Apple Rehab Farmington Valley

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on clinical record reviews, facility documentation, facility policies and interviews for one (1) of three (3) sampled residents (Resident #1) who were reviewed for accidents, the facility failed to monitor the temperature of a hot water source prior to serving the resident a hot beverage resulting in the resident sustaining second degree burns after spilling the hot beverage on him/herself. The finding includes: Resident #1's diagnoses included dementia and type 2 diabetes mellitus. The quarterly Minimum Data Set assessment dated [DATE] identified Resident #1 had a BIMS of ten (10) indicating some memory recall deficits and was independent with eating after set-up. The Resident Care Plan dated 10/20/24 identified Resident #1 required staff assistance with completing activities of daily living (ADL). Interventions directed, in part, for staff to set-up the meals and assist with eating as needed. The nurse's note dated 10/22/24 at 6:00 AM identified the Director of Nursing was called to Resident #1's room…

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 review of the clinical record, facility documentation, facility policy, and interviews for one (1) of three (3) residents, (Resident #1), reviewed for accidents, the facility failed to ensure that a physician was informed of a request to repeat X-rays due to increased pain timely. The findings include: Resident #1 was admitted to the facility with diagnoses that included polyarthritis, osteomyelitis vertebra, erosive arthritis, and osteoporosis. An undated face sheet identified that Resident #1 was responsible for him/herself. Physician's orders dated 6/1/23 directed Methadone 5 mg tablet, 3 tablets every 8 hours for pain and Oxycontin 60 mg, 3 tablets every 8 hours for pain. A physician's order dated 6/1/23 directed Oxycodone 30 mg, 2 tablets every 3 hours as needed for pain. Give at least one hour before or after scheduled narcotic. Do not give with scheduled Oxycontin and Methadone. The quarterly MDS dated [DATE] identified Resident #1 had no impairments in cognition, was independent with transfers…

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 review of facility documentation, facility policy, and interviews for four (4) of four (4) staff (RN #1, LPN #1, LPN #2 and LPN #3) reviewed for competencies, the facility failed to complete and document new hires completed orientation checklist and competencies. The findings include: 1. RN #1 was hired to the facility on 7/13/23 and was currently in orientation. Review of RN #1's employee file failed to identify an orientation checklist and competencies in process. 2. LPN #1 was hired to the facility on 6/22/23 and was currently off orientation and working independently. Review of LPN #1's employee file failed to identify a completed orientation checklist and competencies. Interview with LPN #1 on 9/5/23 at 12:40 PM identified she did not receive an orientation checklist and/or documentation of completed competencies. 3. LPN #2 was hired to the facility on 8/24/23 and was currently in orientation. Review of LPN #2's employee file failed to identify an orientation checklist and competencies in process. 4. LPN #3 was hired to the facility on 7/27/23 and was currently off…

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, review of the clinical record, facility documentation, facility policy, and interviews for 1 of 3 residents ,(Resident #1), reviewed for falls, the facility failed to ensure fall assessments were completed in accordance with facility policy. The findings include: Resident #1 was admitted to the facility on [DATE] with diagnoses that included nondisplaced fracture of left femur, malignant cancer of left breast, stroke, acute respiratory failure and dementia. Review of the fall risk assessment dated [DATE] identified Resident #1 was at risk of falling. Review of the nursing quarterly/annual evaluation dated 11/21/22 identified Resident #1 was not at risk for falls. The quarterly MDS dated [DATE] identified Resident #1 had no impairments in cognition, required extensive assistance of one staff for activities of daily living (ADL's), had an upper extremity and lower extremity impairment on one side of the body and used a walker and wheelchair. Review of the care plan dated 5/21/23 identified…

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, review of the clinical record, facility documentation, facility policy, and interviews for 1 of 3 residents, (Resident #1), reviewed for oxygen, the facility failed to ensure the resident had a physician order for oxygen administration and care. The findings include: Resident #1 was admitted to the facility on [DATE] and was re-admitted to the facility on [DATE] with diagnoses that included nondisplaced fracture of left femur, malignant cancer of left breast, stroke, acute respiratory failure and dementia. A physician's order dated 10/2/22 directed as needed oxygen at 2 to 3 liters per minute via nasal cannula as needed for respiratory distress and to titrate oxygen via nasal cannula to maintain saturations greater than 92%. The quarterly MDS dated [DATE] identified Resident #1 had no impairments in cognition, required extensive assistance of one staff for activities of daily living (ADL's), had shortness of breath when sitting at rest and when lying flat, and required oxygen therapy.…

