Accura Healthcare of Fullerton

Inspectors wroteLicensure Reference Number 175 NAC 12-006.11(E) Based on observations, record reviews, and interviews, the facility failed to ensure water temperatures in the dishwasher reached the required temperature during the wash cycle to ensure sanitization, failed to maintain cleanliness of the ice machine and convection oven surfaces, and failed to ensure hand hygiene was completed between glove changes in a manner to prevent the spread of foodborne illness. This had the potential to affect all residents. The facility census was 64.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.10(D) Based on observations, record reviews and interviews, the facility failed to maintain a medication error rate of less than 5%, which affected 2 residents (Resident 11 and Resident 17) of 3 sampled residents. The medication error rate was 7.69%. The facility census was 64.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.11(D) Based on observations and interviews, the facility failed to ensure that food was provided at a temperature that was appealing to the residents. This had the potential to affect all residents. The facility census was 64.

Inspectors wroteLicensure Reference Number 175 12-007.04 D Based on observations and interview, the facility failed to ensure that ventilation system were operational in residents bathroom for rooms 33,34,36,39,40 and 41 to prevent odors. The facility census was 64.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.11(E) Based on observation, record review and interview; the facility failed to ensure measures were implemented to prevent the potential for food borne illness related to the proper storage and labeling of food items and the maintenance and cleaning of kitchen equipment. This had the ability to affect all residents that ate from the facility kitchen. The total sample size was 16 and the facility census was 57.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.19 Based on observations, record review and interview; the facility failed to maintain the cleanliness and the condition of the bathroom ceiling ventilation covers, the bathroom floors and toilets and the walls in 14 (Rooms 2, 4, 6, 8, 10, 11, 12, 13, 18, 19, 20, 21, 32 and 35) of 38 occupied resident rooms in the facility. In addition, the facility failed to address missing dentures for Resident 35. The total sample size was 16 and the facility census was 57.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.10(D) Based on observation, interview, and record review; the facility failed to prime Resident 19's insulin pen to ensure delivery of accurate dosing and to ensure a medication error rate of less than 5 percent (%). There were 25 observed opportunities with 2 error observed. The sample size was 12 and the facility census was 57.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.09(F)(iii) Based on record review and interviews; the facility failed to develop new interventions and/or revise current interventions to prevent ongoing falls for Resident 32. The sample size was 7 and the facility census was 57.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.18E1 Based on observation, record review and interview; the facility failed to ensure that portable space heaters were not used, and the exterior surface temperature of the heaters did not reach a level that could pose a risk of thermal burns. This practice had the potential to affect 23 residents that were identified as cognitively impaired with poor safety awareness and were self-mobile of a total census of 59 residents.

Inspectors wroteLICENSURE REFERENCE NUMBER 175 NAC 12-006.04D2 Based on interview and record review; the facility failed to have a qualified Dietary Manager (DM). This had the potential to affect all residents who consumed food from the kitchen. The facility staff identified a census of 58. Review of the facility Job Description for the role of Dietary Service Manager revealed necessary qualifications included the completion of a Dietary Manager certification course. An interview with the DM on 12/13/23 at 8:30 AM revealed the DM was enrolled in dietary manager classes and would not finish until March of 2024. Review of a list of key personnel received from the facility for this location revealed that the Food Service Supervisor was listed as the DM, and there was no Certified DM on the list.

Inspectors wroteLICENSURE REFERENCE NUMBER NAC 12-006.11E Based on observation, record review, and interview; the facility failed to maintain food storage areas and kitchen equipment in a sanitary manner and to store food and perform meal service in a manner to prevent the potential for food borne illness and assure food safety as 1) failed to utilize handwashing and gloving techniques to prevent potential food contamination; 2) touched ready to eat food items with bare hands; 3) failed to properly store food items and to assure items were labeled and dated; and 4) kitchen equipment was free of dirt and debris. This had the ability to affect all residents that ate from the facility kitchen. The total sample size was 22 and the facility census was 58.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.18A Based on observation, interview, and record review; the facility failed to ensure the environment was clean and in good repair. There were 30 residents residing in the units with the identified concerns. The facility census was 58.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.04A3b Based on record review and interview, the facility failed to ensure background checks through the State Nurse Aide (NA) registry were completed on 2 of 5 employees. The facility census was 58.

Inspectors wroteLICENSURE REFERENCE NUMBER 175 NAC 12-006.04C3a(6) Based on record review and interview; the facility failed to notify Resident 27's physician of a change in condition and Resident 18's representative of a fracture in a timely manner. The sample size was 3 and the facility census was 58.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.05(1) Based on record review and interview; the facility failed to ensure Residents 9 and 54 received the required Advanced Beneficiary Notification (ABN- required notice of discharge from Medicare skilled care services) that informed the residents of the cost of receiving continued skilled care services once discharged from Medicare. The sample size was 3 and the facility census was 58.

Inspectors wroteLicensure Reference Number 175NAC 12-006.02(8) Based on record review and interview; the facility failed to complete investigations for injuries of unknown origin for 2 (Residents 18 and 43) of 2 sampled residents. The facility census was 58.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.09B Based on observation, record review and interview; the facility failed to accurately Code the Minimum Data Set (MDS-federally mandated comprehensive assessment used to develop resident Care Plans) regarding Resident 19's Preadmission Screening and Resident Review (PASARR- federally mandated preadmission assessment performed to determine if resident's have Significant Mental Illness (SMI) or Intellectual Disability (ID), to assure appropriate placement and treatment) and Resident 32's use of Restraints. The sample size was 16 and the facility census was 58.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.09D Based on record review and interview, the facility failed to ensure residents were free from unnecessary medications related to long term use of antibiotic medications for 3 residents (Resident 22, 43 & 44) that did not specify a duration and had no supporting documentation for clinical use based on laboratory results. The sample size was 3 and the facility census was 58.

Inspectors wroteLicensure Reference Number 175 NAC 12.006.09D Based on record review and interview, the facility failed to ensure psychotropic medications (a type of psychoactive medication which alters chemicals in the brain to affect changes in behavior, mood and emotion) had the required diagnosis for 1(Resident 57) of 6 sampled residents. The facility census was 58.