Elk City Nursing And Rehabilitation Center

Based on observation, record review, and interview, the facility failed to ensure:a. proper labeling/dating of stored bread, b. both the large and small ice machines were cleaned and free from debris, andc. hand hygiene was maintained during meal service to prevent cross contamination during kitchen observations. The DON identified 46 residents received food from the kitchen. Findings: A policy titled Receiving and Open Date Policy, undated, read in part, It is the policy of the nursing home to date food products received from delivery trucks upon arrival to facility and upon use. A policy titled Dietary Personnel Hand hygiene Policy, undated, read in part, The goal is to prevent the spread of foodborne illness and ensure the safety of residents, staff, and visitors.Gloves will be worn when handling ready-to-eat foods or other situations where bare hand contact is prohibited or poses a risk of contamination.Staff will be trained on the importance of hand hygiene, proper procedures, and the consequences of non-compliance.After touching any unclean surface or object that could…

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, record review, and interview, the facility failed to ensure:a. a nebulizer mouthpiece was stored in a manner that promoted infection control practice for 1 (#3) of 2 sampled residents reviewed for respiratory care, andb. clean linens were stored appropriately for 1 of 1 laundry room observation.The DON identified 47 residents resided in the facility and 16 residents received nebulizer treatments.Findings:1. On 07/29/25 at 11:50 a.m., a nebulizer machine with a mouthpiece was observed on top of Resident #3's drawer. The mouthpiece was set on top of the drawer.An undated facility Use of Hand-Held Nebulizers policy read in part, All staff involved in the administration must follow infection control procedures and adhere to the treatment protocol to prevent cross-contamination and ensure efficacy.An undated facility Linen Storage Policy and Procedure policy read in part, All linen used in the facility must be stored, handled, and distributed in a manner that maintains cleanliness, prevents contamination, and complies with infection control standards.A physician's…

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 and interview, the facility failed to ensure a registered nurse coordinated and signed resident assessments prior to submission to CMS. The DON reported 51 residents resided in the facility. Findings: A Clinical - MDS list, dated 12/02/23 through 03/18/24, documented 112 assessments had been submitted to CMS and accepted. On 03/20/24 at 2:38 p.m., the MDS coordinator reported being a licensed practical nurse not a registered nurse. The MDS coordinator reported she had signed all the assessments that were submitted to CMS between 12/02/23 through 03/18/24. On 03/20/24 2:40 p.m., the DON reported the facility did not have a policy related to completing and submitting MDS assessments. The DON reported being aware that MDS assessments required an RN signature and had failed to sign any of the MDS assessments dated 12/02/23 through 03/18/24.

Based on record review and interview the facility failed to provide timely and complete beneficiary notices to three (#51, #16, #109) of three sampled residents reviewed for beneficiary notices. The Administrator identified 51 residents resided in the facility. Findings: An undated Form Instructions for the Notice of Medicare Non-Coverage (NOMNC) CMS-10123 policy, read in part, .The provider must ensure that the beneficiary or representative signs and dated the NOMNC to demonstrate that the beneficiary or representative received the notice and understands that the termination decision can be disputed . A Notice of Medicare Non-Coverage (NOMNC) policy, dated 03/18/24, read in part, .It is the policy of this facility that [name of facility] must deliver required notice to residents/resident representatives at least 2 calendar days prior to termination of skilled nursing care . 1. Resident #51's Notice of Medicare Non-Coverage documented skilled services would end on 11/11/23. There was no resident or resident representative signature or date on the document. A Skilled Nursing Facility…

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, interview the facility failed to develop a comprehensive care plan related to hospice, antipsychotic, anticoagulant, and opioid medications for two residents (#14 and #46) of 13 sampled residents reviewed for care plans. The Administrator identified 51 residents resided in the facility. Findings: 1. Resident #14 had diagnosis which included Dementia, depression, and pain. Facility had no Care Plan policy until 03/19/24. A care plan, dated 11/30/22, documented no focused area's for antipsychotic, anticoagulant, and opiod medications on the comprehensive care plan. On 03/19/24 at 11:34 a.m., the MDS Coordinator #1 was asked What the policy was for developing a comprehensive care plan. They stated they go by the resident's diagnosis and the cause section from admit MDS. They were then asked to review the comprehensive careplan for resident #14 and determine if the care plan had focus area's addressing the antipsychotic, anticoagulant, and Opioid mediation for Resident #14. They stated No, they are not on the care plan. They were then asked what the process if…

