SEASIDE NURSING AND RETIREMENT HOME

850 BAXTER BOULEVARD, PORTLAND, ME 04103 (207) 774-7878
For profit - Corporation 137 Beds FIRST ATLANTIC HEALTHCARE Data: November 2025
Trust Grade
73/100
#34 of 77 in ME
Last Inspection: January 2023

Over 2 years since last inspection. Current conditions may differ from available data.

Overview

Seaside Nursing and Retirement Home has received a Trust Grade of B, indicating it is a good choice among nursing facilities. Ranked #34 out of 77 in Maine, it is in the top half of facilities in the state, and #11 out of 17 in Cumberland County shows there are only a few local options that are better. Unfortunately, the facility's performance is worsening, as the number of identified issues increased from 8 in 2021 to 9 in 2023. Staffing is a relative strength with a rating of 4 out of 5 stars and a turnover rate of 44%, which is below the state average of 49%. However, there are concerns, such as less RN coverage than 76% of facilities in Maine, which may impact care quality. Specific incidents noted during inspections include a resident not having their teeth brushed for months, a lack of care plan meetings for several residents, and an unsecured medication cart that could allow unauthorized access to medications. While the home has some strengths, these weaknesses suggest that families should carefully consider these factors in their decision-making.

Trust Score
B
73/100
In Maine
#34/77
Top 44%
Safety Record
Low Risk
No red flags
Inspections
Getting Worse
8 → 9 violations
Staff Stability
○ Average
44% turnover. Near Maine's 48% average. Typical for the industry.
Penalties
✓ Good
$3,250 in fines. Lower than most Maine facilities. Relatively clean record.
Skilled Nurses
✓ Good
Each resident gets 43 minutes of Registered Nurse (RN) attention daily — more than average for Maine. RNs are trained to catch health problems early.
Violations
⚠ Watch
18 deficiencies on record. Higher than average. Multiple issues found across inspections.
★★★★☆
4.0
Overall Rating
★★★★☆
4.0
Staff Levels
★★☆☆☆
2.0
Care Quality
★★★★☆
4.0
Inspection Score
Stable
2021: 8 issues
2023: 9 issues

The Good

  • 4-Star Staffing Rating · Above-average nurse staffing levels
  • Full Sprinkler Coverage · Fire safety systems throughout facility
  • No fines on record
  • Staff turnover below average (44%)

    4 points below Maine average of 48%

Facility shows strength in staffing levels, fire safety.

The Bad

Staff Turnover: 44%

Near Maine avg (46%)

Typical for the industry

Federal Fines: $3,250

Below median ($33,413)

Minor penalties assessed

Chain: FIRST ATLANTIC HEALTHCARE

Part of a multi-facility chain

Ask about local staffing decisions and management

The Ugly 18 deficiencies on record

Oct 2023 1 deficiency
CONCERN (D) 📢 Someone Reported This

A family member, employee, or ombudsman was alarmed enough to file a formal complaint

Potential for Harm - no one hurt, but risky conditions existed

Deficiency F0727 (Tag F0727)

Could have caused harm · This affected 1 resident

Based on record review and interviews, the facility failed to use the services of a Registered Nurse (RN) for at least 8 consecutive hours a day, 7 days a week on 1 of 61 days reviewed for RN coverage...

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Based on record review and interviews, the facility failed to use the services of a Registered Nurse (RN) for at least 8 consecutive hours a day, 7 days a week on 1 of 61 days reviewed for RN coverage. Finding: On 10/3/2023, during review of Auguest and September 2023 staffing records, it was discovered that there was no Registered Nurse (RN) coverage on Saturday, 9/23/2023. On 10/3/2023 at 10:15 a.m., during an interview with the Director of Nursing (DON) she reviewed the documentation and stated that she was unaware of that information. The lack of RN coverage on 9/23/2023 was confirmed at 10:20 a.m.
Mar 2023 1 deficiency
CONCERN (D) 📢 Someone Reported This

A family member, employee, or ombudsman was alarmed enough to file a formal complaint

Potential for Harm - no one hurt, but risky conditions existed

Deficiency F0711 (Tag F0711)

Could have caused harm · This affected 1 resident

Based on record reviews and interviews, the facility failed to ensure the physician reviewed the resident's total program of care, which included signing orders for medications and treatments listed o...

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Based on record reviews and interviews, the facility failed to ensure the physician reviewed the resident's total program of care, which included signing orders for medications and treatments listed on the Physician Orders (block orders) in a timely manner for 1 of 3 sampled residents (Residents #3). Finding: Documentation in Resident #3's clinical record stated that the Physician signed the Physician Orders (block orders) on 12/8/22. These orders were in effect for 60 days. The next Physician Orders (block orders), including a 10-day grace period, needed review and the Physician's signature by 2/16/23. The medical record lacked evidence that Physician reviewed and signed orders on or around 2/16/23. On 3/22/23 at 1:05 p.m., the finding was confirmed with the charge nurse. On 3/22/23 at 1:30 p.m., the finding was discussed at the exit interview with the Administrator and Director of Nursing.
Jan 2023 7 deficiencies
CONCERN (D)

Potential for Harm - no one hurt, but risky conditions existed

Quality of Care (Tag F0684)

Could have caused harm · This affected 1 resident

Based on interview and record review, the facility failed to follow physician orders for 1 of 24 sampled Residents (#53) . Findings: On 1/11/23 at 9:37 a.m., during an interview, Resident #53, reporte...

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Based on interview and record review, the facility failed to follow physician orders for 1 of 24 sampled Residents (#53) . Findings: On 1/11/23 at 9:37 a.m., during an interview, Resident #53, reported that he/she was recently given a dose of oxycodone and then given another dose approximately 3 hours later and he/she had slept the majority of that day. The clinical record showed the following: Physician orders for Oxycodone HCL 5mg (milligram) tablet, Dose: (0.5 tablet/2.5mg) by mouth every 6 hours as needed for acute pain, pain level 3-6 and Oxycodone HCL 5mg tablet, (1 tablet/5mg) by mouth every 6 hours as needed for acute pain, pain level 7-10. The Treatment Administration indicates on 12/1/22 the residents pain level was 5. The Medication Administration Record (MAR) indicated on 12/1/22 the resident recieved Oxycodone 5mg at 4:52 a.m. and 8:00 a.m. The facility's narcotic count book indicates on 12/1/22 the resident recieved Oxycodone 5mg at 4:52 a.m., and 8:00 a.m. On 1/11/23, at approximately 3:00 p.m. a surveyor confirmed the above findings with the Director of Nursing.
CONCERN (D)

Potential for Harm - no one hurt, but risky conditions existed

Deficiency F0757 (Tag F0757)

Could have caused harm · This affected 1 resident

Based on record reviews and interviews the facility failed to adequately monitor residents receiving antipsychotic medications for tardive dyskinesia and/or other movement disorders for 2 of 5 residen...

