Butler Rehab And Healthcare Center

Based on observation, interview and record review, the facility failed to ensure the physician's order prescribed enteral supplemental tube feeding (tubes inserted into the gastrointestinal tract to provide a patient with enteral nutrition) formula and failed to update the resident's care plan to include details on the prescribed tube feeding formula for one sampled resident (Resident #7) who was dependent on enteral nutritional feedings out 14 sampled residents. The facility census of 59 residents. Requested the facility's Tube Feeding policy did not receive at time of exit. Review of the tube feeding formula manufacture information on website dated 2026 showed: -Diabetisource AC 1.2 calories (cal) per milliliter (ml) (a tube feeding formula made with a unique blend of carbohydrates that includes pureed fruits and vegetables for resident that are diabetic for reduce sugar intake). -Fibersource HN 1.2 cal (a nutritionally complete tube feeding formula with fiber, contains protein from milk and soy and was Lactose intolerance and gluten-free).1. Review of Resident#7's admission…

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 ensure respiratory face masks and tubing were covered to prevent cross contamination when not in use for two sampled residents (Resident #13, and #6) out of 14 sampled residents. The facility census was 59 residents. Review of the facility Oxygen Administration policy and procedure dated 10/24/22, showed:-All oxygen tubing, humidifiers, masks and cannulas used to deliver oxygen are for single resident use only and will be changed weekly when visibly soiled or as indicated.-Oxygen items will be stored in a plastic bag at the resident's bedside to protect the equipment from dust and dirt when not in use. 1. Review of Resident #13's Face Sheet showed he was admitted with diagnoses that included:-Chronic Obstructive Pulmonary Disease (COPD a condition involving constriction of the airways and difficulty or discomfort in breathing).-Heart disease.-Respiratory failure.-Chronic cough.-Rhinitis (the inflammation and swelling of the mucous membrane…

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 a cold dish (cottage cheese fruit plate) was served at a temperature at or close to 41 F (degrees Fahrenheit) to three residents who received room trays and resided on the 100 Hall. The facility census was 59 residents. 1. Review of the undated recipe for cottage cheese fruit plate, showed:-Ingredients which included lettuce leaves, cottage cheese, diced peaches, diced fruit and maraschino cherry halves.-Methods which included: Return ingredients to refrigerator storage if preparation is interrupted.-Place a 4-ounce scoop of cottage cheese on top of lettuce leaf.-Drain canned fruit.-Arrange 4 ounces of fruit around the cottage cheese.-Critical Control Point (CCP- specific step or procedure in a process where control can be applied to prevent, eliminate, or reduce a food safety hazard (biological, physical, or chemical) to an acceptable level, hold for service at 41 F or lower.Observation on 2/23/25 at 11:53 A.M. showed Dietary Aide (DA) A placed the bowls of cottage cheese fruit plate on room tray…

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 the pureed (food that is blended, chopped, mashed, or strained until it becomes a soft and smooth consistency) chicken tenders were a smooth consistency. This practice potentially affected two residents with pureed diets. The facility census was 59 residents. 1. Review of the undated recipe for pureed baked chicken, for 1 serving, showed:-1 serving of baked chicken.-Chicken base to taste with 1 ounce of water. -Commercial thickener (a substance such as cornstarch or other carbohydrate which is added to foods to increase the viscosity of liquids without altering their, taste).Observation on 2/23/26 at11:24 A.M., showed the Dietary Manager (DM):-Made pureed chicken and added broth, but did not add thickener.-There was not a recipe book open while he/she made the pureed chicken.-After he/she placed the pureed chicken in a pan, he/she did not taste the chicken.Observation on 2/23/26 at 12:02 P.M., showed the state surveyor:-Tasted the pureed chicken. -The pureed chicken did not have a smooth texture and was…

