Diversicare Of Boaz

Based on observation, interview, facility document review, and facility policy review, the facility failed to store, prepare, distribute, and serve food in accordance with professional standards for food service safety. Specifically, the facility failed to discard expired foods; properly store foods in a refrigerator and freezer; maintain cold foods on the tray line to at least 41 degrees Fahrenheit (F); and wash, rinse, and sanitize dishes according to manufacturer instructions. These deficient practices had the potential to affect all residents who received food from the kitchen. Findings included: A facility Census List: 06/10/2025 included a list of 89 residents and their physician ordered diets. The document revealed each resident was on a regular diet or controlled carbohydrate diet (CCD). 1. A policy from the contracted company providing dietary services titled, Food Storage: Cold Foods, revised 02/2023, revealed, All Time/Temperature Control for Safety (TCS) foods, frozen and refrigerated, will be appropriately stored in accordance with guidelines of the FDA [Food and Drug…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on record review, interview, and facility document and policy review, the facility failed to provide access to resident funds on an ongoing basis. This had the potential to affect 62 of 90 residents whose personal funds were managed by the facility. Findings included: A facility policy titled, Resident Trust, dated [DATE], Each Center shall have standardized policies for the handling of resident trust accounts, both active resident funds and the funds of deceased residents. The policy revealed no process for how and when residents would be able to access their funds managed by the facility. A facility Trial Balance document with resident fund balances as of [DATE], revealed 62 residents with active accounts. During an interview on [DATE] at 11:02 AM, Resident #11 stated they had funds managed by the facility and that they were not able to make withdrawals on Saturdays or Sundays because the business office staff were not at the facility. During an interview on [DATE] at 11:24 AM, Resident #8 stated they…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on record review, interview, and facility document and policy review, the facility failed to ensure resident rights were protected, and efforts were made to resolve a grievance for 1 (Resident #64) of 3 residents reviewed for grievances. Findings included: A facility policy titled, Customer Concern (Grievance) Policy, effective 07/2018, revealed the purpose of the policy was to Support each customer's (patient's/resident's) right to voice concerns (grievances) and to ensure after receiving a concern, the center actively seeks a resolution and keeps the customer appropriately apprised of its progress toward resolution. The policy revealed, In resolving the concern, both the Administrator and the customer will develop a plan of action which will be specific about what is to occur. The center will implement the plan of action. The Administrator shall follow up on the correction of the problem and finalize the Customer Concern Form validating the resolution of the concern including who did what, when, and where. The Administrator shall contact the customer to assure him/her that…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY .Based on interview, record review, and facility document and policy review, the facility failed to protect the resident's right to be free from verbal abuse perpetrated by staff for 2 (Resident #56 and Resident #39) of 11 sampled residents reviewed for abuse. Findings included: A facility policy titled, Abuse, Neglect, Misappropriation, Exploitation Policy, effective 01/2019, indicated, Purpose: To prohibit and prevent abuse, neglect, exploitation, misappropriation of resident property and to ensure reporting and investigation of alleged violations (to include injuries of unknown source, mistreatment and involuntary seclusion) in accordance with Federal and State Laws. The policy also indicated, Verbal abuse: May be considered to be a type of mental abuse. Verbal abuse includes the use of oral, written, or gestured communication, or sounds, to residents within hearing distance, regardless of age, ability to comprehend, or disability. The policy also specified, Mental Abuse: is the use of verbal or nonverbal…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on interview, record review, facility document review, and facility policy review, the facility failed to ensure residents were free from any physical restraint not required to treat the resident's medical symptoms, which affected 1 (Resident #299) of 1 resident reviewed for use of restraints. Findings included: A facility policy titled, Restraint, dated 11/28/2016, revealed, Upon determination a patient/resident presents with medical symptoms that may require a restraint, they are evaluated for the least restrictive device. This evaluation includes physical considerations, medical issues and possible restraint alternatives such as referrals to rehab [rehabilitation] therapy or mental health services. An admission Record indicated the facility admitted Resident #299 on 03/22/2024. According to the admission Record, the resident had a medical history that included a diagnosis of Alzheimer's disease. An admission Minimum Data Set (MDS), with an Assessment Reference Date (ARD) of 04/03/2024, revealed Resident #299 had a Brief Interview for Mental Status (BIMS) score of 4, which…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interview, record review, and facility document and policy review, the facility failed to ensure staff reported allegations of staff-to-resident abuse to administration within two hours for 2 (Resident #37 and Resident #300) of 11 sampled residents reviewed for abuse.Findings included: A facility policy titled, “Abuse, Neglect, Misappropriation, Exploitation Policy,” effective 01/2019, indicated, “7. Reporting and Response: Alleged violations/violations will be reported to the Administrator, designee immediately. Immediately reporting all alleged violations to the Administrator, designee, state agency, adult protective services and to all other quired agencies (e.g. [for example], law enforcement when applicable) within specified timeframes.” The table column titled, “Alleged Violations,” and row titled “When” revealed, “All alleged violations - Immediately but not later than 1. 