean was soiled with food residue throughout.
* The rim to the flour bin was soiled.
* A mixing bowl stored clean had drops of water inside.
* A 24 piece muffin pan stored clean had brown residue throughout. * The milk fridge had heavy ice condensation inside.

A further interview was held with the FSS at that time. Surveyor #1 requested to read the last Food Establishment Inspection Report written up by the city of Everett. The report, dated 4/15/16, identified the facility’s need to replace the kitchen tiles. The FSS acknowledged that the kitchen tiles, as noted above, were still in disrepair.

2. On 09/08/2016 at 9:23 A.M., observations made by Surveyor #2 of the Main 1 nourishment kitchen indicated the following:
· The counter next to the microwave had 1 jar of Smucker’s jelly opened and dated 9/5. Printed on the jar, it said Refrigerate after opening.
· The counter next to the microwave had 1 jar of Peanut Kids peanut butter opened and dated 9/5. Expiration date printed on jar was 06-14-16.
· The temperature log taped to freezer door was dated May. When Surveyor #2 requested the September log from the nursing staff, nursing said they were unsure of where it was kept and did not provide surveyor with an updated log.
· The freezer had 1 pink colored stained tissue that was wet and stuck at the back of the first shelf.
· The fridge had a loose fitting door handle that wiggled when opening. · There was no light in the fridge and the lightbulb was missing.
· Water was dripping from the back of the middle top of the fridge.
· There was condensation on the top shelf of the fridge and spilled orange colored juice. In addition the following undated and unidentified food items were observed in the refrigerator.
· There was 1 Motts apple juice bottle filled fully with clear colored liquid, opened and undated.
· There was 1 Motts apple juice bottle filled ¾ full with clear colored liquid, opened and undated, labeled Moon Men.
· There was 1 Ocean Spray orange juice bottle filled fully with clear colored liquid, opened and undated, labeled Just Try.

3. On 09/08/2016 at 12:00 P.M., observations made by Surveyor #2 of the Main 2 nourishment kitchen indicated the following:
· The shelf on the top right had 1 jar of Smucker’s jelly opened and undated. Printed on the jar, it said Refrigerate after opening.
· No Temperature logs were present.
· The fridge had 2 boxes of supplements called Resource 2.0 open and undated.
· The fridge had 5 Ocean Spray orange juice bottles open and undated.
· The fridge had 1 Thirster Juice prune juice bottle open and undated.
· The fridge had 2 Ocean Spray cranberry juice bottles open and undated. On 9/08/16 at 12:30 P.M. during interview with 2 nursing staff, they said nursing is to place a sticker on the bottles when opened indicating date of expiration after opened.

Failed to maintain drug records and properly mark/label drugs and other similar products according to accepted professional standards.

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation and staff interview, the facility failed to ensure that opened multi use vials of medications were properly dated and/or removed when expired on two of four nursing units.

Findings include:

1. An inspection of the Main 1 Unit on [DATE] at 8:00 A.M. with Nurse #1 and Nurse 2 revealed the following:

A. A multidose vial of Lantus insulin was opened and dated [DATE] with an expiration date of [DATE].

B. A multidose vial of Novolog insulin was opened and dated [DATE] with and expiration date of [DATE]. C. Two multidose vials of Humalog insulin were opened, one vial was not dated, therefore a expiration date could not be determined. While the 2nd vial had an expiration date of [DATE]. Therefore, these medications were expired and should have been removed. During an interview with Nurse #1 and Nurse #2 on [DATE] at 8:10 A.M., they said the medications were expired and should have been removed.

2. An inspection of the Main 2 medication room on [DATE] at 9:05 A.M., revealed 1 multidose vial of Tuberculin solution opened and undated, therefore, a expiration date could not be determined.

During an interview with the Nurse #3 on [DATE] at 9:07 A.M., she said the vial should have been dated when it was opened and she would dispose of it.

Failed to put firmly secured handrails on each side of hallways.

Based on observation the Facility failed to provide secure handrails for the Residents to utilize on 2 of 4 nursing units (Main 1 and Main 2), and also in the hallway on the ground floor that resident’s utilize to go to lunch or use the activity/dining area.

Findings include:

For Main 2, on 9/8/16 from 9:30 A.M. to 10:20 A.M., and again during and extended survey on 9/15/2016 from 9:45 A.M. to 12:00 P.M., the following was observed:

The handrail between room 207 and 209 was loose and pulling away from the wall.

The handrail between room 204 and 206 was loose and pulling away from the wall.

The handrail next to room 208 was loose and pulling away from the wall.

The handrail to the right of the soiled utility room was loose and pulling away from the wall.

The handrail to the left of the soilded utility room was loose and pulling away from the wall.

The handrail between 215 and 217 was loose and pulling away from the wall.

The handrail next to the exit from Main 2 to Leavitt 2 was loose and pulling away from the wall. For Main 1, during an extended survey on 9/15/16 from 12:10 P.M. to 12:15 P.M. the following was observed:

The hand rail on the wall in between room M111 and the elevator is loose and pulling from the wall.

The hand rail across from room M117 is loose and pulling away from the wall.

The hand rail across from room M118 is loose and pulling away from the wall.

On 9/15/16 at 11:11 a.m., on the ground floor the following was observed: The hand rail in between the main building and Plunkett building is loose and pulling away from the wall.

