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NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, staff interviews, and review of the policy, the facility failed to maintain a functioning call light system to alert staff of a resident's need. This had the potential to affect all 35 residents residing in the facility. The facility census was 35. Findings include: Observations on 02/07/24 at 8:24 A.M., revealed call lights flashing in the hallway. Observation of the nurse station, where the call light board is located, revealed no sound could be heard but three red lights were flashing, indicating the call light had been activated. Interview on 03/07/24 at 8:27 A.M., with Licensed Practical Nurse (LPN) # 102 verified the three red flashing lights indicated residents needed assistance and verified no sound was coming from the panel. LPN #102 stated room [ROOM NUMBER]'s panel was not working, and those residents had bells to alert staff of needs. The panel in room [ROOM NUMBER] could not be reset. Interview on 02/07/24 at 1:45 P.M., with Maintenance Man #132 revealed he had no knowledge 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, medical record review, staff interviews, and policy review, the facility failed to ensure an incontinent resident was provided with resident specific and timely incontinence assistance. This affected one (#3) of three residents reviewed for the provision of incontinence care and The facility census was 34. Findings include: Review of Resident #3's medical record revealed an admission date of 07/24/23, with the diagnoses including: cerebral palsy, seizure disorder, autistic disorder, mild intellectual disability, anemia, abscess of prostate, dysphagia, and sepsis. Review of the Minimum Data Set (MDS) assessment dated [DATE] assessed Resident #3 with severe cognitive impairment, unable to make needs known, dependent on staff for the completion of activities of daily living including toileting, and incontinent of bowel and bladder. Review of the nursing plan of care was initiated on 07/30/23, to address Resident #3 risk for decline in activity of daily living function and/or participation as…

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, review of the Centers for Disease Control and Prevention (CDC) website, and policy review, the facility failed to implement proper shut the doors to the rooms and post signage outside the door for residents with droplet isolation precautions. This affected three (#2, #14, and #42) out of the three residents reviewed for droplet isolation precautions. The facility had 16 residents with droplet isolation precautions. The facility census was 39. 1. Review of the medical record for Resident #14 revealed an admission date of 07/20/23. Diagnoses included atrioventricular block, malignant neoplasm of the prostate, and COVID-19. Review of the infection progress note, dated 07/30/23 at 1:50 P.M., stated Resident #14 tested positive for COVID-19. Review of the care plan for Resident #14 revealed an actual infection related to COVID-19 care plan, dated 07/31/23, with an intervention for contact/droplet precautions due to COVID-19. Review of the physician orders for Resident #14 revealed a physician order, dated 07/31/23, for single room contact/droplet…

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, resident interview, staff interviews, and review of facility policy, the facility failed to ensure residents who required staff assistance with activities of daily living (ADLs), received adequate and timely care to maintain good personal hygiene including shaving and nail care and timely repositioning. This affected four residents (#4, #26, #9, and #190) of five residents reviewed for ADLs. The facility census was 39. Findings Include: 1. Review of Resident #4's medical record revealed an admission date of 02/21/21. Diagnoses included history of Coronavirus (COVID-19), need for assistance with personal care, cognitive communication deficit, major depressive disorder, and bipolar disorder. Review of Resident #4's Minimum Data Set (MDS) assessment dated [DATE] revealed a Brief Interview for Mental Status (BIMS) score of 15 indicating Resident #4 was cognitively intact. Resident #4 required extensive assistance with bed mobility, and dressing. Resident #4 was totally dependent on staff for…

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 2. Observation on 04/18/23 from 8:01 A.M. to 8:12 A.M. of breakfast trays being delivered to the resident's room, revealed State Tested Nursing Assistants (STNAs) (#341 and #344) were noted to touch personal items of residents as well as the residents while delivering the breakfast trays. Continued observations revealed neither STNA performed any hand hygiene after assisting the residents and before delivering the next breakfast tray. Interview on 04/18/23 at 8:13 A.M. with STNAs (#341 and #344) verified they did not perform the appropriate hand hygiene between the resident's trays being delivered. 3. Review of the medical record for resident #9 revealed an admission date of 03/22/17 with a diagnosis of hemiplegia and hemiparesis. Review of the quarterly MDS assessment dated [DATE] revealed Resident #9 had impaired cognition and required limited assistance of one staff for eating. Observations of the dining room on 04/20/23 at 12:00 P.M., revealed Resident #9 sitting at the assistance table with two other…

