Inspection Reports for Advanced Center for Nursing and Rehabilitation
CT, 06519
Back to Facility ProfileInspection Report Summary
The most recent inspection on November 17, 2025, found one deficiency related to previously cited tags that were confirmed corrected as of September 19, 2025. Earlier inspections showed a pattern of deficiencies primarily involving resident care, documentation, and medication management, with several follow-up visits confirming corrections. Complaint investigations were mostly unsubstantiated in recent years, though substantiated complaints in 2022 and earlier involved issues such as delayed reporting, inadequate supervision, and failure to develop comprehensive care plans, including some immediate jeopardy findings in 2022 related to resident safety and oversight. Enforcement actions such as fines or license suspensions were not listed in the available reports. The facility’s recent inspection history indicates improvement with previously cited deficiencies addressed and no new violations noted in the latest monitoring visit.
Deficiencies (last 7 years)
Deficiencies (over 7 years)
16.9 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
202% worse than Connecticut average
Connecticut average: 5.6 deficiencies/yearDeficiencies per year
16
12
8
4
0
Census
Latest occupancy rate
89% occupied
Based on a November 2025 inspection.
Census over time
Inspection Report
Monitoring
Census: 202
Capacity: 226
Deficiencies: 1
Date: Nov 17, 2025
Visit Reason
Monitoring visit to verify compliance status of previously cited deficiencies at Advanced Center for Nursing & Rehabilitation.
Findings
A desk audit confirmed that tags F580, F602, F658, and F684 were brought back into compliance as of 2025-09-19. The facility administrator was notified of these findings on 2025-11-18.
Deficiencies (1)
Tags F580, F602, F658, and F684 were previously cited but have been brought back into compliance.
Report Facts
Licensed Bed Capacity: 226
Census: 202
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jaclyn Pascale | Administrator | Notified of compliance status via telephone on 2025-11-18. |
| Jennifer Green | Survey Team Leader, RN | Conducted the inspection. |
| Maureen Golas-Markure | Supervisor, RN | Supervising nurse for the inspection. |
Inspection Report
Complaint Investigation
Census: 203
Capacity: 226
Deficiencies: 0
Date: Nov 3, 2025
Visit Reason
The inspection visit was conducted as a complaint investigation referenced by Complaint Investigation #2648126.
Complaint Details
Complaint Investigation #2648126 was conducted and found no violations; the complaint was not substantiated.
Findings
No violations of the General Statutes of Connecticut and/or the regulations of Connecticut State Agencies were identified at the time of this inspection.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jaclyn Pascale | Administrator | Personnel contacted during the inspection. |
Inspection Report
Follow-Up
Census: 203
Capacity: 226
Deficiencies: 0
Date: Oct 31, 2025
Visit Reason
The visit was a follow-up inspection to verify correction of previous deficiencies.
Findings
No violations of the General Statutes of Connecticut and/or regulations were identified at the time of this inspection. Violation 4a was identified as corrected as of 2025-09-26, and the administrator was notified that all violations were corrected.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jacklyn Pascale | administrator | Personnel contacted during the inspection |
| James Tan | Report submitted by |
Inspection Report
Follow-Up
Census: 203
Capacity: 226
Deficiencies: 10
Date: Oct 31, 2025
Visit Reason
A follow-up visit was conducted to review the implementation of the Plan of Correction for violations previously cited in the violation letter dated 2025-10-14.
Findings
All previously identified violations (1a, 2a, 3a, 5a, 6a, 7a, 8a, 9a, 9b, and 4a) were found to be corrected as of the dates specified, with the administrator notified in person on 2025-10-31 at 1:30 PM that all violations were corrected.
Deficiencies (10)
Violation 1a
Violation 2a
Violation 3a
Violation 4a
Violation 5a
Violation 6a
Violation 7a
Violation 8a
Violation 9a
Violation 9b
Report Facts
Licensed Bed Capacity: 226
Census: 203
Violation correction dates: Violations 1a, 2a, 3a, 5a, 6a, 7a, 8a, 9a, 9b corrected as of 2025-10-02; Violation 4a corrected as of 2025-09-26
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jacklyn Pascale | Administrator | Contacted personnel and notified of violation corrections |
Inspection Report
Complaint Investigation
Census: 202
Capacity: 226
Deficiencies: 0
Date: Sep 24, 2025
Visit Reason
The inspection was conducted as a complaint investigation related to Complaint Investigation #2618119.
Complaint Details
Complaint Investigation #2618119 was the basis for the inspection; substantiation status is not explicitly stated.
Findings
Violations of the General Statutes of Connecticut and/or regulations of Connecticut State Agencies were identified at the time of this inspection.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jaclyn Pascale | Administrator | Personnel contacted during the inspection. |
| Kenitra Sherman | DNS | Personnel contacted during the inspection. |
Inspection Report
Complaint Investigation
Census: 211
Capacity: 226
Deficiencies: 0
Date: Jun 9, 2025
Visit Reason
The inspection was conducted as part of complaint investigations #44624 and #44440.
Complaint Details
Complaint investigations #44624 and #44440 were reviewed; no violations were substantiated.
Findings
No violations of the General Statutes of Connecticut and/or regulations of Connecticut State Agencies were identified at the time of this inspection.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jaclyn Pascale | Administrator | Personnel contacted during the inspection. |
Inspection Report
Plan of Correction
Capacity: 226
Deficiencies: 1
Date: Jun 2, 2025
Visit Reason
A desk audit was conducted to review the facility's plan of correction for an earlier enforcement action dated 3/17/25.
Findings
The desk audit verified that Tag F 686 and the corresponding violation were corrected and back in compliance as of 4/7/25.
Deficiencies (1)
Tag F 686 violation
Report Facts
Licensed Bed Capacity: 226
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jaclyn Pascale | Administrator | Personnel contacted during inspection |
| Linda M. Gagnon | HPS Surveyor | Surveyor conducting the inspection |
Inspection Report
Renewal
Capacity: 226
Deficiencies: 1
Date: Jun 2, 2025
Visit Reason
The inspection was conducted as a renewal licensing inspection, including a desk audit to review the facility's plan of correction for an earlier enforcement action dated 3/17/25.
