Perry County Nursing And Rehabilitation Center

Based on observations, interviews, record review and facility policy review, it was determined that the facility failed to develop and implement a comprehensive person-centered care plan for one (Resident #58) of five residents reviewed for comprehensive person center care plans. The findings include: Review of an admission Record indicated the facility admitted Resident #58 on 09/25/2025 with diagnoses that included degeneration of the brain, dementia with mood disturbances, depression, anxiety, wandering and repeated falls. Review of a quarterly Minimum Data Set (MDS), with an Assessment Reference Date (ARD) of 01/02/2026, revealed Resident #58 had a Brief Interview for Mental Status (BIMS) score of 4 which indicated the resident had severe cognitive impairment and was severely impaired for daily decision making. The MDS indicated Resident #58 was dependent on supervision of staff and touch assistance to walk 10 feet, to walk 50 feet with two turns and to walk 150 feet. Position changes from sitting to lying, lying or sitting on the side of the bed was supervision and touch…

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, record review, interview, and review of the facility policy, the facility failed to ensure employees washed their hands between handling dirty equipment and clean equipment, food items stored on the freezer were covered or sealed to prevent the potential for foodborne illnesses, and hot food items were maintained of 135 degrees Fahrenheit or above on the steam table while awaiting service to prevent potential food borne illness for residents who received meals from 1 of 1 kitchen. The findings are: 1. On 9/3/24 at 9:20 AM, Dietary [NAME] (DC) #1 removed a bottle of coke and a glass containing coke from the counter and placed them on the window bar, contaminating her hands. DC #1 removed her gloves from the glove box and placed them on her hands, contaminating the gloves in the process. Without changing gloves and washing her hands. DC #1 then picked up a cucumber from the counter and peeled it. The cucumber slices were placed on top of the salad to be served to the residents who requested salad with their meals. 2. On 9/3/24 at 9:35 AM, the following…

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 meals were prepared and served according to the planned written menu to ensure that nutritionally balanced meals were provided for the residents for 1 of 1 meal observed. The findings are. 1. On 9/3/24 the noon meal menu indicated all residents on mechanical soft diets were to receive 2 ounces of gravy and for pureed diets, 2 ounces of gravy and one #10 (equivalent to 3 ounces) scoop of pureed bread. 2. On 9/3/24 at 12:23 PM, the residents on pureed diets were not served cornbread or regular bread. There were no substitutes served to the residents in place of bread. 3. On 9/3/24 at 12:50 PM, the residents on mechanical soft diets were not served gravy. 4. On 9/3/2024 at 1:06 PM, during an interview Dietary [NAME] (DC) #1 was asked about the texture of the pureed bread prepared to serve to the residents on pureed diets. DC #1 stated it looked like a dough ball when prepared, so it was not served to the residents. DC #1 confirmed she made gravy but forgot to serve it.

Based on observations, record review, interview, and review of the facility policy, the facility failed to ensure pureed food items were blended to a smooth, lump free consistency to minimize the risk of choking or other complications for those residents who required pureed diets for 1 of 1 meal observed. The findings are: 1. On 9/03/24 at 11:50 AM, Dietary [NAME] (DC) #3 placed 6 servings of breaded fried pork chops into a blender, added a carton of whole milk and pureed. At 11:52 AM, DC #3 scraped pureed pork chops into a pan, covered the pan with foil and placed it in the oven. The consistency of the pureed fried chops was more of a ground texture and thick. 2. On 9/3/24 at 11:09 AM, DC #3 used a #8 scoop (1/2 cup) to portion 6 servings of turnip greens into a blender and pureed. At 11:11 AM, DC #3 poured the pureed greens into a pan, covered the pan with foil and placed it in the oven. The consistency of the pureed turnip greens was thick. 3. On 9/3/24 at 11:23 AM, DC #3 used a #8 scoop to portion 6 servings of black-eyed peas into a blender, added a carton of whole milk and…

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 residents on the Dementia Unit were supervised at all times to prevent accidents and hazards for 1 (Resident #50) sampled resident. Findings are: On 9/3/2024 at 12:18 PM, Resident #50 was in the Observation Hall (a locked unit for residents with dementia) Dining Room sitting in a mobility device. Resident #50 self-propelled up to the trash can, located along the outside wall, lifted the lid and reached in with both hands. Resident #50 closed the lid and self-propelled out of the dining room. Staff was not in dining room during this time. On 9/3/2024 at 12:58 PM, Certified Nursing Assistant (CNA) #4 left seven dementia residents to eat in the Observation Hall Dining Room unattended (drink and meals were in front of residents). CNA #4 went to get an alternative meal for a resident. CNA #4 was gone from the dining room between 12:58 PM to 1:06 PM. On 9/5/2024 at 8:45 AM, CNA #4 stated it was unsanitary for Resident #50 to place both arms in the trash bin. You don't want the resident to pick anything up…

