Sharkey-Issaquena Nursing Home

Based on observations, staff interviews, record reviews, and facility policy review, the facility failed to check and record food temperatures before serving all meals for the last 30 of 30 days. Findings Included: A review of the facility's policy titled Monitoring Temperatures of Cooked Foods revealed, Policy: The temperature of potentially hazardous cooked foods will be monitored to ensure that the foods are not in the danger zone (above 41 degrees F (Fahrenheit) and below 135 degrees F) for more than six hours . Cooking, holding, and storage temperatures should be recorded on a Food Temperature Monitoring Log. These logs should be maintained for at least three (3) months. During an observation of the kitchen on 10/2/24 at 11:35 AM, it was noted that kitchen staff were serving lunch to the dining room residents from the steam table. A record review of the meal temperature logbook revealed there was no documentation for breakfast, lunch, or dinner since 9/2/24. In an interview with the Dietary Manager (DM) on 10/2/24 at 11:40 AM, she stated that the kitchen staff had not been…

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 reviews, staff interviews, and facility policy review, the facility failed to establish and maintain an infection prevention and control program designed to prevent the transmission of communicable diseases and infections. This failure was evidenced by the facility's failure to administer a second-step tuberculin (TB) skin test to one (1) of 17 residents (Resident #104) and 34 of 37 employees, who had no documentation of a negative TB skin test within the last 12 months. Findings Include: A review of the facility's policy titled TB Testing MS, with a revision date of 4/14, stated: Resident Testing for Tuberculosis .Residents .shall have a baseline Tuberculin Skin Test (TST) performed with the initial step of a two-step Mantoux TST placed within 30 days prior to the day of admission. The second step shall be administered, read, and documented within 10-21 days of the first step . Employee Testing for Tuberculosis .Employees with a negative tuberculin skin test and a negative symptom 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.

Based on observations, staff interviews, and facility policy review, the facility failed to conceal the urine collection bag for a resident's indwelling urinary catheter, thus failing to maintain the dignity of a resident, for one (1) of two (2) residents with urinary catheters. (Resident #51). Findings Include: A review of the facility's policy titled Resident Rights revealed, It is the policy of this facility to ensure that the rights of the residents residing at this facility are upheld in the highest regard . 2. Each resident has the right to a dignified existence . During observations on 10/01/24 at 10:50 AM and 1:28 PM, it was noted that Resident #51's door was open, and an indwelling catheter bag was visible hanging on the side of the bed, without a privacy cover. In a follow-up observation and interview on 10/01/24 at 1:29 PM, Registered Nurse (RN) #1 confirmed that the catheter bag had no privacy cover and agreed that it should have been covered to maintain the resident's dignity. During an interview on 10/01/24 at 1:31 PM, the Director of Nursing (DON) verified that…

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, staff interviews and facility policy review, the facility failed to accurately complete and request a Preadmission Screening and Resident Review (PASARR) for a resident with a history of mental illness for one (1) of 12 residents reviewed. Resident #106 Findings Include: Record review of the facility policy titled, Pre-admission Screening PAS/PASRR with a revision date of 6/13 revealed under, Level II PASRR . When Level 1 screening on the PAS (Preadmission Screening) indicates possible Mental Illness or Intellectual Disability/Developmental Disability and related conditions (RC) the DOM (Division of Medicaid) will notify Proper Name to review the case. Record review of the Level 1 PAS (Pre admission Screening) for Resident #106, with a submission date of 9/30/24, revealed under, Referral Question #28. Does resident have any history of abusing alcohol or drugs? No was marked. #31. Does resident have any history of mental illness? No was marked. #32. Does resident take, or have a history of taking psychotropic medication(s)? No was marked. Record review of 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 observations, record review, interviews and facility policy review, the facility failed to provide adequate care and treatment to a pressure ulcer to improve healing for Resident #104, for one (1) of 1 resident reviewed for pressure ulcers. Findings Include: Review of the facility policy titled Wound Care with a revision date of 10/2/24 revealed under, Purpose: To provide standardized procedures for the prevention, identification, treatment, and ongoing management of wounds, ensuring the highest quality of care for all residents while maintaining compliance with local, state, and federal regulations . Also revealed under, a. Treatment Plan - A treatment plan will be developed by the wound care team and documented in the resident's medical record. This plan may include: - Cleansing and dressing the wound. - Use of appropriate topical medications or advanced wound care products . An interview with the Director of Nursing (DON) on 10/1/24 at 12:32 PM revealed, she was doing the wound care until 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 staff interview, record review, and facility policy review, the facility failed to ensure a resident receiving an as needed (PRN) psychotropic medication had a stop date for one (1) of two (2) medication reviews. Resident #108 Findings Include: Review of the facility policy titled Psychotropic Medications for PRN (as needed) Use and Gradual Dose Reduction (GDR) Reviews undated, revealed under, Policy: . PRN use of psychotropic medications will be strictly regulated and monitored to comply with CMS (Centers for Medicare and Medicaid Services) regulations and ensure resident safety .Time Limitation: PRN orders for psychotropic medications must be limited to 14 days. After 14 days, the attending physician must review the resident's condition before extending the PRN order for continued use. This review must include a clinical evaluation to determine if continued PRN use is necessary. Record review of the September 2024 Medication Administration Record (MAR) for Resident #108, revealed an order dated 9/3/24, Lorazepam 1 MG (milligram) tablet administer 1 mg (milligram) q…

