Casa De Ramana Rehabilitation Center

Based on interview, and record review, the facility failed to ensure that information to file a grievance or complaint was readily available to residents during their facility stay, for seven Residents out of 13 residents. Specifically, for seven residents attending the Resident Council group meeting during the facility survey, the facility failed to ensure residents had access to grievance/concern/complaint forms so the residents could formulate grievances anonymously, should they choose not to alert a staff member of their concern(s). Findings include: Review of the facility policy titled Resident Rights and Responsibilities Guideline, last revised 9/27/18, indicated: -upon admission the Director of Admissions/Designee provided residents with a copy of Residents Rights. -you may voice grievances concerning your care without fear of discrimination or reprisal. Review of the facility's policy titled Resident- Grievance Guideline, last revised 6/26/19, indicated that it is the policy of this organization to: -support each Resident's right to voice concerns/grievances. -uphold 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.

Based on record review, and interview, the facility failed to accurately complete a Level I Preadmission Screening and Resident Review (PASARR- screen to determine if a resident had an intellectual or developmental disability (ID or DD) and/or serious mental illness (SMI) and needed further evaluation) for one Resident (#87), out of a total sample of 22 total residents. Specifically, for Resident #87, the facility failed to accurately complete a Level I PASRR indicating that the Resident had a diagnosis of Bipolar Disorder, and received emergency psychiatric services while hospitalized within the last two years in the community, resulting in a Level II PASRR Evaluation (an evaluation conducted to determine if an individual who screened positive for an SMI or ID/DD requires specialized services) not being completed as required. Findings include: Resident #87 was admitted to the facility in November 2023, with diagnoses including Bipolar Disorder (a mental health condition that causes extreme mood swings that include emotional highs [mania or hypomania] and lows [depression]), Anxiety…

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, interview, and record review, the facility failed to provide Activities of Daily Living (ADLs: fundamental skills required to independently care for oneself, such as eating, bathing, and mobility) care and services pertaining to mobility for one Resident (#106), out of a total sample of 22 residents. Specifically, the facility failed to provide care and services that would maintain and/or improve Resident #106's functional mobility when the Resident was discontinued from Physical Therapy (PT) services and required the assistance of one staff member with ambulation. Findings include: Resident #106 was admitted to the facility in September 2024 with diagnoses including muscle weakness (lack of muscle strength), Wernicke's Encephalopathy (a brain and memory disorder caused by a lack of thiamine [vitamin B1], that causes mental confusion, vision problems, and lack of muscle coordination), Metabolic Encephalopathy (altered mental status) and Cognitive Communication Deficit (difficulty in…

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 provide assistance with activities of daily living (ADLs- fundamental skills required to independently care for oneself, such as eating, bathing, and mobility) for one Resident (#1) out of a total sample of 22 residents. Specifically, the facility failed to ensure Resident #1 was provided personal hygiene assistance for nail trimming and cleaning. Findings include: Review of the Facility policy titled ADL Support Guideline, dated 8/10/17, indicated: -Residents who are unable to carry out ADLs independently will receive the services necessary to maintain good nutrition, grooming, and personal and oral hygiene. Resident #1 was admitted to the facility in August 2021, with diagnoses including Non-Traumatic Intracerebral Hemorrhage (bleeding in the brain that occurs without trauma or surgery), Intraventricular (a sudden bleeding in the tissues and ventricles of the brain) and Hemiplegia (paralysis of one side of the body) and Hemiparesis (muscle weakness or partial paralysis on one side of the body) 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 records reviewed and interviews, for one of three sampled residents (Resident #1), who had moderate cognitive impairment, the Facility failed to ensure staff implemented and followed their Abuse Policy when on 08/14/24 sometime between 5:30 A.M. and 6:00 A.M. (exact time unknown), after witnessing Certified Nurse Aide (CNA) #1 put a blanket across Resident #1's lap/torso and secure it in place by tying it behind his/her wheelchair, CNA #2 did not report the incident to Nurse #1 or Administration, and Resident #1 remained in his/her room, unattended by staff, secured in his/her wheelchair for at least three hours before another staff member discovered and released it. Findings include: Review of the Facility Policy titled Abuse Prohibition Guideline, dated as review 10/24/22, indicated the following: -the resident has the right to be free from abuse, neglect, misappropriation of resident property and exploitation. This includes freedom from corporal punishment, involuntary seclusion, and physical and chemical restraint not required to treat the resident's medical symptoms, -…