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Based on record reviews and interviews the facility failed to adequately monitor residents receiving antipsychotic medications for tardive dyskinesia and/or other movement disorders for 2 of 5 residents reviewed for unnecessary medication. (#21 and #50) Findings: 1. On 1/11/2022, Resident 50's clinical record, contained a physician's orders, dated 11/16/22 for Abilify an antipsychotic medication, used to treat a psychiatric/mood disorder. The Consultant Pharmacist's Medication Regimen Review dated 10/1/22-10/31/22 states Antipsychotics have the capacity to cause tardive dyskinesia and other movement disorders. Recommend movement test such as AIMS [Abnormal Involuntary Movement Scale] or DISCUS [Dyskinesia Identification System Condensed User Scale], be performed at least every six months while this resident continues on antipsychotic therapy. The resident continues on Abilify. The last AIMS/DISCUS located in the chart was dated 3/28/22. Additionally, this document has a handwritten note which states scheduled Q 6 months [months] start 12/16 The surveyor could not locate evidence of a completed AIMS or DISCUS in the clinical record after the 3/28/22 date as recommended by the Consultant Pharmacist. 2. On review of Resident 21's clinical record, the record contained a physician's order, dated 12/22/22 for Zyprexa an antipsychotic medication, used to treat akathsia related reactions (agitation, restlessness or distress related reactions). The last AIMS/DISCUS located in the chart was dated 2/18/22. The surveyor could not locate an AIMS/DISCUS test completed after the 2/18/22 dated. On 1/11/2023, at approximately 4:00 p.m. This was confirmed with the Administrator and the Director of Nursing.
CONCERN (E)

Potential for Harm - no one hurt, but risky conditions existed

Deficiency F0561 (Tag F0561)

Could have caused harm · This affected multiple residents

2. On 1/9/23 at 1:28 p.m., during an interview, Resident #26 stated that his/her teeth had not been brushed in months. Review of Certified Nursing Assistant (CNA) documentation for personal hygiene t...

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2. On 1/9/23 at 1:28 p.m., during an interview, Resident #26 stated that his/her teeth had not been brushed in months. Review of Certified Nursing Assistant (CNA) documentation for personal hygiene task, which includes shaving, applying makeup, washing/drying face and hands, combing hair and brushing teeth indicates Resident #26 did not receive personal hygiene (either morning, evening, or both) for a total of 28 days from October 2022 through January 12, 2023. On 1/13/23 at approximately 12:45 p.m., the above finding was discussed with the Administrator. Based on record review and interviews, the facility failed to ensure that a resident's choice in the area of dental were being followed for 2 of 4 sampled residents reviewed for dental (Resident #15 and #26). Findings: 1. On 1/10/23 at 10:02 a.m., during an interview, Resident #15 stated that his/her teeth are not brushed daily stating, my daughter comes in and brushes my teeth, but she only comes in once a week. I need it at least once a day, maybe twice. Review of the Certified Nursing Assistant (CNA) documentation for the personal hygiene task, which includes shaving, applying makeup, washing/drying face and hands, combing hair and brushing teeth indicates Resident #15 did not receive personal hygiene a total of 16 days from November 2022 through January 12, 2023. On 1/12/23 at 2:49 p.m., the above finding was discussed with the Director of Nursing.
CONCERN (E)

Potential for Harm - no one hurt, but risky conditions existed

Deficiency F0657 (Tag F0657)

Could have caused harm · This affected multiple residents

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** 2. During review of Resident 26's medical record, included a MDS Quarterly assessment dated [DATE]. The clinical record lacked e...

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**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** 2. During review of Resident 26's medical record, included a MDS Quarterly assessment dated [DATE]. The clinical record lacked evidence that a care plan meeting was held by the IDT for the10/26/22 Quarterly assessment. 3. On 1/9/23 at 11:17 a.m., Resident #53, stated the facility had not had recent care plan meetings with him/her and They don't tell me about my care plan. I want one. During review of Resident #53's medical record, the surveyor noted the following MDS Assessments: Quarterly Assessments dated 2/06/22, 5/06/22, 7/20/22 and 1/4/23 and the Annual assessment dated [DATE]. The clinical record lacked evidence that a care plan meeting was held by the IDT for the above assessments. On 1/12/23 at 11:38 a.m. these findings were discussed with the Director of Nursing. Based on interview and record review, the facility failed to review and revise the care plan by an interdisciplinary team (IDT), that included, to the extent possible, participation of the resident and/or his/her representative after each assessment for 3 of 24 sampled residents (#10, #26 and #53). Findings: 1. During review of Resident 10's medical record, the surveyor noted the following Minimum Data Set (MDS) Assessments: Significant Change in Status assessment dated [DATE], Quarterly Review assessments, dated 7/20/22 and 10/18/22 and another Significant Change in Status assessment dated [DATE]. The clinical record lacked evidence that a care plan meeting was held by the IDT for the above assessments. In addition, the last documented IDT meeting was held on 1/21/22.
CONCERN (E)

Potential for Harm - no one hurt, but risky conditions existed

Deficiency F0761 (Tag F0761)

Could have caused harm · This affected multiple residents

Based on observations and interviews, the facility failed to ensure that medications were stored properly by having unlocked and unattended medication cart with medication stored on top of the cart al...