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 label and date food stored in the refrigerator and freezer for one (1) of two (2) kitchen tours. Findings include: Record review of the Storage of Frozen Food policy, undated, revealed the facility ensures the quality and safety of frozen food through accepted storage practices. Frozen foods are dated when received. The first in, first out method is used: products with the earliest date are stored in front of products with a later date. Frozen food is stored in the original package. Record review of the Storage of Refrigerated Food policy, undated, revealed the facility ensures the quality and safety and sanitation of refrigerated foods through accepted storage practices. All opened foods are labeled with common name of food, date stored, and use-by-date. On 12/15/19 at 10:51 AM, observation in the kitchen, revealed a zip-lock plastic bag of squash, in the freezer, without a date or label, a plastic bag of cut broccoli, without a date or label, and eight (8) cups of pudding on a metal pan, covered…

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, staff interview, and facility policy review, the facility failed to develop a care plan for anticoagulant medication for two (2) of 12 resident care plans reviewed, Residents #24 and #34. Findings include: Record review of the Care Plan policy, undated, revealed a comprehensive care plan will be developed for each resident, that includes measurable, objective goals, with specific timeframes for meeting those goals. Resident #24 Record review of the comprehensive care plan for Resident #24, revealed no care plan was developed for the anticoagulant, Coumadin, and its possible side effects, which would include bleeding. Record review of Resident #24's December 2019 Physician Orders, revealed an order dated 11/20/19, for Coumadin 3 milligram (mg) daily at bedtime. Resident #34 Record review of the care plan for Resident #34, revealed a care plan for administering an anticoagulant as ordered, however, there was no care plan developed for monitoring possible side effects, which would include bleeding. Record review of Resident #34's December 2019 Physician Orders,…

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, staff interview, and facility policy review, the facility failed to prevent the likelihood of infection, during medication administration, for one (1) of three (3) of six (6) residents observed for medication administration. Findings include: Review of the Infection Control - Standard and Transmission-based Precautions, policy, undated, revealed: It is the policy of the facility to ensure that appropriate infection prevention and control measures are taken to prevent the spread of communicable disease and infections in accordance with State and Federal Regulation, and national guidelines. Procedure: Standard Precautions, 1. All staff are to adhere to standard precautions. a. Personal protective equipment is to be worn to protect health care workers (i.e. have a barrier) from contact with body fluids. b. Personal protective equipment includes gloves, gowns, masks, goggles and or face shield. c. The personal protective equipment worn will vary by task being performed and likelihood of exposure to body fluid. 2. Standard precautions apply to all residents. Review…

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, staff interview, and facility policy review, the facility failed to administer eye drops as ordered by the physician for one (1) of 32 medication administration opportunities; Resident #17. Findings include: Review of the facility's Drug Administration policy, dated 06/94, revealed the complete act of medication administration entailed removing an individual dose from a previously dispensed, properly labeled container (including a unit dose container), verifying it with the physician's orders, giving the individual dose to the proper resident, and promptly recording the time and dose given. An observation during medication administration on 10/10/2018 at 8:22 AM revealed Licensed Practical Nurse (LPN) #1 administered Ketorolac 0.5% ophthalmic (opth) solution one (1) drop into Resident #17's left eye. Review of the cumulative October 2018 Physician Orders for Resident #17, revealed an order dated 09/06/18 for Ketorolac 0.5% opth solution one (1) drop in right eye four times a day. An interview, with LPN #1, on 10/10/2018 at 8:38 AM, confirmed Ketorolac 0.5% opth…

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.