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 and record review, the facility failed to ensure a safe and appropriate discharge when the facility staff sent one resident, (Resident #1) out of seven sampled residents, to the hospital with discharge paperwork indicating to return the resident to a homeless shelter in the city. The facility census was 55 residents. A discharge policy was requested from the facility and not received.1. Review of Resident #1's face sheet, undated, showed:-The resident was admitted to the facility on [DATE].-The resident was his/her own representative.Review of the resident's quarterly Minimum Data Set (MDS-a standardized assessment tool that measured health status in nursing home residents) dated 5/22/25, showed:-The resident was cognitively intact. -The resident had diabetes (a chronic condition where blood sugar levels are too high).-The resident had a Traumatic Brain Injury (TBI- an injury to the brain caused by an external physical force, such as a blow, bump, jolt, or penetration to the head).Review 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 and record review, contracted Physical Therapy Assistant (PTA) A did not adhere to resident's rights to be informed of care or refuse care by not explaining each treatment he/she was providing for seen residents prior to providing their treatments for seven residents (Residents #1, #2, #3, #4, #5, #6 and #7) causing those residents to feel uncomfortable with the PTA A's treatments out of eleven sampled residents. The facility census was 77 residents. On 4/29/25, the facility Administration was notified of the past noncompliance which occurred on 4/21/25. Facility staff were educated on resident rights, informed care, abuse and neglect protocols and customer service. The deficiency was corrected on 4/21/25. Review of the facility's Resident Rights-Quality of Life Policy revised on May 1, 2023 showed: -The purpose of the policy was to ensure that all residents are treated with the level of dignity they are entitled to while residing at the facility. -Each resident was to have been cared for in 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 interview and record review, the facility failed to ensure one sampled resident's (Resident #29) care plan was updated to reflect an unstageable pressure ulcer (full thickness tissue loss in which the base of the ulcer is covered by slough (yellow, tan, gray, green or brown) and/or eschar (tan, brown or black) in the wound bed); failed to ensure one sampled resident's (Resident #18) care plan was updated to reflect requiring assistance / supervision with smoking; failed to ensure one sampled resident's (Resident #38) care plan was updated to reflect his/her current pain level, frequency, and interventions; failed to ensure one sampled resident's (Resident #46) care plan reflected all pressure ulcers (localized injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination with shear and/or friction) were addressed with current status and interventions/treatments out of 15 sampled residents. The facility census was 56 residents. Review 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 observation, interview, and record review, the facility failed to ensure residents were screened for Tuberculosis (TB-a communicable disease that affects especially the lungs, that is characterized by fever, cough, difficulty in breathing, abnormal lung tissue and function) for four sampled residents (Resident #29, #38, #47, and #50) out of 15 sampled residents; and failed to properly screen new employees for TB for two sampled employees, (Employee's G and J) out of ten sampled new employees prior to hire. The facility census was 56 residents. Review of the facility's policy (Tuberculosis - Screening) dated October 24, 2022 showed: -The facility screened residents for TB upon admission, readmission, and as indicated thereafter. -Any resident without documentation receives a baseline (two-step test) upon admission. -When the first TB test is negative, a follow-up TB test is administered one to three weeks after the initial test was read. -The Attending Physician screens new admissions for possible signs…

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 and record review, the facility failed to provide 12 hours of training/in-services to include behavior and dementia training, abuse and neglect prevention, and resident rights, for three Certified Nursing Assistants (CNA B, C, & D). The facility census was 56 residents. A policy was requested and not provided by the time of exit. 1. Review of the list of current employees who were CNA's showed three CNA's were chosen for records to be reviewed for the required 12 hour training/in-services. 2. Review of CNA B's training record dated April 2023 to April 2024 showed he/she was hired on 8/27/21 and worked as needed (PRN) and attended the following in-services: -On 4/28/23 nurses meeting (did not say what the topic was). -On 5/19/23 COVID changes, Transmission Based Precautions (TBP), New owner. -On 7/31/23 abuse prevention and prohibition program, interact-stop and watch early warning tool. -He/She did not receive training/in-services for the following: --Abuse and Neglect. --Behavior and dementia…