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, staff interview and review of facility policy, the facility failed to ensure residents who required assistance with eating were provided with a dignified dining experience. This affected one resident (#26) of one resident observed in the dining room who required assistance with eating. There were twelve residents in the dining room. In addition, the facility failed to ensure residents in the dining room received meals timely in relation to other residents. This affected one resident (#90) of eleven residents observed to be eating in the dining room. The facility census was 39. Findings Include: 1. Review of Resident #26's medical record revealed an admission date of 01/21/21. Diagnoses included dysphagia, cerebrovascular disease, speech and language deficit, need for assistance with personal care, cerebral palsy, epilepsy, and aphasia. Review of Resident #26's Minimum Data Set (MDS) assessment dated [DATE], revealed a Brief Interview for Mental Status (BIMS) score was not able to be…

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 medical record review, observations, resident interview, staff interview and review of the facility policy, the facility failed to ensure a resident's physician was notified of changes in skin conditions. This affected one resident (#11) of the three residents reviewed for notifications. The facility also failed to ensure the physician was notified when a resident's blood sample for testing was not able to be completed. This affected one resident (#17) of the three-residents reviewed for notification. The Facility census was 39. 1. Review of Resident #11's medical record revealed an admission date of 06/02/20. Diagnoses included type II diabetes, urinary incontinence, uterine cancer, dysphagia, major depressive disorder, anxiety disorder, epilepsy, and obesity. Review of Resident #11's Minimum Data Set (MDS) assessment dated [DATE], revealed a Brief Interview for Mental Status (BIMS) score of 15 indicating Resident #11 was cognitively intact. Resident #11 had moisture associated skin damage (MASD) at…

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, resident interview, and staff interview, the facility failed to ensure resident's rooms were maintained in a clean and homelike manner. This affected one resident (#13) of 39 residents reviewed for their environment. The facility census was 39. Findings include: Review of the medical record for Resident #13 revealed an admission date of 11/05/14 with diagnoses of anxiety and depression. Review of the quarterly Minimum Data Set (MDS) assessment, dated 01/04/23, revealed Resident #13 had intact cognition and mobilized independently. Observation on 04/18/23 at 9:04 A.M. of Resident #13's room, revealed an unfinished, white drywall patch on the yellow wall behind his recliner chair. The patch was dented in, and the dust came off and onto the side of Resident #13's recliner chair. Further observation revealed 7 to 10 colored plastic pieces of holiday grass on the floor around Resident #13's room. Interview with Resident #13 at the same time, revealed the resident did not like the unpainted drywall patch behind his recliner. Interview on 04/18/23 at approximately…

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 medical record review, staff interview, and facility policy review the facility failed to ensure resident's baseline care plans were accurate and complete. This affected two residents (#91 and #190) of three reviewed for baseline care plans. The facility census was 39. Findings include: 1. Review of the medical record of Resident #91 revealed an admission date of 04/12/23. Diagnoses included type II diabetes mellitus, essential hypertension, migraine without aura, hyperlipidemia, hereditary and idiopathic neuropathy. Diagnoses added on 04/19/23 included localized edema, bipolar disorder, anxiety disorder, and metabolic syndrome. Review of the Baseline Care Plan dated 04/12/23 revealed mental health needs related to bipolar; however, there were no interventions documented for the diagnosis. The form indicated the skin was intact and a pressure reducing mattress would be utilized. Medications included antipsychotics and antidepressants without documenting specific ones. The form did not indicate 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 staff interview, review of the medical record, and review of the facility policy, the facility failed to ensure comprehensive care plans were individualized for each resident. This affected two residents (#22 and #34) of 14 residents reviewed for comprehensive care plans. The Facility census was 39. Findings include: 1. Review of the medical record for Resident #22 revealed an admission date of 09/22/20 with diagnoses of Alzheimer's disease and insomnia. Review of the comprehensive Minimum Data Set (MDS) assessment dated [DATE] revealed Resident #22 had impaired cognition. Review of the comprehensive care plan for Resident #22 revealed a care area initiated 02/08/23 indicating Resident #22 received an antidepressant medication (Trazodone) for insomnia and was at risk for having side effects or an adverse reaction. Review of all discontinued, completed, and current physician orders for Resident #22 revealed she had no orders for Trazodone. Interview on 04/20/23 at 9:23 A.M. with the MDS Coordinator #333…

