Nhc Healthcare Rossville

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observations, interviews, record review, and policy review, the facility failed to ensure to ensure urinary catheter bags were properly positioned in a manner to prevent potential urinary tract infections due to contamination for three of five residents (Residents (R)8, R9, and R87) reviewed for urinary catheters and urinary tract infections out of a total sample of 29 residents. Findings include: Review of the facility's undated policy titled, Catheter Care, revealed Indwelling catheter care will be performed at least once daily .Provide privacy for the resident. Complete hand hygiene .Replace the cover over the resident. Clean and return equipment as indicated. 1. Review of the Resident Face Sheet, located in the electronic medical record (EMR) under the Resident tab, documented R8 was admitted to the facility on [DATE], and had diagnoses that included neuromuscular dysfunction of bladder. Review of R8's five day Minimum Data Set (MDS) assessment located in the EMR under the RAI tab with an Assessment…

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 interview, record review, and review of the facility's policy, the facility failed to ensure residents were free from misappropriation for one of 30 sampled residents (Resident (R) 56). R56 reported to the Director of Social Services (DSS) that she was missing money; however, the DSS failed to ensure the resident was protected from further misappropriation. Findings include: Review of the facility's policy titled, Patient Protection and Response Policy for Allegations/Incidents of Abuse, Neglect, Misappropriation of Property and Exploitation, revised 02/01/23 revealed, .1. Definition Policy. Abuse, Neglect, Misappropriation of Patient Property and exploitation, as hereafter defined, will not be tolerated by anyone, including staff, patients, consultants, volunteers .The patient has the right to be free from abuse, neglect, misappropriation of patient property, and exploitation .Misappropriation of Patient Property: the deliberate misplacement, exploitation, or wrongful, temporary or permanent use of 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 observation, interviews, record review, and policy review, the facility failed to ensure that respiratory equipment was cleaned, stored, and/or administered per facility policy for two of 29 sampled residents (R) (R25 and R23). Staff failed to clean and air-dry nebulizer equipment between uses, failed to assess R25 prior to and after the nebulizer treatment, and failed to ensure R25's nebulizer machine was clean. Findings included: A review of the undated policy titled Oral Inhalation Administration, dated 1/1/2019, documented obtain a baseline pulse, respiratory rate, and lung sounds .obtain a post-treatment, pulse, respiratory rate, and lung sounds, and document findings on the Medication Administration Record (MAR) or in the resident's medical record, rinse the equipment, and when equipment is completely dry, store in a plastic bag with the resident's name and the date on it . 1. A review of the Resident Face Sheet, located in the electronic medical record (EMR) under the Resident tab, documented R25…

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 policy review, the facility failed to ensure pharmacy services thoroughly reviewed the resident medication regimens to identify irregularities related to the use of trazodone, an antidepressant and sedative, for one of six residents (R) (R70) reviewed for unnecessary medication. Findings included: A review of a document provided by the facility titled Medication Monitoring and Management, dated 1/1/2019, indicated In order to optimize the therapeutic benefit of medication therapy and minimize or prevent potential adverse consequences, facility staff, the attending physician/prescriber, and the consultant pharmacist perform ongoing monitoring for appropriate, effective, and safe medication use . A review of a document provided by the facility titled Drug Regimen Review for [NAME] Health Care Facility, dated 2/1/2021, indicated . To ensure timely pharmacist conducted drug regimen review (DRR) for every resident, including guidelines for documentation and communication to…

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, record review, and interviews, the facility failed to ensure that one of six residents (R) (R70) reviewed for unnecessary medication use received antipsychotic medication at the appropriate time of day. Findings included: Upon entrance the facility on 3/4/2024 at 8:45 AM, R70 was observed in the dining room which is also used for activities asleep in her wheelchair. Every morning on 3/4/2024 through 3/8/2024, R70 was observed asleep during activities that took place starting at 10:00 AM. A review of R70's undated admission Record, located in the electronic medical record (EMR) under the Profile tab, revealed the resident was admitted to the facility on [DATE] with diagnoses which included dementia, anxiety, and major depressive disorder. A review of R70's Physician Order's, located in the resident's EMR under the Orders tab, revealed an order dated 7/11/2023 for trazodone tablet; 150 mg; 1/2 tab 75mg; oral; once a day at 8:00 AM for insomnia. This was prescribed by the nurse practitioner.…