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 interview and record review, the facility failed to develop a spend down plan for two sampled residents (Resident #13 and #18) out of two residents sampled for the resident fund review process, who maintained a balance of more than $5,726.00 (the legal Missouri Medicaid limit) in their account for more than one month. The total facility census was 56 residents. Review of the facility's policy titled Resident's Funds Handling and Recording revised 10/24/22 showed: -The facility would notify the resident if his/her Resident Trust Fund (RTF) account was within $200.00 of the Social Security Income (SSI-Medicaid) legal limit. 1. Review of Resident #13's RTF statements showed: -On 9/1/23 the resident's balance was $8049.94. -On 10/3/23 the resident's balance was $8806.38. -On 11/3/23 the resident's balance was $8993.86. -On 12/30/23 the resident's balance was $9303.54. -On 1/3/24 the resident's balance was $9656.71. -On 2/2/24 the resident's balance was $11044.75. -On 3/1/24 the resident's balance was $10800.34. 2. Review of Resident #18's RTF statements showed: -On 9/5/23 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 Based on interview and record review, the facility failed to properly and accurately document a resident's advanced directives (wishes for what procedures, if any, a person would like to have should the heart stop beating and/or they stopped breathing) by reporting full code (giving the resident Cardiopulmonary Resuscitation CPR- An emergency procedure used to restart a person's heartbeat and breathing after one or both have stopped) and Do Not Resuscitate (DNR-do not provide life-saving measures) on the resident's care plan for one sampled resident (Resident #27) out of 15 sampled residents. The facility census was 56 residents. Review of the facility's Advance Directives Policy, dated [DATE], showed: -The facility respected a resident's advance directive and complied with the resident's wishes expressed in the advance directive. -Upon admission the admission staff obtained a copy of a resident's advance directive. -A copy of the resident's advance directive was included the resident's medical record. -Advance…

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 interview and record review the facility failed to follow their policy to conduct Criminal Background Checks (CBC) for new employees, not having on the policy to check the Nurses Aide (NA) Registry (a data base that provided the list of eligible nursing assistants who can be employed by long-term care facilities as health workers) for all employees prior to hire, and not completing a check of the NA Registry for two sampled employees (Employee B and Employee F) out of ten sampled new employees. The facility census was 56 residents. Review of the facility's Staff Screening policy, dated 10/24/22, showed: -Prior to employment the facility verified and documented or obtained a copy of the following information: --Previous/current employer regarding work history, allegations of abuse against residents, employees, or others. --Criminal Background Checks. --National Sex Offender Public Website. --Office of Inspector General Exclusion Screening. --State exclusion screening, if applicable. --Current licenses and certifications. --References and disclosure of information. -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 observation, interview and record review, the facility failed to provide treatment/services, equipment, supplies or assistance to maintain and improve range of motion (ROM) and mobility for one sampled resident (Resident #38) reviewed for ROM out of 15 sampled residents. The facility census was 56 residents. Review of the facility policy titled Range of Motion Exercises dated 10/24/22 indicated: -Staff used a physician order to deliver ROM exercises to residents. -The exercises were used to prevent/decrease contractures and increase ROM for a joint. 1. Review of Resident #38's undated face sheet indicated he/she had the following diagnoses: -Cerebral infarction (stroke). -Dysphasia (impairment in the production of speech resulting from brain disease or damage). -Hemiplegia and hemiparesis following cerebral infarction affecting the left side (paralysis of the left side of the body). -Muscle weakness. Review of the resident's admission orders showed an order for a left arm splint dated 2/1/24 with no end date. Review of the resident's Interdisciplinary Rehabilitation…

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 and record review, the facility failed to ensure the resident's monthly pharmacy Drug Regimen Review (DRR) recommendations were reviewed and acted upon by the physician, for one sampled resident (Resident #29), out of 15 sampled residents. The facility census was 56 residents. Review of the facility's policy titled Drug Regimen Review dated 10/24/22 showed: -The pharmacist was responsible for reviewing each resident's medication regimen at least once a month to identify irregularities and to identify clinically significant risks and/or actual or potential adverse consequences which may result from or be associated with medications. -The pharmacist was responsible for reporting any irregularities to the Attending Physician, the facility's Medical Director, and the Director of Nursing (DON), and these reports must be acted upon. -The pharmacist performing the Drug DRR will review the residents' medical records to appropriately monitor the medication regimen and verify the medication 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.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview, and record review, the facility failed to ensure two sampled residents (Resident #25 and #51) received dental services for broken teeth out of 15 sampled residents. The facility census was 56 residents. Review of the facility's policy, Dental Services dated October 24, 2022 showed: -It was the responsibility of each staff member within the nursing department to ensure good oral care for each resident. -An assessment of the oral cavity and teeth was to have been preformed upon admission and as necessary. -Observe mouth for any adverse conditions such as bleeding, swelling, unusual mouth odor or any complaint of pain or discomfort. -Note any such condition in the resident's chart. -Report problem to the charge nurse. -Refer and or assist the resident to obtain dental services as indicated for routine and emergency dental care including making appointment for the resident, if needed or requested and arranging transportation to and from the dentist's office. -Routine services include…