Findings
The desk audit completed on 6/2/25 verified that the cited violations (Tags F 580 & 755) were corrected and the facility was back in compliance as of 4/7/25.
Deficiencies (1)
Violations related to Tags F 580 & 755
Report Facts
Licensed Bed Capacity: 226
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jaclyn Pascale | Administrator | Personnel contacted during the inspection |
| Linda M. Gagnon | HPS Surveyor | Surveyor conducting the inspection |
Inspection Report
Follow-Up
Census: 209
Capacity: 226
Deficiencies: 0
Date: Apr 1, 2025
Visit Reason
Revisit for the purpose of reviewing compliance with Plan of Correction for surveys dated 2/13/2025.
Findings
The inspection was a follow-up visit to verify correction of previous deficiencies. The violation was confirmed corrected as of 4/09/2025.
Report Facts
Licensed Bed Capacity: 226
Census: 209
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jaclyn Pascale | Administrator | Contacted to notify that the violation was corrected. |
Inspection Report
Follow-Up
Census: 209
Capacity: 226
Deficiencies: 1
Date: Apr 1, 2025
Visit Reason
A follow-up visit was conducted to review the implementation of the Plan of Correction for violations identified in a prior inspection.
Findings
All 25 previously identified violations were corrected as of the follow-up visit on 2025-04-01, and the facility administrator and DNS were notified in person.
Deficiencies (1)
Violation #1 through Violation #25 were identified as corrected.
Report Facts
Violations corrected: 25
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jaclyn Pascale | Administrator | Notified in person of correction of all violations during follow-up visit. |
| Tierra Mathews | DNS | Notified in person of correction of all violations during follow-up visit. |
Inspection Report
Complaint Investigation
Census: 211
Capacity: 226
Deficiencies: 0
Date: Mar 17, 2025
Visit Reason
The inspection visit was conducted as a complaint investigation related to complaint numbers #43282 and #39849.
Complaint Details
Complaint investigation was conducted for complaints #43282 and #39849. No substantiation status is provided.
Findings
The report does not explicitly state the findings or violations identified during the inspection.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Terri Anderson-Murray | RN | Report submitted by |
| Jaclyn Pascale | Administrator | Personnel contacted during inspection |
Inspection Report
Complaint Investigation
Deficiencies: 1
Date: Mar 17, 2025
Visit Reason
An unannounced visit was made to Advanced Center for Nursing & Rehabilitation on March 17, 2025, by a representative of the Facility Licensing and Investigations Section of the Department of Public Health for the purpose of conducting multiple investigations.
Complaint Details
Complaint numbers #39849 and #43282 are referenced. The visit was complaint-driven, but substantiation status is not explicitly stated.
Findings
The report details a violation of Connecticut state regulations identified during the visit, including deficient practices related to wound care and pressure ulcer prevention for Resident #1. The resident had a pressure ulcer and treatment delays were noted, leading to transfer to hospital for further evaluation.
Deficiencies (1)
Failure to document weekly skin assessments and delayed initiation of recommended wound treatments for Resident #1.
Report Facts
Complaint numbers: 2
Length of pressure ulcer: 12.5
Width of pressure ulcer: 7.4
Depth of pressure ulcer: 0.3
Days delay: 5
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Karen Gworek | Supervising Nurse Consultant | Author of the notice letter regarding the inspection and violations. |
| Registered Nurse #1 | Registered Nurse | Interviewed regarding wound care recommendations and documentation. |
| Director of Nurses | Director of Nurses | Interviewed about wound care equipment and treatment implementation. |
| Medical Director | Provided notes identifying Resident #1's viral skin eruption and wound condition. |
Inspection Report
Complaint Investigation
Census: 217
Capacity: 226
Deficiencies: 0
Date: Feb 13, 2025
Visit Reason
The inspection visit was conducted as a complaint investigation related to Complaint Investigation #42834.
Complaint Details
Complaint Investigation #42834 was the basis for the inspection. Violations were substantiated as indicated by the attached violation letter.
Findings
Violations of the General Statutes of Connecticut and/or regulations of Connecticut State Agencies were identified at the time of this inspection, as referenced in the attached violation letter dated 2/27/25.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jaclyn Pascale | Administrator | Personnel contacted during the inspection. |
| Connie Vumback | RN | Report submitted by. |
Inspection Report
Renewal
Census: 215
Capacity: 226
Deficiencies: 0
Date: Jan 16, 2025
Visit Reason
The inspection was conducted as a licensing inspection for renewal purposes and included review of complaint investigations with multiple complaint numbers referenced.
Complaint Details
Complaint investigations referenced with numbers CT# 42346, CT# 42015, #42727, #42733, #42734, and #42735.
Findings
Violations of the General Statutes of Connecticut and/or regulations were identified at the time of this inspection, as noted in the attached violation letter.
Inspection Report
Follow-Up
Census: 210
Capacity: 226
Deficiencies: 0
Date: Oct 16, 2024
Visit Reason
A desk audit was completed on 10/16/24 to review the implementation of the Plan of Correction for the Violation letter dated 8/13/24.
Findings
No violations of the General Statutes of Connecticut and/or regulations of Connecticut State Agencies were identified at the time of this inspection. Violation #1a was identified as corrected as of 10/16/24.
Report Facts
Licensed Bed Capacity: 226
Census: 210
Employees mentioned
| Name | Title | Context |
|---|---|---|
| James Tan | Survey Team Leader | Reported and submitted the inspection report |
Inspection Report
Follow-Up
Census: 210
Capacity: 226
Deficiencies: 1
Date: Oct 16, 2024
Visit Reason
The inspection visit was a desk audit conducted to review the implementation of the Plan of Correction for a previously issued violation letter dated 2024-08-13.
Findings
The violation identified as Violation #1a was corrected as of the inspection date. The administrator was notified by telephone and email that all violations were corrected.
Deficiencies (1)
Violation #1a
Report Facts
Licensed Bed Capacity: 226
Census: 210
Inspection Report
Complaint Investigation
Census: 216
Capacity: 226
Deficiencies: 0
Date: Jan 9, 2024
Visit Reason
The inspection visit was conducted as a complaint investigation, specifically referencing Complaint Investigation #00036738.
