Nhc Healthcare, Franklin

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on policy review, medical record review, and interview, the facility failed to ensure Care Plan conference meetings were held at least quarterly for 1 of 21 (Resident #33) sampled residents reviewed for care plan meetings. The findings include: Review of the facility's DOCUMENTATION GUIDELINES, dated October 2021, revealed .SECTION VII PATIENT CARE PLANS .Patient's goals for care and preferences will be determined and used to develop their plan of care .The patient care plan schedule will be developed first to accommodate the patients' and patient representative' schedule/ability to attend .All clinical assessments will be completed before the meeting is convened and will be used to inform the care plan development .Patient/patient representative participation will continue to be documented via [by way of] the care plan approval form in the EHR [Electronic Health Record] .Care plans are updated as needed but are reviewed completely by the interdisciplinary team on a quarterly basis within 7 days 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.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on policy review, medical record review, and interview the facility failed to notify the resident representative of a skin tear for 1 of 2 sampled residents (Resident # 29) reviewed for non pressure related skin conditions. The findings include: Review of the facility's policy titled, Change in a Resident's Condition or Status, revised February 2021, revealed .Our facility promptly notifies the resident .and the resident representative of changes in the resident's medical/mental condition and/or status .Except in medical emergencies, notifications will be made within twenty-four (24) hours of a change occurring in the resident's medical/mental condition or status . Review of the medical record revealed Resident #29 was admitted to the facility on [DATE] with diagnoses of Alzheimer's Disease, Dementia, Heart Failure, Diabetes, and Long Term Use of Anticoagulant. Review of the admission Minimum Data Set (MDS) dated [DATE], revealed Resident #29 had a Brief Interview for Mental Status (BIMS) score of 4, which…

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 review of the facility's contracted housekeeping proposal, Maintenance Supervisor's Job Description review, Housekeeping Supervisor Job Description review, policy review, observation, and interview, the facility failed to provide effective housekeeping services and maintenance services to maintain a sanitary, orderly, and comfortable environment as evidenced by trash and debris lying on the floors, sticky floors with a buildup of dirt and grime, dust and cobwebs in the corner behind a door, exposed wires, dirty fall mats and overbed table bases, telephones lying on the floor, dirty bathroom floors and toilet, missing privacy curtains, and a fan covered in thick gray dust in 7 of 46 resident rooms (room [ROOM NUMBER], #410, #411, #503, #507, #508, and #510) observed. The findings include: Review of the facility's contracted housekeeping proposal dated 6/9/2022 revealed, .keeping your property well-maintained and exceptionally clean is extremely important .[Named Housekeeping Company] uses the very latest…

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 ensure interventions were implemented to maintain nutritional status for 2 or 2 residents (Resident #29 and #65) reviewed for nutrition and failed to ensure skin assessment documentation was not completed for 1 of 2 residents (Resident #49) reviewed for non-pressure related skin conditions. The findings include: Review of the facility's policy titled, .Weight Monitoring, revised 3/2021, revealed .Interventions will be determined by the Dietician or designee based on the individual patient needs .The interdisciplinary team will play an active role in combating insidious .weight loss through routine involvement in the patient's plan of care . Review of the facility's policy title, .Obtaining Weights, dated 3/2021, revealed .Weights will be obtained upon admission, weekly times four weeks, and then monthly . Review of the medical record, revealed Resident #29 was admitted to the facility on [DATE] with diagnoses of…

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, observation, and interview, the facility failed to provide care and services to maintain an indwelling urinary catheter when nursing staff failed to obtain a physician's order, provide catheter care, and record urinary output for the use of an indwelling urinary catheter (a plastic tube inserted into the bladder used to drain urine into a plastic bag) for 1 of 2 sampled residents (Resident #58) reviewed for the use of an indwelling urinary catheter. The findings include: Review of the facility's policy titled Catheter Care, revised September 2014, revealed .The purpose of this procedure is to prevent catheter-associated urinary tract infections . Review of the medical record, revealed Resident #58 was admitted to the facility on [DATE] with diagnoses of Cerebral Infarction, Dysphagia, Hemiplegia and Hemiparesis, and Urinary Retention. Review of the admission Minimum Data Set, dated [DATE] revealed Resident #58 was assessed with a Brief Interview for Mental…

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 monitor oxygen administration and oxygen tubing maintenance for 1 of 3 residents (Resident #56) reviewed for respiratory services. The findings include: Review of the facility's policy titled, Respiratory [NAME], dated 1/2005, revealed .Assessment Focus .oxygen monitoring .change .maintenance of equipment . Review of the medical record, revealed Resident #56 was admitted to the facility on [DATE] with diagnoses of Senile Degeneration of Brain, Palliative Care, and Heart Failure, and Dementia. Review of the Physician Order dated 8/31/2022, revealed .02 [oxygen] at 2-3L [liters] to keep sats [saturations] above 92 % [percent] . Review of the Medication Administration Record (MAR) dated 9/1/2022 - 9/28/2022, revealed there was no documentation for monitoring of oxygen administration and binasal cannula maintenance. Observation in the resident's room on 9/26/2022 at 11:25 AM, revealed Resident #56 was receiving oxygen…

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, observation, and interview, the facility failed to ensure practices were maintained to prevent the potential spread of infection when 1 of 3 (Registered Nurse (RN) #1) nurses failed to properly clean the nebulizer equipment after use during medication administration, 2 of 16 (Certified Nursing Assistant (CNA) #1) and (Licensed Practical Nurse (LPN) #2) staff members touched the residents' food during dining, and Respiratory Therapist (RT) #1 failed to perform appropriate infection control practice during tracheostomy care. The findings included: 1. The facility's SPECIFIC MEDICATION ADMINISTRATION PROCEDURES policy dated 6/2016 documented, .Rinse and disinfect the nebulizer equipment .Wash pieces (except tubing) with warm, soapy water .Rinse with hot water .Allow to air dry completely on paper . Observations in Resident #174's room on 12/18/18 at 8:34 AM, RN #1 washed her hands and performed the nebulizer treatment as ordered. RN #1 failed to clean the nebulizer equipment after use, 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, medical record review, review of fall investigation reports, and interview, the facility failed to ensure that fall investigations were completed for 1 of 18 (Resident #57) sampled residents reviewed for falls. The findings included: 1. The facility's PROTECTION/PREVENTION PROGRAMS-FALLS PREVENTION PROGRAM policy revised 8/13/13 documented, . [Named facility] takes a person centered approach to falls prevention. Comprehensive assessment and root cause analysis are two very important tools in the prevention of falls and the recurrence of falls .a Falls Committee .monitors falls and utilizes data to systemically address falls . 2. The facility's INCIDENT AND ACCIDENT PROCESS revised 8/13/13 documented, .Investigation into the incident/accident: -Obtain information on what happened-what was actually seen or heard. If not witnessed, get patient's statement about what happened .Document all known facts, results of assessment including complete description of injuries, treatment, notification…

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.