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 interview and record review, the facility failed to develop a comprehensive and complete Emergency Operational Preparedness (EOP) program that included plans and procedures relating to the electrical power system where the critical safe devices, appliances and facility fixtures and systems were not listed as being supported by the essential electrical systems (EES) or generator. The lack of emergency operational ability and functionality of the facility would have a direct effect on the residents and staff in the event of a normal electrical supply being interrupted during an emergency or evacuation. This deficient practice potentially affects all residents, family, visitors, and staff who reside, use, visit, volunteer, or work in the facility's six facility smoke compartments. The facility census was 64 residents with a capacity for 98 residents. 1. Record review of the facility's Emergency Operations Plan (EOP) updated on 1/7/22 showed, in the event of an interruption of normal electrical power, no documentation of what would supply electricity to the following devices,…

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 interview and record review, the facility failed to ensure the Employee Disqualification List (EDL), Criminal Background Checks (CBCs), and/or the Nurse Aide (NA) Registry were completed prior to hire, re-hire, and/or periodically, and to ensure potential employees did not have a Federal Indicator (FI - a marker given to a potential employee who has committed abuse, neglect, or misappropriation of property against residents) prior to hire for ten out of ten sampled employees. The facility census was 64 residents. Record review of the facility's Employee Background Checks (Screening) F606 policy last revised 11/2017 showed: -Background checks are completed per state guidelines on each employee. -The facility would not knowingly employee individuals who have been found guilty of abusing, neglecting or mistreating residents or misappropriating their properties and/or, have findings entered into the State nurse registry or licensing authorities any knowledge of actions by court of law during background checks or ongoing employment. -All employees would have CBCs, State 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.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interview and record review, the facility failed to the extent practicable, to include residents and their representatives in the care planning process and to conduct care plan conferences to include resident/resident representative participation for four sampled residents (Residents #38, #16, #20, and #22) out of 16 sampled residents. The facility census was 64 residents. Record review of the facility policy Comprehensive Care Plans revised 11/2017 showed: -The facility's care planning/Interdisciplinary team, in coordination with the resident, his/her family member or representative, developed and maintained a comprehensive care plan for each resident that identified the highest level of function the resident may be expected to obtain. -Assessments of residents were ongoing and care plans revised as information about the resident's conditions changes. 1. Record review of Resident #38's admission Record showed he/she was admitted to the facility on [DATE]: -Had the following diagnoses: --Parkinson's…

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 and record review, the facility failed to ensure recommendations from the pharmacist for Gradual Dose Reduction (GDR) of psychotropic medications (drugs which affect psychic function, behavior, or experience) were acted upon or acted upon timely by the resident's physician for four sampled residents (Resident's, #33, #20 #50, and #38) out of 16 sampled residents. The facility census was 64 residents. Record review of Policy titled Tapering Medications and Gradual Dose Reduction-F 758 dated 9/2012 and revised 11/2017, and last approved on 5/2022 showed: -Tapering of medications and gradual dose reductions would be completed in consultation with the Attending Physician and Consultant Pharmacist and would be conducted per CMS guidelines. -The Consultant Pharmacist would consider tapering of medications or a gradual dose reductions as one approach to find an optimal dose or determine whether continued use of a medication benefited the resident. -Tapering would be per current CMS guidelines.…

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 interview and record review, the facility failed to maintain an infection prevention and control program designed to help prevent the development and transmission of communicable diseases when the facility failed to properly screen new employees for tuberculosis ((TB) a communicable disease that affects especially the lungs, that is characterized by fever, cough, difficulty in breathing, abnormal lung tissue and function) for five out of ten sampled new and continuing employees (Employees C, E, F, I and J) prior to and after their hire date per the facility policy. The facility census was 64 residents. Record review of the facility's, Tuberculosis, (TB) Employee Screening for F880, policy dated September 2021 showed the Employee Health Coordinator (or designee) would accept documented verification of two-step TST (TB skin test), BAMT (a TB test checks to see if you have been infected with Mycobacterium tuberculosis complex, which is the bacteria that causes tuberculosis (TB)), or chest x-ray results from the applicant within the preceding 12 months and/or arrange for all TB…