Complaint Details
Complaint Investigation #00036738 was the reason for the visit; no violations were found during the inspection.
Findings
No violations of the General Statutes of Connecticut and/or regulations of Connecticut State Agencies were identified at the time of this inspection.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Robert Fritz | Administrator | Personnel contacted during the inspection. |
| LaVallia Carter | DNS | Personnel contacted during the inspection. |
| Fran Topulos | ADNS | Personnel contacted during the inspection. |
| Harvey Bauer | Regional Administrator | Personnel contacted during the inspection. |
Inspection Report
Census: 214
Capacity: 222
Deficiencies: 0
Date: Dec 14, 2023
Visit Reason
The document is a desk audit inspection report for the Advanced Center for Nursing, reviewing compliance and regulatory status without an onsite inspection.
Findings
No violations of the General Statutes of Connecticut or regulations were identified at the time of this desk audit inspection. A narrative report/additional information is attached.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Robert Fritz | Administrator | Personnel contacted during the inspection |
Inspection Report
Census: 214
Capacity: 222
Deficiencies: 0
Date: Dec 14, 2023
Visit Reason
The inspection was a desk audit to review compliance with regulations, with no onsite inspection date provided and no violations identified at the time of this inspection.
Findings
No violations of the General Statutes of Connecticut or regulations were identified during this desk audit inspection. A narrative report and additional information were attached.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Robert Fritz | Administrator | Personnel contacted during the inspection |
| Stephanie Schumann | NC | Report submitted by |
Inspection Report
Complaint Investigation
Census: 208
Capacity: 226
Deficiencies: 0
Date: Nov 20, 2023
Visit Reason
The inspection visit was conducted as part of Complaint Investigation #36415 to review compliance with state regulations.
Complaint Details
Complaint Investigation #36415 was the reason for the visit. Violations were not identified at the time of inspection.
Findings
No violations of the General Statutes of Connecticut and/or regulations of Connecticut State Agencies were identified at the time of this inspection.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Lavallia Carter | DNS | Personnel contacted during the inspection. |
Inspection Report
Complaint Investigation
Census: 191
Capacity: 224
Deficiencies: 1
Date: Sep 20, 2022
Visit Reason
An unannounced visit was made to Advanced Center For Nursing & Rehabilitation on September 20, 2022, for the purpose of conducting a Complaint Investigation Survey and Focused Infection Control Survey.
Complaint Details
Complaint Investigation #32902 was conducted. The complaint involved a resident found unresponsive with fentanyl in their possession, leading to emergency intervention and subsequent visitation restrictions. The complaint was substantiated as violations were identified.
Findings
The facility failed to ensure residents' rights to receive visitors at their choosing, resulting in suspension of visitation for all residents except those on hospice or comfort measures following an incident involving a resident's accidental fentanyl overdose. The facility visitation policy was reviewed and visitation restrictions were implemented temporarily.
Deficiencies (1)
Failed to ensure the resident's rights to receive visitors at their choosing and failed to ensure the visitation policy honored those rights, resulting in suspension of visitation except for hospice or comfort measures residents.
Report Facts
Licensed Bed Capacity: 224
Census: 191
Date of onsite inspection: Sep 20, 2022
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Katerina Zhao | Administrator | Named as personnel contacted and recipient of the notice |
| Peter M Donato | DNS (Director of Nursing Services) | Named as personnel contacted during inspection and interviewed regarding visitation policy |
| Maureen Golas-Markure | Supervising Nurse Consultant | Signed the notice letter regarding the complaint investigation and plan of correction |
| Errolee Bryan Miller | FLIS Staff | Reported the inspection and submitted the licensing inspection report |
Inspection Report
Renewal
Census: 191
Capacity: 226
Deficiencies: 0
Date: Apr 7, 2022
Visit Reason
The visit was conducted as a renewal inspection including an extended survey and multiple complaint investigations.
Complaint Details
The inspection included complaint investigations for CT #31843, CT#31934, CT#31933, CT 32015, CT# 31984 and CT 31994.
Findings
Violations of the public health code were identified during the inspection, but the facility was found to meet the minimum requirements of the Public Health Code after review of staffing and facility tour.
Report Facts
Licensed Bed Capacity: 226
Census: 191
Inspection Dates: 4
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jim Christofori | Administrator | Personnel contacted during inspection |
| Kristien Digovanni | Director of Nursing | Personnel contacted during inspection |
| Cara Urban | Survey Team Leader | Reported and signed inspection report |
| Evelyn Polanco | RN, NC, FLIS | Inspection team member |
| Laura Norton Trombley | NC, FLIS | Inspection team member |
| Maureen Golas Markure | SNC, FLIS | Inspection team member and supervisor |
| Janet Rosato | RN, NC, FLIS | Inspection team member |
Inspection Report
Complaint Investigation
Census: 191
Capacity: 226
Deficiencies: 13
Date: Apr 7, 2022
Visit Reason
The inspection was an unannounced visit conducted on 3/21/2022, 3/22/2022, and 4/7/2022 for multiple investigations and an extended survey, including complaint investigations for several complaint numbers, to determine compliance with regulations for Long Term Care Facilities.
Complaint Details
The visit included complaint investigations for complaints #31843, #31933, #31934, #31993, #32015, #31984, and #31994. Violations were substantiated as noted in the findings and enforcement actions.
Findings
Violations of the General Statutes of Connecticut and regulations were identified related to resident care, medication administration, leave of absence policies, contraband control, psychosocial oversight, and documentation. The facility failed to ensure timely physician notification, adequate supervision, and proper care planning for residents with substance abuse and other conditions. Immediate Jeopardy findings were noted in several areas.
Deficiencies (13)
Failure to ensure a resident was granted an independent leave of absence according to resident preference.
Failure to ensure timely physician notification for residents with contraband, elevated blood glucose, and psychiatric service needs.
Failure to develop comprehensive care plans related to substance use disorder and administration of Narcan.
Failure to ensure accurate documentation for a resident transferred to the emergency room.