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Based on observations and interviews, the facility failed to ensure that medications were stored properly by having unlocked and unattended medication cart with medication stored on top of the cart allowing residents and unauthorized persons access to them on 1 of 5 days of survey. In addition, the facility failed to adequately date and properly dispose of open medications according to manufacturer specifications and failed to ensure expired medications were removed from the supply available for use on 2 of 4 units observed (Unit 2 and Unit 5). Findings: 1. On 1/13/23 at 12:00 p.m., on Unit 2, a surveyor observed an unlocked and unattended medication cart in the hallway outside of a resident room. On top of the cart was 2 plastic bins both containing various insulin vials, insulin pens and pen needles, in individual plastic bags labeled with the resident names. The RN walked out of a resident's room took something off the cart and stated, I forgot to lock it. She then locked the cart and walked back into a resident's room, leaving the insulins an needles unattended on top of the cart. At approx. 12:02 p.m., 2 surveyors observed the insulins and needles on top of the unattended cart. When the RN returned to the cart, she confirmed she always leaves them on top of the cart stating, I was told I could leave it there as long as a half an hour. On 1/13/23 at 12:18 p.m., during an interview with the Director of Nursing, the surveyor discussed the above observation. 2. On 1/9/23 at 9:48 a.m., observation of Unit 5's medication room refrigerator with the Registered Nurse unit manager. Refrigerator contained and open vial of Pfizer-Bio/Tech COVID-19 Vaccine Bivolent original and Omicron BA 4/BA.5, labeled with expiration date of 1/2/23. At this time, the RN discarded the expired vaccine. 3. On 1/9/23 at 9:52 a.m., observation of Unit 5's nurse treatment cart with the RN, the surveyor noted an opened Kwikpen containing insulin, labeled with an open date of 10/20/22. At this time, the RN stated the order for this particular insulin was discontinued on 11/16/22 and should've been discarded. 4. On 1/9/23 at 1:16 p.m., observation of Unit 5's medication cart with the Certified Medication Technician (CNA-M), the surveyor noted and open bottle of one a day multi vitamin with iron with a best by date of 10/22. 5. On 1/10/23 at 8:22 a.m., observation of Unit 2's Nurse treatment cart with the Licensed Practical Nurse (LPN), surveyor noted the following: > One open vial of Lantus insulin not labeled with an open or discard date with manufacturer's directions to should be discard after 28 days after opening. > One opened vial of Novolog insulin not labeled with open or discard date with manufacturer's directions to should be discard after 28 days after opening. > One opened Victoza pen not labeled with open or discard date, with manufacturer's instructions to discard pen 30 days after first use. On 1/10/23 at approx. 4:00 p.m., during an interview with the Director of Nursing, the above findings were discussed.
CONCERN (E)

Potential for Harm - no one hurt, but risky conditions existed

Infection Control (Tag F0880)

Could have caused harm · This affected multiple residents

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Unit 2: On 1/9/23 at 1:25 p.m., observation of room [ROOM NUMBER] with an unlabeled bedpan sitting on the floor with an unlabele...

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**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Unit 2: On 1/9/23 at 1:25 p.m., observation of room [ROOM NUMBER] with an unlabeled bedpan sitting on the floor with an unlabeled pink plastic wash basin in the bedpan. On 1/9/23 at 10:43 a.m., on 1/10/23 and on 1/11/23, observation of room [ROOM NUMBER] with an unlabeled cushion seat stored on the floor with an uncovered with bedpan stored on top of it. On 1/10/23 at 9:15 a.m., observation of room [ROOM NUMBER] with a basin stored on the floor. On 1/10/23 at 9:15 a.m., observation of room [ROOM NUMBER] with a bed pan stored on top the toilet seat. On 1/10/23 at 11:38 a.m., observation of room [ROOM NUMBER] with 3 labeled urinals hanging from the bathroom handrail. On 1/11/23 at approximately 12:15 p.m. observation of room [ROOM NUMBER] had brown feces looking material smeared on the floor. On 1/11/23 from 12:05 p.m. to 12:19 p.m., an Environmental tour was conducted on Unit 2 with the Administrator and the Director of Nursing, in which the above concerns were confirmed. Based on observations and interviews, the facility failed to provide a sanitary environment to help prevent the development and transmission of infections related to the storage of residents' personal care items for 3 of 5 days of survey on 3 of 5 units (Unit 2, Unit 4 and Unit 5). Findings: Unit 4: On 1/9/23 at 4:00 p.m., observation of room [ROOM NUMBER] with an unlabeled urinal hanging from the bathroom handrail. On 1/11/23 at 9:14 a.m., an additional observation of a basin on the bathroom floor with a urine hat in the basin. On 1/10/23 at 9:52 a.m., and on 1/11/23 at 9:09 a.m., observations of room [ROOM NUMBER] with a basin on the bathroom floor and 2 labeled urinals hanging from the handrails. On 1/10/23 at 10:28 a.m., and on 1/11/23 at 9:28 a.m., observations of room [ROOM NUMBER] with a urinal hanging from the bathroom handrail. On 1/10/23 at 10:39 a.m., observations of room [ROOM NUMBER] with a urinal hanging from the bathroom handrail, a basin with a bed pan on top of it on the bathroom floor. On 1/11/23 at 9:16 a.m., an additional observation of a bed pan stored on top of the toilet and a basin on the bathroom floor. Unit 5: On 1/9/23 at 10:56 a.m. and on 1/11/23 at 8:59 a.m., observations of room [ROOM NUMBER] to have the commode bucket on the bathroom floor. On 1/11/23 from 11:12a.m., to 11:29 a.m., an Environmental tour was conducted on Unit 4 and Unit 5 with the Administrator and the Director of Nursing, in which the above concerns were observed by all parties.
MINOR (B)

Minor Issue - procedural, no safety impact

Safe Environment (Tag F0584)

Minor procedural issue · This affected multiple residents

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On 1/11/23, at approximately 12:05-12:19 p.m., an environmental tour was conducted on unit 2 with the Administrator and Director...