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 tour of the Dietary Department and staff interview, the facility failed to ensure the kitchen and equipment was maintained in a sanitary manner. The findings include: Tour of the Dietary Department on 3/1/23 at 10:30 AM with the Dietary Manager identified the following: a. The window sill above the 3 bay pot sink was noted to have a heavy accumulation of black crumb like material. The 2 water faucets of the 3 bay sink were in the off position, but dripping water. b. The wall tile below the airconditioner was noted with a heavy accumulation of dirt, drip marks, and grime. c. The kitchen floor was covered with debris, the tile coving perimeter around the entire kitchen was noted with a heavy accumulation of dust, grime and debris. d. The area above the coffee machine was observed with duct tape around the pipes coming out of the wall. e. A 5 tier black metal cart with clean metal mixing bowls on the shelves was observed to be soiled with a heavy accumulation of grime, dust and debris. f. A 4 tier metal rack containing clean coffee dispensers contained crumbs, dust and grime.…

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 clinical record reviews, observations, facility documentation review, facility policy review, and interviews for four of six residents (Residents #18, 40 and 84) reviewed for activities of daily living (ADL), the facility failed to ensure ADL/shower care was provided in accordance to the plan of care to residents requiring assistance with personal care and for one of four sampled residents (Resident #26) who required extensive assistance with ADL, the facility failed to ensure that assistance with meal set up was administered. The findings included: 1. Resident #18's diagnoses included chronic obstructive pulmonary disease, morbid obesity, congestive heart failure, and osteoarthritis of the right knee. A physician's orders dated 12/22/22 directed to provide a shower following the facility's policy. The quarterly Minimum Data Set (MDS) dated [DATE] identified Resident #18 had a Brief Interview for Mental Status (BIMS) of fifteen out of fifteen, indicating no cognitive impairment. The resident required…

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 clinical record review, facility documentation review, facility policy review, and interviews for one of one resident (Resident # 22) reviewed for communication, the facility failed to ensure audiology services were provided timely. The findings include: Resident #22's diagnoses included diabetes mellitus, glaucoma, and acute respiratory failure. Audiology consultation requests dated 9/27/2022 and 9/29/2022 identified one was signed by the APRN the other, signed by the physician both directed audiology services be provided to Resident #22 due to new verbal communication difficulties as noted by family or staff to have decreased responsiveness, complaints of newly decreased hearing and decreased participation in social activities including decreased interaction. The quarterly Minimum Data Set (MDS) assessment dated [DATE] identified Resident # 22 had no cognitive impairment and the resident's hearing was adequate. On 3/6/2023 at 12:30 PM an interview with the DNS indicated there was a consult 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.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on clinical record review, review of facility policy and interview for ( Resident #22) reviewed for limited Range of Motion, the facility failed to identify risk for prevention of hand contracture. The findings include: Resident # 22's diagnoses included in part, respiratory failure, diabetes mellitus, muscle weakness and difficulty walking. A physician's order dated 8/3/2022 directed an Occupational Therapy (OT) Evaluation and to provide OT 5 times a week for 4 weeks. The quarterly Minimum Data Set (MDS) assessment dated [DATE] identified Resident # 22 had a no cognitive impairment and required extensive assistance of 2 persons for bed mobility, two persons to transfer, extensive assistance of one person for toileting and personal hygiene and total assistance of one person for bathing. An observation made on 3/1/2023 at 11:35 AM noted Resident #22 had a contracture of the left hand and without a splint in place. An observation and during resident interview on 3/06/23 at 12:45 PM identified Resident #22…

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 staff interview and record review for facility staffing, the facility failed to provide sufficient staffing to ensure the Dining Room remained open and for Residents # 18 and # 40 to receive showers in accordance to the plan of care. The findings included: 1. The staffing schedule dated 2/26/23 identified that there were 10 Nurse Aides (NA) that worked on the 7:00 AM to 3:00 PM shift for 117 residents. The staffing schedule further identified that 11 NA's were scheduled to work the 7:00 AM to 3:00 PM shift but 1 NA called out. Interview with Dietary Aide #1 on 3/7/23 at 1:23 PM identified that she believed that the dining room on Southwing was not open on 2/26/23 when she worked. Interview with the ADNS on 3/8/23 at 2:30 PM identified that she was the Nursing Supervisor that day who closed the Southwing Dining Room on 2/26/23. She further identified that there were 4 NA's working on the unit that day instead of 5 NA's. She also identified that the DNS was notified and gave her permission to close the…