Failure to ensure hospital insulin orders were reviewed and staff notified timely of elevated blood sugar levels.
Failure to provide adequate supervision to prevent residents' access to contraband and ensure safety.
Failure to ensure timely physician visits for new admissions.
Failure to provide adequate psychosocial oversight for residents with substance abuse.
Failure to properly store and dispose of methadone bottles and maintain medication administration policies.
Failure to ensure complete and accurate medical records including signed forms and documentation of leave of absence assessments.
Failure to ensure adequate supervision and safety for residents regarding contraband and smoking materials.
Failure to ensure effective Quality Assurance and Performance Improvement (QAPI) program addressing care and management practices.
Failure to ensure comprehensive care plans and documentation for residents with substance abuse and chronic conditions.
Report Facts
Licensed Bed Capacity: 226
Census: 191
Dates of Onsite Inspection: Inspection conducted on 3/21/2022, 3/22/2022, and 4/7/2022.
Plan of Correction Submission Deadline: Plan of correction to be submitted by May 14, 2022.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| James Christofori | Administrator | Named in findings related to leave of absence policy and facility administration. |
| Krisiten Digovanni | Director of Nursing (DON) | Named in findings related to resident care, supervision, and documentation. |
| Maureen Golas-Markure | Supervising Nurse Consultant | Signed the report and involved in complaint investigation. |
| Cara Urban | Survey Team Leader | Conducted the inspection and signed the report. |
| Evelyn Polanco | FLIS Staff | Participated in the inspection. |
| Laura Trombley-Norton | FLIS Staff | Participated in the inspection. |
| Janet Rosato | FLIS Staff | Participated in the inspection. |
Inspection Report
Annual Inspection
Deficiencies: 4
Date: Apr 4, 2022
Visit Reason
The inspection was conducted to assess compliance with federal regulations regarding comprehensive resident assessments, quarterly reviews, and accuracy of Minimum Data Set (MDS) assessments at the Advanced Center for Nursing & Rehabilitation.
Findings
The facility failed to complete admission and quarterly MDS assessments timely and accurately. Specific deficiencies included a late admission MDS assessment for Resident #126, an incomplete quarterly MDS assessment for Resident #35, and inaccurate coding of MDS assessments for Residents #33 and #129, including failure to identify a positive PASRR and presence of a Foley catheter.
Deficiencies (4)
Failure to complete admission MDS assessment timely for Resident #126 (completed 90 days late).
Failure to complete quarterly MDS assessment timely for Resident #35 (23 days late).
Inaccurate coding of MDS assessment for Resident #33, failing to identify positive level II PASRR.
Inaccurate coding of admission MDS assessment for Resident #129, failing to identify presence of Foley catheter.
Report Facts
Days late for admission MDS assessment: 90
Days late for quarterly MDS assessment: 23
Assessment Reference Date (ARD): Nov 16, 2021
Assessment Reference Date (ARD): Feb 24, 2022
Employees mentioned
| Name | Title | Context |
|---|---|---|
| RN #2 | MDS nurse | Interviewed regarding late admission MDS assessment for Resident #126 and coding error for Resident #33 |
| LPN #1 | MDS nurse | Interviewed regarding incomplete quarterly MDS assessment for Resident #35 |
| Regional RN #1 | Regional RN | Interviewed regarding facility awareness and plan to ensure timely MDS completion |
| Regional MDS RN #2 | Regional MDS RN | Interviewed regarding coding error on admission MDS assessment for Resident #129 |
Inspection Report
Renewal
Census: 184
Capacity: 226
Deficiencies: 13
Date: Apr 1, 2022
Visit Reason
Unannounced visits were made to Advanced Center For Nursing & Rehabilitation concluding on April 4, 2022, for the purpose of conducting a Recertification Survey to determine compliance with 42 CFR Part 483 requirements for Long Term Care Facilities.
Findings
The facility was found to have multiple violations of Connecticut State Agencies regulations including issues with call bell accessibility, pressure ulcer care, shower room maintenance, timely completion of MDS assessments, wound care, weight loss management, oxygen tubing, infection control, and IV therapy documentation. Plans of correction were submitted for each violation.
Deficiencies (13)
Facility failed to ensure the call bell was within reach for Resident #618.
Facility failed to ensure timely notification of responsible party for pressure ulcer on Resident #119.
Facility failed to maintain shower room in clean, comfortable, home-like manner; cracked and missing tiles, rusted heater.
Facility failed to ensure timely completion of MDS admission assessment for Resident #126.
Facility failed to ensure timely completion of quarterly MDS assessment for Resident #35.
Facility failed to ensure accurate coding of MDS assessment for Residents #33 and #129.
Facility failed to monitor intake and output for Resident #119 with feeding tube and Foley catheter.
Facility failed to ensure wound treatment was provided in a clean manner for Resident #119.
Facility failed to ensure timely and appropriate weight loss management for Residents #23 and #119.
Facility failed to ensure timely change of oxygen tubing for Resident #616.
Facility failed to maintain accurate and complete clinical records for pressure ulcer care for Resident #119.
Facility failed to ensure infection control and proper storage of supplies for Resident #188 and facility infection control program.
Facility failed to maintain an IV therapy log with required information and documentation.
Report Facts
Licensed Bed/Bassinet Capacity: 226
Census: 184
Inspection Dates: Inspection conducted on 3/29, 3/30, 3/31, 4/1, and 4/4 of 2022
Employees mentioned
| Name | Title | Context |
|---|---|---|
| James Christofori | Administrator | Named in relation to findings and plans of correction |
| Kristin DiGiovanni | DNS | Named in relation to findings and plans of correction |
| Maureen Golas Markure | Supervising Nurse Consultant | Signed the notice letter regarding plan of correction submission |
Inspection Report
Renewal
Census: 184
Capacity: 626
Deficiencies: 0
Date: Mar 29, 2022
Visit Reason
The inspection was conducted as a renewal licensing inspection for the Advanced Center for Nursing facility.
Findings
No violations of the General Statutes of Connecticut and/or regulations of Connecticut State Agencies were identified at the time of this inspection. Certification files were reviewed and CRF grant verification was completed.