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**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On 1/11/23, at approximately 12:05-12:19 p.m., an environmental tour was conducted on unit 2 with the Administrator and Director of Nursing in which the following was observed or discussed: Unit 2 > room [ROOM NUMBER] the toilet is cracked in the front near the bottom. > room [ROOM NUMBER] the window shade was torn and would not stay down. Staff tapes the shade shut. There is a draft from the window and it does not open or close easily. The Resident reported that there is a cold air breeze. Based on observations and interviews, the facility failed to adequately provide housekeeping and maintenance services necessary to maintain the building in good repair and in a sanitary condition on 3 of 5 Units. (Unit 4, Unit 5, and Unit 2). Findings: On 1/11/23 from 11:12 a.m., to 11:29 a.m., an Environmental tour was conducted on Unit 4 and Unit 5 with the Administrator and the Director of Nursing, in which the following was observed by all parties. Unit 4 > room [ROOM NUMBER]-1 behind the headboard was a large gouge exposing sheetrock, on the wall. > room [ROOM NUMBER] beside the recliner was a large gouge area of wall with sheet rock exposed and the fall mat was completely torn/ripped on both ends with the foam coming out. Unit 5 > room [ROOM NUMBER] behind the recliner chair was 2 large gouges, exposing sheetrock, on the wall.
Mar 2021 8 deficiencies
CONCERN (D)

Potential for Harm - no one hurt, but risky conditions existed

Deficiency F0558 (Tag F0558)

Could have caused harm · This affected 1 resident

Based on observation and interview the facility failed to ensure that a call bell was accessible to 1 of 40 sampled residents (#23). On 3/16/2021 at 10:29 a.m., during an interview with Resident #23, ...

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Based on observation and interview the facility failed to ensure that a call bell was accessible to 1 of 40 sampled residents (#23). On 3/16/2021 at 10:29 a.m., during an interview with Resident #23, a surveyor observed that the call bell was out of reach to the resident, preventing resident from activating the call bell for assistance. Resident stated it is not long enough. It has always been that way. Resident stated he/she has the roommate ring for assistance when needs help. On 3/16/2021 at 2:11 p.m. this finding was discussed with the Senior Health Care Corporate Operations Officer and Interim Administrator.
CONCERN (D)

Potential for Harm - no one hurt, but risky conditions existed

Accident Prevention (Tag F0689)

Could have caused harm · This affected 1 resident

Based on record review and interview, the facility failed to ensure a smoking assessment was conducted for 1 of 3 residents reviewed for smoking (#71). In addition, the facility failed to ensure chemi...

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Based on record review and interview, the facility failed to ensure a smoking assessment was conducted for 1 of 3 residents reviewed for smoking (#71). In addition, the facility failed to ensure chemicals were properly secured during 1 fo 4 days of survey on 1 of 6 units (100 unit). Finding: 1. Upon review of Resident #71's current care plan, smoking was identified as a resident need/preference. The approaches listed included re-evaluate by safety per the policy and as needed, remind me of safety issues, provide my smoking materials when needed, report any safety issues, remind me of safety issues, giving the staff my smoking materials for lock up each time I use them. Review of the facility's policy, Smoking Policy - Residents, revised 11/2017, stated: 8. A resident's ability to smoke safely will be re-evaluated quarterly, upon a significant change (physical or cognitive), and as determined by the staff. On 3/17/2021 at 9:45 a.m., the Nurse Manager of the 300 Unit, stated Resident #71 goes out to smoke about once per day, the last couple days he/she hasn't been. The Nurse Manager stated Resident #71 keeps smoking materials in his/her possession, and that smoking assessments are completed every 6 months. On 3/18/2021 at 1:40 p.m., LPN #1 stated smoking evaluations should be completed annually. The LPN searched Resident #71's clinical record and located the most recent smoking assessment, dated 3/5/2018. On 3/18/2021 at 2:45 p.m., the Director of Nursing confirmed Resident #71 did not have a current smoking assessment 2. On 3/16/2021 form 10:33 a.m. to 10:43 a.m., the housekeeping cart on Unit 100 was observed to be unlocked, with no housekeeping staff around. The cart contained 1 full bottle of Mikro-quat detergent, 1 half full bottle of Clorox germicidal bleach, 1 full can of Comet Cleaner with Bleach, and 1 half full bottle of Febreze. The Safety Data Sheets were reviewed and indicated the following First Aid Measures: The Safety Data Sheet (SDS) for Mikro Quat detergent: Eye contact- Rinse with plenty of water. Skin contact- Rinse with plenty of water. If swallowed- Rinse mouth. Get medical attention if symptoms occur. If inhaled- et medical attention if symptoms occur. The Safety Data Sheet (SDS) for Clorox Germicidal Bleach: General Advice- Show this safety data sheet to the doctor in attendance. Eye contact- Hold open eye and rinse slowly and gently with water for 15-20 minutes. Remove contact lenses if present after the first 5 minutes then continue rinsing eye. Call a poison control center or doctor for treatment advice. Skin contact- Wash off immediately with plenty of water. If skin irritation persists, call a physician. Inhalation- Remove to fresh air. If breathing is difficult, give oxygen. Call a physician or Poison Control Center immediately. Ingestion- Drink 1 or 2 glasses of water. Do not induce vomiting without medical advice. Call a physician or Poison Control Center immediately. The Safety Data Sheet (SDS) for Comet Cleaner with Bleach: Eye contact- Rinse with plenty of water. Get medical attention immediately if irritation persists. Skin contact- Rinse with plenty of water. Get medical attention if irritation develops and persists. Ingestion- Drink 1 or 2 glasses of water. Do NOT induce vomiting. Get medical attention immediately if symptoms occur. Inhalation- Move to fresh air. If symptoms persist, call a physician. The Safety Data Sheet (SDS) for Febreze Professional Fabric Refresher Deep Penetrating- Concentrate: Eye contact- Rinse with plenty of water. Get medical attention immediately if irritation persists. Skin contact- Remove/take of immediately all contaminated clothing. Rinse skin with water/shower. Get medical attention immediately if symptoms occur. Ingestion- Drink 1 or 2 glasses of water. Do NOT induce vomiting. Get medical attention immediately if symptoms occur. Inhalation- Move to fresh air. If symptoms persist, call a physician. On 3/16/2021 at 10:42 a.m., the Administrator and Administrator In Training (AI T)observed the housekeeping cart and confirmed the housekeeping cart was unable to lock and that the chemicals were unable to be secured. On 3/16/2021 at 10:43 a.m., Housekeeper #1 came back and confirmed with the surveyor that the cart was unlocked and contained cleaning chemicals. The housekeeper stated that the lock is broke and the key won't work and that she was unable to secure the chemicals.
CONCERN (D)

Potential for Harm - no one hurt, but risky conditions existed

Garbage Disposal (Tag F0814)

Could have caused harm · This affected 1 resident

Based on observation and interview, the facility failed to maintain a garbage storage area in a sanitary condition to prevent the harborage and feeding of pests on 1 of 4 days of survey. Findings: On ...

