Lenoir Health Care Center

Based on observation, interview and record review, the facility staff failed to store food in a manner to prevent potential contamination, out-dated use and reuse of single-service containers. This failure had the potential to affect residents who dined in the Woods Central and Olive [NAME] units and residents who received modified textured diets. The facility census was 48. 1. Review of the facility's Food Storage Policy, revised 10/01/20, showed: -Inspect food regularly for damage due to spoilage; -Items that arrive in their original packaging with a manufacturer's expiration date will utilize that date for discard: a. Should an item be opened and stored in a different container, it will be labeled with an open date and discard date; -Food safety practices based on ServSafe Standards will be followed at all times. Review of the ServSafe Manager's Manual, 7th edition, Chapter 5 (The Flow of Food: Purchasing, Receiving, and Storage) showed: -Following good storage guidelines for food and nonfood items will help keep these items safe and preserve their quality. In general, you must…

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, facility staff failed to use enhanced barrier precautions (EBP) (an infection control practice that requires staff to wear personal protective equipment (PPE) for five residents (Resident #15, #25, #27, #40, and #14) of five sampled residents who required care. The facility census was 48. 1. Review of the facility policy titled Enhanced Barrier Precautions, dated 02/25/25, showed EBP are utilized to prevent the spread of multi-drug resistant organisms (MDRO)s (bacteria or fungi that have developed resistance to one or more classes of antimicrobial agents, making them difficult to treat) to residents. EBPs employ targeted gown and glove use during high contact resident care activities when contact precautions do not otherwise apply. Gloves and gown are applied prior to performing the high contact resident care activity (as opposed to before entering the room) for residents that have a wound or indwelling medical device, and secretions or excretions that are…

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, facility staff failed to use appropriate infection control procedures to prevent the spread of bacteria or other infectious causing contaminants when staff failed to perform appropriate hand hygiene and glove changes during incontinent care for three residents (Resident #32, #35, and #36), and failed to properly handle soiled linens for one resident (Resident #36). The facility census was 49. 1. Review of the facility's Hand Hygiene policy, reviewed 01/30/24, showed all personnel shall follow the handwashing/hand hygiene procedures to help prevent the spread of infection to other personnel, residents, and visitors. Review showed: -Use an alcohol-based hand rub containing at least 60% alcohol, or, alternatively soap (antimicrobial or non-antimicrobial) and water for the following situations: a. Before and after contact with residents; b. Before moving from a contaminated body site to a clean body site during resident care; c. After removing gloves; -The use 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, resident and staff interview, and record review, facility staff failed to provide safe mechanical lift transfers for four (Resident #28, #29, #32, and #35) out of 13 sampled residents. Facility staff failed to provide safe medication storage for three residents (Resident #23, #36, and #8). The facility census was 49. 1. Review of the facility's Safe Lifting and Movement of Residents policy, dated 10/14/19, showed staff were directed as follows: -Staff responsible for direct resident care will be trained in the use of a mechanical lifting devices; -Staff will be observed for competency in using mechanical lifts and observed periodically for adherence to policies and procedures regarding the use of equipment and safe lifting techniques. Review of the mechanical lift manufacturer's manual, dated 10/01/18, showed a warming, the legs of the lift must be in the maximum open position for optimum stability and safety. If it is necessary to close the legs of the lift to maneuver the lift under 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 interviews and record review, staff failed to maintain a professional standard of care when staff failed to ensure one resident's (Resident #36) care plan for advanced directives (code status - decision to start or withhold Cardiopulmonary Resuscitation - CPR) matched the physician ordered advanced directive and failed to notify the physician for further direction when an ordered supplement was unavailable. The facility census was 49. 1. Review of the facility's Advanced Directives policy, reviewed [DATE], showed: -Prior to admission or upon admission of a resident, the Social Service Director (SSD) or designee will inquire of the resident and their representative about the existence of any written advanced directive; -Information about whether or not the resident has executed an advanced directive shall be displayed in the ribbon in the Electronic Health Record (EHR); -The plan of care for each resident will be consistent with their documented treatment preferences and/or advanced directives; -A 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.