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 and interview, the facility failed to ensure care plans were reviewed and revised after each assessment for two (#31 and #36) of 13 residents whose care plans were reviewed. The administrator identified 51 residents resided in the facility. Findings: 1. Resident #31 was admitted with diagnoses which included non-Alzheimer's dementia, dementia with other behavioral disturbance, and depression A care plan, revised 09/13/23, documented [name removed] has a mood problem r/t depression. The care plan contained no documentation of being reviewed or revised with quarterly assessments since 09/13/23. A physician order, dated 12/29/23, documented Quetiapine 25 mg 1 tablet by mouth one time a day for behavioral and psychological symptoms of dementia. A quarterly assessment, dated 02/21/24, documented cognition was moderately impaired and routine use of antipsychotic medication. 2. Resident #36 had diagnoses which included non-Alzheimer's dementia, depression, and dementia with other behavioral disturbance. A care plan, revised on 05/31/23, documented [name removed] uses…

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, record review, and interview, the facility failed to ensure staff maintained infection control measures when passing medications. The Administrator identifed 51 residents resided in the facility. Findings: A Policy and Procedure, dated 03/04/21, read in part, .Precautions are utilized to prevent and control transmission of infectious organisms through direct and indirect contact .Hand hygiene means cleaning your hands by using either handwashing .antiseptic hand wash .antiseptic hand rub .medication preparation areas .Proper cleaning/disinfection of resident care care equipment including equipment shared among residents . On 03/19/24 at 7:32 a.m., CMA #2 obtained a blood pressure with a manual cuff and stethoscope on Resident #15. CMA #2 was observed to place their stethoscope around their neck and put the manual BP cuff back on the cart. CMA #2 did not sanitize the cuff or stethoscope or their hands. On 03/19/24 at 7:44 a.m., CMA #2 was observed to obtain a blood pressure on Resident #39 with a manual cuff and stethoscope. CMA #2 placed the stethoscope around…

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 and interview the faciity failed to complete a significant change assessment for one (#57) of two sampled residents reviewed for a significant change. Findings: Resident #57 had diagnoses which included Parkinson's, repeated falls and pain. A Physician Order, dated 01/12/24 documented to admit the resident to hospice services. The clinical health record did not document a significant change assessment had been completed. The last assessment completed was a quarterly assessment on 02/08/24. On 03/18/24 at 4:11 p.m., the DON was asked if a significant change should have been completed when the resident was admitted to hospice. They stated Yes.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on record review and interview the facility failed to ensure resident assessments was transmitted within seven days of completion for one (#44) of two sampled residents reviewed for resident assessments. The Administrator identified 51 residents resided in the facility. Resident #44's quarterly assessment, dated 01/21/24, had been completed but still showed In Progress in the clinical health record. On 03/20/24 at 9:02 a.m., the MDS coordinator was asked why does the quarterly MDS, dated [DATE], still say In progress. They stated, I don't know might have missed it.

Based on record review and interview, the facility failed to ensure neurological checks were accurately completed for one (#22) of two sampled residents reviewed for neurological checks. The Administrator identified 51 residents resided in the facility. Findings: A Resident Falls policy, dated 03/19/22, read in part .Assessments of falls with head injury or unwitnessed falls shall include neurological checks as follows: a. Q 15 min x 4, Q 30 min x 2, Q 1 Hr x 2, Q 2 Hrs x 1, Q 8 Hrs x 72 HRS . Resident #22 had diagnoses which included, debility, dementia and arthritis. A nurse progress note, dated 10/29/23 at 7:10 a.m., read in part, .Res observed in floor in sitting position .neuro [checks] initiated . A Neurological Record, dated 10/29/23 at 7:15 a.m., documented neuro checks were started every fifteen minutes for an hour, every 30 minutes times one check, every hour for two checks, every two hours for one check, then every shift for seven shifts. The record did not document neuro check was completed at 30 minutes for a second time, and did not document times eight hour checks had…

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 and interview the facility failed to ensure staff secured medication carts when unattended. The Administrator identified 51 residents resided in the facility. Findings: On 03/19/24 at 07:32 a.m., CMA #2 was observed to be preparing medications at their cart. They left the cart unlocked and stepped a few feet away with their back to the cart to administer medications. On 03/19/24 at 07:38 a.m., CMA #2 was observed to leave their med cart unlocked to answer the phone. On 03/19/24 at 9:42 a.m., CMA #2 was asked when should the cart be secured. They stated everytime their away from it. CMA #2 was asked if they recalled leaving their cart unlocked. They stated they did not remember. On 03/19/24 10:49 a.m., the DON was asked is there any time when a cart should be left unlocked if the med aide is not present. They stated No.