Adept Nursing & Rehab of Ashland

Inspectors wroteLicensure Reference Number 175 NAC 12-006.10(D) Based on record review, observations and interviews, the facility failed to administer medications according to practitioner's orders or manufacturer's recommendations by administering medications after a meal consumption for medication to be given 60 minutes prior to meals. This included observation of 25 medication administration opportunities with 3 errors resulting in an error rate of 12%. This failure affected 2 (Residents 21 and 65 ) of 3 sampled residents. The facility census was 77.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.05(E) Based on record review and interview the facility failed to provide the resident/resident representative education and receive informed consent for use of psychotropic medications (any medication that affects behavior, mood, thoughts, or perception) as required for 1 (Resident 10) of 1 sampled resident. The facility census was 77.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.10(C)Based on interview and record review, the facility failed to prime a insulin pen prior to administer insulin for 1 (Resident 15) of 3 sampled residents and failed to ensure 1 (Residents 15) of 5 sampled resident's who received Jardiance (an oral diabetes medication) was provided per the provider's order. The facility census was 77.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.09(H)(vi)(3)(g) Based on record reviews, observations, and interviews the facility failed to provide staff training/competency testing for use of a Trilogy machine (a noninvasive machine that provides ventilation/breathing support) for 2 (Resident 10 and Resident 21) of 2 sampled residents. The facility census was 77.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.09 and 12-006.09(E)Based on record review and interviews; the facility failed to evaluate and implement interventions to manage triggers (any stimuli that cause a person to re-experience the trauma or its associated emotions) for 1 (Resident 21) of 1 sampled resident with a self-reported diagnosis of Post Traumatic Stress Disorder (PTSD) through evaluation and care planning of potential triggers or situations that could lead to re-traumatization. The facility census was 77.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.09(F)(iii) Based on record review and interview, the facility failed to update the Comprehensive Care Plan - (CCP- written instructions needed to provide effective and person centered care of the resident that meet professional standards of quality care) to accurately reflect interventions to minimize behaviors for 2 (Residents 1 and 2) of 3 sampled residents. The facility census was 81.

Inspectors wroteLicensure Reference Number 175 NAC 12.006.09(I) Based on observation, interview, and record review, the facility failed to implement interventions to prevent falls for 3 (Residents 1, 2, and 3) of 4 sampled residents. The facility census was 82.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.18(B) Based on observation, interviews and record reviews, the facility failed to prevent cross contamination related to: 1. staff not wearing masks, 2. staff not wearing masks correctly, 3. staff carrying dirty linens next to their uniforms, and 4. reusable items potentially contaminated were not handled in a way to prevent the spread of COVID. The sample size was 5 and the facility census was 80.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.04B(ii)(1) Based on interview and record review that facility failed to ensure 2 staff members (Nurse Aide (NA)-O and NA-P) that had been employed longer than one year had completed the 12 hours of continuing education required to maintain a Nurse Aide (NA) license. The sample size was 5. The facility identified a census of 83. Findings Are: A record review of education hours for 5 staff members that had been employed at the facility for more than one year revealed that 2 staff members (NA-O and NA-P) had not received 12 hours of continuing education in the last one year as required to maintain their Nurse Aide (NA) certification. [...]

Inspectors wroteLicensure Reference Number 175 NAC 1-009.04(i) Based on observation, interviews, and record reviews; the facility failed to ensure a safe water temperatures on the Memory Care Unit (MCU). This had the potential to affect 9 of 9 sampled resident rooms on the MCU. The facility census was 83 at the time of survey.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.19B Based on observation, interview, and record review; the facility failed to ensure the facility's mechanical ventilation was functioning in resident's bathroom for rooms on the Memory Care Unit (MCU). This had to affected all 9 of 9 resident rooms on MCU. The facility census was 83 at the time of survey.

Inspectors wroteBased on interview and record review; the facility failed to ensure baths were provided at least once weekly for 3 (Residents 7, 36 and 87) of 5 sampled residents. The facility identified a census of 83. Findings Are: A record review of the undated facility policy titled Resident Showers read as follows: Residents will be provided showers as per request or as per facility schedule protocols and based upon resident safety. A. A record review of the document titled admission Record dated 6/11/24 revealed Resident 87 had been accepted into the facility on 5/28/24 with a primary diagnoses of Muscle Wasting (when muscles waste away) and Atrophy (decrease in size of a body part, cell, organ, or other tissue, wasting) of multiple sites. [...]

Inspectors wroteLicensure Reference Number 175 NAC 12-006.09B Based on record review and interview; the facility failed to ensure the Minimum Data Set (MDS, a comprehensive assessment of each resident's functional capabilities used to develop a resident's plan of care) was coded correctly for 2 residents (Residents 53 and 75) of 4 samples residents The facility census was 83 at the time of survey.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.09H(iv) Based on interview and record review; the facility failed to ensure routine bowel movements for 2 (Residents 53 and 75) of 4 sampled residents. The facility census was 83 at the time of survey.

Inspectors wroteBased on interview and record review, the facility failed to notify a hospice provider regarding the death for 1 (Resident 2) out of 3 sampled residents for hospice care. The facility census was 83.

Inspectors wroteLicensure Reference: 175 NAC 12-006.09D7 Based on observation, interview, and record review, the facility failed to implement interventions to protect 2 [Residents 1 and 2] of 3 sampled residents from potential burns. The facility had a total census of 88 residents.

Inspectors wroteBased on observation, interviews, and record review, the facility failed to respect a resident's right to personal privacy during medication administration for 1 (Resident #60) of 4 residents observed for medication administration.

Inspectors wroteBased on observation, interviews, and record review, the facility failed to follow safe medication administration infection control practices during medication administration for 1 (Resident #60) of 4 residents observed for medication administration.