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 foods stored in the storage area, freezer, and refrigerator were covered, sealed and dated to minimize the potential for food borne illness for residents who received meals from 1 of 1 kitchen; and expired food items were promptly removed from stock to prevent potential food borne illness for residents who received meal trays from I of I kitchen; dietary staff washed their hands and changed gloves before handling food items to prevent the potential for cross contamination for residents who received meals from 1 of 1 kitchen. and hot food items on the steamtable were maintained at a temperature at or above 135 degrees Fahrenheit while awaiting service, to prevent potential food borne illness for residents who received meals from 1 of 1 kitchen. These failed practices had the potential to affect 52 residents who received meals from the Kitchen (Total Census: 54), according to the list provided by the Dietary Supervisor on 07/17/2023 PM The findings are: 1. On 07/16/23 at 10:28 AM An opened bag of bread…

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 medication was stored in a safe manner and failed to ensure expired medications were removed from one of one medication rooms, to prevent potential administration of an expired medication to a resident. The failed practices had the potential to affect all 54 residents who reside in the facility. The findings are: 1. On 07/11/2023 at 10:39 AM observed Resident #25 in a recliner in their room. On the over bed table, within reach of the resident, were two medications with the resident's name on the label. One was a Breo Ellipta Inhaler the other was an Ipratropium Bromide Solution nasal spray. Resident #25 stated, I am supposed to take it back to her (meaning the nurse) after I give it to myself. I always do it that way. a. On 07/16/2023 at 10:40 AM interview with Licensed Practical Nurse (LPN) #2 who stated, she left the inhaler in the room, and stated he thought the resident had a self-administration assessment. b. Review of the policy, Medication, Self-Administration of, last updated on 5/1/15 noted, .storage 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, record review, and interview, the facility failed to ensure meals were prepared and served according to the planned written menu to meet the nutritional needs of the residents for 1 of 1 meal observed. This failed practice had the potential to affect 44 residents who received regular diets,10 residents who received mechanical soft diets, and 8 residents who received pureed diets from the kitchen according to a list provided by the Assistant Dietary Supervisor on 07/16/2023. The findings are: 1. The facility menu for lunch provided by the Assistant Dietary Supervisor on 07/16/23 at 1:37 PM, noted each resident who received regular diets were to receive 4 ounces of fried chicken, each resident on mechanical soft were to receive 4 ounces of ground fried chicken and each resident on pureed diets were to receive a #8 scoop (4-ounces) of pureed fried chicken. 2. The following observations were made during the noon meal preparation and meal observation. a. On 07/16/23 at 10:59 AM Dietary Employee (DE) #1 used a #16 (Blue) scoop (2 ounce) to place 18 servings 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 prevent a resident from self-administering medications without being assessed for self-administration of medication for 1 (resident #25) of 15 sampled residents. On 07/11/2023 at 10:39 AM observed Resident #25 in a recliner in their room. On the over bed table, within reach of the resident, were two medications with the resident's name on the label. One was a Breo Ellipta Inhaler the other was an Ipratropium Bromide Solution nasal spray. Resident #25 stated, I am supposed to take it back to her (meaning the nurse) after I give it to myself. I always do it that way. Review of the physician orders dated 08/09/2022 revealed an order for Breo Ellipta Aerosol Powder inhalation one time a day and Ipratropium Bromide Solution nasal spray two times a day. There was no order for the resident to self-administer the medications. A review of Resident #25 medical record failed to reveal a medication self-administration assessment. A review of Resident #25 care plan revealed a care plan for allergies, last updated 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 follow the physicians order to change oxygen tubing for 1 (resident #32) of eight (Resident #2, #4, #13, #25, #26, #32, #39, and #41) sampled residents who received supplemental oxygen. The findings are: On 07/16/2023 at 11:02 AM observed Resident #32 lying in bed with oxygen in place. An oxygen concentrator was at the bedside, with a humidifier bottle and oxygen tubing connected both were dated 07/06/23. Review of the physician orders dated 06/21/2023 noted, change oxygen tubing, clean filter and oxygen cabinet, date all tubing every Thursday on the 7 am-7 pm shift. On 07/18/2023 at 2:20 PM the surveyor asked Licensed Practical Nurse (LPN) #4 who is responsible for taking care of the residents' oxygen, who is responsible for changing the oxygen tubing and when is it changed? LPN #4 stated the nurses monitor the oxygen, and the treatment nurse changes the tubing every Thursday. On 07/18/2023 at 2:30 PM the surveyor asked LPN #3 who is responsible for taking care of the residents' oxygen, who is responsible for…

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.