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Based on observation and interview, the facility failed to maintain a garbage storage area in a sanitary condition to prevent the harborage and feeding of pests on 1 of 4 days of survey. Findings: On 3/17/2021 at 8:20 a.m., a surveyor and the Food Service Director observed 1 of 2 trash dumpsters open (cardboard) and also observed there was trash (cigarette butts, nursing gloves, food debris, cardboard and paper products) on the ground around the dumpsters. At this time the Food Service Director confirmed the dumpster (cardboard) was open and there was trash (cigarette butts, nursing gloves, food debris, cardboard and paper products) on the ground around the dumpsters.
CONCERN (E)

Potential for Harm - no one hurt, but risky conditions existed

Safe Environment (Tag F0584)

Could have caused harm · This affected multiple residents

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations and interview, the facility failed to adequately provide housekeeping and maintenance services necessary t...

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**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations and interview, the facility failed to adequately provide housekeeping and maintenance services necessary to maintain the building in good repair and sanitary conditions on 4 of 6 units (100, 200, 300, and 400) for 1 of 1 Environmental tours. Findings: On 3/19/2021 from 8:10 a.m. to 8:35 a.m., a surveyor and the Environmental Services Director conducted a tour of the facility in which the following findings were observed: Unit 100: - The patient lift had a dirty/dusty base and chipped/missing paint on the swing arm and the base creating uncleanable surfaces. - There were 2 (two) sit-to-stand lifts that had dirt/debris in the foot base, which was rusty. - Resident room [ROOM NUMBER]- The box fan, on the floor, was dirty/dusty. - Resident room [ROOM NUMBER]- The bathroom exhaust fan was dirty/dusty. Unit 200: - The left side and right side wall heating units, at the end of the unit by the exit door, were rusty. - Resident room [ROOM NUMBER]-B - The privacy curtain was in disrepair and an outlet cover was broken at the head of the bed. - Resident room [ROOM NUMBER] - The privacy curtain was in disrepair. - The wall mounted fan, at the nurse's station was dirty/dusty. - The floor behind the nurse's station was missing 2 (two) large sections of flooring, exposing sub-flooring and creating uncleanable surfaces. - The floor in the kitchenette, behind the nursing station, had numerous broken floor tiles. Unit 300: - The hallway ceiling vents, by the nurse's station and Resident room [ROOM NUMBER] were dirty/dusty. - The patient lift had broken leg guards and chipped/missing paint on the mast and base, creating uncleanable surfaces. - The left side and right side wall heating units, at the end of the unit by the exit door, were rusty. - Resident room [ROOM NUMBER] - There were holes in the wall by the clock and the sheetrock under the window was gouged, creating uncleanable surfaces. - Resident room [ROOM NUMBER] - The bathroom faucet was leaking and would not shut off, the floor mats ripped/worn on edges by Bed-B, the fan was dirty/dusty, and Bed-A privacy curtain had brown stains on it. - Resident room [ROOM NUMBER] - The fan was dirty/dusty. - Resident room [ROOM NUMBER] - The fan was dirty/dusty. - Resident room [ROOM NUMBER] - Bed-B's wheelchair had rubber stretch bands and tape wrapped around wheels creating uncleanable surfaces, the was a dark brown dried substance on the floor in front of the bureau, and the fan was dirty/dusty. - room [ROOM NUMBER] - The bedside fan for Bed-A is dirty/dusty and Bed-B privacy curtain is soiled. - Resident room [ROOM NUMBER] - The fan is dirty/dusty, the baseboard heater had chipped/missing paint creating an uncleanable surface, and the bathroom door is chipped/gouged on the lower edge. - Resident room [ROOM NUMBER] - The paint, on the wall above the baseboard heater, was peeling creating an uncleanable surface. - Resident room [ROOM NUMBER] - The cove base by the closet was coming off, the bathroom door was gouged, the fan was dirty/dusty, the wall was gouged and had holes in it to the left of the fan, and the privacy curtain was soiled. - Resident room [ROOM NUMBER] - The bathroom door was gouged. - Resident room [ROOM NUMBER] - The light was out in the bathroom, the bathroom door was gouged, and the closet door was gouged. - Resident room [ROOM NUMBER] - The privacy curtain was soiled and the fan was dirty/dusty. - Resident room [ROOM NUMBER] - The cloth covering of the chair in room is soiled, wall is marred by the fan. - Resident room [ROOM NUMBER] - The fan was dirty/dusty. Unit 400: The 5(five) hallway ceiling vents were rusty and dirty/dusty. On 3/19/2021 at 8:35 a.m., the Environmental Services Director confirmed the findings.
CONCERN (E)

Potential for Harm - no one hurt, but risky conditions existed

Deficiency F0657 (Tag F0657)

Could have caused harm · This affected multiple residents

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** 4. On 3/17/2021 at 8:08 a.m., during an interview with Resident #7 he/she stated the facility talks to his/her daughter regardin...