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, clinical record review, facility policy review and interviews for 1 sample resident (Resident #2) reviewed for dental, the facility failed to offer the resident/representative to participate in dental services and failed to ensure the resident had an oral examination by a license dentist in accordance to facility policy. The findings include: Resident #2's diagnoses included spastic cerebral palsy, dementia, schizophrenia, anxiety and depression. Review of facility census record dated 3/18/22 identified Resident # 2 was admitted in the facility with Medicaid as payor source. The nursing admission assessment dated [DATE] for oral assessment identified Resident #2 with own teeth and poor condition of teeth. The nutritional assessment dated [DATE] in part noted for oral assessment identified Resident #2 with own teeth in poor condition. The admission MDS assessment dated [DATE] identified Resident #2 with severe cognitive impairment and required extensive assist of 2 person with transfer,…

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 clinical record review, review of facility documentation, review of facility policy, and interviews for one of two sampled residents (Resident #108) who was incontinent of bowel and required extensive assistance with toileting and personal care, the facility failed to provide timely incontinent care causing the resident to remain soiled during the dinner meal. The findings include: Resident #108's diagnoses included left hip fractures in multiple locations, right rib fracture, urinary retention, and diabetes mellitus. The nursing admission assessment dated [DATE] identified Resident #108 was cognitively intact, non-ambulatory, non-weight bearing to lower extremities, required assistance for positioning, bathing, and dressing. The assessment further identified that the resident required a bedpan, was incontinent of bowels, and had an indwelling catheter. The physician's orders dated 1/21/23 included toe touch pressure to left lower extremity, mechanical lift for transfers with assist of two. 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.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on tour of the facility with the Director of Maintenance and Administrator, and staff interviews, the facility failed to ensure a clean, comfortable, homelike environment. The findings include: On 3/1/23 from 9:00 AM through 3:00 PM and on 3/2/23 from 9:00 AM through 10:00 AM the following was identified: a. The main hallway at the intersection of the Annex Unit, Rehab Unit and the Administrative offices, beyond the metal bifold doors was identified to have four 16 inch by 16 inch laminate tiles pulling up from the floor. b. room [ROOM NUMBER]'s bathroom sink faucets were connected opposite of the indicators on the sink handles. The hot water line was connected to the cold faucet, and the cold water line was connected to the hot faucet. Subsequent to surveyor inquiry from the State Agency Building, Fire and Safety Inspectors on 3/2/23, the floor tiles were replaced and the faucet in room [ROOM NUMBER] was repaired. On 3/1/23 from 9:00 AM through 3/8/23 at 11:00 AM, a facility tour with the Director 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, record review and review of facility policy for 1 of 3 residents (Resident #515) reviewed for mistreatment, the facility failed to investigate an allegation of abuse. The findings include: Resident #515's diagnosis included compression fracture of the lumbar vertebra, depression and cardiac arrhythmia (abnormal heartbeat). The admission Minimum Data Set (MDS) assessment dated [DATE] identified Resident #515 was cognitively intact, required extensive assistance with two staff for transfers, bed mobility, dressing, hygiene and toilet use. Additionally, Resident #515 required minimal assistance with eating. The Resident Care Plan dated 7/28/22 identified Resident #515 required assistance with activities of daily living with interventions that included the use of assistive devises such as a wheelchair, dentures, and a walker. A Grievance Log entry titled Concern Form dated 8/4/22 identified Resident #515 expressed feelings that a staff member was rough with the care provided. The Concern Form…

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 for 1 of 3 sampled residents (Resident #74), reviewed for Pre-admission Screening and Record Review (PASARR), the facility failed to notify the agency responsible for a Level 2 determination when the 180 day approval stay had expired. The findings include: Resident #74's diagnoses included schizophrenia, anxiety disorder and diabetes. A PASARR Level 1 screen dated [DATE] identified Resident #74 was approved for a 180 day stay at the long term care facility (terminating on [DATE]). Resident #74 was admitted to the facility on [DATE]. A Resident Care Plan (RCP) dated [DATE] identified a problem of a positive Level of Care (LOC) related to a psychiatric diagnosis. Interventions included a yearly psychiatric evaluation, case management services and training for supportive community living skills, mental health counseling, ongoing evaluation of psychotropic medications, socialization, facility staff supportive counseling, training on self care activities of daily living and self…