Report Facts
Inspection dates: 5
Employees mentioned
| Name | Title | Context |
|---|---|---|
| James Christofini | Admin | Personnel contacted during inspection |
| Krishna DiGuarangi | DNS | Personnel contacted during inspection |
Inspection Report
Complaint Investigation
Census: 191
Capacity: 226
Deficiencies: 12
Date: Mar 21, 2022
Visit Reason
An unannounced visit was made to the facility on 3/21/2022, 3/22/2022, 3/23/2022, and 3/24/2022 for multiple investigations and an extended survey including complaint investigations #CT31843, CT31934, CT31933, CT32015, CT31984, and CT31994 to determine compliance with regulations and public health code.
Complaint Details
Complaint investigations #CT31843, CT31934, CT31933, CT32015, CT31984, and CT31994 were conducted. The findings resulted in immediate jeopardy determinations related to resident care, supervision, and documentation failures.
Findings
Violations of the public health code and regulations were identified related to resident care, medication administration, leave of absence policies, contraband control, and psychosocial oversight. The facility failed to ensure adequate supervision, timely physician notification, and proper documentation. Immediate jeopardy findings were noted and plans of correction were required.
Deficiencies (12)
Failure to ensure a resident was granted an independent leave of absence according to resident preference.
Failure to ensure timely physician notification when a resident was found with contraband, elevated blood glucose, and timely psychiatric services notification for Narcan administration.
Failure to ensure comprehensive resident care plans related to substance use disorder including leave of absence status and contraband or Narcan administration.
Failure to ensure accurate documentation for a resident transferred to the emergency room.
Failure to ensure timely notification of elevated blood sugar and hospital insulin recommendations.
Failure to ensure adequate supervision to prevent residents' access to drug paraphernalia and contraband.
Failure to ensure timely physician visits for new admissions and ongoing care.
Failure to provide adequate psychosocial oversight to residents with substance abuse dependency.
Failure to store drugs and biologicals in locked compartments with proper controls.
Failure to ensure proper disposal of methadone bottles after administration.
Failure to ensure complete and accurate medical records including signed and dated forms and documentation of changes in condition.
Failure to ensure effective Quality Assurance and Performance Improvement (QAPI) program addressing all systems of care and management practices.
Report Facts
Licensed Bed Capacity: 226
Census: 191
Inspection Dates: 2022-03-21 to 2022-03-24
Plan of Correction Submission Deadline: May 14, 2022
Employees mentioned
| Name | Title | Context |
|---|---|---|
| James Christofori | Administrator | Named in relation to findings and correspondence. |
| Kristien Digovanni | Director of Nursing (DON) | Named in relation to findings and interviews. |
| Cara Urban | Survey Team Leader, RN, BSN, FLIS | Lead surveyor and report submitter. |
| Evelyn Polanco | RN, NC, FLIS | Survey team member. |
| Laura Norton Trombley | NC, FLIS | Survey team member. |
| Maureen Golas Markure | SNC, FLIS, Supervising Nurse Consultant | Supervisor and signatory on report. |
| Janet Rosato | RN, NC, FLIS | Survey team member. |
Inspection Report
Complaint Investigation
Census: 191
Capacity: 226
Deficiencies: 12
Date: Mar 21, 2022
Visit Reason
Complaint Investigation Survey conducted to determine compliance with 42 CFR Part 483 requirements for long Term Care Facilities, triggered by complaints CT #31843, 31933 and #31934.
Complaint Details
Complaint Investigation Survey conducted due to complaints CT #31843, 31933 and #31934. Immediate Jeopardy identified related to drug paraphernalia possession, lack of care plans for substance use disorder, failure to notify providers of elevated blood sugar, failure to transfer residents after Narcan administration, and inadequate psychosocial oversight.
Findings
Immediate Jeopardy was identified due to failures in ensuring residents were free from possession of drug paraphernalia, comprehensive care plans for substance use disorder were not developed, timely notification of elevated blood sugar was not made, and residents requiring Narcan administration were not transferred to hospital. Additional deficiencies included failure to ensure adequate psychosocial oversight, medication administration issues, inadequate supervision to prevent access to contraband, incomplete medical records, and lack of effective administrative oversight.
Deficiencies (12)
Failure to ensure residents were free from possession of drug paraphernalia and access to contraband requiring Narcan administration.
Failure to develop and implement comprehensive care plans related to substance use disorder including assessing leave of absence status.
Failure to notify provider timely of elevated blood sugar for a resident receiving insulin with blood sugar ≥ 200, resulting in hospital admission with blood sugar over 600.
Failure to transfer resident to hospital for evaluation after administration of Narcan.
Failure to ensure adequate psychosocial oversight to provide emotional and behavioral services to residents with substance use dependency.
Failure to ensure medication administration was accurate and timely, including failure to document medication refusals and failure to administer injectable antipsychotic medication as ordered.
Failure to ensure medical records were complete, accurate, and included signed and dated forms, interdisciplinary assessments, documentation of contraband, change in condition, and RN assessments.
Failure to ensure timely physician visits for new admissions within regulatory timeframes.
Failure to ensure proper storage and disposal of Methadone bottles after administration.
Failure to ensure adequate supervision and assistance to prevent accidents and access to contraband.
Failure to ensure residents did not have independent access to lighters and staff did not question residents for lighters upon return from smoking leave of absence.
Failure to maintain effective administrative oversight including lack of documented monthly Administrator and DON meetings, Medical Director rounds, and quarterly Medical Staff and Infection Control meetings.