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**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** 4. On 3/17/2021 at 8:08 a.m., during an interview with Resident #7 he/she stated the facility talks to his/her daughter regarding the plan of care and no they haven't come and talked to me about it. On 3/18/2021 during a review of Residents #7's medical record, the record lacked evidence that a care plan meeting was held by the IDT that included, to the extent possible, participation of Resident #7 to review and revise the care plan on 10/7/2020, 12/28/2020 and 3/18/2021. On 3/18/2021 at 12:08 p.m., in an additional interview with Resident #7 surveyor asked if he/she was invited to the IDT earlier in the morning, No, I would like to know they are having one. On 3/18/2021 at 12:11 p.m., in an interview with the Licensed Practical Nurse Manager, surveyor asked if Resident #7 was invited to the IDT earlier in the morning, he stated, No, I did not ask [resident] ahead of time. [resident] did not want to get out of bed. So, I talked to [resident] after. 5. On 3/17/2021 at 9:18 a.m., during an interview with Resident #28, he/she stated no, not that I know of when asked if he/she is invited and/or participates in his/her plan of care. On 3/18/2021 during a review of Residents #28's medical record, the record lacked evidence that a care plan meeting was held by the IDT that included, to the extent possible, participation of Resident #28 to review and revise the care plan on 5/1/2020, 7/23/2020, 10/15/2020 and 1/7/2021. On 3/18/2021 at 11:54 a.m., in an interview with Licensed Social Worker (LSW) she confirmed the chart does not reflect the residents participation and/or refusal for attending the care plan meetings stating, we ask them and we will be putting their responses whether it's a decline and why they decline. We need to going forward. 6. On 3/16/2021 at 11:04 a.m., Personal Protective Equipment (PPE) was observed hanging from the door of Resident #3's room. Signage was noted instructing to check with nurse and which PPE was required for providing specific types of care. On 3/16/2021 at 11:07 a.m., Resident #3 stated There is something in my urine they can't get rid of so when they are coming in to care for me, they put a gown on. A review of Resident #3's clinical record, current care plan and [NAME], did not indicate a diagnosis of a drug resistant organism, or that he/she required contact precautions when staff provided care. On 3/18/2021 at 10:40 a.m., the Nurse Manager of the 300 unit stated the resident was on transmission based precautions for CRE (Carbapenem Resistant Enterobacterales), in the urine. On 3/19/2021 at 10:20 am., in an interview with the surveyor, the Nurse Manager of the 300 Unit confirmed Resident #3 required transmission based precautions for CRE, and that the resident's current care plan had not been revised to include a diagnosis of CRE, or that transmission based precautions were required to prevent disease transmission. Based on interviews and record review, the facility failed to review and revise the care plan by an interdisciplinary team (IDT), that included, to the extent possible, participation of the resident and/or his/her representative to review and revise the care plan after each assessment for 5 of 40 sampled residents (#56, #33, #86, #7, #28). In addition, facility failed to revise a resident's care plan to reflect the current needs in the area of infection control (#3). Findings: 1. On 3/16/2021 during a record review of Resident #56, the record lacked evidence that a family representative and/or Resident #56, to the extent possible, was included to participate to review and revise the care plan on 02/12/2021. On 3/18/2021 at approximately 11:30 a.m., Social Services Director confirmed that the clinical record lacks evidence that responsible party and/or Resident #56 were notified of the 02/12/2021 Interdisciplinary Team Meeting. 2.On 3/18/2021 during a record review of Resident #33, the record lacked evidence that a family representative and/or Resident #33, to the extent possible, was included to participate to review and revise his/her plan of care during the Interdisciplinary Team Meeting on 1/22/2021. On 3/18/2021 at approximately 11:15 a.m., Social Services Director confirmed that the clinical record lacks evidence that a family representative and/or Resident #33 were notified of the 1/22/2021 Interdisciplinary Team Meeting. 3. On 3/18/2021 during a record review of Resident #86, the clinical record lacked evidence that a family representative and/or Resident #86, to the extent possible, was included to participate to review and revise his/her plan of care in the 3/5/2021 Interdisciplinary Team Meeting. On 3/19/2021 at 12:10 p.m., in a follow-up interview with Resident #86, he/she stated that that he/she does not recall being invited or attending a care plan meeting for 3/5/2021. On 3/19/2021 at 1:24 p.m., Social Services Director confirmed that the clinical record lacked evidence that Resident's #56, #33 and #86 were included to participate in the review and revision of their plan of care.
CONCERN (E)

Potential for Harm - no one hurt, but risky conditions existed

Deficiency F0761 (Tag F0761)

Could have caused harm · This affected multiple residents

2. On 3/17/2021 at 12:25 p.m., two surveyors observed the medication cart on Unit 100 with the Licensed Practical (LPN). Unmarked medications were observed in an unlabeled medication cup in the top dr...

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2. On 3/17/2021 at 12:25 p.m., two surveyors observed the medication cart on Unit 100 with the Licensed Practical (LPN). Unmarked medications were observed in an unlabeled medication cup in the top drawer in the back. The LPN said that she had the meds pulled for the resident and went to give them and he/she was still sleeping. She placed them in the cart to give them later. She stated that, I should have marked them, the labels for that are right there and I just didn't. 3. On 3/17/2021 12:30 p.m., a medication cart on Unit 200 was observed to be unlocked and unattended. Two surveyors confirmed with RN that the medication cart was unlocked while she was off the unit. 4. On 3/19/2021 at 8:13 a.m., a medication cart on Unit 200 was observed to be unlocked and unattended. Two surveyors confirmed with LPN that her med cart was not locked and not attended. Facilities Policy and Procedure: Medication Administration with a revised date of 6/2018 indicates, 17. For residents not in their rooms or otherwise unavailable to receive medication on the pass, the MAR may be flagged After completing the medication pass, the nurse will return to the missed resident to administer the medication. And Facilities Policy and Procedure for Storage of Medications with a revised date of 6/2018. indicates, 7. Compartments, (including, but not limited to, drawers, cabinets, rooms, carts, and boxes.) containing drugs or biologicals shall be locked when not in use, and trays or carts used to transport such items shall not be left unattended if open or otherwise potentially available to others On 3/19/2021 at approx. 3:00 p.m. in an interview with the Director of Nursing, survey team confirmed the above findings. Based on observation and interview, the facility failed to label a multidose Tuberculin Purified Protein Derivative (TB) vials that was available for use, with an open date, in 1 of 3 medication storage refrigerators (Wing 5). In addition, the facility failed to store medication properly (100 unit) on 3/17/2021 and a medication cart was left unlocked and unattended (200 unit) on 3/17/2021 and 3/19/2021). Findings: 1. On 3/18/2021 at 10:00 a.m., two surveyors observed two open, multidose vials of Tuberculin Purified Protein Derivative, with the following manufacturer's instructions, discard open product after 30 days. Further observation revealed that the TB vials/containers did not have an opened date nor a discard date. The finding was confirmed at the time of the observation with the Nurse Manager of Wing 5.
CONCERN (E)

Potential for Harm - no one hurt, but risky conditions existed

Food Safety (Tag F0812)

Could have caused harm · This affected multiple residents

Based on observation and interview, the facility failed to ensure the kitchen was maintained in a clean and sanitary manner for 1 of 1 kitchen tour observations. Findings: On 3/16/2021 from 9:30 a.m....