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 clinical record review, facility documentation review, facility policy review and interviews for 1 sample resident (Resident #19) reviewed for fall, the facility failed to ensure the staff follow the physician's order for the resident transfer status. The findings include: Resident #19 diagnoses included bipolar disorder, dementia, type 2 diabetes mellitus, osteoarthritis and depression. Review of undated resident care card identified Resident #19 required assistance of 2 people with transfer. The physician's order dated 10/19/22 directed to transfer Resident #19 with assist of 2 person from bed to wheelchair and a maximum assist of 1 person at bed level for activity of daily living and toileting. The annual Minimum Data Set (MDS) assessment dated [DATE] identified Resident #19 with mild cognitive impairment and noted the resident required extensive assist of 2 person assist with transfer, dressing, toileting, hygiene and non-ambulatory. The nurse's note dated 1/19/23 identified Resident #19 had a fall…

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 clinical record review, facility policy review, and interviews for one of one resident (Resident # 22) reviewed for Tube Feeding, the facility failed to ensure that Oxygen(O2) tubing and nebulizer supplies were dated in accordance to facility policy. The findings include: Resident # 22 's diagnoses included Acute Respiratory Failure and diabetes mellitus. A physician s order dated 7/5/2022 directed to provide continuous oxygen at one liter via nasal cannula. A physician's order dated 8/12/2022 directed to change and label O2 tubing every week on Saturday during the night shift and as needed. Observation and interview with RN# 1 on 3/6/2023 at 10:35 AM identified the oxygen tubing Resident #22 was wearing and the nebulizer equipment. The nebulizer equipment was attached to the nebulizer machine with no date and or label and when to change the nebulizer equipment. The equipment should have a bag to store them in when not in use. RN #1 further indicated she would provide all new equipment for Resident #22. A physician's order dated 3/3/2023 directed DuoNeb respiratory…

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 clinical record review and interviews for one of three residents (Resident #113) reviewed for closed record review, the facility failed to ensure that the physician and Advanced Practice Registered Nurse ( APRN) written visits were in the clinical record. The findings include: Resident # 113's diagnosis included dementia, anxiety, and hypertension. The quarterly Minimum Data Set (MDS) assessment dated [DATE] indicated Resident #113 had severe cognitive impairment. A progress note dated 1/13/2023 identified Resident #113 had vomited and was seen by the APRN with new physician's orders written. A progress note dated 1/16/2023 at 5:01 PM indicated Resident #113 was lethargic at times had poor eye contact and responded to tactile stimuli with respirations of 32 ( Normal Range 12- 20) per minute, the resident was receiving intravenous therapy and was seen by the Medical Director with new physician's orders to decrease the intravenous fluid and a new order for antibiotics. A physician's order dated 1/16/2023…

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 for 2 of 3 medication rooms and staff interview, the facility failed to remove expired medications and equipment. The findings include: Observation of the medication room for the Annex Unit with Licensed Practical Nurse (LPN) #8 on 3/7/23 at 8:40 AM identified the following: 1. Two Epi-Pen Auto injector 0.3 mg pre filled auto inject syringes with an expiration date of 12/2022 (over 2 months past the expiration date). 2. A second set of two Epi-Pen Auto injector 0.3 mg prefilled auto inject syringes expired 12/2022 (over 2 months past the expiration date). 3. A third set of two Epi-Pen Auto injector 0.3 mg prefilled auto inject syringes with an expiration date of 01/2023 (over 1 month past the expiration date). 4. One Bottle of Lactulose Solution 16 ounces with an expiration date of 8/2022. Interview with Registered Nurse (RN) #3 indicated she was responsible for quarterly medication room inspections and removal of expired medications. Additionally, she indicated she had not been able to keep…