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, medical record review, staff interview, and facility policy review, the facility failed to provide pressure ulcer care for residents. This affected one resident (#91) of two reviewed for pressure ulcers. The facility census was 39. Findings include: Review of the medical record of Resident #91 revealed an admission date of 04/12/23. Diagnoses include type II diabetes mellitus, essential hypertension, migraine without aura, hyperlipidemia, hereditary and idiopathic neuropathy, localized edema, bipolar disorder, anxiety disorder, and metabolic syndrome. Review of the admission assessment dated [DATE] at 10:35 P.M., revealed the presence of a stage II pressure ulcer measuring 5 centimeters (cm) in length, 3 cm in length and no depth on the left buttock. Review of the active April 2023 physician's orders for Resident #91, revealed no active treatment orders for the resident's stage II pressure wound on the left buttock. Observation on 04/19/23 at 9:45 A.M. with Assistant Director of Nursing…

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 medical record review and staff interview, the facility failed to ensure fluids were monitored for residents. This affected one resident (#17) of one resident reviewed for dialysis. The facility census was 39. Findings include: Review of the medical record of Resident #17 revealed the most recent admission date of 03/07/23. The initial admission date was 03/24/22. Diagnoses include hypertensive heart and chronic kidney disease with heart failure, end stage renal disease with dependence on renal dialysis, anxiety disorder, atherosclerotic heart disease of native coronary artery without angina pectoris, diabetes, major depressive disorder. Review of the annual Minimum Data Set (MDS) dated [DATE] for Resident #17, revealed the resident had minimal cognition deficit. The assessment revealed to the resident she had a diagnosis of end stage renal disease and received dialysis. Review of the nutritional care plan dated 04/05/22 revealed the facility was to provide a fluid restriction as ordered. The care plan…

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 medical record review, observation, and staff interview, the facility failed to ensure a physician ordered abdominal binder was applied to secure a resident's feeding tube. This affected one resident (#35) of one reviewed for tube feeding. The facility identified two residents who received tube feeding. The facility census was 39. Findings Include: Review of Resident #35's medical record revealed an admission date of 01/26/23. Diagnoses included epilepsy, dysphagia, cerebral palsy, mild intellectual disabilities, and autistic disorder. Review of Resident #35's Minimum Data Set (MDS) assessment dated [DATE], and 03/14/23 revealed a Brief Interview for Mental Status (BIMS) was not assessed. Review of Resident #35's 03/14/23 MDS revealed he required limited assistance with bed mobility, and extensive assistance for transfer. Resident #35 was totally dependent on staff for dressing, eating, toileting, and personal hygiene. Assessment revealed Resident #35 had an abdominal feeding tube and received 25…

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, staff interviews, and review of facility policy, the facility failed to ensure a peripherally inserted central catheter (PICC) was maintained appropriately. This affected one resident (#29) of one resident reviewed for intravenous (IV) therapy services. The facility census was 39. Findings include: Review of the medical record of Resident #29 revealed an admission date of 04/06/22. Diagnoses included, but not limited to, osteomyelitis of sacral and sacrococcygeal lumbar region, atherosclerotic heart disease of native coronary artery without angina pectoris, personal history of transient ischemic attack and cerebral infarction without residual deficits, paroxysmal atrial fibrillation, and essential hypertension. Review of the significant change Minimum Data Set (MDS) assessment dated [DATE] revealed Resident #29 was cognitively intact and required total assistance for all care. The assessment indicated the resident had received IV medications in the facility. 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.

Based on staff interview and record review, the facility failed to ensure the physician responded in a timely manner to the pharmacist's recommendation during a monthly medication review. This affected one resident (#13) of five residents reviewed for unnecessary medications. The facility census was 39. Findings include: Review of the medical record for Resident #13 revealed an admission date of 11/05/14 with diagnoses of anxiety and depression. Review of the quarterly Minimum Data Set (MDS) assessment, dated 01/04/23, revealed Resident #13 had intact cognition. Review of a facility document titled Physician Recommendation Form dated 09/01/22, revealed a recommendation from the pharmacist to the provider to review the necessity to continue use of buspirone (an anti-anxiety medication) and the necessity to continue use of sertraline (an antidepressant) for Resident #13. Further review revealed the provider responded on 11/20/22 and determined Resident #13 should remain on the medications. Interview on 04/20/23 at 12:40 P.M. with the Director of Nursing (DON) confirmed the response…

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 medical record review and staff interview, the facility failed to ensure residents prescribed medications had appropriate indications for their use. This affected one resident (#91) of five reviewed for unnecessary medications. The facility census was 39. Findings include: Review of the medical record of Resident #91 revealed an admission date of 04/12/23. Diagnoses included type II diabetes mellitus, essential hypertension, migraine without aura, hyperlipidemia, hereditary and idiopathic neuropathy. Diagnoses were added on 04/19/23 which included localized edema, bipolar disorder, anxiety disorder, and metabolic syndrome. Review of the physician orders dated 04/12/23 for Resident #91, revealed an order for Aripiprazole (antipsychotic) five milligrams (mgs) by mouth one time daily for health maintenance. An order for Duloxetine hydrochloride (anti-depressant) capsule 60 mg, give two capsules by mouth once daily for health maintenance. An order for Hydroxyzine (antihistamine) 25 mg by mouth twice a day for health maintenance. An order for Furosemide (diuretic) 40 mg by mouth…