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Based on observation and interview, the facility failed to ensure the kitchen was maintained in a clean and sanitary manner for 1 of 1 kitchen tour observations. Findings: On 3/16/2021 from 9:30 a.m. to 10:00 a.m., a surveyor completed a tour of the kitchen with the Food Service Director (FSD) in which the following findings were observed: - There were multiple soiled ceiling tiles above the hood system. - The ceiling grid, above the dish washer, was rusty. - There were two lights, above the dishwasher, that had dirt/debris in the lenses. - There were 2 (two) stacks of hot plates that were observed to be wet stacked. - There were 5 (five) wall mounted fans, throughout the kitchen, that were dirty/dusty. - The walk-in refrigerator door was rusty and missing coating, at the bottom, on the inside of the door. - The walk-in freezer had dirt/debris on the floor under the shelving units. On 3/16/2021 at 10:00 a.m., the Food Service Director confirmed the findings.
CONCERN (E)

Potential for Harm - no one hurt, but risky conditions existed

Infection Control (Tag F0880)

Could have caused harm · This affected multiple residents

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** 3. On 3/16/2021 at 10:20 a.m., and on 3/17/2021 at 8:42 a.m., observations of room [ROOM NUMBER]-2 which had a bed pan stored un...

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**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** 3. On 3/16/2021 at 10:20 a.m., and on 3/17/2021 at 8:42 a.m., observations of room [ROOM NUMBER]-2 which had a bed pan stored under the bed, upside down on the floor. On 3/17/2021 at 9:26 a.m., surveyor and the Licensed Practical Nurse (LPN) Manager, observed the bed pan on the floor. The LPN confirmed the infection control concerns and immediately disposed of the bed pan. 4. On 3/18/2021 at 10:08 a.m., observation of Resident #25 being pushed in a wheelchair down the hallway with an uncovered urinary catheter drainage bag hooked under the resident's wheelchair and was dragging on the floor. The Certified Nurses Aide stopped and re-adjusted the bag and confirmed the bag was uncovered and dragging on the floor. On 03/18/2021 at approximately 10:15 a.m., a surveyor discussed the above findings with the Director of Nursing. Based on interviews and observations, the facility failed to ensure staff followed facility policy and followed the Centers for Disease Control (CDC) recommendations for infection control practices, regarding hand hygiene practices, to provide a sanitary environment to help prevent the development and transmission of disease and infection related to hand hygiene for 1 of 4 days of survey. Further, the facility failed to handle linen in a manner to prevent the spread of infection on 1 of 4 days of survey. In addition, the facility failed to provide a sanitary environment to help prevent the development and transmission and infection related to bed pan storage and Foley bag (urine drainage bag) for 2 of 4 days of survey. (Unit 100) (room [ROOM NUMBER]-2) (Resident #25) Findings: 1. On 3/16/2021 at 11:50 a.m., on the 100 Unit, Certified Nursing Assistant, CNA #1 was observed delivering a lunch tray to resident room [ROOM NUMBER]. CNA #1 exited room [ROOM NUMBER] and immediately assisted another resident who was eating without sanitizing her hands. On 3/16/2021 at 11:51 a.m., CNA. #1 confirmed that she did not sanitize her hands after coming out of resident Room106 before assisting another resident and she should have. The Center for Disease Control (CDC) Guidance for Healthcare Providers about Hand Hygiene and COVID-19- updated May 17, 2020 states, Hand hygiene is an important part of the U.S. response to the international emergence of COVID-19. Practicing hand hygiene, which includes the use of alcohol-based hand rub (ABHR) or handwashing, is a simple yet effective way to prevent the spread of pathogens and infections in healthcare settings. Healthcare personnel should use an alcohol-based hand rub or wash with soap and water for the following clinical indications: After touching a patient or the patient's immediate environment. After contact with blood, body fluids, or contaminated surfaces. The facility's Hand Washing Hygiene Policy, revision date 05/2018, states in section 7-p. 7.-Use an alcohol-based hand rub containing at least 62%alcohol: or, alternatively, soap (antimicrobial or non-antimicrobial) and water for the following situations: p.-Before and after assisting a resident with meals. 2. On 3/16/2021 at 10:52 a.m., on the 100 Unit, Laundry Worker #1 was observed collecting dirty linen from the soiled utility room with no gloves on. After putting the soiled linen bag into the soiled laundry cart, he proceeded to the clean utility room and retrieved a blanket without sanitizing his hands. At this time, Laundry Worker #1 confirmed he had no gloves on and did not sanitize his hands before accessing the clean utility room. The facility's Departmental (Environmental Services) - Laundry and Linen Policy, Effective date 11/2017 states under General Guidelines: Standard Precautions-2.-Wash hands after handling soiled linen and before handling clean linen.
Apr 2019 1 deficiency
CONCERN (D)

Potential for Harm - no one hurt, but risky conditions existed

Safe Environment (Tag F0584)

Could have caused harm · This affected 1 resident

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations and interviews, the facility failed to adequately provide housekeeping and maintenance services necessary ...