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, staff interviews, record review, and review of the facility's policies titled, Safety & Sanitation Best Practice Guidelines, Dry Storage and Safety and Sanitation Best Practice Guidelines (subject) Refrigerator and Freezer Storage, the facility failed to maintain sanitary conditions in the dietary kitchen. This deficient practice had the potential to adversely affect 89 of 91 residents that received meal trays from the kitchen. Findings include: Review of the policy titled Safety and Sanitation Best Practice Guidelines (subject) Dry Storage with the original date 2003 and reviewed/revised date of November 2017 revealed no chemical or cleaners may be stored in the dry food storage area. The best practice regarding herbs and spices is to use within one year of purchase date. Foods will be stored in original package if possible. Scoops should be stored in a sanitary method with handles of scoops not contacting food. A designated area in or near the storeroom should be labeled for dented cans…

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, resident and staff interviews, and record review, the facility failed to maintain effective pest control in the kitchen with the potential to affect all 89 of 91 residents receiving oral feedings. Findings include: An observation on 1/17/2023 at 10:00 a.m. revealed a tray with a paper liner on a shelf in the dry storage area which spices were stored upon, had black, oblong shaped substances on the paper liner all around the spices. A five pound bag of cocoa was observed stored in a cannister dated as opened on 9/1 with black, oblong shaped substances on the lid of the cannister. An observation on 1/18/2023 at 1:45 p.m. revealed a mouse trap in the main kitchen behind the tilt skillet and a bait station on the floor at the back door. Review of the pest control company's Customer Service Report revealed the service included pesticide application of alpine to the kitchen, performed exterior rodent service, checked accessible rodent stations and cleaned/reset traps as needed, checked bait stations, and replaced bait as needed. The service was provided monthly 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 observations, resident and staff interviews, record review, and review of the facility policy titled, NHC Respiratory Manual, the facility failed to maintain bilevel positive airway pressure (BiPAP) equipment in a sanitary manner for two of four sampled residents (R) (R#59 and R#21). The deficient practice had the potential to affect R#59 and R#21 who were receiving positive airway pressure (PAP) therapy. Findings include: Review of the facility policy titled, NHC Respiratory Manual, Section II Procedures; Section H, Subject: Monitoring Devices (revised October 2013), revealed the following: Infection Control: the mask should be cleaned daily with soap and water; headgear should be cleaned when soiled with soap and water; hose needs to be cleaned with soap and water weekly; change filters as recommended by manufacturer. 1. Review of the electronic medical record (EMR) for R#59 revealed she admitted with diagnoses to include chronic respiratory failure (CRF) with hypoxia, chronic respiratory failure…

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, staff interviews, record review, and review of the policy titled, Specific Medication Administering Procedures, the facility failed to ensure the medication error rate was less than 5%. There were four errors with 27 opportunities for one of seven residents (R) (R#40) for a medication error rate of 14.81%. Findings include: Review of the policy titled, Specific Medication Administering Procedures dated 1/1/2019, revealed the policy: To administer medications in a safe and effective manner. The procedures sections revealed: C. 1) Prior to removing the medication package/container from the cart/drawer; a. Check medication administration record/treatment administration record (MAR/TAR) for order. 2) Prior to removing the medication from the container; a. Check the label against the order on the MAR. Observation of medication administration on 1/18/2023 at 9:05 a.m. on the North Hall with Licensed Practical Nurse (LPN) BB revealed her to check the MARS for R#40 and remove the following medications from the cart: one amlodipine (a medication used to treat…

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 review of the facility's policies titled, Medication Storage in the Facility and Specific Medication Administration Procedures, the facility failed to ensure that medications were properly labeled on two of two medication carts (North Hall cart and South Hall cart). Specifically, an intravenous (IV) medication bag did not contain a label with the name of the medication, the date and time of the infusion, or the nurse's name or initials and an opened box of ophthalmic (eye) drops were without an open date or a discard date labeled on the box or container. Findings include: Review of the policy titled, Medication Storage in the Facility dated 1/1/2019 revealed the policy statement of: Medications and biologicals are stored safely, securely, and properly, following manufacturer's recommendations or those of the supplier. Procedures section titled Infusion Therapy Storage and Labeling: F: Facility should assure that infusion therapy labels include the: 1) Resident name, medication name, 2) Volume, infusion rate, 3) Name and quantity of each…

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.