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 clinical record review, facility policy review and interviews for 1 sample resident (Resident #2) reviewed for food allergy, the facility failed to ensure Resident #2 was not served food that could cause an allergic reaction. The findings include: Resident #2's diagnoses included spastic cerebral palsy, dementia, schizophrenia, anxiety, and depression. Resident #2 allergy record identified the resident was allergic to penicillin (medication), cephalosporins (medication), quinolones (medication), onion, orange juice and peach. A review of Resident #2 meal tray ticket during the survey identified he/she was allergic to onion, peach and orange juice. The physician's order dated 3/22/22 identified Resident #2 had a regular diet, puree/level 1 texture, and thin liquid consistency. The resident required 1:1 feeding and noted Resident # 2 needed to sit upright. The admission MDS assessment dated [DATE] identified Resident #2 with severe cognitive impairment and the resident required extensive assist of 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 a review of the clinical record, staff interviews and a review of the facility policy, for one sampled resident reviewed for pain (Resident # 360), the facility failed to provide effective pain management. The findings include: Resident # 360 was admitted to the facility on [DATE] with diagnoses that included osteoarthritis of spine with radiculopathy (pinched nerve) in the lumbar region, current breast cancer and contusions to the back and forearm. An admission evaluation dated 12/9/19 at 1:11 PM identified Resident #360 was alert, pleasant and cooperative. A physician's order dated 12/9/19 directed to assess pain every shift using the pain scale. Further orders directed Soma 350 milligrams (mg) every 6 hours as needed for muscle spasms and Hydrocodone 5 mg with Acetaminophen 325 mg every 6 hours as need for moderate to severe pain. A physician's progress note dated 12/10/19 identified Resident #360 had left lower spinal pain with radiation and a right upper extremity hematoma. A physician order dated…

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 observations, a review of the clinical record, staff interviews and a review of the facility policy, for 1 sampled resident (Resident #38) reviewed for choices, the facility failed to provide individualized assistance in accordance with their wishes and care plan. The findings include: Resident #38 was admitted to the facility on [DATE] with diagnoses that included cellulitis, falls, osteoarthritis, lumbar disc degeneration, morbid obesity, anxiety, chronic obstructive pulmonary disease, and muscle weakness. The care plan dated 12/15/19 identified, required assistance with all of his/her activities of daily living. Interventions directed to assist the Resident with application of his/her arm sling in the morning, grooming, dressing, mouth care and assistance with bathing activities. The care plan further directed that Resident #38 was awake at 5:00 AM and to have him/her up, washed and dressed by 7:30 AM. The admission Minimum Data Set (MDS) dated [DATE], identified intact cognition, required extensive…

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 a review of the clinical record, a review of facility documentation, staff interviews, and a review of the facility policy for 1 of 3 residents reviewed for abuse (Resident #91), the facility failed to protect the resident from misappropriation of personal property. The findings include: Resident #91's diagnoses included major depressive disorder, dementia with behavioral disturbance, diabetes mellitus and schizoaffective disorder. The care plan dated 2/28/16 identified Resident #91 had a chronic/ progressive decline in intellectual functioning characterized by deficits in memory, judgment, decision making and thought process related to the dementia process. Interventions included to offer consistent daily routines and repeat communication by using more than one method (words, gestures, facial expression). A quarterly Minimum Data Set (MDS) dated [DATE] identified severe cognitive impairment and required extensive assistance with dressing, personal hygiene, bed mobility transfers between surfaces with…

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 review of the clinical record, a review of facility documentation, staff interviews, and a review of the facility policy for 1 of 3 residents reviewed for abuse (Resident #91), the facility failed to provide evidence that a comprehensive investigation for misappropriation of a resident's personal property was conducted. The findings include: Resident #91's diagnoses include major depressive disorder, dementia with behavioral disturbance, diabetes mellitus and schizoaffective disorder. The care plan dated 2/28/16 identified a chronic/ progressive decline in intellectual functioning characterized by a deficit in memory, judgment, decision making and thought process related to the dementia process. Interventions included to offer consistent daily routines and repeat communication using more than one method (words, gestures, facial expression). A quarterly Minimum Data Set, dated [DATE] identified severe cognitive impairment and required extensive assistance with dressing, personal hygiene, bed mobility…

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 review of the clinical record, facility documentation, facility policy, and interviews for 1 of 5 residents (Resident #94) reviewed for unnecessary medications, the facility failed to ensure a psychoactive as needed medication was ordered for fourteen days. The findings include: Resident #94 was admitted to the facility on [DATE] with diagnoses that included unspecified dementia without behavioral disturbances, and anxiety. The care plan dated 11/4/19 identified Resident #94 had episodes of paranoia. Interventions included to administer medications as ordered. The quarterly Minimum Data Set (MDS) dated [DATE] identified severe cognitive impairment, delusions, wandering behaviors and received antipsychotic medications. A physician's order dated 1/31/20 directed the administration of Lorazepam 0.5 milligram (mg) by mouth once daily and as needed every 6 hours for anxiety through 2/4/20. A physician's order dated 2/10/20 directed to discontinue the administration of Lorazepam at 9:00 AM to Resident #94.…

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.