Gateway Care Center
GATEWAY CARE CENTER in EATONTOWN, NJ — inspection on January 9, 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
During the morning medication administration observation on 1/3/25, the surveyor observed three (3) nurses administer medications to six (6) residents.
There were 27 opportunities, and two (2) errors were observed which calculated to a medication administration error rate of 7.4%.
The deficient practices were identified for one (1) of six (6) residents, (Resident #122), that were administered medications by one (1) of three (3) nurses that were observed.
The deficient practices were evidenced by the following:
On 1/3/25 at 8:59 AM, during the morning medication administration pass, the surveyor observed Registered Nurse (RN#1) at the door of Resident #122's room with the medication cart. RN#1 stated that she was about to administer the resident's eye drops and patches. RN#1 showed the surveyor the container of eye drops, and two (2) packages labeled Max Strength Aspercreme with 4% Lidocaine pain relief patch (a topical patch containing Lidocaine used for pain relief) that were on the resident's overbed table. RN#1 stated that the resident had physician's orders (PO) for the Lidocaine patches to be applied to two (2) different sites, the right shoulder and the left shoulder.
At that time, the surveyor observed RN#1 open each Lidocaine 4% patch package and wrote the date on the patch and then applied one patch to the left shoulder and one patch to the right shoulder.
The surveyor obtained one of the empty Lidocaine 4% patch packages for review. RN#1 then spoke to Resident #122 in the resident's language.
The surveyor observed the resident smiling and lifted both elbows halfway up in the air and then back down. RN#1 translated for the surveyor and stated that the resident had said that they felt that the pain was improving.
Upon returning to the medication cart, RN#1 showed the surveyor the electronic medication administration record (EMAR) which revealed a PO dated 9/29/24 for Lidocaine External Patch 5% (Lidocaine) Apply to left shoulder topically one time a day for pain and remove per schedule. In addition, another PO dated 9/29/24 for Lidocaine External Patch 5% (Lidocaine) Apply to right shoulder topically one time a day for pain and remove per schedule.
The surveyor then showed RN#1 the empty package of the Lidocaine patch which revealed the strength of 4%. RN#1 acknowledged that the Lidocaine 4% patches that she had applied to each site was not the 5 % strength that was ordered.
The RN#1 stated, I gave the wrong amount. (ERROR #1 and ERROR #2)
The surveyor reviewed the medical record for Resident #122.
A review of the Admission Record revealed diagnoses that included, but not limited to, dementia and a history of falling.
315177
Form Approved OMB
STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A.
Building 315177 B.
Wing 01/09/2025
NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE
Gateway Care Center 139 Grant Ave Eatontown, NJ 07724
The facility failed to prevent and address these weight losses in a timely manner, which included the failure to a.) ascertain (to find out) food preferences, b.) implement fortified foods (foods that are nutrient dense in calories and protein), c.) provide culturally appropriate alternate meal options d.) implement and monitor weekly weights, and e.) consistently monitor intake and record consumption of a physician prescribed supplement. In addition, the facility relied on cultural food brought in by family when they visited approximately once a month as a nutritional intervention.
This deficient practice was identified for 1 of 5 residents (Resident #67) reviewed for weight loss.
The evidence was as follows:
A review of an undated facility policy Weight Management and Intervention Procedure, reflected that the interdisciplinary team would strive to prevent, monitor and intervene when a resident experienced an undesirable weight loss. It also included that a 5% weight loss in a one-month time frame was considered significant and a 10% loss within six months was considered significant and a weight loss greater than 10% in six months was considered severe. In addition, it reflected that the registered dietitian (RD) would review residents' weights by the 15th of each month and the team would discuss and analyze negative trends and interventions at the monthly weight meetings.
A review of an undated facility policy Nutritional Procedure, reflected that all residents should receive appropriate nutrition tailored to their individual health needs and food preferences for overall health and quality of life.
Nutritional assessments should include a resident's dietary habits, preferred foods, favorite meals and traditional foods from their cultural background. It also reflected that staff should report any changes in eating habits and weights to the RD promptly. In addition, it included to maintain accurate and current records of all assessments, care plans, and residents' food preferences.
A review of an undated facility policy Interdisciplinary Care Planning Protocol, reflected that dietary should include an overview of their assessments of the residents needs and problems, which should be specific and individualized.
On 1/03/25 at 12:46 PM, the surveyor observed Resident #67 in their room.
There was an untouched lunch tray on the overbed table.
On 1/06/25 at 12:20 PM, the surveyor observed the resident lying in their bed.
Upon inquiry, the Certified Nurse Aide (CNA #1) stated that the resident refused lunch and that an alternate was usually offered; however, there were no culturally appropriate alternate meals available.
315177
Form Approved OMB
STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A.
Building 315177 B.
Wing 01/09/2025
NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE
Gateway Care Center 139 Grant Ave Eatontown, NJ 07724