Optima Care Fountains
OPTIMA CARE FOUNTAINS in SECAUCUS, NJ — inspection on January 30, 2025.
Found 1 citation. 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
According to the Admission Record (AR), Resident #1 was admitted to the facility on [DATE], with diagnoses that included but were not limited to: Parkinson's Disease, Unspecified Dementia, and Unspecified Depression.
A review of Resident #1's Minimum Data Set (MDS), an assessment tool dated 10/12/2024, revealed a Brief Interview of Mental Status (BIMS) of 14 out of 15, which indicated the resident's cognition was intact.
A review of Resident #1's Order Summary Sheet (OSR) with active orders as of 12/1/2024 revealed the following medication orders:
Ativan 0.5 milligrams (mg)-give one tablet by mouth every 12 hours with an active order date of 04/07/2024.
Carbidopa-Levodopa 25-100mg-give one tablet by mouth three times a day with an active order date of 04/05/2024.
Mirtazapine 7.5mg-give one tablet by mouth at bedtime with an active order date of 04/05/2024.
Rosuvastatin Calcium 10mg- give one tablet by mouth in the evening with an active order date of 07/29/2024.
A review of Resident #1's Medication Administration Record (MAR) for December 2024 revealed a code of NN for Ativan 0.5mgs at 8:00 PM, Carbidopa-Levodopa 25-100mg at 9:00 PM, Mirtazapine 7.5mgs at 9:00 PM, and Rosuvastatin Calcium 10mg at 10:00 PM on 12/9/2024, 12/12/2024, 12/19/2024, 12/22/2024 at 9:00 PM.
Further review of the MAR revealed that code NN meant other/see nurse notes.
A review of Resident #1's Progress Notes (PNs) dated 12/9/2024 at 6:43 PM, 12/12/2024 at 6:59 PM and 12/22/2024 at 6:35 PM revealed a note from the nurse that stated, due meds given. A PN dated 12/12/2024 at 6:59 PM revealed a note from the nurse that stated, meds given.
315476
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 315476 B.
Wing 01/30/2025
NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE
Optima Care Fountains 505 County Avenue Secaucus, NJ 07094