Senior Care of Marion

Based on review of facility policy, record review and interview, the facility failed to report an allegation of verbal abuse within the 2 hour reporting timeframe for an altercation between Resident (R)1 and Licensed Practical Nurse (LPN)1 for 1 of 3 residents reviewed for abuse. Findings include:Review of the facility policy titled Abuse, Neglect, and Exploitation documents under Section VII. Reporting/Reponse of Abuse, Neglect and Exploitation, When abuse, neglect or exploitation is suspected: 1. Immediately report all alleged violations to the Administrator, state agency, adult protective services and to all other required agencies (e.g. law enforcement when applicable) within specified time frames; 2. Assure that reporters are free from retaliation or reprisal; 3. Reporting to the state nurse aide registry or licensing authorities any knowledge it has of any actions by a court of law which would indicate an employee is unfit for service.Review of R1's Face Sheet revealed the facility admitted R1 with diagnoses including, but not limited to, anxiety, major depressive disorder,…

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 review of facility policy, observation and interview, the facility failed to follow Enhanced Barrier Precautions (EBP) while providing care for Resident (R)4 for 1 of 1 resident observed receiving care while on EBP. The facility further failed to follow infection control protocols and procedures during laundry services in 1 of 1 laundry rooms. Findings include: (1) Review of the undated facility policy titled Enhanced Barrier Precautions revealed, Policy Statement Enhanced barrier precautions (EBPs) are utilized to prevent the spread of multi-drug resistant organisms (MDROs) to residents. Policy Interpretation and Implementation . 2. EBPs employ targeted gown and glove use during high-contact resident care activities when contact precautions do not otherwise apply. a. Gloves and gown are applied prior to performing the high contact resident care activity (as opposed to before entering the room). 3. Examples of high-contact resident care activities requiring the use of gown and gloves for EBPs include: a. dressing b. bathing/showering; c. transfering; d. providing hygiene;…

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 review of facility policy, observation and interview, the facility failed to check the placement of a feeding tube for Resident (R)23 prior to flushing the feeding tube with 60 milliliters of water for 1 of 1 residents observed with a feeding tube. Review of the undated facility policy titled Medication Administration via Enteral Tube revealed, It is the policy of this facility to ensure the safe and effective administration of medications via enteral feeding tubes by utilizing best practice guidelines . Policy Explanation and Compliance Guidelines: . 8. Enteral tube placement must be verified prior to administering any fluids or medication.Review of the undated facility policy titled Flushing a Feeding Tube revealed It is the policy of this facility to ensure that staff providing care and services to the resident via a feeding tube are aware of, and competent in, and utilize facility protocols regarding feeding nutrition and care. Feeding tube care and services will be provided in accordance with resident needs and professional standards of practice . Definition: 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.

Based on observations, interviews and review of facility policies, the facility failed to store, prepare and serve foods under sanitary conditions in 1 of 1 main kitchen. This failure had the potential to increase the spread of foodborne illness to all residents. Findings Include: Review of the undated facility policy titled Food Storage, under the section Canned Foods, revealed, Dented or bulging cans shall be placed on damaged goods shelf and returned for credit. Review of the facility policy titled Serving Utensils dated 08/2018 revealed, Standard serving utensils will be used for serving appropriate products. Review of the undated facility policy titled Hand Washing and Glove Use, revealed, Guidelines for hand washing and glove use to promote safe and sanitary conditions throughout the department. Section 2 Handwashing Procedure: Hands must be washed prior . working with different food substances i.e. raw chicken to fresh fruit, following contact with any unsanitary surface i.e. touching hair sneezing, opening doors, etc. An observation during the initial tour of the main…

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 review of facility policy, the facility failed to ensure kitchen staff maintained appropriate infection control measures for the safe handling of foods in 1 of 1 main kitchen. This failure had the potential to increase the spread of foodborne illness to all residents, due to cross contamination. Findings Include: Review of the facility policy titled Serving Utensils dated 08/2018 revealed, Standard serving utensils will be used for serving appropriate products. Review of the undated facility policy titled, Hand Washing and Glove Use, revealed, Guidelines for hand washing and glove use to promote safe and sanitary conditions throughout the department. Section 2 Handwashing Procedure: Hands must be washed prior . working with different food substances i.e. raw chicken to fresh fruit, following contact with any unsanitary surface i.e. touching hair sneezing, opening doors, etc. During a follow-up observation of the main kitchen on 06/01/22 at 12:52 PM observations were made during temperatures of the tray line and food plating. Cook1 was observed…

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 reviews, interviews and review of the facility policy titled, Promoting/Maintaining Resident Dignity, the facility failed to ensure resident's call bells were answered timely for Resident (R)127, for 1 of 2 residents reviewed for call bells not being answered timely. The findings include: Review of the undated facility policy titled, Promoting/Maintaining Resident Dignity, states, Policy, It is the practice of this facility to protect and promote resident rights and treat each resident with respect and dignity as well as care for each resident in a manner and in an environment, that maintains or enhances resident's quality of life by recognizing each resident's individuality. Compliance Guidelines: 1. All staff members are involved in providing care to residents to promote and maintain resident dignity and respect resident rights. 4. The resident's former lifestyle and personal choices will be considered when providing care and services to meet the resident's needs and preferences. 6. Respond to requests for assistance in a timely manner. 14. Each resident will 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 record review, interviews and review of the facility weight policy, the facility failed to follow the physician orders and facility policy regarding accurate and timely recordings of weights for Resident (R)24, R26 and R7 in order to collaborate care with the residents physician and the Registered Dietitian for 3 of 3 residents reviewed for Nutrition. Findings include: Review of the facility's weight policy (undated) states If the month-to-month weight has more than a 5% (percent) change, then the weight will be retaken within 24 hours and in the presence of a licensed personnel and Weights will be obtained on all other residents on the 5th of each month 1. On 06/02/22 at approximately 09:25 AM, a six month review of the medical record for R24, who had been admitted to the facility on [DATE] with diagnoses including, but not limited to diabetes mellitus and cirrhosis of liver, revealed a physician order for weights to be taken monthly on the 5th of the month. Further review showed that all weights taken…