Report Facts
Deficiencies cited: 12
Residents present: 191
Total capacity: 226
Blood glucose levels: 633
Blood glucose levels: 210
Blood glucose levels: 200
Methadone dose: 100
Narcan dose: 4
Medication refusal dates: 3
Employees mentioned
| Name | Title | Context |
|---|---|---|
| APRN #3 | Psychiatric Advanced Practice Registered Nurse | Provided psychiatric evaluations and noted resident drug use and Narcan administration; indicated lack of notification and psychosocial follow-up. |
| DON | Director of Nursing | Involved in oversight failures including lack of reassessment of LOA, failure to investigate contraband incidents, and failure to ensure documentation. |
| RN #2 | Regional Nurse | Provided information on medication administration issues and facility processes. |
| RN #4 | Registered Nurse | Provided information on resident care and medication administration. |
| Administrator | Failed to provide evidence of administrative oversight and meeting documentation. | |
| Security Guard #1 | Observed giving cigarettes to residents and failed to check for lighters upon return. | |
| LPN #8 | Licensed Practical Nurse | Signed LOA risk assessment form without interdisciplinary team signatures. |
| LPN #9 | Licensed Practical Nurse | Reported blood glucose level but failed to document in clinical record. |
| RN #3 | Registered Nurse | Failed to document RN assessment after resident found unresponsive. |
| RN #5 | Registered Nurse | Provided information on methadone bottle disposal. |
| RPh #1 | Registered Pharmacist | Provided information on medication order delays and clarifications. |
Inspection Report
Abbreviated Survey
Census: 226
Capacity: 175
Deficiencies: 0
Date: Nov 17, 2020
Visit Reason
A COVID-19 Focused Survey was conducted to determine compliance with 42 CFR Part 483 Requirements for Long Term Care Facilities, including proper infection prevention and control practices to prevent the development and transmission of COVID-19.
Findings
The COVID-19 Focused Infection Control Survey found the facility compliant with no deficiencies cited related to infection prevention and control practices.
Inspection Report
Abbreviated Survey
Deficiencies: 1
Date: May 7, 2020
Visit Reason
An unannounced visit was conducted on May 7, 2020, by the Facility Licensing and Investigations Section of the Department of Public Health to perform a COVID-19 focused infection control survey at Advanced Center For Nursing & Rehabilitation.
Findings
The survey found that Resident #24's room lacked proper signage and a PPE cart to identify transmission mode and proper PPE use. The facility policy for prevention and control of COVID-19 was reviewed, and droplet precautions were implemented immediately after the surveyor's inquiry.
Deficiencies (1)
Resident #24's room did not have any signage posted on the door or proximal area and did not have a PPE cart at the entrance of the room or proximal area.
Report Facts
Date of physician orders: May 6, 2020
Plan of correction submission deadline: May 31, 2020
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Sandra Vermont-Hollis | Supervising Nurse Consultant | Author of the notice and contact for questions regarding violations. |
| Marley West | BSN, RN, DNS | Responsible for ensuring compliance and provided the plan of correction response. |
Inspection Report
Complaint Investigation
Census: 210
Capacity: 226
Deficiencies: 0
Date: Jan 6, 2020
Visit Reason
The inspection was conducted as a complaint investigation related to complaint numbers 26124, 26348, 25361, 24981, 26371, 21845, and 25793.
Complaint Details
Complaint investigation involved multiple complaint numbers as listed; substantiation status is not explicitly stated.
Findings
Violations of the General Statutes of Connecticut and/or regulations of Connecticut State Agencies were identified at the time of this inspection, with a violation letter dated 1/17/20. Some violations were not identified at the time of this inspection.
Report Facts
Licensed Bed Capacity: 226
Census: 210
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Daniel Brencher | Administrator | Personnel contacted during inspection |
| Marley West | Unknown | Personnel contacted during inspection |
Inspection Report
Complaint Investigation
Census: 203
Capacity: 226
Deficiencies: 0
Date: Dec 12, 2019
Visit Reason
The visit was a revisit for the purpose of reviewing the plan of correction for the violation letter dated 10/7/19.
Complaint Details
Complaint investigation #26278 was conducted due to allegations of mistreatment and failure to report in a timely manner. The findings included verbal abuse, failure to report allegations within required timeframes, and failure to ensure proper care and monitoring of residents. The complaint was substantiated with multiple violations identified.
Findings
Based on a tour of the facility, review of facility documentation and plan of correction education, in-services, audits, clinical record review and interviews, violations numbered 1a, 2a,b,c,d,e,f,g,h,i, 3a, 4a,b, 5a, 6a, 7a,b, 8a were identified as corrected. As a result of this visit, no violations were issued.
Report Facts
Licensed Bed: 226
Census: 203
Deficiencies cited: 8
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Marie Mathieu | RN/NC | Report submitted by Marie Mathieu, RN/NC for the revisit inspection. |
| Daniel Brencher | Administrator | Named as facility administrator contacted during inspections. |
| Marley West | DNS | Named as Director of Nursing Services contacted during inspections. |
| Karen Gworek | Supervising Nurse Consultant | Signed complaint investigation and correspondence related to complaint #26278. |
| Heidi Caron | Supervising Nurse Consultant | Signed complaint investigation correspondence related to complaint #25593. |
Inspection Report
Plan of Correction
Deficiencies: 1
Date: Nov 6, 2019
Visit Reason
An unannounced visit was conducted at Advanced Center For Nursing & Rehabilitation on November 6, 2019, by the Department of Public Health for the purpose of conducting an investigation related to allegations of mistreatment.
Complaint Details
Complaint #26278 was investigated regarding an allegation of mistreatment of Resident #1. The complaint was substantiated by findings that the facility delayed reporting the allegation to the state agency beyond the required timeframe.
Findings
The facility was found to have failed to report an allegation of mistreatment of a resident to the state agency in a timely manner, with the report being made ten hours after the incident instead of within two hours as required by policy.
Deficiencies (1)
Failure to report the allegation of mistreatment to the state agency within the required two-hour timeframe.
Report Facts
Hours delayed in reporting: 10
Resident sample size: 3
Date of incident: Dec 3, 2018
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Karen Gworek | Supervising Nurse Consultant | Signed the letter and involved in directing the plan of correction. |
| Daniel Brencher | Administrator | Facility administrator addressed in the report. |
| Director of Nursing | Director of Nursing (DON) | Identified as responsible for reporting the allegation and compliance with the plan of correction. |
Inspection Report
Annual Inspection
Deficiencies: 8
Date: Sep 26, 2019
Visit Reason
Unannounced visits were made to the facility on September 23-26, 2019 by representatives of the Facility Licensing & Investigations Section for the purpose of conducting a licensure inspection and certification survey.