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 and record review, the facility failed to offer/formulate advanced directives (documents that allow one to communicate their health care preferences when decision-making capacity is lost) and/or a Durable Power of Attorney (DPOA- a person previously identified to make decisions for an individual in the event of inability to make wishes known) for two sampled residents (Resident #50 and #16) out of 16 sampled residents. The facility census was 64 residents. Record review of the facility policy Advanced Directives revised 11/2017 showed: -Prior to or upon admission written information would be given to the resident/family regarding formulating advanced directives and request any current advanced directives. -The advanced directives would be reviewed annually. 1. Record review of Resident #50's admission Record showed he/she was admitted to the facility on [DATE] and had the following diagnoses: -Stroke. -Dysphagia (inability or difficulty swallowing). -Aphagia (loss of ability to produce or…

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 interview and record review, the facility failed to provide a completed Skilled Nursing Facility Advance Beneficiary Notice (SNFABN - form CMS-10055) at the termination of Medicare Part A benefits for two sampled residents (Resident #47 and #43) out of two sampled residents who remained in the facility upon discharge from Medicare Part A services. The facility census was 64 residents. Record review of the Centers for Medicare and Medicaid Services Survey and Certification memo (S&C -09-20), dated 1/9/09 showed: -The Notice of Medicare Provider Non-Coverage (NOMNC - form CMS-10123) is issued when all covered Medicare services end for coverage reasons. -If the Skilled Nursing Facility (SNF) believes on admission or during a resident's stay that Medicare will not pay for skilled nursing or specialized rehabilitative services and the provider believes that an otherwise covered item or service may be denied as not reasonable or necessary, the facility must inform the resident or his/her legal representative in writing why these specific services may not be covered and 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, interview, and record review, the facility failed to ensure a comprehensive care plan was developed and implemented for three sampled residents (Resident #8, #38, and #51) out of 16 sampled residents. The facility census was 64 residents. Record review of Policy titled Care Plans-Comprehensive-F 656, F 657, F 658 dated 9/2012 and revised 11/2017, and last approved on 5/2022 showed: -An individualized comprehensive person centered care plan that included measurable objectives and time frames that met the resident's medical, nursing, mental, and psychological needs was developed for each residents. -Person Centered Care: A focus on the resident as the locus of the community and supported the resident in making their own choices and having control over their daily lives. -The care plan would describe the resident's nursing, medical, physical, mental, and psychosocial prefaces. 1. Record review of Resident #51's Face Sheet showed he/she was admitted to the facility on [DATE]. Record review 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 observation, interview and record review, the facility failed to ensure adequate supervision while eating and drinking for one sampled resident (Resident #50) out of 16 sampled residents who had a diagnosis of dysphagia (inability or difficulty swallowing). The facility census was 64 residents. A policy was requested related to supervised eating but it did not contain information on residents with swallowing issues. 1. Record review of Resident #50's admission Record showed he/she was admitted to the facility on [DATE] and had the following diagnoses: -Stroke. -Dysphagia. -Aphagia (loss of ability to produce or comprehend language due to brain injury). Record review of the resident's physician's Order Summary Report (OSR) dated 3/15/22 showed a order for a regular diet with mechanical soft chopped meat and regular thin liquids. Record review of the resident's significant change Minimum Data Set (MDS-a federally mandated assessment tool required to be completed by staff for care planning) dated 7/14/22…

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 observation, interview and record review, the facility failed to provide necessary behavioral health care services for a resident's psychosocial well-being when staff did not address the resident's behaviors, which included verbal aggression and physical aggression for one sampled resident (Resident #50) out of 16 sampled residents. The facility census was 64 residents. Record review of the facility policy Behavioral Health Services revised 11/2017 showed: -The facility should assess the resident for needed behavioral health services upon admission, quarterly and with a change of condition. -Apply a person centered approach to care which included knowledge of each individual's daily routine, lifelong patterns, interests, preferences and choices. -Interact and communicate with the resident in a manner that promoted mental and psychosocial well-being. 1. Record review of Resident #50's admission Record showed he/she was admitted to the facility on [DATE] and had the following diagnoses: -Stroke.…

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.