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, review of the kitchen cleaning schedule, and review of facility policy, the facility failed to maintain a clean kitchen. This affected 40 of 40 residents who receive food from the kitchen. Findings include: Observation of the kitchen on 12/17/19 at 10:44 A.M. revealed a heavy amount of dust like particles near the food preparation surfaces. A stand alone refrigerator placed next to two kitchen surface areas had a heavy amount of dust like particles on the back, top, and vent of the refrigerator. Between the stand alone refrigerator and the kitchen surface area, there were electrical outlets and wiring enclosed in metal from the outlet to the ceiling were observed to have a heavy amount of dust like particles. Dietary staff were prepping lunch for the residents on the surfaces near the heavily dusted areas. Interview on 12/17/19 10:46 A.M. with Dietary Manager #175 verified the outside of the refrigerator, outlet, and metal tubing has not been cleaned for a long time and the amount of dust was unacceptable. Review of the facility cleaning…

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, record review and review of facility policy, the facility failed to provide a hoyer lift to accommodate the resident's needs. This affected one resident (#25) of one resident review for accommodation of needs. The facility census was 40. Findings include: Review of the medical record for Resident #25 revealed the resident was admitted on [DATE]. Diagnoses included diabetes mellitus type II, difficulty walking, muscle weakness, restless leg syndrome and a body mass index of 70 or greater. Review of the care plan, created on 03/08/19, revealed the resident had mobility limitations including not ambulating, impaired standing balance, and use of upper side rails as an enabler to assist with mobilization in bed. An intervention in the care plan included to a two person assist and the use of a mechanical lift for transfers in and out of bed daily, as needed. Review of the Minimum Data Set (MDS) 3.0 assessment, dated 10/03/19, revealed the resident had no cognitive…

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 medical record review, review of facility policy, observation and staff and resident interview, the facility failed to provide invitations to care conferences to two residents (#10 and #25). Additionally, the facility failed to update a resident's plan of care with for one resident (#1). This affected three residents (Resident #1, #10 and #25) of twelve residents who had care plans reviewed. The facility census was 40. Findings include: 1. Review of the medical record for Resident #1 revealed the resident was admitted to the facility on [DATE]. Diagnoses included Parkinson's disease, delusional disorder, depressions, anxiety and restless leg syndrome. Review of the admission information revealed a note from 04/16/19 of Resident #1 residing in the Assisted living area and was found outside the building as well as a history of falls. Review of a plan of care, dated 06/21/19, revealed mobility, activities of daily living and fall risks were identified as issues. The plan of care did not include 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 medical record review, review of facility policy and staff interview, the facility failed to obtain an ordered laboratory test timely for one resident. This affected one (Resident #34) of 12 residents reviewed during the annual survey for laboratory tests. The facility identified 23 residents who had orders for laboratory tests in the last 90 days. The facility census was 40. Findings include: Review of the medical record for Resident #34 revealed the resident was admitted to the facility on [DATE] and re-admitted on [DATE]. Diagnoses included sepsis, hematuria (bloody urine), Methicillin Resistant Staphylococcus Aureus (MRSA) (drug resistant infection), and an acquired absence of bilateral legs above the knees. Review of the physician orders, dated 12/10/19, revealed the resident was in contact isolation due to MRSA in a rectal perineal wound. It further revealed the resident was to have the the rectal perineal area swabbed to check for the presence of MRSA. Review of a Treatment Administration Record,…

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 resident and staff interview, record review and review of facility policy, the facility failed to ensure residents received dental services. This affected one resident (#25) of one resident review for ancillary services. The facility census was 40. Findings include: Review of the medical record for Resident #25 revealed the resident was admitted on [DATE]. Diagnoses included diabetes mellitus type II, hypoglycemia and muscle weakness. Review of the Minimum Data Set (MDS) 3.0 assessment, dated 10/03/19, revealed the resident had no cognitive issues, abnormal behaviors, or rejection of care. Review of the care plan, created on 03/08/19, verified the resident has potential for dental/oral cavity deficits related to having broken teeth and the resident has a history of tooth abscess. The care plan interventions included coordinating arrangements for dental care, and transportation as needed/as ordered. Review of a dental note, dated 07/29/19, revealed Resident #25 was complaining of a lower right tooth…

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.