Arma Operator, LLC

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY The facility reported a census of 40 residents. Based on observation, interview and record review, the facility failed to prepare, store, and serve food in a sanitary manner for the residents of the facility. Findings included: - On 12/17/24 at 12:55 PM, during the initial tour of the facility with Dietary Staff BB the following areas of concern were identified: 1. A squeeze type bottle of ranch salad dressing had an open date of 10/11/24. 2. A squeeze type bottle of Italian salad dressing had an open date of 10/04/24. 3. A one-gallon container of pickle relish had an open date of 06/04/24. 4. An open package of turkey lunch meat had an open date of 12/03/24. Dietary Staff BB stated all the above items were beyond their safe use date, which varied from seven days for the lunch meat and would consult with consulting staff GG to determine the safe use period for the salad dressings and pickle relish. The following opened items lacked open dates: 1. A one-gallon container of pickle slices. 2. A one-gallon container…

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.

The facility reported a census of 41 residents. Based on observation, interview, and record review, the facility failed to maintain and/or dispose of garbage and refuse properly in a sanitary condition to prevent the harborage and feeding of pests. Findings included: - On 03/14/23 at 08:45 AM, during a tour of the kitchen areas with Dietary Staff (DS) BB, revealed six dumpster containers from the backside of the kitchen. The observation included two dumpster lids open with trash bags exposed out the top and with one missing lid. Trash and debris surrounded the outside ground level of the dumpster units. On 03/14/23 at 8:45 AM, DS BB verified the above findings. She reported the entire facility used the dumpsters and should close the lids to contain the trash and refuse. Dietary Staff BB stated the missing lid had been missing for a while and a new one on order. She agreed the open lids should have been closed. The facility lacked a policy for containment of the garbage and refuse. The facility failed to maintain and/or dispose of facility garbage and refuse properly in a sanitary…

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.

The facility reported a census of 41 residents. Based on interview and record review the facility failed to file grievance reports and follow up with resident concerns voiced during the resident council meetings. Findings included: - Review of the resident council notes revealed the following concerns: 1. On 08/15/22, the residents had concerns that the call lights were not getting answered in a timely fashion, wished the food was warmer and the veggies were not burnt. 2. On 09/19/22, the residents had concerns that 90 percent of the meals were cold, the Certified Medication Aides (CMA) would forget pills and the Certified Nurse's Aides (CNAs) on the east hall were not being courteous to each other. 3. On 10/17/22, the residents had concerns that they went twice down to play BINGO, and nobody showed up. 4. On 11/21/22, the residents had concerns of a chair that needed repaired and that the staff needed to make sure the dishes were clean and none of them chipped. 5. On 12/20/22, the residents had concerns that the staff were taking too long to answer call lights. 6. On 01/23/23, 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 The facility reported a census of 41 residents, with 17 sampled for review. Based on interview and record review the facility failed to thoroughly investigate allegations when they failed to conduct resident interviews specifically related to the allegations of the self-investigations for two residents R6 and R23 on three occurrences of resident to resident altercation/abuse, and for two residents, R31 and R28 when the facility investigated resident to resident altercation/sexual abuse. Findings included: - The Medical Diagnosis tab for R6 included diagnoses of Alzheimer's Disease (a progressive mental deterioration characterized by confusion and memory failure), metabolic encephalopathy (a chemical imbalance of the blood that affects the brain that can lead to personality changes), and anxiety disorder (feelings of worry, anxiety, or fear that are strong enough to interfere with one's daily activities). The Annual Minimum Data Set (MDS), dated [DATE] assessed R6 with a Brief Interview of Mental Status (BIMS)…

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.

- On 03/16/23 at 08:14 AM, observation of medication pass by Certified Medication Aide (CMA) LL revealed she removed the cap off of a bottle of eye drops and placed it on an unsanitary towel on top of the medication cart. The towel contained brown colored spots on it. CMA LL administered the eye drops to R16 then replaced the cap on the bottle of eye drops without sanitizing it first. On 03/16/23 at 08:24 AM, during observation of medication pass, CMA LL used a digital wrist blood pressure cuff on R23 without sanitizing it first and prior observation revealed she used it on another resident prior to that. CMA LL failed to sanitize the blood pressure cuff after use on R23. On 03/16/23 at 08:29 AM, CMA LL stated she does not sanitize the blood pressure cuff between resident uses, had done that when there was an outbreak of COVID-19 (highly contagious respiratory disease) but she did not do that now. On 03/20/23 at 01:37 PM, Administrative Nurse D stated the cap of the eye drop container should not be placed on top of the soiled towel on the med cart and it further explained it was not…

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.

