Cave City Nursing Home INC

Based on record review, interview, and facility policy review, the facility failed to ensure medications were administered according to physician's orders for one (Resident #40) of five residents reviewed. The findings include: A review of Resident #40’s quarterly Minimum Data Set with an Assessment Reference Date of 06/26/2025, indicated the resident had a Brief Interview for Mental Status score of 14, which indicated Resident #40 was cognitively intact. A review of Resident #40's active Physician's Orders, as of 07/01/2025, revealed the resident had diagnoses which included post-traumatic stress disorder, osteoarthritis, and generalized anxiety disorder. The resident’s Physician’s Orders also revealed the resident had medication orders, with an order date of 04/23/2025, for one benzodiazepine tablet for generalized anxiety disorder, to be given at bedtime, and one compound opioid pain medication tablet for pain, to be given every eight hours as needed. Resident #40’s Physician’s Orders also revealed not to administer either medication within two hours of each other. A review of…

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 and record review, the facility failed to ensure written information regarding the right to formulate an advanced directive was provided to the residents or their responsible parties, to enable them to make informed decisions regarding which measures would be provided or withheld at the end of life for 2 (Residents #8 and #45) of 3 residents reviewed for Advance Directive. The findings include: 1. Resident #45 was admitted on [DATE] with a diagnosis of Dementia. a. On 04/01/2024 at 02:31 PM, during a review of Resident #45's chart, no advance directive was located. b. On 04/02/2024 at 12:04 PM, the Facility provided a Do Not Resuscitate (DNR) order, and an order appointing guardian of the person and estate and an order for disbursement of funds. c. On 04/04/2024 at 09:01 AM, the Director of Nursing (DON) was asked, Should [Resident #45] have an advance directive located in the resident's medical chart? She stated, Yep. When asked, Why? She stated, So we know what [Resident #45's] wishes are.…

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 observation, interview and record review, the facility failed to ensure resident fingernails were kept clean for 3 (Residents #8, #53, and #66) of 3 sampled residents, oral hygiene was being completed for 1 (Resident #66) of 1 sampled resident, and male residents were shaved to promote good personal hygiene for 2 (Resident #53, and #66) of 2 sampled residents. The findings are: A facility policy titled, 'Activities of Daily Living (ADLs)' dated 10/04/2022 documented, .Care and services will be provided for the following activities of daily living: 1. Bathing, dressing, grooming and oral care . A resident who is unable to carry out activities of daily living will receive the necessary services to maintain good nutrition, grooming, and personal and oral hygiene . 1. Resident #8's Care Plan dated 03/15/2019 revealed, .CNA'S [Certified Nursing Assistants] assist to keep nails clean and observe for jagged edges report prn [as needed] Nurse provide trimming due to DM [Diabetes Mellitus] . a. The Quarterly Minimum Data Set (MDS) with an Assessment Reference Date (ARD) of…

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 observation, interview and record review, the facility failed to ensure the clothes dryers remained free of lint build-up to decrease the potential for fire and loss of laundry services in 1 of 1 laundry room. This failed practice had the potential to affect all 78 residents due to the potential for the interruption of laundry services and due to the proximity of the laundry room. The findings are: On 04/03/2024 at 11:03 AM, the Surveyor observed all 3 dryers in the laundry room had a 0.5 inch lint buildup on their lint screens. On 04/03/2024 at 11:12 AM, Laundry Worker #1 was asked, how often do you remove the lint from the dryers? Laundry Worker #1 said, every two hours. The Surveyor asked, can you explain why the dryer lint removal log was not signed off on 04/02/2024 for the evening shift? Laundry Worker #1 said, I guess she forgot to sign it. The Surveyor asked, why is the log not signed for this morning (04/03/24)? Laundry Worker #1 said, I was going to sign them off, but I was going to lunch first. The Surveyor asked, what can happen if lint isn't removed every two…

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 observation, interview and record review, the facility failed to ensure proper handwashing/hand sanitizing was completed during dining observation. The findings are: On 04/01/2024 at 12:06 PM, the Surveyor observed Certified Nursing Assistant (CNA) #2 take a tray from a meal cart and set it up for a resident, then CNA #2 removed another tray from the cart and set it up for another resident. The CNA did not perform hand sanitation before providing either tray. During a concurrent observation on 04/01/2024 at 12:06 PM, the Surveyor observed CNA #3 removing a tray from a meal cart and setting it up for a resident. The CNA then repeated the process without performing hand sanitation for two other residents. CNA #3 then went and picked up a chair and placed it in between 2 residents and began feeding both residents without performing hand sanitization before beginning, or between feeding each resident. During an interview on 04/01/2024 at 12:52 PM, CNA #3 was asked, what should be done before serving a tray to a resident? CNA #3 said, sanitize my hands. During an interview on…

