Signature Healthcare Of Greeneville

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on facility policy review, medical record review, observation, and interviews, the facility failed to administer a continuous enteral feeding (liquid nutrition provided by a tube inserted into the abdomen) as ordered by the physician for 1 resident (Resident #61) of 1 resident reviewed for continuous enteral feedings.The findings include:Review of the facility's policy titled, Gastrostomy Feeding [enteral feeding] Guidelines, dated 2/7/2023, revealed .Verify the correct formula .Review of the facility's policy titled, Physicians Orders, dated 1/30/2026, revealed .It is the standard of this facility that physician orders are followed .Licensed Nurses .are expected to follow physician's orders .Review of the medical record revealed Resident #61 was admitted to the facility on [DATE] with diagnoses including Multiple Sclerosis, Dysphagia, Functional Quadriplegia, Gastrostomy Status (a tube inserted into the abdomen for the administration of feeding), and Unspecified Severe Protein-Calorie Malnutrition. 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 facility policy review, observations, and interviews, the facility failed to offer hand hygiene assistance to 4 residents (Residents #120, #122, #111, and #11) prior to meals of 4 residents observed during meal service on 1 of 5 units observed for meal tray distribution. The findings include: Review of the facility's policy titled, Assistance with Meals, revised 5/5/2025, revealed .Facility staff will assist residents with setup and meal preparations as needed to include offering resident to wash their hands prior to meal with washcloth, hand sanitizer or provided toilette . Review of the medical record revealed Resident #120 was admitted to the facility on [DATE] with diagnoses including Spinal Stenosis, Unspecified Lack of Coordination, Chronic Kidney Disease, and Other Recurrent Depressive Disorders. Review of the Brief Interview for Mental Status (BIMS) assessment for Resident #120 dated 3/13/2026, revealed the resident scored a 15 which indicated the resident was cognitively intact. 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.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on facility policy review, medical record review, facility investigation review, personnel file review, and interview, the facility failed to protect a resident's rights to be free from misappropriation and/or exploitation when money totaling $600.00 was taken from 1 resident (Resident #34) of 8 sampled residents reviewed for misappropriation. The findings include: Review of the facility policy titled, Abuse, Neglect and Misappropriation of Property, revised on 10/17/2022, revealed .It is the organizations intention to prevent the occurrence of abuse, neglect and misappropriation of property .and to assure that all alleged violations of federal or state laws .are investigated and reported immediately . Review of the medical record revealed Resident #34 was admitted to the facility on [DATE] with diagnoses including Functional Quadriplegia, Hypertension, Type 2 Diabetes Mellitus, and Heart Disease. Review of the quarterly Minimum Data Set (MDS) assessment dated [DATE], revealed Resident #34 scored a 15 on…

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. The facility failed to report an allegation of resident to resident abuse that occurred between Resident #5 and #6 on 4/11/2024 to the State Survey Agency. Review of the medical record revealed Resident #5 was admitted to the facility on [DATE] with diagnoses including Fracture of Left Femur, Generalized Anxiety Disorder (GAD), and Dementia. Review of a quarterly MDS assessment dated [DATE], revealed Resident #5 scored a 2 on the BIMS assessment, which indicated severe cognitive impairment, and exhibited inattention. The resident had physical behavioral symptoms noted. Review of the Nurse's Progress Notes for Resident #5 dated 4/11/2024, revealed the Assistant Director of Nursing (ADON) documented at approximately 5:35 PM, Resident #5 was in dining area propelling self in wheelchair. Resident #5 was yelling out sporadically and Resident #6 showed physical aggression towards Resident #5. Residents #5 and #6 were immediately separated and no injuries were noted. Review of the Nurse Practitioner (NP) Progress…