The facility reported a census of 41 residents with seventeen selected for review. Based on observation, interview, and record review, the facility failed to ensure accommodation of needs were met for two or the residents, Resident (R)17 and R13 by failure to have their call light in reach so they could alert staff of any needs. Findings included: - The Quarterly Minimum Data Set dated 12/22/22 for R17 assessed her having absence of spoken words, required assistance with Activities of Daily Livings, and had limitation to her range of motion to one side of her upper extremities. On 03/14/23 at 04:19 PM, observed R17 sitting in the recliner in her room and the call light cord was across the bed with the call light button out of the resident's reach. A sign that read Call don't fall was posted on the door of her room. R17 pointed to her bed and when asked if she wanted to lay down, she shook her head up and down indicating yes. The surveyor alerted the staff to R17's request. R17 was using a facial tissue to wipe her mouth with her left hand. On 03/14/23 at 04:50 PM, Licensed Nurse…

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 The facility reported a census of 41 with 17 selected for review including three reviewed for hospitalization. Based on record review and interview, the facility failed to provide notification to the Ombudsman office for Resident (R)12 and R6 following transfers to the hospital. Findings included: - The Progress Note dated 12/30/22 at 10:45 AM, revealed the facility transferred R12 to the emergency room for evaluation. The Progress Note dated 12/30/22 at 03:30 PM, revealed R12 admitted to the hospital. The electronic medical record lacked documentation of notification to the Ombudsman office. On 03/21/23 at 12:08 PM, Social Service Staff X stated she emails the Ombudsman at the end of every month and forgot to send an email. Social Service Staff X stated an email was to be sent monthly and it had not been sent since August or September that she sent the notification to the Ombudsman office. On 03/21/23 at 12:12 PM, Administrative Staff A stated she expected the Ombudsman office to receive notification monthly 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 The facility reported a census of 41 residents with 17 selected for review including three residents reviewed for activities of daily living (ADL's). Based on observation, record review, and interview, the facility failed to provide appropriate hygiene and grooming cares to Resident (R)33. Findings included: - The Medical Diagnosis tab for R33 included diagnoses of dementia (progressive mental disorder characterized by failing memory, confusion) and diabetes mellitus (when the body cannot use glucose, not enough insulin made or the body cannot respond to the insulin). The Quarterly Minimum Data Set (MDS) dated [DATE] assessed R33 with loss of short- and long-term memory and with severely impaired decision-making ability. He required extensive assistance of two or more with personal hygiene and bathing. The Annual MDS dated 12/25/22 for R33 revealed no changes to his memory, decision making skills, personal hygiene, or bathing assistance. The Activities of Daily Living Care Area Assessment was not triggered 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 The facility reported a census of 41 residents, with six residents sampled for accidents. Based on observation, interview and record review, the facility failed to identify contributing causes of one Resident (R24) of the six sampled residents, with multiple injuries of unknown origin (skin tears and bruise) and failed to implement appropriate immediate interventions to prevent further repeated skin injuries for this resident. Finding included: - Review of Resident (R)24's, Physician Orders, dated 03/01/23, revealed diagnoses which included, non-displaced inter-trochanteric fracture of left femur (broken upper left leg), dementia (progressive mental disorder characterized by failing memory, confusion), iron deficiency anemia (condition without enough healthy red blood cells to carry adequate oxygen to body tissues), and hypothyroidism(condition characterized by decreased activity of the thyroid gland). The admission Minimum Data Set (MDS) dated [DATE], documented, the Brief Interview for Mental Status (BIMS)…

