Noxubee County Nursing Home

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, staff interview and facility policy review the facility failed to maintain a clean and homelike environment as evidenced by a dirty air conditioning unit in one (1) of 30 rooms observed. room [ROOM NUMBER]. Findings Include: Review of the facility policy, Routine Cleaning and Disinfection with revision date of February 2023, revealed, It is the policy of this facility to ensure the provision of routine cleaning and disinfection in order to provide a safe, sanitary environment and to prevent the development and transmission of infections to the extent possible . An observation on 06/09/25 at 11:23 AM and on 06/11/25 at 2:55 PM, in room [ROOM NUMBER], revealed a dirty air conditioning unit that had a damp, black substance scattered on the plastic slats on the front panel. There were also scattered food particles and dried crumbs on the front lower part of the thermostat section of the air conditioner unit. An observation in room [ROOM NUMBER] and interview with Licensed Practical Nurse (LPN…

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, resident and staff interviews, and facility policy review, the facility failed to address a grievance regarding answering a call light and providing Activities of Daily Living (ADL) care in a timely manner for one (1) of the 17 sampled residents. Resident #45 Findings include: A review of the facility policy titled Policy Statement Filing Grievances/Complaints with a revision date of 3/17/17 revealed, .Staff will assist in completing and filing a grievance or complaint when such requests are made. Grievances include, but are not limited to, resident care, treatment, abuse, neglect .2. Grievances can be filed orally, in writing, or anonymously .4. Grievances will be responded to within 5 working days of the date the grievance was filed. Immediate action will be taken on grievances where alleged violations of any resident rights are reported to prevent further potential violations . An observation and interview on 6/09/25 at 10:20 AM, revealed Resident #45 lying in her bed and she was visibly upset. Resident #45 stated, It has been almost three hours that I have…

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 staff interviews and record review, the facility failed to ensure an as needed (PRN) psychotropic hypnotic medication for insomnia was limited to 14 days or to an appropriate time frame approved by the provider for one (1) of five (5) medication reviews. Resident #20 Findings include: Record review of facility letterhead signed by the Administrator and dated 6/12/25 revealed, (Proper name of facility) does not have a policy on stop dates for psychotropic drugs. Record review of Resident #20's Orders revealed an order dated 4/17/25 for Zolpidem 5 milligram oral tablet .every night at bedtime PRN for insomnia. Record review of Consultant Pharmacist Recommendation to Physician dated 4/23/25, revealed, Ambien 5 mg (milligrams) qhs (every night at bedtime) PRN (as needed) for insomnia. May we extend the above order for 6 months? The physician's response was, Agree .Cont (continue) it 6 months. During an interview on 6/11/25 at 10:10 AM, Registered Nurse/Minimum Data Set Coordinator (RN/MDS) revealed Resident…

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, resident and staff interviews, record review, and facility policy review, the facility failed to implement a person-centered care plan for providing incontinent care for one (1) of the 18 care plans reviewed. Resident #45 Findings include: Record review of facility policy titled Quality of Care undated revealed, Each resident shall receive optimal care to attain and/or maintain the highest mental and physical functional status as defined by the comprehensive assessment and plan of care. Additionally, the resident will receive the appropriate interventions to maintain or to improve his/her abilities. Record review of Resident #45's care plan, updated 4/9/25 revealed Plan Comments: I am incontinent of bowels . Outcomes .I will be kept clean & dry of incontinent bowel .Interventions .Provide incontinence/pericare after each incontinent episode . Record review of Resident #45's care plan, updated 4/9/25 revealed Plan Comments: I have a potential for complications associated with urinary incontinence .Outcomes .I will be kept clean, dry, & comfortable daily…

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, resident and staff interviews, record review, and facility policy review, the facility failed to ensure Activities of Daily Living (ADLs) with incontinent care was provided for one (1) of 17 sampled residents. Resident #45 Findings include: Record review of facility policy titled Quality of Care undated revealed, .The policy of the facility is to establish a minimum acceptable level of daily care, which shall include and involve the maximum utilization of the resident's capabilities, while providing the necessary assistance to accomplish the following: . Toileting .Staff is to check and change incontinent residents every 2 hours and prn (as needed) . On 6/09/25 at 10:20 AM, during an observation and interview revealed Resident #45 lying in her bed visibly upset and stated, It has been almost three hours that I have been sitting in a poopy diaper the last time my diaper was changed was on the night shift. Resident #45 further revealed, I have put my call light on several times this morning. They come in and ask me what I need, and I tell them I need my diaper…

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 staff interview, record review, and facility letterhead review, the facility failed to monitor residents for side effects of anticoagulant medication use for two (2) of five (5) medication reviews. Resident #27 and Resident #56 Findings include: Record review of facility letterhead signed by the Administrator and dated 6/12/25 revealed, (Proper name of nursing home) does not have a policy on anticoagulant monitoring. Resident #27 Record review of Resident #27's Orders revealed an order dated 8/26/24 for Apixaban (Eliquis) 5 milligram oral tablet) .BID (two times daily). During an interview on 6/10/25 at 3:40 PM, Licensed Practical Nurse (LPN) #3 revealed Resident #27 received an anticoagulant medication and acknowledged awareness of the risk of anticoagulant medication use and the need to observe for bruising or bleeding. She revealed there was not an area in the computer documentation to prompt the nurses to monitor or to document that the resident was monitored for bleeding or bruising. During an interview on 6/11/25 at 10:10 AM, the Registered Nurse/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.

