Accura Healthcare of Neligh

Inspectors wroteLicensure Reference Number 175 NAC 12-006.19 Based on observation, interview, and record review, the facility failed to ensure an air conditioning system to maintain comfortable temperatures below 81 degrees F [Fahrenheit] in common areas of the facility. This has the potential to affect all 30 residents of the facility.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.04(D) Based on record review and interview; the facility failed to ensure 8 hours of consecutive Registered Nurse (RN) coverage in a 24-hour period 7 days per week as required. This had the potential to affect all facility residents. The facility census was 30.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.19(A)Based on observation, record review and interview; the facility failed to ensure the building was clean and in good repair. The facility census was 30.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.05(S)Based on record review and interview; the facility failed to ensure Resident 32 received dignified care when staff did not respond in a timely manner to a request for assistance with toileting. The sample size was 22 and the facility census was 30.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.02(H)Based on record review and interview; the facility failed to report allegations of potential abuse of Residents 32 and 29 to the State Agency as required. The sample size was 2 and the facility census was 30.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.18(A)Based on record review and interview; the facility failed to offer Resident 29 the recommended Pneumococcal vaccines in accordance with facility policy and Center for Disease Control (CDC) guidelines. The sample size was 5 and the facility census was 30.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.18(A)Based on record review and interview; the facility failed to offer Resident 10 the recommended Covid-19 vaccines in accordance with facility policy and Center for Disease Control (CDC) guidelines. The sample size was 5 and the facility census was 30.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.19 Based on observations, record review and interview; the facility failed to ensure mechanical lifts were maintained in a manner to promote resident safety. This has the potential to affect all residents who utilized mechanical lifts. In addition, the facility failed to ensure the wall, curtain, light cover and bathroom door frame were maintained in good repair in room C11, maintain the cleanliness of the bathroom ceiling ventilation covers, maintain the door frames to the resident's room and bathrooms to be free of chipped paint to 29 rooms ( C5 to C14, D15 to D27, B30 to B530) and maintain the cleanliness and condition of bathroom floors in room C11 and D25. The sample size was 19 and the facility census was 33.

Inspectors wroteLICENSURE REFERENCE NUMBER 175 NAC 12-006.09D7 (b) Based on observations, interviews, and record review; the facility failed to implement fall interventions, and to develop and/or revise fall interventions for the prevention of ongoing falls for Residents 5, 15 and 19. The sample size was 4 and the facility census was 33.

Inspectors wroteLICENSURE REFERENCE NUMBER 175 NAC 12-006.09D3 Based on observation, record review and interview; the facility staff failed to provide care and management of Resident 6's urinary catheter (tube placed into the bladder to drain urine) to prevent the potential for infections and/or complications. The sample size was 1 and the facility census was 33.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.12(A)(vi) Based on record review and interviews; the facility failed to follow the consultant pharmacist's recommendations to address irregularities in the medication regimen for Resident 16. The sample size was 6 and the facility census was 33.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.17 Based on observation, record review, and interview; the facility failed to prevent the potential for cross contamination as the staff failed to utilize the required Personal Protective Equipment (PPE) when performing direct cares for Resident 6 who was on Enhanced Barrier Precautions and to change gloves and perform hand hygiene at appropriate intervals when providing wound care for Residents 5 and 6. The total sample size was 19 and the census was 33.

Inspectors wroteF. Review of the facility policy Administering Medication, undated, revealed the following: -only licensed persons were to administer and document the administration of medications, -the Director of Nursing (DON) supervised and directed all personnel who administered medications, -medications were administered in accordance with prescriber orders, and -staff were to follow established facility infection control procedures for the administration of medications. G. Observation on 3/18/24 at 8:10 AM revealed MA-G performed hand hygiene, obtained Resident 4's medication cards from the medication cart, compared each medication card to the Medication Administration Record (MAR), MA-G pushed the medication out of the window of the medication card into MA-G's bare hand, then MA-G placed the medication into the medication cup. MA-G repeated this process for a total of 12 medications. [...]

Inspectors wroteLicensure Reference Number 175 NAC 12-006.09D7 Based on observations, record review and interview, the facility failed to develop and/or implement interventions to prevent ongoing elopements for Resident 236 and falls for Residents 27 and 5. The sample size was 6 and the facility census was 33.

Inspectors wroteLICENSURE REFERENCE NUMBER 175 NAC 12-006.05(8) Based on observations, record review and interview; the facility staff failed to evaluate the use of a seatbelt as a restraint for 1 (Resident 30) of 1 sampled resident. The facility identified a census of 33.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.09B Based on record review and interview; the facility failed to accurately code Resident 25's Minimum Data Set (MDS- a federally mandated assessment tool used in care planning) to reflect the resident's current urinary and nutritional interventions. The sample size was 18 and the facility census was 33.

Inspectors wroteLicensure Reference Number: 175 NAC 12-006.09D Based on record review and interview; the facility failed to ensure that routine assessments were completed to monitor for adverse side effects of anti-psychotic medications (medication used to treat psychosis) for 1 (Resident 2) of 5 sampled residents. The facility census was 33.

Inspectors wroteLicensure Reference Number 175 NAC 12-006. 04B Based on record review and interview; the facility failed to provide the required abuse training for new and existing staff. The sample size was 8 and the facility census was 33.

Inspectors wroteLicensure Reference Number 175 NAC 12-006. 04B Based on record review and interview; the facility failed to provide the required abuse training for new and existing staff. The sample size was 8 and the facility census was 33.