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 policy, observations, and interviews, the facility failed to provide a clean and homelike environment in 1 resident's (Resident #64) room of 6 resident rooms observed. The findings include: Review of the facility policy titled, Resident Rights revised 8/16/2018, showed .All residents will be treated in a manner and in an environment that promotes maintenance or enhancement of quality of life . Review of the facility policy titled, Maintenance dated 1/2005, showed .The maintenance department is responsible for maintaining the buildings, grounds and equipment in a safe and operable manner at all times .Maintaining the building in good repair and free from hazards . Resident #64 was admitted to the facility on [DATE], with diagnoses including Unspecified Dementia with Behavioral Disturbance, Unspecified Macular Degeneration, Unspecified Hearing Loss, and History of falling. Record review of Resident #64's quarterly Minimum Data Set assessment dated [DATE] showed a brief interview 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 develop a care plan addressing hospice care and management for 1 resident (Resident #48) of 20 residents reviewed for care plans. The findings include: Review of a facility policy titled Hospice Program dated 5/2018, showed .plan of care will be developed and shall include directives for managing pain and other uncomfortable symptoms . Review of a facility policy titled Comprehensive Care Plans, dated 4/2021, showed .A person-centered Comprehensive Care Plan .Describe the services that are to be furnished to attain or maintain the resident's highest practicable physical, mental, and psychosocial well-being . Resident #48 was admitted to the facility on [DATE] with diagnoses including Bipolar Disorder, Anxiety Disorder, Depressive Disorders, and Hospice Care. Review of the admission Minimum Data Set (MDS) assessment dated [DATE], showed Resident #48 was cognitively intact and received hospice services.…

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 ensure medications were stored and administered safely for 1 resident (Resident #86) of 6 residents reviewed for medication administration, which had the potential to cause an accident, when a nurse left Resident #86's medication at the bedside unattended. The findings include: Review of facility's policy titled, Administering Medications, revised 4/2019 showed, Medications are administered in a safe .manner .as prescribed .Only person licensed .administer and document the administration of medications may do so .Residents may self-administer .medications only if the Attending Physician .has determined .capacity to do so safely . Resident #86 was admitted to the facility on [DATE] with diagnoses including Chronic Obstructive Pulmonary Disease, Chronic Pain Syndrome, and Polyneuropathy. Review of the quarterly Minimum Data Set (MDS) assessment dated [DATE], showed Resident #86 was cognitively intact and 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.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on medical record review and interview, the facility failed to make a referral to the state-designated authority for a Level II Pre-admission Screening and Resident Review (PASARR) after newly identified serious mental disorders were diagnosed for 2 residents (#48, #86) of 8 residents reviewed for PASARR. The findings include: Medical record review revealed Resident #48 was admitted to the facility on [DATE] with diagnoses including Dementia, Schizoaffective Disorder, Depression, and Hypotension. Continued review revealed diagnosis of Psychotic Disorder with Delusions was added on 7/8/19. Medical record review of the most recent PASARR Level I assessment dated [DATE] revealed Resident #48 had no diagnosis of mental illness. Medical record review revealed Resident #86 was admitted to the facility on [DATE] with diagnosis of Dementia. Continued review revealed diagnosis of Major Depressive Disorder was added on 1/9/19 and a diagnosis of Psychotic Disorder with Delusions was added on 5/7/19. 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.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on review of the facility policy, medical record review and interview, the facility failed to develop a comprehensive care plan for the diagnosis of Psychosis for 1 resident (#86) of 23 residents reviewed for care plans. The findings include: Review of the facility policy Comprehensive Care Plans last revised 7/19/18, revealed .revised as information about the resident and the resident's condition change . Medical record review revealed Resident #86 was admitted to the facility on [DATE] with diagnosis of Dementia. Continued review revealed a diagnosis of Major Depressive Disorder was added on 1/9/19 and a diagnosis of Psychotic Disorder with Delusions was added on 5/7/19. Medical record review of a Psychiatric Initial Diagnostic Interview dated 5/7/19 revealed .seeing the patient .major depressive disorder, unspecified psychosis . Medical record review of a Quarterly Minimum Data Set (MDS) dated [DATE] revealed Resident #86 had diagnoses of Non-Alzheimer's Dementia, Anxiety, Depression, and Psychotic…

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.