Truman W Smith Children's Care Center

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview, and record review, the facility failed to ensure the appropriate treatment and services to prevent complications was provided for 2 of 6 residents reviewed for feeding tube management. (Resident #1 and Resident #2)The facility failed to follow the physician's orders for Resident #1's feeding tube (medical device to deliver nutrition, hydration, and medication directly to the stomach) rate (how fast it was given) of delivery on 3/16/26 and 3/17/26.The facility failed to follow the physician orders for Resident #2's feeding tube duration of administration and total volume (amount) of feeding on 3/17/26.These failures placed residents at risk for vomiting, aspiration (accidental breathing in food, liquid, or foreign material into airway/lungs which increased the risk of pneumonia (lung infection), malnutrition, and weight gain or loss.Findings included:1. Record review of Resident #1's face sheet dated 3/17/26 indicated Resident #1 was an [AGE] year-old male admitted to 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.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observations, interviews, and record reviews, the facility failed to treat each resident with respect and dignity and provide care in a manner that promoted maintenance or enhancement of his or her quality of life for 1 of 24 residents (Resident #63) reviewed for resident rights. The facility failed to ensure RT C acknowledged Resident #63 while providing care on 11/16/25. This failure could place residents at an increased risk of anxiety and a diminished quality of life.The findings included: Record review of the order summary report, dated 11/18/25, reflected Resident #63 was an [AGE] year-old male who admitted to the facility on [DATE] with diagnoses of obstructive hydrocephalus (buildup of fluid in cavities called ventricles deep within the brain, which increases the size of the ventricles and puts pressure on the brain), neuromuscular scoliosis (sideways curvature of the spine), chronic respiratory failure with hypoxia (condition where you don't have enough oxygen in the tissues in your body),…

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 observation, interview, and record review, the facility failed to ensure residents who were fed by enteral means received the appropriate treatment and services to prevent complications of enteral feeding for 1 of 11 residents (Resident #18) reviewed for enteral nutrition. The facility failed to ensure Resident #18's head of the bed was elevated while receiving a tube feeding (delivers liquid nutrition through a flexible tube that goes directly into your stomach or small intestine) on 11/16/25. This failure could place residents with gastrostomy tube at risk for complications from feeding tube administration such as aspiration and pneumonia. The findings included: Record review of order summary report, dated 11/17/25, reflected Resident #18 was a [AGE] year-old male who admitted to the facility on [DATE] with diagnoses of dysphagia (difficulty swallowing) and gastrostomy status (surgical procedure that creates an artificial opening through the stomach wall and abdominal wall, allowing for the insertion…

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 record review, the facility failed to provide a safe, functional, sanitary, and comfortable environment for residents, staff, and the public, for 1 of 1 laundry room reviewed for environment. The facility failed to ensure the air filters in the laundry room were clean, the air filters were dirty with a thick dark gray substance. This failure could place the residents at risk of living and working in an unsafe, unsanitary and uncomfortable environment. Findings included: During an observation and interview on 11/17/25 at 2:24 P.M., the laundry room had dirty air filters on the ceiling on the dirty and clean side of laundry room. The air filters had a thick dark gray substance on them. Laundry Aide B said the facility kept the air filters clean. She said the air filters were usually changed once a week. She said the maintenance man usually changed the air filters; she said she thought he changed the air filters last Thursday. She said the air filters got dirty, because the staff opened and closed the doors all the time and the area she worked in…

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 record review the facility failed to store, prepare, distribute, and serve food in accordance with professional standards for food service safety in 1 of 1 kitchen reviewed for food safety requirements and kitchen sanitation. The facility failed to ensure all foods stored in the freezers, and dry pantry were not kept past their expiration dates and did not contain employee personal items. These failures could place residents at risk of foodborne illness and food contamination. Findings included: During an observation of the freezer on 1/12/2025 at 9:20 AM, the following items were observed: (1) 32-ounce bag of frozen hashbrowns that was opened with approximately 1/3 of the bag remaining, wrapped in a plastic shopping bag with no label or date opened. During an observation of the dry pantry on 1/12/2025 at 9:20 AM, the following items were observed: (1) Gallon container of distilled white vinegar that was approximately half full with an open date of 12/26/2024 and an expiration date of 6/7/2022. During an observation and interview on 1/12/2025…

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 observation, interview, and record review, the facility failed to establish and maintain an infection prevention and control program designed to provide a safe, sanitary, and comfortable environment, and to help prevent the development and transmission of communicable diseases and infections for 1 of 2 residents observed for incontinent care infection control practices (Resident #79), and 3 of 3 residents observed for medication administration control practices. (Resident #'s 27, 91, 71). 1.CNA A did not change her gloves or sanitize her hands after performing incontinent care on the front perineal area for Resident #79 and touched clean areas. 2. The facility failed to ensure RN G performed hand hygiene before and after administering medications to 3 different residents. These failures could place residents at risk of exposure to communicable diseases, cross-contamination, and infections. Findings included: 1.Record review of the undated face sheet indicated Resident #79 was a [AGE] year-old female…

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 observation, interview, and record review, the facility failed to provide a safe, functional, sanitary, and comfortable environment for 1 of 23 residents reviewed for environment. (Resident #48) 1. The facility failed to remove a green sputum filled suction canister over ¾ full in the room of Resident #48 a timely manner. This failure placed resident at risk of exposure to growing bacteria from another resident, living in an uncomfortable environment and a decrease in quality of life and self-worth. Findings included: 1. Record review of the face sheet 01/14/25 indicated Resident #48 was a [AGE] years old male and was admitted on [DATE] with diagnoses including disease of upper respiratory tract ( a common viral infection that affects the nose, throat and airways), major depressive disorder (a mental illness that causes a persistent low mood and loss of interest in activities) and other specified disorders of white blood cells (a category of blood conditions that affect white blood cell function).…

