M.M. Ewing Continuing Care Center

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observations, interviews and record review conducted during the Recertification Survey from 7/17/23 to 7/21/23, it was determined that for one (Resident #8) of three residents reviewed for communication and sensory deficits, the facility did not ensure that each resident was treated with respect and dignity and care for each resident in a manner that promotes enhancement of their quality of life. Specifically, staff did not identify themselves as requested and per Resident #8's comprehensive care plan (CCP) and did not provide clear communication when providing care to the resident who has communication and sensory deficits. This is evidenced by the following: Resident #8 had diagnoses including legal blindness, acquired absence of the left eye, and hemiplegia (paralysis) of the left upper and lower extremities. The Minimum Data Set assessment dated [DATE], documented that Resident #8 was cognitively intact, required limited to extensive assist of staff for activities of daily living, has limited vision…

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, interviews and record review conducted during the Recertification Survey from 7/17/23 to 7/21/23, it was determined that for one (Resident #16) of three residents reviewed for choices, the facility did not ensure the resident's right to retain and use personal possessions as space permits unless to do so would infringe upon the rights or health and safety of other residents. Specifically, Resident #16 was not given permission to purchase a small personal item to keep in their room without a valid reason. This is evidenced by the following: The undated facility policy Residents Rights and Grievance Policy documented that residents have the right to have and use personal possession such as furniture, clothing, and electronics. Resident #16 had diagnoses including Multiple Sclerosis (a disease that affects the immune system and nerves) and hemiplegia (paralysis of one side of the body). The Minimum Data Set (MDS) assessment dated [DATE], documented that Resident #16 was cognitively intact.…

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 reviews conducted during a Recertification Survey from 7/17/23 to 7/21/23, it was determined that for one (Resident #271) of one resident reviewed for edema (swelling due to excess fluid in the body's tissues, usually occurring in the lower extremities), the facility did not provide services, as outlined by the resident's person-centered comprehensive care plan (CCP) and physician orders, that met professional standards of quality. Specifically, Resident #271 was observed without TED stockings (compressions stockings used for edema and to prevent blood clots in the lower extremities) as ordered by the physician. Additionally, staff documented that the TED stockings were applied to the resident when they were not. This is evidenced by the following: Resident #271 was recently admitted to the facility with diagnoses that included acute respiratory failure, cirrhosis (liver disease), and a stage IV (full thickness tissue loss involving dead tissue, muscle or bone) pressure ulcer. In nursing progress notes dated 7/15/23 to 7/17/23 several…

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 reviews conducted during a Recertification Survey, completed on 11/16/21, it was determined that for one (Resident #115) of five residents reviewed for unnecessary medications and one (Resident #19) of three residents reviewed for indwelling (Foley) catheter, the facility did not develop and implement a plan of care for each resident that included measurable goals and objectives to address the residents' medical, physical, mental, and psychosocial needs. Specifically, The Comprehensive Care Plan (CCP) for Resident #115 did not include person-centered goals and interventions to address the use of psychotropic medications (including both antipsychotic and antidepressant medications) and the CCP for Resident #19 did not include the care of a Foley catheter (indwelling catheter into the bladder and drains urine into a bag), medical indication for, and measurable goals and objectives. This is evidenced by the following: 1.Resident #115 was admitted with diagnosis of hallucinations, major depressive disorder, psychosis, and dementia. 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 observations, interviews and record review conducted during a Recertification Survey, completed on 11/16/21, it was determined that for one (Resident #326) of one resident reviewed, the facility did not ensure that proper fluid intake was monitored and provided to maintain proper hydration and health. Specifically, physician orders for a fluid restriction were not consistently monitored or documented to ensure compliance. This was evidenced by the following: Resident #326 had diagnoses that included hyponatremia (low sodium level), traumatic amputation below the knee and clostridium difficile (an infection in the intestinal tract). The medical admission history and physical report, dated 11/3/21 documented that Resident #326 was alert and appropriate, that the hyponatremia was slowly improving and to continue a fluid restriction of 1000 milliliters (mls) fluid daily and if the resident's sodium level improved the restriction could increase to 1500 mls daily. The physician orders dated 11/4/21 at 10:59 a.m. included the fluid restriction was increased to 1500 mls fluid…

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 reviews conducted during the Recertification Survey, it was determined that for 13 (Residents #123, #129, #30, #52, #73, #59, #35, #45, #77, #167, #106, #118, and #78) of 20 residents reviewed for Baseline Care Plans, the facility did not develop a care plan that included the minimum required health care information within 48 hours of admission and/or provide the resident and/or resident representative with a written summary of the resident's Baseline Care Plan in a language and conveyed in a manner that the resident or representative can understand. This is evidenced by, but not limited to, the following: Review of the facility procedure, Baseline Care Plan (BCP), effective 11/8/18, revealed the facility would develop a BCP within 48 hours of admission and or provide a written summary of the care plan to the resident and the representative prior to completion of the Comprehensive Care Plan (CCP). The BCP will reflect goals/objectives and include interventions that address 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, interviews, and record reviews conducted during the Recertification Survey, it was determined that for one (Resident #143) of three residents reviewed for accidents, the facility did not ensure the implementation of each resident's care plan. Specifically, the resident was not wearing geri sleeves at the time of the 3/18/19 incident, and staff did not instruct the resident to tuck in his arms while going through the doorway. This is evidenced by the following Resident #143 was admitted to the facility on [DATE] and had diagnoses including a traumatic brain injury, rightsided hemiparesis (weakness), and a history of skin tears. The Minimum Data Set Assessment, dated 3/22/19, revealed that the resident's cognitive skills for daily decision making were moderately impaired, and the resident required extensive assistance of staff with bed mobility, transfers, dressing, toileting and personal hygiene. The Comprehensive Care Plan, dated 6/25/18, revealed that the resident sustained a skin tear 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 observations, interviews, and record reviews conducted during the Recertification Survey and complaint investigation (#NY00227931), it was determined that for one (Resident #30) of five residents reviewed for Activities of Daily Living, the facility did not provide the necessary care and services to maintain personal hygiene. The issue involved the lack of incontinence care in a timely manner. This is evidenced by the following: Resident #30 was admitted to the facility on [DATE] and has diagnoses including Alzheimer's dementia, weight loss, and dysphagia (difficulty swallowing). The Minimum Data Set, Assessment, dated 4/17/19, revealed that the resident had severely impaired cognition, was frequently incontinent of bladder and bowel, and required the extensive assist of one staff for transfers and toileting. The Certified Nursing Assistant (CNA) Assignment Summary revealed that the resident required one assist for toilet use and stress incontinence was written under bladder continence. During multiple…

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, interviews, and record reviews conducted during the Recertification Survey, it was determined that for one (Resident #78) of five residents reviewed for unnecessary medications, the facility did not ensure that each resident's drug regimen was free of unnecessary psychotropic medications. The issues involved the lack of consistent non-pharmacological interventions prior to multiple doses of an anti-anxiety medication, and the lack of a medical evaluation prior to renewing the psychotropic medication every 14 days. This is evidenced by the following: Resident #78 was admitted to the facility on [DATE] with diagnosis including, but not limited to, heart failure, diabetes, depression, and morbid obesity. The Minimum Data Set Assessment, dated 2/8/19, revealed that the resident was cognitively intact, had no behaviors and scored 7/27 on the PHQ-9 (an interview used to determine signs and/or symptoms of depression). Multiple observations of the resident throughout the day shift over three days…

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.