These loose hand rails all pose a risk for resident injury. During the exit interview on 9/15/2016, at 2:30 P.M. the Administrator said he was not aware that there were loose handrails on Main 1 and Main 2.

Failed to make sure there is a pest control program to prevent/deal with mice, insects, or other pests.

Based on observation, staff interviews, resident interviews and review of pest control logs, the facility failed to maintain an effective pest control program to ensure that the facility was free of pests, including rodents and black flies.

Findings include:

During interview with Resident #6 on 9/7/16 at 9:15 A.M., the resident said that there are mice in his/her room. Record review revealed that he/she scored a 14/15 on her Brief Interview for Mental Status. He/She said they come out of the hole in the back of his/her bed. He/She said that they come out and stare at his/her room mate. He/she said that the mice get in his/her bureau and eats his/her snacks.

During Resident Group Interview on 9/7/16 at 10:30 A.M., more than half of the resident’s in the group said that there are mice and black flies all over the facility. They said that they wake up to find mice staring at them in the middle of the night. One resident said that there was a mouse on his/her bed the morning of 9/9/16. They said that the black flies are all over the units and they are big and dark black, not as big as a house fly, but not as small as a fruit fly.

On 9/9/16, at 2:30 P.M., observation of resident bedroom L109 revealed that there were rodent droppings in the bottom of a resident armoire and also on the floor around the During interview with Resident #19 on 9/12/16, at 9:00 A.M., the resident said that he/she admitted , 2/2016 and the mice continue to get worse. Resident # 19 scored a 15 out of 15 on his/her Brief Interview for Mental Status evaluation, revealing that he/she is cognitively intact. The resident stated that he/she has lived on two units and that the mice were very overwhelming on Leavitt Unit. He/She then said that they are on Main 1, as well. She stores her food in the drawers of her bureau to keep the mice away.

During interview on 9/9/16 at 9:30 A.M., Nursing Home Administrator said that the source of the rodents appears to be from road work done in the City of Everett. He said that the resident population on Leavitt 1 also invites rodents appearance because the residents may hoard food or put food in places that it doesn’t belong. He did not elaborate on the rodent problem in other patient care areas. On 9/12/16 at 9:44 A.M., Surveyor #5 took the pest control log off of the cart provided in the conference room. When Surveyor #5 picked up log book to move it off of a Family Interview Sheet, rodent feces was revealed on the interview sheet. Further inspection of the cart revealed the bottom shelf had rodent feces on it as well.

On 9/15/16, at 10:25 A.M., NS Resident #1, who scored a 14 out of 15 on his/her Brief Interview for Mental Status evaluation, revealing that he/she is cognitively intact, said that he/she always sees rodents. There is a gap between the floor and her closet. She said that the rodents go under the door and get in the closet. She said that there is one that is too fat and doesn’t fit under.

During Extened Survey on 9/15/16 at 8:30 A.M., the maintenance logs were brought into the conference room on a cart for reivew. When Surveyor #1 looked at the cart, she saw that the bottom teir had rodent feces on it and it was also on a towel that was on the bottom tier.

Through out the standard survey from 9/6/16 through 9/12/16 and during the extended survey on 9/15/16, the large, black flying insects were seen by Surveyor’s in the conference room they were working in.

Please reference F253 in which residents confirm observing mice in the facility and F371 in which two live mice were observed by surveyors recently entaggled in a trap and the Food Service Supervisor confirms on-going observations of mice in the kitchen. Review of the pest control logs reveal that there has been an ongoing pest control issue that is not being resolved by using interventions noted in logs. The pest control logs repeatedly reveal that multiple rodents are being removed and on a bi-weekly basis, even though traps and non – chemical approaches are being applied.

Failed to set up an ongoing quality assessment and assurance group to review quality deficiencies quarterly, and develop corrective plans of action.

Based on documentation and staff interview, the facility failed to maintain a Quality Assurance Program which ensured that the environment was maintained to ensure a safe, clean and comfortable environment for residents.

Please reference F 252 and F 253 evidencing that the facility failed to provide adequate housekeeping and maintenance services necessary to maintain a sanitary, orderly, and comfortable interior throughout the facility including the resident rooms and common areas on 4 of 4 units and common areas; as well as, F371 and F469 which evidence an on-going mice infestation which is not being effectively eradicated.

Findings include:

Review of the facility’s policy, titled Risk Management Program, Revised Quality Assurance Policy, dated January 2014 indicated the following:

– As a part of its Quality Assurance administrative function, Everett Nursing and Rehabilitation Center has established an internal risk managment program as the responsibility of the nursing home Administrator.

– The Risk Management process, operation throught the Quality Assurance Committee must meet monthly and include the Administrator, Director of Nurses, Environmental Services Director and at least two other facility staff.

– Development of plans of action to correct and respond quickly to identified quality deficiencies.

The Quality Assurance Performance Improvement (QAPI) interview, held on 9/12/16 at 4:15 P.M. with the Director of Nursing Services (DNS), indicated that the facility held quarterly QAPI Committee meetings; however, during survey the issues regarding the maintainence of the environment evidenced at F252, F253, F371 and F469 remain long standing issues not addressed. Sign in sheets for the first and second quarter meetings were provided.

During an extended survey on 9/15/16 at 2:30 P.M. the Administrator said that the facility held quarterly QAPI meetings.

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Page Last Updated: December 16, 2017

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