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 record review, the facility failed to maintain an infection prevention and control program designed to provide a safe, sanitary, and comfortable environment and to help prevent the development and transmission of communicable disease and infection for 1 of 6 residents (Residents #1) reviewed for infection control. 1. While in outbreak status for COVID-19, CNA A, LVN B, and Sitter C failed to wear N-95 masks as identified as a requirement in the facility policy. 2. While removing Resident #1's speaker valve, RT D did not wash, sanitize her hands, or wear gloves during the procedure. These deficient practices could place residents at-risk for infection due to improper care practices. The findings included: 1.During an observation and interview on 02/10/2024 at 10:00 a.m., a sign on the front entrance door stated, Masks must be worn in all areas of the facility at all times. CNA A answered the door not wearing a mask. After waiting in the lobby, LVN B entered the lobby not wearing a mask. LVN B instructed the state surveyor that the facility 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.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview, and record review, the facility failed to provide residents with limited range of motion appropriate treatment and services to increase range of motion and to prevent further decrease in range of motion for 4 of 23 residents reviewed for range of motion. (Resident #6, Resident #21, Resident #67, and Resident #68) The facility failed to provide restorative therapy for contractures or contracture prevention for Resident #6, Resident #21, Resident #67, and Resident #68. This failure could place residents who had contractures at risk of not attaining/or maintaining their highest level of physical, mental, and psychosocial well-being. Findings included: 1. Record review of a face sheet dated 12/06/23 revealed Resident #6 was a [AGE] year-old male that admitted to the facility on [DATE]. Resident #6 had diagnoses of cerebral palsy (a group of disorders that affect a person's ability to move and maintain balance and posture), cerebral vascular accident (stroke happens when there is a…

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, interview, and record review, the facility failed to store, prepare, and serve food in accordance with professional standards for food service safety in the facility's only kitchen, reviewed for kitchen sanitation. 1. The facility failed to ensure refrigerated foods were properly labeled and dated. 2. The facility failed to ensure the fryer was clean and free of food debris. These failures could place residents at risk for food-borne illness. Findings included: During an observation of the kitchen refrigerators on 12/04/23 beginning at 08:50AM these items were found: *1 bag of white sliced cheese without a label or date marked on the package *1 bag diced bell peppers dated 11/30/23 - found underneath a metal bowl that contained 1 - package breakfast sausage and 1 - package turkey breast thawing *1 - container of guacamole dated November 21, 2023 During an observation on 12/04/23 at 8:58 AM, the fryer in the kitchen was dirty and covered with splattered chicken fry batter. During an interview on 12/04/23 at 9:00AM, the Dietary Manager said the ready to eat foods…

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 observations, record review and interviews, the facility failed to ensure an environment that was free of accident hazards and that each resident received adequate supervision to prevent accidents for 1 of 24 residents (Resident # 25) reviewed for accidents. The facility failed to protect Resident #25 when CNA A shook off the metal hook from the mechanical lift with her hands causing the metal hook to fall and hit Resident #25 in the chest and fall to her lap. This failure could place residents at risk for injury or harm. Findings included: Record review of Resident # 25's admission Record indicated she was a [AGE] year-old female admitted to the facility on [DATE]. Her diagnoses include Cerebral Palsy (Cerebral palsy (CP) is a group of disorders that affect a person's ability to move and maintain balance and posture), Anoxic Brain Damage (Anoxic brain injuries are caused by a complete lack of oxygen to the brain), Convulsions (A sudden, violent, irregular movement of a limb or of the body, caused by…

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 observation, interview, and record review, the facility failed to maintain and ensure safe and sanitary storage of residents' food items for 1 of 3 resident personal refrigerators reviewed for food safety (Resident # 51). The facility failed to ensure the refrigerator for Resident # 51 did not contain expired foods. This failure could place resident at risk for food borne illnesses. Findings include: Record review of a face sheet dated 09/30/2023 indicated Resident # 51 was an [AGE] year-old male, admitted to the facility on [DATE] with diagnoses including Muscle Wasting and Atrophy (Muscular atrophy is the decrease in size and wasting of muscle tissue), Morbid Obesity (A disorder involving excessive body fat that increases the risk of health problems), Acute Embolism and Thrombosis (Thrombosis is a clot in a blood vessel. An embolism or thromboembolism is a clot that moves through your bloodstream). Record review of a Quarterly MDS dated [DATE] indicated Resident # 51 understood others and made himself…

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 observation, interview, and record review the facility failed to maintain an infection prevention and control program designed to provide a safe, sanitary, and comfortable environment and to help prevent the development and transmission of communicable diseases and infections for 1 of 22 residents (Residents # 5) reviewed for infection control practices. The facility failed to ensure that a urine sample was removed from Resident # 5's dresser. These failures placed residents at risk for cross contamination and infection. Findings include: Record review of an undated face sheet revealed Resident # 5 was a [AGE] year-old male admitted on [DATE] with diagnoses including Autistic Disorder (a developmental disability caused by differences in the brain), Epilepsy (Epilepsy is a disorder of the brain characterized by repeated seizures), Hypo Osmolality (condition where the levels of electrolytes, proteins, and nutrients in the blood are lower than normal). Record review of a quarterly MDS dated [DATE] revealed…

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.