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 The facility reported a census of 41 residents with 17 selected for review including two reviewed for urinary catheter (insertion of a catheter into the bladder to drain the urine into a collection bag) or urinary tract infection (UTI). Based on observation, interview, and record review, the facility failed to ensure Resident (R)18's urinary catheter tubing was appropriately secured to prevent urethral trauma in case of tugging on the catheter tubing. Findings included: - The Medial Diagnosis tab for R18 included a diagnoses of neuromuscular dysfunction of the bladder, benign prostate hypertrophy (BPH - non-cancerous enlargement of the prostate which can lead to interference with urine flow, urinary frequency and urinary tract infections), and the need for assistance with personal care. The Annual Minimum Data Set (MDS) dated [DATE] assessed R18 with a Brief Interview of Mental Status (BIMS) score of 10 indicating moderate cognitive impairment. R18 required extensive assistance of one staff for toilet use 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.

The facility reported a census of 41 residents. Based on interview and observation, the facility failed to appropriately label and store drugs for five residents; when two insulin medications lacked open dates for Resident (R ) 31 and 147; two eye drops lacked opened dates for R30 and R19; and two expired medications remained in the medication carts for R15 and R21. Findings included: - On 08/24/21 at 02:24 PM, inspection of the Certified Medication Aide (CMA) medication cart with CMA R revealed the following: One opened bottle of flonase nasal spray, with pharmacy labeled for Resident (R)15, with an expiration date of 05/15/20. One open bottle of pataday eye drops, with pharmacy labeled for R19, which lacked an opened date. One opened bottle of latanoprost eye drops, with pharmacy labeled for R30, which lacked an open date. Furthermore, on 08/24/21 at 04:58 PM, inspection of the west nurses' medication cart, with Licensed Nurse (LN) H, revealed the following: One open aspartamine insulin pen, ready for use, with pharmacy labeled for R147, which lacked an open date. LN H stated she…

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 The facility reported a census of 41 residents. The sample contained 12 residents. Based on interview and record review, the facility failed to review and revise the care plan for two sampled residents including, Resident (R)6, related to interventions following falls to prevent further accidents and R31, related to care and services for a urinary catheter to prevent urinary tract infections and/or urethral trauma. Findings included: - The signed Physician Order Sheet (POS), dated 07/16/21, documented R6's diagnoses included anxiety (mental or emotional reaction characterized by apprehension, uncertainty and irrational fear), depressive disorder (abnormal emotional state characterized by exaggerated feelings of sadness, worthlessness, emptiness and hopelessness), and unspecified dementia (progressive mental disorder characterized by failing memory, confusion). A significant change Minimum Data Set (MDS), dated [DATE], documented the resident as unable to complete the Brief Interview for Mental Status (BIMS).…

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 The facility reported a census of 41 residents with 12 selected for review including two reviewed for falls. Based on observation, interview, and record review, the facility failed to follow interventions on the care plan for Resident (R)35 to prevent further falls and failed to follow interventions on the care plan for R6 and implement new interventions following falls to prevent further falls. Findings included: - The Order Summary Report, dated 07/16/21, for Resident (R)35 included diagnoses of muscle weakness, abnormalities of gait and mobility, unsteadiness on feet, and Alzheimer's disease (progressive mental deterioration characterized by confusion and memory failure). The Annual Minimum Data Set (MDS), dated [DATE], assessed R35 with short and long term memory impairment and severely impaired decision making. She required extensive assistance of one staff for bed mobility, walking in and out of the room, locomotion on and off the unit, and toilet use. R35 required extensive assistance of two or more staff…

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 The facility reported a census of 41 residents. The sample contained 12 residents, with one selected for review of urinary catheters. Based on observation, interview and record review, the facility failed to appropriately manage the catheter of one of one resident, to prevent urinary tract infections and or urethral trauma to Resident (R) 31. Findings included: - The signed Physician Order Sheet (POS), dated 07/12/21, documented R31's diagnoses included benign prostatic hyperplasia (non-cancerous enlargement of the prostate which can lead to interference with urine flow, urinary frequency and urinary tract infections), and unspecified dementia (progressive mental disorder characterized by failing memory, confusion). An annual Minimum Data Set (MDS), dated [DATE], documented R31's Brief Interview for Mental Status (BIMS) score was 15, which indicated he was cognitively intact. He did not have a urinary catheter. The Urinary Incontinence and Indwelling Catheter Care Area Assessment documented resident was always…

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.