Ahava Healthcare Of Clarksville

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on the American Council on Aging Website review, medical record review, and interview, the facility failed in their responsibility in maintaining assets under $2,000 for the 2026 Tennessee Medicaid allowance for 7 of 58 (Resident #3, #6, #19, #38, #67, #81, and #93) sampled residents. The findings include: 1. Review of the American Council on Aging Website, Tennessee Medicaid (TennCare) Income & Asset Limits for Nursing Homes & In-Home Long Term Care, dated 4/30/2026, revealed .In 2026, single Medicaid Nursing Home applicant in Tennessee must meet the following criteria.Assets under $2,000. 2. Review of the medical record revealed Resident #3 was admitted to the facility on 8/6/2023, with diagnoses including Diabetes Mellitus, Malnutrition, and Hypotension. Review of the Resident Statement Landscape, dated 4/29/2026, revealed Resident #3's balance was $18,955.25, which was $16,955.25 over the $2,000.00 limit. 3. Review of the medical record revealed Resident #6 was admitted to the facility on 5/1/2006,…

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 facility policy review, medical record review, and interview, the facility failed to ensure that all allegations of abuse/misappropriation of property were reported to all appropriate agencies for 1 of 1 (Resident #20) sampled residents reviewed for abuse. The findings include: 1. Review of the undated facility policy titled, Abuse, Neglect, and Exploitation, revealed .It is the policy of this facility to provide protections for the health, welfare and rights of each resident by developing and implementing written policies and procedures that prohibit and prevent abuse, neglect, exploitation and misappropriation of resident property .Misappropriation of Resident Property means the deliberate, misplacement , exploitation, or wrongful, temporary or permanent, use of resident's belongings or money without the resident's consent .Identifying correcting and intervening in situations in which abuse, neglect, exploitation, and/or misappropriation of resident property .Reporting of all alleged violations to 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 policy review, medical record review, and interview, the facility failed to perform an investigation for misappropriation of resident property for 1of 1 (Resident #20) sampled residents reviewed for abuse. The findings include: 1. Review of the undated facility policy titled, Abuse, Neglect, and Exploitation, revealed .It is the policy of this facility to provide protections for the health, welfare and rights of each resident by developing and implementing written policies and procedures that prohibit and prevent abuse, neglect, exploitation and misappropriation of resident property .Misappropriation of Resident Property means the deliberate, misplacement , exploitation, or wrongful, temporary or permanent, use of resident's belongings or money without the resident's consent .An immediate investigation is warranted when suspicion of abuse, neglect, or exploitation, or reports of abuse, neglect, or exploitation occur.Identifying and interviewing all involved persons, including the alleged victim, alleged…

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 facility policy review, facility skill assessment review, medical record review, observation, and interview, the facility failed to ensure the prevention and spread of infection when 2 of 4 staff (Registered Nurse (RN) B and Licensed Practical Nurse (LPN) A) failed to use appropriate Personal Protective Equipment (PPE) and failed to follow infection control procedures during medication administration for 2 of 6 (Residents #15 and #93) sampled residents reviewed. The findings include: 1. Review of the undated facility policy titled, Enhanced Barrier Precautions, revealed .It is the policy of this facility to implement enhanced barrier precautions for the prevention of transmission of multidrug -resident organisms.Enhanced barrier precautions (EBP) refer to an infection control intervention designed to reduce transmission of multidrug-resistant organisms that employs targeted gown and gloves use during high contact resident care activities.PPE for enhanced barrier precautions is only necessary when…

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 the Centers for Disease Control and Prevention (CDC) guidelines, Geriatric Medication Handbook, policy review, Employee Time Punch Reports, Employee Screening Logs, observation, and interview, 3 of 5 nurses (Registered Nurse (RN) #2 and Licensed Practical Nurse (LPN) #1 and #2) failed to maintain infection control practices during medication administration for 4 of 7 sampled residents (Resident #43, #56, #61, and #71) and the facility failed to follow CDC infection control guidelines to ensure practices to prevent the potential spread of Covid-19 when 14 of 132 staff members (Hospitality Aide #1, #2, and #3, Certified Nursing Assistant (CNA) #2, #5, #6, #7, and #8, Occupational Therapist (OT) #1, Registered Nurse (RN) #3 and #4, Licensed Practical Nurse (LPN) #3, Life Enrichment Coordinator, and the Administrator) failed to complete screenings for prevention and detection of COVID-19 prior to work for 4 of 4 days (2/18/2022, 2/19/2022, 2/20/2022, and 2/21/2022) reviewed. This had the potential to affect the 94 residents residing in the facility. The findings include: 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.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on policy review, medical record review, and interview, the facility failed to have required discharge and transfer documentation for 2 of 3 sampled residents (Resident #49 and #284) reviewed for hospitalization. The findings include: Review of facility's undated policy titled, Transfer and Discharge ., revealed .Emergency Transfers/ Discharges initiated by the facility .Obtain physician's orders .complete and send with the resident .a Transfer Form .Document assessment findings and other relative information regarding the transfer in the medical record . Review of the medical record, revealed Resident #49 was admitted to the facility on [DATE] with diagnoses of Non-STEMI (Non ST Elevated Myocardial Infarction), End Stage Renal Disease, Hemodialysis, Diabetes Mellitus, Hypertension, and Cerebral Vascular Accident. Review of a Nurses' Progress Note dated 12/18/2021, revealed .Res [resident] w/ [with] complaints of chest pain .also stating that R [right] arm had no feeling .Res .stating she felt she was…

