Desert Cove Nursing Center
Desert Cove Nursing Center in CHANDLER, AZ — inspection on September 19, 2025.
Found 2 citations. Severity: Standard violations.
Health inspections identify deficiencies that facilities must correct within required timeframes. Violations range from minor documentation issues to serious safety concerns and are subject to follow-up verification.
Inspection Findings
Based on the comprehensive assessment of a resident, the facility must ensure that's residents receive treatment and care in accordance with professional standards of practice, the comprehensive person-centered care plan, and the residents' choices.
The facility must provide care and services in accordance with paragraph (a) for the following activities of daily living: bathing, dressing, grooming, and oral care. A resident who is unable to carry out activities of daily living receives the necessary services to maintain good nutrition, grooming, and personal and oral hygiene.
Review of the facility policy titled Tub Baths and Showers, revised May 19, 2025, revealed that tub baths and showers provide personal hygiene, stimulate circulation, and reduce tension for a patient.
They also allow observation of the condition of a patient's skin and assessment of joint mobility and muscle strength.
The implementation of a tub bath or shower included to document the procedure.
Documentation associated with tub baths and showers includes: skin condition, discoloration or redness, tolerance of the procedure, and teaching provided to the patient and family (if applicable).
Review of the facility policy titled Nursing Documentation, issued August 20, 2019, revealed this facility will ensure nursing documentation is consistent with professional standards of practice, the state nurse practice act, and any state laws governing the scope of nursing practice.
The medical record must reflect the resident's condition and the care and services provided across all disciplines to ensure information is available to facilitate communication among the interdisciplinary team.
The medical record must contain an accurate representation of the actual experience of the resident and include enough information to provide a picture of the resident's progress, including his/her response to treatment and/or services, and changes in his/her condition, plan of care goals, objectives and/or interventions.
Facility ID:
IDENTIFICATION NUMBER:
A.
Building
COMPLETED
09/19/2025
STREET ADDRESS, CITY, STATE, ZIP CODE
Desert Cove Nursing Center
1750 West Frye Road Chandler, AZ 85224
SUMMARY STATEMENT OF DEFICIENCIES
and flushing the catheter, and to empty the catheter every shift and that some require more frequent emptying.
Staff #9 stated that if a resident had a physician order to empty the catheter and monitor the output, then the nurse or the CNA would record the amount of urine that was emptied.
Staff #9 stated that if the catheter bag was not emptied regularly or only emptied once a day, then that could cause an infection.An interview was conducted with the Social Services Director (Staff #36) on September 19, 2025, at 11:35 A.M.
Staff #36 stated that if a resident raises a concern or complains about something then Staff #36 speaks to the resident and fill out a comment and concern card, and that Staff #36 takes it to the management team to have the issue addressed.
Staff #36 stated that Resident #5 will say care items have not been completed by staff, and that Resident #5 had raised a concern about his catheter bag not being emptied.An interview was conducted with the Director of Nursing (DON / Staff #80) on September 19, 2025, at 11:51 A.M.
Staff #80 stated that daily catheter care includes cleansing with soap and water, emptying the catheter, and that some require flushing.
Additionally, the DON stated that the care is recorded on the MAR / TAR.
The DON stated that the importance of daily catheter care is to keep it clean and to prevent infection.
Additionally, Staff #80 stated that if a resident had a physician order to empty the catheter bag and monitor the output three times a day then that would be important to prevent infections and to prevent the bag from getting too full with urine backing up into the catheter tube.
Also, the DON stated that if the physician order indicated to empty the catheter bag three times a day, and it was only completed once a day, then that would not meet her expectations.
The MAR/TAR for August 2025 was reviewed together, and the DON stated that there were blank log entries for multiple dates and times, and that it could mean that the CNA did not get the information to the nurse.
The DON stated that there was no other way to tell if the catheter was emptied or not.
Review of the facility policy titled Indwelling Urinary Catheter (Foley) Management, revised June 27, 2023, revealed that the facility will ensure that residents admitted with a urinary catheter, or determined to need a urinary catheter for a medical indication will have the following areas addressed: insertion, ongoing care, and catheter removal protocols that adhere to professional standards of practice and infection prevention and control procedures and ongoing monitoring for changes in condition related to potential catheter acquired UTIs, recognizing, reporting and addressing such changes.
Additionally, a resident who is incontinent of bladder receives appropriate treatment and services to prevent urinary tract infections and to restore continence to the extent possible.
General guidelines for urinary catheter maintenance include to empty the collecting bag regularly using a separate, clean collecting container for each patient.
Facility ID: