Rennes Health And Rehab Center-Rhinelander

Based on observations, interviews and record reviews, the facility did not ensure staff maintained 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. The facility did not transport soiled laundry in a sanitary manner. This has the potential to affect the 17 residents that live between R90's room and the dirty linen storage area.The facility did not transport clean linen from laundry through the facility to patient's rooms on a hanging rack. This has the potential to affect all 35 residents whose linen at minimum is laundered and transported by the facility. Registered Nurse (RN) F did not practice hand hygiene or wear gloves when giving a subcutaneous injection to a resident (R) (R32).Certified Nursing Assistant (CNA) H delivered fresh water cups into R10's and R73's room and then into R7's and R24's room without practicing any hand hygiene between rooms and after handling dirty water cups. CNA G did not perform hand hygiene after…

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 reviews and interviews, the facility did not ensure that a resident who is fed by enteral means received the appropriate treatment and services to prevent complications of enteral feedings for 1 out of 1 resident (R) reviewed. (R90)Nurse did not measure enteral feeding appropriately and if not questioned, she would have had too much enteral feeding in the tube feeding set up.Nurse did not prime the tubing before connecting the feeding tubing to the J-G tubing, resulting in the air in tubing to be pushed into R90's stomach.Findings include:Surveyor asked for all policies that pertain to tube feeding. Surveyor received two polices Maintaining Patency of a Feeding Tube (Flushing), revised 2012, and Administering Medications through an Enteral Tube, revised May 2014. Neither policy addresses setting up and administering a tube feeding.The American Society for Parenteral and Enteral Nutrition, Enteral Nutrition Practice Recommendations indicate that priming the tubing is a standard…

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 and interview the facility did not provide adequate equipment to allow residents to call for staff assistance through a communication system which relays the call directly to a staff member, or to a centralized staff work area, for 1 resident (R1) out of 6 sampled residents. This had the potential to affect all 6 residents. * R1 did not have access to a call light while R1 was left in spa room unsupervised. Findings include: On 10/02/25 at 10:29 AM, Surveyor observed spa room down 400-wing. Surveyor did not observe a call light in the spa tub room. Surveyor did not observe a call light cord long enough to reach to the spa tub room from the shower room. On 10/02/25 at 10:36 AM, Surveyor observed spa room down 100-wing. Surveyor did not observe a call light in the spa tub room. Surveyor did not observe a call light cord long enough to reach to the spa tub room from the shower room. On 10/02/25 at 3:14 PM, Surveyor interviewed Director of Nursing (DON) B and asked DON B's expectation for call lights in the spa room and staff utilizing the call light. DON B reported…

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 interview and record review, the facility did not immediately report to the resident's representative when a resident was found unresponsive in spa tub and was transferred via Emergency Medical Services (EMS) to the Emergency Department (ED). This occurred for 1 of 1 resident (R) reviewed, (R1).Findings include: R1 was admitted to the facility on [DATE] with diagnoses including, in part, chronic obstructive pulmonary disease, left bundle branch block, bipolar disorder with moderate depression, COVID-19 respiratory disease, urinary tract infection, hypertensive chronic kidney disease stage 1-4, epigastric pain chronic, flaccid neuropathic bladder, anxiety, hyperlipidemia, insomnia, peptic ulcer, benign prostatic hyperplasia, right artificial hip and knee joint. R1's Minimum Data Set (MDS) assessment, dated 09/05/25, identified on admission that R1 had a Brief Interview for Mental Status (BIMS) score of 14. This indicated R1 had intact cognition. The MDS assessment also identified R1 required…

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 the interview and record review, the facility did not report 1 of 1 (R1) potential misconduct incidents to the State's Office of Caregiver Quality (OCQ) via the State's Misconduct Incident Reporting (MIR) system immediately upon learning of the incident.Findings include: Facility policy titled, Abuse Prevention, dated reviewed on November 23, 2016, states in part: .Neglect Definition-Means failure to provide goods and services necessary to avoid physical harm, mental anguish, or mental illness.*Facility will immediately report all alleged violations involving mistreatment, neglect, of abuse, including injuries of unknown source to the facility administration and to the Division of Quality Assurance. CMS defines immediately to be as soon as possible but not to exceed 24 hours after discovery of the incident. R1 was admitted to the facility on [DATE] with diagnoses including, in part, chronic obstructive pulmonary disease, left bundle branch block, bipolar disorder with moderate depression, COVID-19…

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 and interview, the facility did not conduct a Preadmission Screening and Resident Review (PASRR) Level II screen for R7, who has a serious mental disorder and is taking psychotropic medication to treat symptoms of major mental disorder to ensure he received care and services in the most integrated setting appropriate to his needs. The facility practice affected 1 of 2 residents reviewed (R7). This is evidenced by: Surveyor requested and reviewed the policy titled Forward Health Update, Your First Source of Forward Health Policy and Program dated November 2023. The policy in part read: PASRR Level II Referrals: ~As part of the PASRR Level I screen process in the portal, if required, the completed Level I screen will be forwarded on to Wisconsin's PASRR onto Wisconsin's PASRR Level II screen. ~The Level II screen is in place to determine if a person has a .serious mental illness as defined by federal PASRR regulations. Responses completed during the Level I screening process will determine…