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**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations and interviews, the facility failed to adequately provide housekeeping and maintenance services necessary to maintain the building in good repair, and sanitary condition, for 1 of 1 environmental tour. Findings: On 04/25/19 from 11:55 a.m. to 12:20 p.m., a surveyor conducted an environmental tour with the Environmental Services Director, the Maintenance Assistant and the Administrator in Training in which the following findings were observed: - Resident room [ROOM NUMBER] had marred and gouged walls in the bathroom and in the room. - Resident room [ROOM NUMBER] had a wheelchair with gauze tied around the armrests creating uncleanable surfaces. - Resident room [ROOM NUMBER] had a wheelchair with foam and tape on the back creating uncleanable surfaces. - Resident room [ROOM NUMBER] had a floor patch, approximately 6 x10, next to the bed that was ripped and had the seams coming up creating uncleanable surface. Also, the closet door frame was marred and the sheetrock, on the adjacent wall, was damaged and exposed. Additionally, the left armrest on the wheelchair was ripped and covered with duct tape creating an uncleanable surface. - Resident room [ROOM NUMBER] had a bathroom doorframe that had chipped/missing paint and the room baseboard heater was rusty creating uncleanable surfaces. Additionally, the ceiling was stained in three places. - Resident room [ROOM NUMBER] had dust on all the flat surfaces. Additionally, the wall and floor fans were dusty/dirty. - Resident room [ROOM NUMBER] had a dirty/dusty wall fan, gouged/exposed sheetrock behind the window bed and the bathroom sink faucet was rusty around it. - Resident room [ROOM NUMBER] had the wall next to the bathroom door frame with gouged/exposed sheet rock creating an uncleanable surface. - Resident room [ROOM NUMBER] had a dirty/dusty wall fan. - Resident room [ROOM NUMBER] had a hole around the bathroom drain pipe and had dried liquid residue on the wall under the sink. - The Medicare patient lift, on the 300 Unit, had chipped/missing paint on the arms and the base had dirt/debris on it. - The sit to stand patient lifts, one on the 100 Unit and one on the 300 Unit, had dirt/debris on base and foot area as well as dried liquid residue. - The electric wheelchair, in the 300 Unit dining area, had tape and foam on the back creating uncleanable surfaces. On 04/25/19 at 12:20 p.m., a surveyor confirmed the findings in an interview with the Environmental Services Director, the Maintenance Assistant and the Administrator in Training.
Understanding Severity Codes (click to expand)
Life-Threatening (Immediate Jeopardy)
J - Isolated K - Pattern L - Widespread
Actual Harm
G - Isolated H - Pattern I - Widespread
Potential for Harm
D - Isolated E - Pattern F - Widespread
No Harm (Minor)
A - Isolated B - Pattern C - Widespread

Questions to Ask on Your Visit

  • "Can I speak with families of current residents?"
  • "What's your RN coverage like on weekends and overnight?"

Our Honest Assessment

Strengths
  • • No major safety red flags. No abuse findings, life-threatening violations, or SFF status.
  • • $3,250 in fines. Lower than most Maine facilities. Relatively clean record.
  • • 44% turnover. Below Maine's 48% average. Good staff retention means consistent care.
Concerns
  • • 18 deficiencies on record. Higher than average. Multiple issues found across inspections.
Bottom line: Mixed indicators with Trust Score of 73/100. Visit in person and ask pointed questions.

About This Facility

What is Seaside Nursing And Retirement Home's CMS Rating?

CMS assigns SEASIDE NURSING AND RETIREMENT HOME an overall rating of 4 out of 5 stars, which is considered above average nationally. Within Maine, this rating places the facility higher than 99% of the state's 100 nursing homes. This rating reflects solid performance across the metrics CMS uses to evaluate nursing home quality.

How is Seaside Nursing And Retirement Home Staffed?

CMS rates SEASIDE NURSING AND RETIREMENT HOME's staffing level at 4 out of 5 stars, which is above average compared to other nursing homes. Staff turnover is 44%, compared to the Maine average of 46%. This relatively stable workforce can support continuity of care. RN turnover specifically is 57%, which is notably high. RNs provide skilled clinical oversight, so turnover in this role can affect medical care quality.

What Have Inspectors Found at Seaside Nursing And Retirement Home?

State health inspectors documented 18 deficiencies at SEASIDE NURSING AND RETIREMENT HOME during 2019 to 2023. These included: 17 with potential for harm and 1 minor or isolated issues.

Who Owns and Operates Seaside Nursing And Retirement Home?

SEASIDE NURSING AND RETIREMENT HOME is owned by a for-profit company. For-profit facilities operate as businesses with obligations to shareholders or private owners. The facility is operated by FIRST ATLANTIC HEALTHCARE, a chain that manages multiple nursing homes. With 137 certified beds and approximately 129 residents (about 94% occupancy), it is a mid-sized facility located in PORTLAND, Maine.

How Does Seaside Nursing And Retirement Home Compare to Other Maine Nursing Homes?

Compared to the 100 nursing homes in Maine, SEASIDE NURSING AND RETIREMENT HOME's overall rating (4 stars) is above the state average of 3.0, staff turnover (44%) is near the state average of 46%, and health inspection rating (4 stars) is above the national benchmark.

What Should Families Ask When Visiting Seaside Nursing And Retirement Home?

Based on this facility's data, families visiting should ask: "Can I visit during a mealtime to observe dining assistance and food quality?" "How do you handle medical emergencies, and what is your hospital transfer rate?" "Can I speak with family members of current residents about their experience?"

Is Seaside Nursing And Retirement Home Safe?

Based on CMS inspection data, SEASIDE NURSING AND RETIREMENT HOME has a clean safety record: no substantiated abuse findings (meaning no confirmed cases of resident harm), no Immediate Jeopardy citations (the most serious violation level indicating risk of serious injury or death), and is not on the Special Focus Facility watch list (a federal program monitoring the lowest-performing 1% of nursing homes). The facility has a 4-star overall rating and ranks #1 of 100 nursing homes in Maine. While no facility is perfect, families should still ask about staff-to-resident ratios and recent inspection results during their visit.

Do Nurses at Seaside Nursing And Retirement Home Stick Around?

SEASIDE NURSING AND RETIREMENT HOME has a staff turnover rate of 44%, which is about average for Maine nursing homes (state average: 46%). Moderate turnover is common in nursing homes, but families should still ask about staff tenure and how the facility maintains care continuity when employees leave.

Was Seaside Nursing And Retirement Home Ever Fined?

SEASIDE NURSING AND RETIREMENT HOME has been fined $3,250 across 1 penalty action. This is below the Maine average of $33,111. While any fine indicates a compliance issue, fines under $50,000 are relatively common and typically reflect isolated problems that were subsequently corrected. Families should ask what specific issues led to these fines and confirm they've been resolved.

Is Seaside Nursing And Retirement Home on Any Federal Watch List?

SEASIDE NURSING AND RETIREMENT HOME is not on any federal watch list. The most significant is the Special Focus Facility (SFF) program, which identifies the bottom 1% of nursing homes nationally based on persistent, serious quality problems. Not being on this list means the facility has avoided the pattern of deficiencies that triggers enhanced federal oversight. This is a positive indicator, though families should still review the facility's inspection history directly.