Based on observations, interviews and record review, facility staff failed to review, revise and develop individualized interventions for one resident (Resident #5) who exhibited behaviors. The facility census was 49. 1. Review of the Facility Assessment, dated July 2023 through June 2024, showed: -Twenty-eight residents with a diagnosis of Alzheimer Disease (A progressive disease that destroys memory and other important mental functions); -Twenty-one residents with a diagnosis of unspecified dementia (A group of thinking and social symptoms that interferes with daily functioning). Review of the facility's Mood and Behavior policy, undated, showed: -To provide a plan of care that is individualized to the resident's needs based on the comprehensive assessment by the interdisciplinary team; -An initial care plan identifying resident mood and behavior needs will be completed and communicated to care givers; -Any mood and behavior symptoms will be documented by the Interdisciplinary Team while caring for the resident, as well as interventions attempted and outcome; -The community will…

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 staff failed to properly store open food to prevent cross-contamination and outdated usage, to maintain kitchen equipment in a clean and sanitary manner, and to perform hand hygiene and change gloves as often as necessary to prevent cross contamination. This failure had the potential to affect all facility occupants. The census was 32. 1. Review of the facility's Food Storage and Safety Policies, dated 9/10/19, showed staff are directed to contain, store, label, and date everything properly. Observation on 2/1/23 at 12:20 P.M. in the Reach kitchen, showed a refrigerator contained: - Four uncovered cups of orange liquid not labeled, four uncovered cups of brown liquid not labeled, and four uncovered cups of clear liquid not labeled; - Multiple small bowls of citrus slices undated and not labeled; - One container of sliced white circles undated and not labeled. Observation on 2/1/23 at 12:25 P.M. in the Reach kitchen, showed the one opened 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.

Based on interview and record review, facility staff failed to check the Certified Nurses' Assistant (CNA) Registry before hire for all staff in accordance with their policy to ensure they did not have a Federal Indicator (a marker given by the federal government to individuals who have committed abuse/neglect) for three employees (Housekeeper J, Dining Service K and Security L) out of ten sampled employees hired since the last survey. The census was 32. 1. Review of the Pre-Employment Screening Procedures Policy, Revised 3/6/20, showed the following: Background check -Concurrent to the candidate completing the pre-employment testing, the HR Representative will run all required background checks. The HR Representative will log into the background check vendor's site to order the appropriate background check. This includes: -Missouri Nurse Aide Registry (CNA). 2. Review of House Keeper J's employee file, showed the following: -Hire date of 6/20/22; -Staff did not document a CNA registry check was completed. 3. Review of Dining Services K's employee file, showed the following: -Hire…

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, facility staff failed to maintain professional standards of practice by not completing neurological assessments (evaluation completed by staff for early detection of nervous system damage following head trauma) following unwitnessed falls, and falls with a known head injury, for five residents (Resident #6, #16, #20, #23, and #25). The facility census was 32. 1. Review of the facility's Fall and Fall Risk, Managing policy, dated September 2022, showed staff are directed as follows: -A fall without injury is still a fall; -Unless there is evidence suggesting otherwise, when a resident is found on the floor, a fall is considered to have occurred; -The staff, with the input of the attending physician, will implement a resident-centered fall prevention plan to reduce the specific risk factor(s) of falls for each resident at risk or with a history of falls; -If falling recurs despite initial interventions, staff will implement additional or different interventions,…

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, facility staff failed to propel residents in wheelchairs in a manner to prevent accidents by failing to use foot rests, for four residents (Residents #4, #7, #17, and #24). The facility census was 32. 1. Review of the facility's policy titled Assistive Equipment Devices, dated 10/01/18, showed the community provides, maintains, trains, and supervises the use of assistive devices and equipment for residents. The policy shows staff will be trained and will demonstrate competency on the use of devices and equipment prior to assisting or supervising residents. Residents, family, and visitors will be trained, as indicated, on the safe use of equipment and devices. The Assistive Equipment Device policy does not address the use of foot pedals when propelling a resident in a wheelchair. 2. Review of Resident #4's quarterly Minimum Data Set (MDS), a federally mandated assessment instrument completed by facility staff, dated 1/23/23, showed the following: -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 observation, interview and record review facility staff failed to assess for risk of entrapment upon initiation and/or quarterly, and/or obtain informed consent for bed rails for two residents (Resident #23 and #288). The facility census was 32. 1. Review of the facility's Proper Use of Bed Assistive Devices policy, revised 9/16/22, showed: -An assessment will be made to determine the resident's symptoms or reason for using the bed assistive device upon initiation, quarterly, and as needed; -The use of bed assistive devices will be addressed in the resident's care plan; -Consent for using bed assistive devices will be obtained from the resident or resident representative and documented by community protocol; -When a bed assistive device is appropriate, the community should assess the resident's risk for entrapment, and ensure the bed's dimensions are appropriate for the resident's size and weight upon initiation, quarterly, and as needed. 2. Review of Resident #23's significant change Minimum Data Set…

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.