Adept Nursing & Rehab of Central City

Inspectors wroteBased on record reviews and interviews, the facility failed to provide notification to the physician for Resident #7 as required. The facility has a census of 58.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.11EBased on observations, interviews, and record reviews, the facility failed to store, prepare, and serve food in a manner to prevent potential for foodborne illness. Specifically failed were gloves while touching foods, failed to ensure food in storage were labeled, dated or sealed, failed to have thermometers in the milk refrigerator, failed to ensure foods and fluids were at the proper temperature and failed to ensure hand hygiene was completed. This had the potential to affect all 58 residents who ate food prepared in the kitchen.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.04(B)(ii)(2) Based on record reviews and interviews, the facility failed to ensure 4 Medication Assistants of 4 reviewed had competencies completed. The facility had census of 58.

Inspectors wroteLicensure Reference Number 175 NAC 12.006.05(E) Based on record review and interviews, the facility failed to have a signed advanced directive for one resident (resident 11) out of eight sampled residents. Facility census was 58.

Inspectors wroteBased on record reviews and interview, the facility failed to provide notice of end of Medicare coverage for 2 ( Resident 10 and 46) of 3 sampled residents. The facility has a census of 58.

Inspectors wroteBased on interview and record review, the facility failed to notify the ombudsman (a state appointed advocate for residents of nursing homes) of resident discharge for 1 of 1 residents reviewed (Resident 66) as required. The facility census was 58 at the time of the survey.

Inspectors wroteLicensure reference number 175 NAC 12-006.09(H)(iv)(3)Based on observation, interviews and record reviews, the facility failed to maintain the catheter drainage bag below the bladder for 1 (Resident 39) of 1 sampled residents to prevent urinary tract infection. The facility has a census of 58.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.09Based on observation, record reviews and interviews, the facility staff failed to complete an assessment and monitoring after receiving Dialysis services for 1 (Resident 10) of 1 residents. The facility has a census of 58.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.11(D) Based on record reviews, observations, and interviews the facility failed to ensure residents were provided with nourishing and palatable meals. This had the potential to affect all residents who received meals from the kitchen. The facility census was 56. Findings Are: Record review of the policy Food Preparation Guidelines dated 8/1/2023 revealed the policy intent is to prepare foods in a manner to preserve or enhance a resident's nutrition and hydration status. The following three definitions were defined: -Food Attractiveness - the appearance of the food when served to residents, -Food palatability - the taste and flavor of the food, and -Proper (safe and appetizing) temperature meant appetizing food and minimizing the risk for scald and burns. [...]

Inspectors wroteLicensure Reference Number 175 NAC 12-006.11(A)(iii) Based on record reviews, observations, and interviews the facility failed to ensure residents were offered alternate meal items when residents choose not to eat food that was initially served. This had the potential to affect all residents who received meals from the kitchen. The facility census was 56. Findings Are: Record review of the policy Food Preparation Guidelines dated 8/1/2023 revealed the policy intent is to prepare foods in a manner to preserve or enhance a resident's nutrition and hydration status. The policy explanation and compliance guidelines stated in section 4) Food shall be provided in a form that meets each resident's individual needs according to assessment and care plan; 5) Staff shall accommodate resident preferences providing appropriate alternatives; [...]

Inspectors wroteLicensure Reference Number 175 NAC 12-006.19 Based on record reviews, observations, and interviews the facility failed to ensure the facility was a clean and homelike environment, this affected two hallways of 4 sampled. The facility census was 56.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.05(F) Based on record reviews, observations, and interviews the facility failed to ensure call lights were answered promptly for 3 residents (Residents 5, 6, 4) of the 3 sampled residents. The facility census was 56.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.09(H) Based on record review and interview the facility failed to communicate all health information to the receiving health care facility for 1 (Resident 1) of 3 sampled residents. This had the potential to cause resident health problems and safety concerns to not be identified by the receiving facility. The facility census was 56.

Inspectors wroteBased on record review and interviews; the facility failed to ensure a PASRR (Pre-admission Screening and Resident Review) for individuals with a mental disorder or intellectual disability were accurately completed to determine if a level II PASARR review was warranted for 1 (Resident 39) out of 20 sampled residents. The facility census was 60.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.09 Based on record review, observations, and interviews; the facility failed to follow up and complete Physician's orders regarding Auto-PAP (Continuous positive airway pressure) for 1 (Resident 34) of 20 sampled residents. The facility census was 60. A record review of the admission Record revealed that Resident 34 was admitted to the facility on [DATE] with diagnosis of: Obstructive Sleep Apnea(characterized by episodes of a complete airway collapse or a partial collapse with an associated decrease in oxygen saturation or arousal from sleep). An interview on 7/29/24 at 1:30 PM with Resident 34 confirmed that [gender] does not use the Auto-Pap machine because the mask is too tight on [gender] face. Resident 34 revealed that [gender] had informed the staff regarding the mask being too tight. [...]

Inspectors wroteLicensure Reference Number 175 NAC 12-006.18 (B) & (D) Based observations, interviews, and record review; the facility failed to secure a catheter to prevent cross contamination during catheter cares for 1 (Residnet 53), and failed to change gloves and perform hand hygiene when performing peri care and wound care for 3 (Resident 53, 26, and 8) of 3 sampled residents. The facility census was 60.

Inspectors wroteLicensure Reference Number 175 NAC 12.006.09D3 Based on interview and record review, the facility failed to ensure a full Urinalysis (UA)(a test that checks several components of a urine sample) was completed for 1 (Resident 49) of 2 sampled residents. The total facility census was 59.

Inspectors wroteLicensure Reference Number 175 NAC 12.006.09D6 (7) Based on observation, interview, and record review, the facility failed to ensure an oxygen concentrator (a machine that delivers purified oxygen to a resident) was set at the prescribed settin and that the humidifier remained full for 1 (Resident 32) of 2 sampled residents. The total facility census was 59.

Inspectors wroteLicensure Reference Number 175 NAC 12.006.16B2 Based on observation, interview, and record review, The facility failed to ensure weekly skin checks identified 1 (Resident 49) of 2 sampled resident's wounds and failed to document 1 (Resident 49) of 1 sampled resident's refusal of EdemaWare compression stocking. The total facility census was 59.