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 reviews, policy review and interview the facility failed to ensure a dignified dining experience for two Residents (#61 and #103) out of a total sample of 22 residents. Specifically, the facility staff did not promote dignity for Residents #61 and #103, by standing over both residents rather than sitting at eye level, while assisting them with their meals. Findings include: Review of the facility policy for Dignity, dated 9/20/18, indicated that residents who require staff assistance for feeding shall be fed by a staff member who is seated in a chair next to the residents, and staff shall not feed residents while in a standing position. 1. Resident #61 admitted to the facility in June 2023 with diagnoses including Dementia (a range of conditions that affect the brain's ability to think, remember, and function normally) and Dysphagia (difficulty swallowing food or liquid). Review of Resident #61's care plan for Activities of Daily Living (ADL's) last revised 6/20/23, indicated an…

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, record review and interview, the facility failed to provide necessary activities of daily living (ADLs-bathing, dressing, grooming) for one Resident (#80), out of a total sample of 22 residents. Specifically, the facility staff failed to provide grooming pertaining to facial hair removal for Resident #80, who was unable to carry out his/her own ADLs. Findings include: Resident #80 was admitted to the facility in August 2020 with diagnoses including severe Dementia with agitation, and symptoms involving impaired cognitive functions. Review of Resident #80's care plan titled ADLs, revised 6/29/23, indicated the Resident had an ADL self-care performance deficit and the goal was to maintain the current level of function in ADLs. Review of Resident #80's care plan titled Alteration in Musculoskeletal Status Related to Right Wrist Drop, revised 6/29/23, indicated the following intervention: -Assist with ADLs and feeding if needed. Review of a Minimum Data Set (MDS) assessment dated [DATE],…

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, document review and interview, the facility failed to ensure the environment remained as free of accidental hazards for one Resident (#77), out of a total sample of 22 residents. Specifically, the facility staff failed to ensure that Resident #77 did not maintain smoking materials on his/herself as agreed by his/her signing the facility smoking policy. Findings include: Review of the facility's Smoking Guideline policy, dated 4/21/23, indicated the following: -According to State Fire Safety Codes, the Administrator/designees implements methods for the storage of smoking materials, i.e.: matches, lighters, and cigarettes per safety codes. -The Interdisciplinary Team (IDT) ensures a Safe Smoking Evaluation is completed at the time of admission and/or when a resident expresses a desire to smoke (this must be completed for electronic cigarette/vaping devices also). -A Safe Smoking Evaluation will also be completed on a quarterly basis thereafter, and during a significant change of condition. -The evaluation is reviewed by the IDT for ongoing evaluation 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 record review and interview, the facility failed to provide Dialysis (a treatment use to clean the blood when the kidneys are not able remove waste and extra fluids in the blood) care and services for one Resident (#36), out of two applicable residents, in a total sample of 22 residents. Specifically, for Resident #36, the facility failed to ensure that post dialysis weights were documented as ordered by the Physician. Findings include: Resident #36 was admitted to the facility in January 2023 with a diagnosis of Chronic Kidney Disease (CKD-disease characterized by progressive damage and loss of function in the kidneys). Review of Resident #36's dialysis care plan dated 6/22/23, included the following: -Goal: Resident shall attend dialysis appointments as scheduled through the next review. -Intervention: Coordinate services with Dialysis. Monitor labs and vital signs as ordered. Review of a Physician's order dated 6/23/23, indicated: -Dialysis Days: Monday, Wednesday, and Friday at 6:30 A.M. Review 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.