Findings
The inspection identified multiple deficiencies including failure to timely report allegations of abuse, late transmission of Minimum Data Set (MDS) assessments, failure to implement care plans for anticoagulant medication, failure to maintain tube feeding protocols, failure to obtain laboratory tests per physician orders, failure to maintain food safety standards including beard guard use and refrigerator temperatures, and incomplete clinical records documentation.
Deficiencies (8)
Failure to ensure timely reporting of an allegation of mistreatment by staff towards Resident #19.
Failure to transmit resident quarterly and/or annual Minimum Data Set (MDS) assessments to the state agency in a timely manner for 9 residents.
Failure to implement a care plan reflecting use of anticoagulant medication for Resident #330.
Failure to follow physician's order for orthostatic blood pressure monitoring for Resident #126.
Failure to remove gastrostomy tube feeding set up after 24 hours of use and failure to maintain complete daily intake measurements for Resident #202.
Failure to ensure laboratory test (TSH) was completed per physician's orders for Resident #97.
Failure to ensure beard guard use by kitchen staff and failure to maintain proper temperatures in nourishment refrigerator.
Failure to maintain complete clinical record documentation including orthostatic blood pressure monitoring for Resident #198.
Report Facts
Days late for MDS transmission: 62
Days late for MDS transmission: 39
Days late for MDS transmission: 46
Days late for MDS transmission: 56
Days late for MDS transmission: 56
Days late for MDS transmission: 52
Days late for MDS transmission: 42
Days late for MDS transmission: 35
Days late for MDS transmission: 33
Temperature: 60
TSH lab value: 7.88
TSH lab value: 6.5
TSH lab value: 2.47
Employees mentioned
| Name | Title | Context |
|---|---|---|
| LPN #5 | Licensed Practical Nurse | Named in failure to timely report allegation of abuse involving Resident #19. |
| RN #6 | Registered Nurse | Named in failure to timely report allegation of abuse involving Resident #19. |
| Head Cook | Observed mixing food without beard guard and educated on policy. | |
| LPN #2 | Licensed Practical Nurse | Involved in medication reconciliation and administration for Resident #330 anticoagulant medication. |
| PT #1 | Physical Therapist | Brought hospital discharge summary to unit for Resident #330 anticoagulant medication. |
| RN #3 | Registered Nurse | MDS Coordinator terminated due to late MDS transmissions. |
| RN #4 | Registered Nurse | Responsible for transmitting MDS assessments. |
| RN #5 | Registered Nurse | Unable to provide documentation of repeat TSH lab for Resident #97. |
| APRN #1 | Advanced Practice Registered Nurse | Provided expectations for lab monitoring and medication reconciliation. |
| DNS | Director of Nursing Services | Responsible for ensuring compliance with plans of correction and identified multiple deficiencies. |
Inspection Report
Plan of Correction
Deficiencies: 8
Date: Sep 26, 2019
Visit Reason
Unannounced visits were made to Advanced Center For Nursing & Rehabilitation concluding on September 26, 2019, for the purpose of conducting multiple investigations, a licensing renewal, and certification inspection.
Findings
The report details multiple violations of Connecticut State Regulations related to abuse reporting, timely submission of Minimum Data Set (MDS) assessments, care planning for anticoagulant medication, medication reconciliation, enteral feeding, laboratory testing, dietary services, and infection control. Plans of correction are provided for each violation with education, audits, and policy reviews.
Deficiencies (8)
Failure to ensure a staff member reported an allegation of mistreatment in a timely manner.
Failure to transmit residents' quarterly and annual Minimum Data Set (MDS) assessments to the state agency in a timely manner.
Failure to implement a care plan reflecting the use of an anticoagulant medication.
Failure to ensure clinical record completeness related to unnecessary medications and medication reconciliation.
Failure to remove a gastrostomy tube feeding set up after 24 hours of use and failure to maintain complete daily intake measurements.
Failure to obtain lab work per physician's orders for a resident.
Failure to ensure proper food handling and maintenance of temperatures in nourishment refrigerator.
Failure to ensure necessary information was part of the clinical record related to infection control and blood pressure documentation.
Report Facts
Compliance Date: Nov 7, 2019
Plan of Correction Submission Deadline: Oct 17, 2019
Number of Residents Reviewed for MDS Assessment Violation: 9
Number of Residents Reviewed for Anticoagulant Medication Violation: 1
Number of Residents Reviewed for Enteral Feeding Violation: 1
Number of Residents Reviewed for Laboratory Services Violation: 1
Number of Residents Reviewed for Unnecessary Medication Violation: 1
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Cher Michaud | Supervising Nurse Consultant | Signed letter as Supervising Nurse Consultant for Facility Licensing and Investigations Section. |
| Daniel Brencher | Administrator | Facility Administrator named in the report. |
| LPN #5 | Named in abuse reporting violation for failure to report timely. | |
| RN #3 | Named as MDS Coordinator terminated for failure to transmit MDS assessments timely. | |
| RN #4 | Named as responsible for transmitting MDS assessments. | |
| Director of Nurses (DNS) | Named as responsible for ensuring compliance with plans of correction. |
Inspection Report
Plan of Correction
Deficiencies: 2
Date: Jun 24, 2019
Visit Reason
An unannounced visit was made to Advanced Center For Nursing & Rehabilitation on June 24, 2019 by a representative of the Facility Licensing and Investigations Section of the Department of Public Health for the purpose of conducting an investigation inspection with additional information received through June 24, 2019.
Complaint Details
Complaint #25593 triggered the investigation inspection.
Findings
The facility was found to have violations related to inaccurate and incomplete clinical documentation, specifically regarding discharge MDS assessments and weight documentation for Resident #1. The facility failed to ensure accurate coding of discharge dates and failed to document weekly weights as required. Plans of correction were submitted addressing these deficiencies.
Deficiencies (2)
Facility failed to ensure the MDS was accurate, including incorrect discharge MDS date coding for Resident #1.
Facility failed to ensure the clinical record was complete and accurate, including failure to document weights obtained for Resident #1.