Based on observation, interview, and facility policy review, the facility failed to ensure medications were stored properly in a secure manner in the medication cart for one (1) of five (5) medication administration observations. Findings Include: Review of the facility policy titled Medication Storage, undated, revealed .1. General Guidelines: c. During a medication pass, medications must be under the direct observation of the person administering medications or locked in the medication storage area/cart . An observation on 06/11/25 at 9:05 AM, revealed a medication card of Lasix tablets on top of an unattended medication cart. An observation revealed Licensed Practical Nurse (LPN) #1 walked away from the medication cart down to the end of the hall in the sitting area and assisted a resident in a wheelchair to her room to receive her medications. An interview on 06/11/25 at 9:15 AM with LPN #1 revealed that medications were supposed to be locked up in the the medication carts when unattended. She confirmed that she left the Lasix 40 milligram (mg) medication card face down on 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 facility policy review the facility failed to utilize protective barriers to prevent possible contamination and spread of bacteria during two (2) of five (5) resident medication administration observations. Resident #1 and Resident #43. Findings Include: Review of the facility policy, Administration of Eye Drops or Ointments Policy with revision date of 04/24/23 revealed, Eye medications are administered as ordered by the physician and in accordance with professional standards of practice .5. Administration: a. Remove medication cap and place on clean, dry surface (i.e. tissue or paper towel) to prevent contamination Resident #1 An observation on 06/11/25 at 8:20 AM, during Resident #1's medication pass revealed Licensed Practical Nurse (LPN) #1, removed Timolol eye drop bottle from the box and placed it on the overbed table with no barrier in use and had not sanitized the overbed table prior to placing the eye drop bottle on the table. LPN #1 administered the eye drops, placed the eye drop bottle back on the overbed table and then returned it 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 staff interview, record review and facility policy review the facility failed to accurately complete a Minimum Data Set (MDS) assessment as evidenced by the presence of a pressure ulcer not being indicated on the assessment for one (1) of 16 MDS assessments reviewed. Resident #50 Findings Include: Review of the facility policy titled, MDS 3.0 Completion with an implementation date of 6/14/21 and no revision date revealed under the Policy .Residents are assessed, using a comprehensive assessment process, in order to identify care needs and to develop an interdisciplinary care plan. An interview on 10/18/23 at 8:45 AM, with Registered Nurse (RN)/Treatment Nurse #1 revealed that Resident #50's pressure ulcer was facility acquired and was currently still receiving treatment to the heel that started in July of this year. Review of Resident #50's physicians orders revealed an order dated 7/27/23 to Paint left (L) heel Deep Tissue Injury (DTI) with betadine for one week. Review of Resident #50's MDS 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 on observation, staff interview, record review and facility policy review the facility failed to implement a care plan regarding the placement of hand rolls per physician's order for one (1) of 16 care plans reviewed. Resident #29 Findings include: Review of the facility policy titled, Comprehensive Care Plans with an implementation date of 6/14/21 revealed, Policy .It is the policy of this facility to develop and implement a comprehensive person-centered care plan for each resident, consistent with resident rights, that includes measurable objectives and timeframes to meet a residents medical, nursing, and mental and psychosocial needs . Record review of Resident #29's care plan with an onset date of 9/3/23 revealed, I am at risk for pressure ulcers related to poor body control/positioning, poor cognition, contractures to right and left hand . Approaches . Resident to wear hand roll in bilateral hands on at 9 AM and off at 3 PM to help prevent further contracture . On 10/16/23 at 11:33 AM, observation…

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, staff interview and record review, the facility failed to place hand rolls on a resident with contractures for one (1) of 25 residents reviewed with contractures. Resident #29 Findings include: Review of the typed documentation on facility letterhead dated 10/19/23 and signed by the Administrator revealed, We have no policy on splints or hand rolls. An observation on 10/16/23 at 11:33 AM revealed Resident #29 had contracted hands bilaterally with no splints. An observation on 10/17/23 at 11:15 AM revealed Resident #29 lying in bed; hands contracted bilaterally with no splints or hand roll. Record review of Resident #29's Physician Orders revealed an order dated 10/14/21 for resident to wear hand roll in bilateral hands, on at 9 AM and off at 3 PM, to help prevent further contracture. An interview on 10/17/23 at 3:05 PM, with Licensed Practical Nurse (LPN) #1 revealed Resident #29's hand rolls are supposed to be applied by the treatment nurse and are documented on the Treatment…

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, facility policy review, record reviews, and staff interviews the facility failed to prevent the likelihood of infection, as evidenced by failure to change the water flush bag and feeding tube bag every 24 hours for one (1) of six (6) residents reviewed with a Percutaneous Endoscopic Gastrostomy (PEG) tube. Resident #35 Findings Include: Record review of facility policy titled, Gastrostomy Tube Feedings Continuous Feeding Per Pump, dated 12/21/21, revealed . 6. Bottles of formula and/or feeding bags are to be changed every 24 hours . An observation on 06/06/22 at 1:38 PM revealed Resident #35's PEG tube feeding bag was empty and a filled water flush bag. Both bags were hanging on the PEG feeding pump pole and was labeled with the date of 6/4/22 on each bag. An observation and interview on 6/6/22 at 1: 45 PM, with the Licensed Practical Nurse, (LPN)#1 confirmed she worked on 6/4/22 on the 7:00 AM to 3:00 PM shift. She confirmed that the date on the water flush bag and that the date on the empty PEG tube feeding bag that were presently hanging on the PEG feeding…

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.