2 hours if the alleged violation involves abuse or results in serious bodily injury. 2. 24 hours if the alleged violation does…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on interview, record review, and facility document and policy review, the facility failed to immediately put protective measures in place to prevent further potential abuse following an allegation of staff-to-resident verbal abuse for 1 (Resident # 37) of 11 sampled residents reviewed for abuse. The facility also failed to have evidence that allegations of abuse and/or neglect were thoroughly investigated for 2 (Resident #300 and Resident #14) of 11 sampled residents reviewed for abuse. Findings included: 1. A facility policy titled, “Abuse, Neglect, Misappropriation, Exploitation Policy,” effective 01/2019, indicated: “Purpose: To prohibit and prevent abuse, neglect, exploitation, misappropriation of resident property and to ensure reporting and investigation of alleged violations (to include injuries of unknown source, mistreatment and involuntary seclusion) in accordance with Federal and State Laws.” The policy revealed, “The following protocol has been established in the event of an allegation of abuse: 1. Protection,” which included, “If the suspected perpetrator is a…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on observations, interviews and a review of the facility's policy titled, Dishwashing Procedures, the facility failed to ensure two pans and serving trays were allowed to air dry before storage. This had the potential to affect all 89 residents being served food from the kitchen. The RESIDENT CENSUS AND CONDITIONS OF RESIDENTS (Form CMS-672) signed by the Director of Nursing and dated 9/17/2019, indicated the facility had a total of 89 residents. Findings include: The facility's policy titled, Dishwashing Procedures, with an effective date of 8/1/2012, documented POLICY It is the policy of this facility to properly sanitize dishes and to establish systems to avoid the improper handling of dishware . General Rules: . 4. Clean dishes must be allowed to air dry before storage . During the initial tour of the kitchen on 9/16/2019 at 3:38 PM, two line pans were observed wet nesting. Wet nesting occurs when clean pans are stacked together without completely drying first. On 9/18/2019 at 12:02 PM, the surveyor observed a stack of serving trays with water droplets between each tray.…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on record review, interview and review of a policy tilted Abuse Policy the facility failed to ensure an allegation of sexual abuse and verbal abuse were reported to the State Agency within 2 hours. This affected 2 of 5 abuse records reviewed during the survey and Resident Identifier's (RI) #62 and RI #141. Findings Include: Review of a policy tilted Abuse Policy with an effective date of June 2018 documented: .Reporting .1. Any allegation of abuse within two hours . 1) On 8/8/18 at 11:00 a.m., the surveyor reviewed the online incident report involving an allegation of sexual abuse concerning RI #62. The facility became aware of the incident on 5/6/18 at 3:11 p.m. and did not report the incident until 5/6/18 at 6:31 p.m. On 8/8/18 at 12:38 p.m., an interview was completed with Employee Identified (EI) #1, Administrator, Abuse Coordinator. EI # 1 stated the allegation of abuse concerning RI #62 occurred on 5/6/18 around 3:11 p.m. and was reported to the State Agency on 5/6/18 at 6:31 p.m. EI #1 stated it should have been reported by 5:11 p.m. on 6/23/18, within 2 hours. EI #2…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on Record Review and Interview the facility failed to ensure Resident Identifier (RI) # 9's Significant Change Minimum Data Set (MDS) with an Assessment Reference Date (ARD) of 5/18/18 documented the use of oxygen. This affected 1 of 19 residents whose MDS's were reviewed for accuracy. Findings Include: RI # 9 was admitted to the facility on [DATE] with diagnoses to include chronic obstructive pulmonary disease with acute exacerbation. A review of RI # 9's Physician Orders documented: .O2(oxygen) @ 2L(liters)/M(minute) per NC (nasal canal) PRN (as needed) .every day and night shift .4/16/18 . A review of RI # 9's Significant Change MDS with an ARD of 5/18/18 on 8/8/18 at 4:00 p.m. did not document the use of oxygen in Section O. An interview was conducted with Employee Indentifer (EI) # 4, Registered Nurse (RN) MDS Coordinator on 8/8/18 at 4:35 p.m. EI # 4 stated RI # 9 was currently receiving PRN oxygen. EI # 4 further stated RI # 9 received oxygen 3 times during the look back period for the Significant…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview, record review, [NAME] & [NAME] Eighth Edition and [NAME] and [NAME], Fundamentals of Nursing, Ninth Edition, the facility failed to ensure Resident Identifier (RI) # 9's nebulizer machine tubing and face mask were bagged after use and the medication cup and face mask were changed out weekly. This affected 1 of 1 resident sampled who received nebulizer treatments. Findings Include: A review of [NAME] & [NAME] 8th Edition, Chapter 21, Page 528 documented: .Proper storage reduces transfer of microorganisms . A review of of [NAME] and [NAME], Fundamentals of Nursing, Ninth Edition, Chapter 29, Infection Prevention and Control, page 455, documented: .Cleaning. Cleaning is the removal of organic material .from objects and surfaces .When an object comes in contact with an infectious or potentially infectious material, it is contaminated . RI # 9 was admitted to the facility on [DATE] with diagnoses to include Chronic Obstructive Pulmonary Disease with Exacerbation . A review of RI # 9's…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.