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 reviews, interviews, and review of the facility policy titled, Notification of Changes, the facility failed to notify the attending physician and the personal representative of a significant weight loss for Resident (R)7 and R26, for 2 of 3 residents reviewed for nutrition. The findings include: Review of the undated facility policy titled, Notification of Changes, states, The purpose of this policy is to ensure the facility promptly informs the resident, consults the resident's physician; and notify, consistent with his her authority, resident's representative when there is a change requiring notification. Circumstances requiring notification include: 2. Significant change in the resident's physical , mental psychosocial condition such as deterioration in health, mental or psychosocial status. 3. Circumstances that require a need to alter treatment. Additional considerations: Competent individuals: The facility must still contact the resident's physician and notify resident's representative, if known. Residents incapable of making decisions: The representative would…

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 reviews and interviews, the facility failed to ensure the Comprehensive Plan of Care was reviewed and revised with interventions to prevent weight loss and or decrease further weight loss for Resident #26 and Resident #7 for 2 of 3 residents reviewed for Nutrition. The findings included: The facility admitted R26 on 2/2/2022 with diagnoses including, but not limited to, Protein-Calorie Malnutrition, Seizures, Metabolic Encephalopathy, Disorder of the Thyroid, Autistic Disorder, and Tube Feeding. Review on 5/31/2022 at 5:24 PM of the Comprehensive Plan of Care for Resident #26 states under, Need, states, Resident is at risk for weight loss. NPO (nothing by mouth) receives enteral feeding per MD order. Jevity 1.5 can bolus, 6 times daily with 50ml flush before and after each bolus administered. Include 350 mls of water with/in between administration of bolus feed to total 2080 mls of water in 24 hours. Goals: Resident will not have a significant weight loss through review period. The Interventions include: Keep HOB (head of bed) elevated minimal 30 degrees.…

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, review of medical records, interviews and review of the facility policy titled, Wound Treatment Guidelines, the facility failed to ensure a procedure was followed during wound care to prevent infection and to promote wound healing for Resident (R)7. Specifically, Licensed Practical Nurse (LPN) #1 failed to clean scissors before use, during a dressing change for R7 for 1 of 1 residents reviewed for wound care. The findings included: Review on 6/1/2022 at 10:47 AM of the wound care policy titled, Wound Treatment Guidelines, states, To promote wound healing of various types of wounds, it is the policy of this facility to provide evidence based treatments in accordance with current standards of practice and physician orders. The facility admitted R7 on 4/7/2022 with diagnoses including, but not limited to, Rhabdomyolysis, Hyponatremia, Volume Depletion and Pressure Ulcers. Review on 5/31/2022 at 5:24 PM of the medical record revealed a physician's order which read: Clean area to left buttock with wound cleanser, apply Calcium Alginate, and cover with border gauze…

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 reviews, interviews, and review of the facility policy titled Weight Prevention, the facility failed to monitor weights and to ensure interventions were put into place to prevent further weight loss or to decrease weight loss for Resident (R)26 and R7 for 2 of 3 residents reviewed for nutrition. The Findings include: Review of the undated facility policy titled, Weight Prevention, states, The Registered Dietician/Designee will review the patient/resident's nutritional status to prevent and control undesirable weight loss. The Policy Explanation and Compliance Guidelines, are as follows: 1. Input monthly weights into the computer. Review the computer-generated weight reports to identify significant eight changes and insidious weight trends. 8. Address significant weight loss or gain in the dietary progress notes and by developing and/or updating the plan of care. 9. Determine why weight loss has occurred. With patient/resident input, develop an appropriate plan to increase intake. 11. Supplements as ordered. The facility admitted R26 on 2/2/22 with diagnoses…

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, record reviews, review of facility policy titled, Unnecessary Drugs - Without Adequate Indication for Use, the facility failed to ensure Resident (R)179 was free from an unnecessary medication, Seroquel, an antipsychotic medication for 1 of 5 residents reviewed for Unnecessary Medications. Findings Include: Review of the undated facility policy titled, Unnecessary Drugs - Without Adequate Indication for Use revealed, It is the facility's policy that each resident's drug regimen is managed and monitored to promote or maintain the resident's highest practicable mental, physical, and psychosocial well-being . 2. The attending physician will assume leadership in medication management . taking into consideration the following elements: a. Dose b. Duration of use c. Indications and clinical need for medication. 3. Documentation will be provided in the resident's medical record to show adequate indications for medication's use and the diagnosed condition for which it was prescribed. The 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 observations, interviews, and review of the facility policy titled, Dryer Vents/Lint Check, the facility failed to remove an excessive amount of lint built up on the wiring above the lint basket and the inside upper three sides of 1 of 1 clothes dryers Findings include: Review of the facility policy titled, Dryer Vents/Lint Check states, Confirm that the lint is removed from the stack and inside the dryer. It is a fire hazard and a code violation if this is not maintained. Laundry staff will check and clean daily. Lint Catch/Screens: 1. Lint catchers should be cleaned after each load. 3. A fine layer of lint can form across the screen and stop the flow of clean air out of the dryer, hampering the speed of drying the items. An observation on 6/2/22 at 8:35 AM revealed an excessive amount of lint over the lint basket on the wiring and on the inside upper 3 sides of 1 clothes dryer. An interview on 6/2/22 at 8:40 AM with the laundry worker and the Housekeeping Supervisor confirmed the findings.