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 policy review, observation, and interview, the facility failed to ensure food was served under sanitary conditions when 6 of 17 staff members (Certified Nursing Assistant (CNA) #1, #2, #3 and #4, Registered Nurse (RN) #1, and the Life Enrichment Coordinator) touched foods with their bare hands and failed to perform hand hygiene for 13 of 88 sampled residents (Resident #15, #22, #28, #38, #40, #46, #48, #58, #64, #69, #82, #84, and #337) observed during dining. The findings include: Review of the facility's policy titled, Dining Service, dated 8/23/2017, revealed .During delivery of the dining service the staff will .prevent the eating surfaces from coming in contact with staff clothing .Handle cups/glasses on the outside of the container .Handle knives, forks, and spoons by the handles .Keeping their hands away from their hair and face when handling food . Review of the facility's undated policy titled, Hand Hygiene, revealed .All staff will perform proper hand hygiene procedures to prevent the spread of infection to other personnel, residents .This applies to all staff…

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 Pre-admission Screening and Resident Review (PASRR) User Guide for Medicaid Certified Nursing Facilities, medical record review, and interview, the facility failed to resubmit a PASRR after the resident had the addition of a new mental health diagnosis for 3 of 12 sampled residents (Resident #17, #39, and #64) reviewed for PASRR. The findings include: Review of the PASRR User Guide for Medicaid Certified Nursing Facilities, dated 12/11/2018, revealed .Resident Review--you will submit the Level I if the individual has .a significant change in status .Potential Outcomes--PASRR Level II . Review of the medical record, revealed Resident #17 was admitted to the facility on [DATE] with diagnoses of Post-Traumatic Stress Disorder, Lack of Coordination, Atrial Fibrillation, and Insomnia. Review of the Physician's Orders dated 12/15/2021, revealed .Depakote Tablet Delayed Release 250 mg [milligram] .by mouth at bedtime for Anticonvulsant .Depakote Tablet Delayed Release 500 mg .by mouth for at bedtime 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 Based on policy review, medical record review, observation, and interview, the facility failed to obtain a Physician's Order for oxygen therapy for 1 of 3 sampled residents (Resident #386) reviewed for respiratory services. The findings include: Review of the facility's undated policy titled, POLICY Oxygen Administration, revealed .Oxygen is administered under orders of a physician . Review of the medical record, revealed Resident #386 was admitted to the facility on [DATE] with diagnoses of Chronic Obstructive Pulmonary Disease, Pneumonia, Asthma, and Dependence on Supplemental Oxygen. Review of the medical record, revealed there was not a Physician's Order for oxygen. Review of the Baseline Care Plan dated 3/4/2022, revealed .Oxygen therapy - while a resident . Review of the Nurse's notes dated 3/4/2022, revealed .new admit .on O2 [oxygen] at 4L [liters] . Observation in the resident's room on 3/7/2022 at 4:22 PM, 3/8/2022 at 5:00 PM, 3/9/2022 at 8:24 AM and 11:05 AM, and 3/10/22 at 8:19 AM and 9:55 PM,…

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 policy review, observation, and interview, the facility failed to ensure medications were labeled and stored appropriately when opened multidose bottles did not have an open date and medications were stored past their expiration date in 1 of 4 medication storage areas (400 Hall Medication Cart) and when unsecured medications were observed 1 of 60 resident rooms (Resident #336's room). The findings include: Review of the facility's undated policy titled, Medication Storage, revealed .It is the policy of this facility to ensure all medications housed on our premises will be stored in the pharmacy and/or medication rooms .All drugs and biologicals will be stored in locked compartments .The pharmacy and all medication rooms are routinely inspected .for discontinued, outdated .medications . Observation in the resident's room on 3/7/2022 at 10:49 and 4:53 PM, and 3/8/2022 at 12:55 PM and 7:12 PM, revealed an Albuterol Sulfate inhaler on Resident #336's bedside table. Observation of the 400 Hall Medication Cart on 3/8/2022 at 5:45 PM, revealed for following: a. 1 opened and…

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 policy review, service agreement, medical record review, and interview, the facility failed to ensure accurate medical records for medication orders, medication administration, diagnoses, and discontinued medications for 2 of 22 sampled residents (Resident #17 and #386) reviewed. The findings include: Review of the facility's titled, Physicians Orders, dated 12/2017, revealed .Physician orders are obtained to provide a clear direction in the care of the resident .When receiving an order .repeat the order to clarify and ensure the following necessary information is received .Dosage .Route of administration .Diagnosis for medication . Review of the .[Named Behavioral Health Services] .AGREEMENT . dated 6/5/2019, revealed .Provide Psychological and/or Psychiatric .as available to the residents of the Facility .Provide psychiatric medication management .Maintain all respective medical record documentation including assessment and progress notes in accordance with the Facility's established Medical 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.