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 did not develop and implement a comprehensive individualized care plan to meet the needs of 2 of 18 residents (R) R29 and R8. This is evidenced by: According to the Resident Assessment Instrument, The comprehensive care plan is an interdisciplinary communication tool. It must include measurable objectives and time frames and must describe the services that are to be furnished to attain or maintain the resident's highest practicable physical, mental and psychosocial well-being. The care plan should be revised on an ongoing basis to reflect changes in the resident and the care that the resident is receiving. Example 1 R29 was admitted to the facility on [DATE] with diagnosis of neurocognitive disorder with Lewy bodies-with behavior disturbance and dementia and is on palliative care. R29's most recent Minimum Data Set (MDS) is an annual assessment with a date of 07/20/24 indicating R29 requires partial to moderate assistance for personal 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.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview and record review, the facility did not ensure treatment and care were provided in accordance with professional standards of practice for 1 of 3 sampled residents (R)228. The facility did not give instruction on the care plan for staff on the proper use of R228's C-collar (cervical neck brace) or Cervical Thoracic Orthosis (CTO) body brace, nor did staff recognize when the brace was applied incorrectly, and not applied as ordered by the physician. This resulted in pain and an emergency room visit for evaluation for R228. This is evidenced by: R228 was admitted to the facility on [DATE] at 3:25 p.m., and has diagnoses that include, in part, head injury, neck fracture in 3 areas, fractures in 2 areas of the upper back, multiple rib fractures and collar bone fracture following a motor vehicle accident. Surveyor reviewed doctor's order, dated 08/24/23, that indicated R228 needs to wear C-collar at all times and CTO brace when (sitting up) greater than 45 degrees, sitting upright or…

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, record review and interview the facility did not ensure appropriate care and services were provided to prevent urinary tract infection (UTI) for 1 of 1 resident reviewed with an indwelling catheter (R38). R38 did not have a physician order or care plan with specific approaches for care of the indwelling catheter. This is evidenced by: Surveyor requested and reviewed the facility policy titled Catheter Care, Urinary, which was not dated. The policy in part read: Purpose: The purpose of this procedure is to prevent infection of the resident's urinary tract. General Guidelines: ~Determine if changes in daily urinary catheter procedures have been made (e.g. review of care plan .physician orders, ect.). ~Observe the resident for signs and symptoms of urinary tract infection and urinary retention . On 08/28/23 at 10:22 AM, Surveyor spoke with R38 regarding her catheter. R38 indicated staff take care of her catheter by emptying her urine. Surveyor observed a urinary catheter hanging on R38's lower…

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 and interview, the facility did not comprehensively assess trauma or develop a trauma-informed care plan for 1 of 1 resident (R) 1, with diagnosis of post-traumatic stress disorder (PTSD) and history of trauma. R1 has a diagnosis of PTSD with her admission assessment identifying past trauma. The facility did not comprehensively assess R1's trauma or develop a trauma informed care plan. This is evidenced by: Surveyor requested and reviewed the facility policy titled Trauma Informed Care, which is not dated. The policy in part reads: Purpose: To guide staff in appropriate and compassionate care specific to individuals who have experienced trauma. General Guidelines: ~This facility supports a culture of emotional well-being and physical safety for staff, residents and visitors. ~Trauma-informed care is culturally sensitive and person-centered . Resident-Care Strategies ~As part of the comprehensive assessment, identify history of trauma or interpersonal violance when possible. Identifying…

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 did not ensure that nursing staff had the specific competencies and skill set necessary to care for 1 of 1 resident (R)228 with specialized needs. Staff did not have the competency and training to appropriately don and doff a C-collar (cervical neck brace) and a Cervical Thoracic Orthosis (CTO) (upper body brace) for R228's care. Findings include: R228 was admitted to the facility on [DATE] at 3:25 p.m., and has diagnoses that include, in part, head injury, neck fracture in 3 areas, fractures in 2 areas of the upper back, multiple rib fractures and collar bone fracture following a motor vehicle accident. Surveyor reviewed doctor's order, dated 08/24/23, that indicated R228 needs to wear Aspen collar (C-collar) at all times and CTO brace when (sitting up) greater than 45 degrees, sitting upright or out of bed. Care plan dated 08/24/23 states to wear Aspen collar (C-collar) at all times and CTO when out of bed. On 08/28/23 at 10:36 AM, Surveyor…

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 reviews, the facility did not ensure a medication administration rate of less than 5%. During the Medication Administration Task, there were 3 errors out of 36 opportunities observed, yielding a medication administration rate of 8.33%. Resident (R) 20 self administers her inhalers upon directions by staff. Registered Nurse (RN) E handed R20 the Corticosteroid inhaler to administer, before the bronchodilator inhaler. Following the Corticosteroid inhaler administration, RN E did not encourage or offer R20 to rinse her mouth. R45 was given fast-acting insulin (Humalog) at 7:32 AM and did not eat a meal until 8:28 AM. This was 56 minutes after the administration of a fast-acting insulin. This is evidenced by: Drugs. com states for Symbicort, .To reduce the chance of developing a yeast infection in your mouth, rinse with water (but do not swallow) after using this medicine . Drugs.com also states Symbicort contains a combination of budesonide and formoterol. Budesonide is a corticosteroid that reduces inflammation in the body. Formoterol 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 observations and interviews, the facility did not implement appropriate infection prevention and control practices to help prevent the development and transmission of communicable diseases and infections. Staff did not perform hand hygiene when warranted or sanitize the durable medical equipment for 1 of 4 residents (R) R32 observed for cares. Certified Nursing Assistant (CNA) I did not perform hand hygiene when warranted when providing cares to R32. CNA I and CNA J did not sanitize mechanical lift before or after use for R32. This is evidenced by: Example 1 Surveyor requested and reviewed the facility policy titled Handwashing/Hand Hygiene. The policy in part reads, This facility considers hand hygiene the primary means to prevent the spread of infections. The policy lists instances where employees must conduct hand hygiene. such as: Before and after direct resident contact. Before and after assisting a resident with personal care. Upon and after becoming in contact with a resident's intact skin. After contact with a resident's mucous membranes and body fluids or…

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.