Report Facts
Dates of weight recordings: 7
Weight loss percentage: 6.3
Calories: 1137
Calories: 1188
Plan of correction submission deadline: 2019
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Heidi Caron | Supervising Nurse Consultant | Named as the contact for questions regarding deficiencies and instructions in the plan of correction letters. |
| LPN #1 | Identified incorrect discharge MDS date and stated she would complete a correction MDS. | |
| ADON | Stated weights are sometimes recorded on paper clipboards and was unable to provide documentation that weekly weights were included in the EMR. | |
| Dietician | Interviewed regarding weight fluctuations and documentation of reweights for Resident #1. | |
| Director of Nursing | Director of Nursing | Responsible for monitoring the plans of correction. |
Inspection Report
Plan of Correction
Deficiencies: 2
Date: Jun 4, 2019
Visit Reason
An unannounced visit was made to Advanced Center For Nursing & Rehabilitation on June 4, 2019 by a representative of the Facility Licensing and Investigations Section of the Department of Public Health for the purpose of conducting an investigation.
Findings
The report identifies violations related to failure to follow recommendations for obtaining hemoglobin A1c lab tests for a resident with diabetes and failure to ensure respiratory equipment was maintained and stored in a sanitary manner. The facility was required to submit a plan of correction by June 28, 2019.
Deficiencies (2)
Failure to follow a recommendation to obtain hemoglobin A1c per dietitian recommendations for Resident #1 with diabetes.
Failure to ensure respiratory equipment was maintained and/or stored in a sanitary manner according to facility policy for residents reviewed.
Report Facts
Residents reviewed: 5
Residents reviewed: 3
Inspection date: Jun 4, 2019
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Heidi Caron | Supervising Nurse Consultant | Signed letter as Supervising Nurse Consultant for Facility Licensing and Investigations Section |
Inspection Report
Complaint Investigation
Census: 219
Capacity: 226
Deficiencies: 13
Date: Dec 7, 2018
Visit Reason
The inspection was conducted as a complaint investigation related to complaint numbers #24488 and #24386, focusing on violations of Connecticut General Statutes and regulations identified during the inspection.
Complaint Details
Complaint investigation was conducted for complaints #24488 and #24386. Violations were substantiated as indicated by the findings and violation letters.
Findings
The inspection found multiple deficiencies related to resident care, including failure to provide showers per care plans, failure to honor private room requests, incomplete advanced directive forms, inadequate communication regarding resident condition changes, failure to prevent falls, insufficient assistance with activities of daily living, improper handling of controlled substances, and failure to follow vaccination policies. Plans of correction were submitted for each violation.
Deficiencies (13)
Failure to ensure resident received showers according to plan of care and requests, and failure to honor resident's wish for a private room.
Failure to ensure Advanced Directive Forms were completed and signed by physician/resident.
Failure to provide pertinent information to physicians regarding resident's change in condition prior to hospitalization.
Failure to re-admit resident after hospitalization.
Failure to revise plan of care to prevent falls after incidents.
Failure to provide assistance with activities of daily living including ambulation, nail care, and shaving.
Failure to implement interventions for residents at risk for pressure ulcers and contractures.
Failure to ensure residents' splints were properly applied and documented.
Failure to conduct smoking assessments according to facility policy.
Failure to meet residents' nutritional needs and properly document nutritional assessments.
Failure to secure controlled medications properly.
Failure to follow up on pneumococcal vaccinations and document administration.
Failure to prevent contraband drug use and conduct thorough investigations.
Report Facts
Licensed Bed Capacity: 226
Census: 219
Inspection Dates: 2018-12-03 to 2018-12-07
Number of State Surveyors: 8
Number of Nursing Tags: 12
Number of Facilities/Environmental Tags: 1
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Daniel Brencher | Administrator | Named as personnel contacted during inspection and referenced in findings. |
| Marlene West | ONS | Named as personnel contacted during inspection. |
| Connie Greene | Supervising Nurse Consultant | Signed complaint letter and involved in complaint investigation. |
| Heidi Caron | Supervising Nurse Consultant | Signed enforcement and notice letters. |
| Carla Lansque | NC | Submitted report dated 8/9/18 related to review of plan of correction. |
| Peter Donato | ADNS | Named as personnel contacted and involved in plan of correction review. |
Inspection Report
Complaint Investigation
Deficiencies: 12
Date: Dec 7, 2018
Visit Reason
Unannounced visits were made to Advanced Center For Nursing & Rehabilitation by representatives of the Facility Licensing and Investigations Section for the purpose of conducting multiple investigations and a certification inspection, including complaint investigations #24488 and #24386.
Complaint Details
Complaint numbers 24488 and 24386 were investigated as part of the unannounced visits. The findings were substantiated with multiple deficiencies identified.
Findings
The survey found a pattern of deficiencies constituting no actual harm with potential for more than minimal harm that is not immediate jeopardy, requiring corrections. Deficiencies included failure to honor resident preferences, incomplete advance directives, inadequate documentation and communication regarding hospitalizations, failure to revise fall prevention plans, inadequate assistance with activities of daily living, failure to implement care plans for contractures, improper medication security, failure to follow up on pneumococcal vaccinations, and other regulatory violations.
Deficiencies (12)
Failure to honor resident's wish to have a private room.
Failure to ensure Advanced Directive Form was completed and/or signed by physician/resident.
Failure to provide all pertinent information regarding resident's change in condition prior to hospitalization.
Failure to re-admit resident after hospitalization.
Failure to revise plan of care to prevent falls.
Failure to ensure resident was ambulated according to physician's order and provide assistance with nail care and shaving.
Failure to monitor specialty mattress settings according to resident's plan of care.
Failure to implement interventions related to utilization of a hand splint for contractures.
Failure to conduct smoking assessments according to facility policy.
Failure to meet residents' nutritional needs and conduct required nutritional assessments.
Failure to secure controlled drug compartment in medication cart.
Failure to follow up on pneumococcal vaccinations and administer vaccines per policy.
Report Facts
Number of state surveys: 8
Number of total tags: 13
Deficiency severity level: D
Weight loss: 27
Medication dosage: 5
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