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 observation, interview and record review, the facility failed to ensure thickened liquids kept in a cooler remained on ice/with ice packs for 1 (Resident #14) of 1 sampled resident who required thickened liquids. The findings are: The Minimum Data Set (MDS) with an Assessment Reference Date (ARD) of 03/08/2024 documented Resident #14 scored 7 (0-7 indicates severe cognitive impairment) on a Brief Interview for Mental Status (BIMS). The Physician orders dated 04/01/2024 documented, Regular diet, Mechanical Soft texture, Nectar consistency add yogurt, applesauce and nectar thick liquids to each meal for choking. On 04/01/2024 at 10:29 AM, Resident #14 had a red and white cooler at the bedside. Thickened water was found in the cooler sitting in water/melted ice. On 04/02/2024 at 10:38 AM, the Surveyor interviewed Certified Nursing Assistant (CNA) #4 at Resident #14's bedside and asked, Should the residents thicken liquids in the cooler be kept on ice? CNA #4 stated, Yes, it should've been passed with ice water because [Resident #14] is nectar thick. On 04/02/2024 at 10:39 AM,…

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 observation and interview the facility failed to ensure that dishes and utensils were stored properly, food was covered, and hands were washed between clean and dirty tasks to minimize the risk of cross contamination. The failed practice had the potential to affect 82 residents who received their meals from 1 of 1 kitchen according to a list provided by the administrator on 2/3/23 at 8:28 AM. a. On 1/30/23 at 11:20 AM, three nested mixing bowls were stored right side up. There were two large metal pans that were right side up under the steam table. b. On 1/30/23 at 12:05 PM, the tray line was serving lunch, the insulated base and dome plate covers were stored with the inside exposed to air and contaminants. c. On 2/2/23 at 10:42 AM, there were two trays of rolls sitting on the shelf above the range. The rolls were uncovered and open to contaminants. Four full size steam table pans of strawberry cake were cooling on the worktable located toward the back of the kitchen. The cakes were uncovered and open to air and contaminates. d. On 2/2/23 at 10:45 AM, Dietary Employee (DE)…

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 observation, record review, and interview the facility failed ensure humidified oxygen was administered at the physician prescribed rate for 1 (Resident #58) of 6 (R #4, R #17, R #24, R #58, R #69, R #233) sampled residents who received oxygen according to a list provided by the Director of Nursing (DON) on 2/3/23. The findings are: 1.Resident #58 had diagnoses of Chronic Obstructive Pulmonary Disease and Asthma. A Quarterly Minimum Data Set (MDS) with an Assessment Reference Date (ARD) of 1/14/23 documented the resident scored 3 (0-7 indicates severe impairment) on a Brief Interview for Mental Status (BIMS); oxygen used in the past 14 days while a resident. a. Physician Orders dated 4/8/21 documented, .02 [oxygen] at 2L[liters] via NC [nasal canula] PRN [as needed] for SOB [shortness of breath] 02 [oxygen] >90% [percent] .change 02 tubing q [every]72 hours and PRN every 72 hours .Change water on concentrator weekly on Fridays and PRN one time a day every Fri . b. Resident #58's Comprehensive Plan of Care documented, [R #58] .COPD .Revision on: 07/29/2021 .OXYGEN provide 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.

Based on observation, record review, and interview, the facility failed to ensure the Minimum Data Set (MDS) was completed accurately, related to functional status for 1 (Resident #33) of 4 (Resident #32, R #23, R #33, and R #45) sampled residents who required extensive assistance with eating. The findings are: 1.Resident #33 had a diagnosis of Moderate Protein-Calorie Malnutrition. The Annual Minimum Data Set [MDS] with an Assessment Reference Date [ARD] of 11/27/22 documented the resident scored 3 (0 - 7 Indicates Severely Impaired) on a Brief Interview for Mental Status (BIMS); required limited assistance with one person assist for eating; had a feeding tube and was on a mechanical altered diet. a. The Physician Order dated 1/12/21 documented, Regular diet Mechanical Soft texture, Nectar consistency . b. The revised Care Plan dated 5/21/21 documented, [Resident's Name] has an ADL [Activities of Daily Living] self-care performance deficit . EATING: feeding tube and oral diet as directed . current order for regular w. Mech [mechanical] soft and Nectar liquids If resi. [resident]…

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 observation, record review, and interview, the facility failed to ensure palm grips was consistently utilized to prevent further decline in range of motion for 1 (Residents #45) of 5 (Resident #19, R #45, R #32, R #33 and R #23) sample mix residents who had contractures. The findings are: 1.Resident #45 had diagnoses of Alzheimer's and Contractures. The Quarterly Minimum Data Set (MDS) with an Assessment Reference Date (ARD) of 11/20/22 documented the resident was severely impaired in cognitive skills for daily decision, required total assistance of two person assist for bathing, and extensive assistance of two-person assist for bed mobility, transfer, dressing, toilet use, and personal hygiene; had impairment to the upper extremity on one side. a. The Physician Order dated 3/8/22 documented, Ensure bilateral palm grips are in place every morning and at bedtime for contractures . b. The revised Care Plan documented, [Resident's Name] has an ADL [Activities of Daily Living] self-care performance deficit r/t [related to] . Alzheimer's . Limited Mobility, . CONTRACTURES: .…

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.