Accura Healthcare of Ames, LLC

Inspectors wroteBased on clinical record review, policy review and staff interview, the facility failed to ensure the resident or representative received written bed hold information prior to a transfer to the hospital for 2 of 2 residents reviewed for hospitalization (Residents #3 and #69). The facility reported a census of 63 residents.

Inspectors wroteBased on clinical record review, policy review, the Food and Drug Administration (FDA), staff, and resident interviews the facility failed to accurately complete a Minimum Data Set (MDS) assessment for 3 of 20 residents reviewed (Residents #6, #8 and #62). The facility reported a census of 63 residents.

Inspectors wroteBased on record review and staff interview, the facility failed to develop and implement comprehensive care plans accurately reflecting the needs and safety interventions for 2 of 20 sampled residents (Resident #17 and Resident #72). Specifically, the facility didn't address smoking behaviors and supervision for one person and didn't ensure staff implemented established fall prevention interventions for another. The facility reported a census of 63 residents.

Inspectors wroteBased on observations, clinical record review, staff interviews, and policy review the facility failed to maintain infection control practices for 1 of 3 residents reviewed (Resident ##26). The facility failed to complete hand hygiene and change gloves when completing resident care. The facility reported a census of 63 residents.

Inspectors wroteBased on clinical record review and staff interview, the facility failed to submit a Level II Preadmission Screening and Resident Review (PASRR) evaluation for 1 of 1 residents reviewed with a new mental health diagnoses (Resident #49). The facility reported a census of 69 residents.

Inspectors wroteBased on record review, resident interview, staff interview and facility process review, the facility failed to ensure residents environment was free from accidents and hazards by not assessing a resident for safety that verbalized he used a vape pen in his room for 1 of 2 residents reviewed for smoking (Resident #67). The facility reported a census of 69 residents.

Inspectors wroteBased on staff interview, resident interview, clinical records and observation the facility failed to provide appropriate interventions to minimize or prevent urinary tract infections for 3 of 4 residents reviewed with urinary catheters (Residents #11, #55, and #68). The facility reported a census of 69 residents.

Inspectors wroteBased on observation, policy review, and staff interview, the facility failed to label, date and store food/utensil in accordance with profession standards for food safety to reduce the risk of contamination and food borne illness. The facility reported a census of 69 residents.

Inspectors wroteBased on the Center of Medicare and Medicaid Services (CMS) Payroll Based Journal (PBJ) Staff Data Report (October 1, 2024 December 31, 2024) review, facility staffing assignments review, staff punch detail review, and staff interviews, the facility failed to submit accurate staffing data for the PBJ Staffing Data Report which indicated the facility had excessively low weekend staffing. The facility reported a census of 69 residents.

Inspectors wroteBased on observation, clinical record review, staff interviews, facility self report and facility inservice record, the facility failed to ensure a resident was safe in the environment. Review revealed Resident #1 required assistance of one staff for personal hygiene and ambulation. On 7/4/24 at approximately 6:58 a.m., Staff A, Certified Nursing Assistant (CNA) assisted Resident #1 to the bathroom with a walker. Staff A proceeded to leave Resident #1 alone in the bathroom for which Resident #1 lost balance and fell to the bathroom floor and sustained a left hip fracture. Additionally on 8/27/24, Resident #2 was transported to an appointment with no staff assistance, fell while at the appointment, taken to the nearest emergency room and sustained a dental fracture to upper incisors. The facility reported a census of 65 residents.

Inspectors wroteBased on observation, clinical record review, resident interview, staff interview and policy review, the facility failed to provide adequate supervision to 3 of 5 residents observed (Residents #19, #31 and #46) during medication administration. The facility reported a census of 64 residents.

Inspectors wroteBased on observation, staff interview, and policy review, the facility failed to serve food to maintain a safe and appetizing temperature. The facility reported a census of 64.

Inspectors wroteBased on observations, staff interviews, and facility policy review, the facility failed to maintain sanitary practices by improperly storing and serving food. In addition, the dietary staff failed to wear hairnets while in the food service area. The facility reported a census of 64 residents.

Inspectors wroteBased on observation, interview, and clinical record review, the facility failed to maintain confidentiality of 2 of 5 residents reviewed (Residents #19 and #46) during the process of medication administration. The facility reported a census of 64 residents.

Inspectors wroteBased on clinical record review and staff interview, the facility failed to refer one resident (Resident #57) with a Level I Preadmission Screening and Resident Review (PASARR) with a diagnosed serious mental disorder for evaluation of a Level II PASARR at the time the diagnosis was known to the facility for 1 of 1 resident reviewed for PASARR. The facility reported a census of 64.

Inspectors wroteBased on observation and staff interviews, the facility failed to maintain a safe environment by leaving a medication cart unlocked and unsupervised. The facility reported a census of 64 residents

Inspectors wroteBased on observation, menu review, staff interview, and policy review, the facility failed to serve the correct serving size of protein for 3 of 5 residents who received pureed diets. The facility reported a census of 64 residents.

Inspectors wroteBased on observation, staff interview, and policy review, the facility failed to maintain proper infection control practices to protect against potential cross contamination for 2 of 16 residents observed (Resident #2 and #41). As a Certified Medication Aide (CMA) prepare Resident #2's medication, they failed to perform hand hygiene after coughing and blowing their nose. In addition, the facility failed to keep a resident's blanket clean after placing in a shared sink before putting it back on a resident (Resident #41). The facility reported a census of 64.

Inspectors wroteBased on record review, facility policy review, staff, and resident interviews, the facility failed to follow professional standards for medication administration by failing to administer Dilaudid, a narcotic pain medication for 1 of 3 residents reviewed (Resident #6) as ordered by the provider as needed for post-surgical pain.