Adviniacare Newport, LLC

Inspectors wroteBased on clinical record review and staff interview, the facility failed to provide written notification, including the reason for the room change, prior to changing a resident's room or roommate assignment for 1 of 1 resident reviewed whose room and roommate were changed without prior notification, Resident ID #1.

Inspectors wroteBased on clinical record review and staff interview, the facility failed to meet professional standards of quality regarding not following physician orders for obtaining weights for 1 of 3 residents reviewed for nutrition, Resident ID #1. Additionally, the facility failed to follow the policy to reweigh residents to ensure accuracy when the weight falls outside of the established parameters for 2 of 3 resident's reviewed, Resident ID #s 1 and 3.

Inspectors wroteBased on surveyor observation, record review, and staff interview, the facility failed to store, prepare, distribute and serve food in accordance with professional standards for food service safety relative to the main kitchen and 2 of 3 nourishment units observed.

Inspectors wroteBased on clinical record review and staff interview, it has been determined that the facility failed to implement and maintain an effective, comprehensive, data-driven, Quality Assurance and Performance Improvement (QAPI) program that focuses on indicators of the outcomes of care and quality of life, related to 2 of 2 certified medication technicians (CMT) evaluations reviewed, Staff N and O.

Inspectors wroteBased on surveyor observation, staff and resident interview, the facility failed to provide a private space for resident council meetings that are held monthly as required.

Inspectors wroteBased on record review, staff, and resident interviews, the facility failed to follow and implement physician's orders related to the facility's Bowel Evacuation Protocol for 2 of 2 residents reviewed who did not have a bowel movement for over three days, Resident ID #s 78 and 11.

Inspectors wroteBased on surveyor observation, clinical record review, and staff interview, the facility failed to ensure the residents' environment remains as free of accident hazards as possible, related to securing medications and hazardous equipment (razor) for 1 of 1 treatment cart observed on a secured unit in close proximity to Resident ID #s 9 and 14, and for 1 of 2 smokers reviewed without a smoking assessment, Resident ID #21.

Inspectors wroteBased on surveyor observation, clinical record review, staff and resident interviews, the facility failed to provide a safe, functional, sanitary and comfortable environment for resident's relative to 1 of 1 privacy curtain observed with staining, and for 2 of 3 units reviewed without an assigned housekeeper.

Inspectors wroteBased on clinical record review and staff interview, the facility failed to ensure that residents receive treatment and care in accordance with professional standards of practice, relative to physician's orders for 1 of 3 residents reviewed who receives Eliquis (a medication prescribed to prevent and treat blood clots), Resident ID #64.

Inspectors wroteBased on surveyor observation, clinical record review, staff, and resident interview, the facility failed to provide activities of daily living (ADL) care for 1 of 1 resident reviewed for who receives hospice services, Resident ID #78.

Inspectors wroteBased on clinical record review and staff interview, the facility failed to provide appropriate treatment and services for 1 of 2 residents reviewed with an indwelling foley catheter (a flexible tube that collects urine from the bladder and empties into a drainage bag) related to urine output monitoring, Resident ID #10.

Inspectors wroteBased on surveyor observation, clinical record review, and staff interview, the facility failed to ensure residents who are fed through a feeding tube receive the appropriate treatment and services to prevent complications for 1 of 1 resident reviewed for a continuous feeding via a jejunal tube (J-tube, a surgically placed device used to give direct access to the small intestine for supplemental feeding, hydration or medicine), Resident ID #13.

Inspectors wroteBased on surveyor observation, clinical record review, and staff interview, the facility failed to ensure that each resident's medication regimen is free from a medication error rate of 5% or greater. Based on 25 opportunities for errors observed during the medication administration task, there were four errors resulting in an error rate of 16% affecting Resident ID #s 43, 81, 62 and 101.

Inspectors wroteBased on surveyor observation, clinical record review, and staff interview, the facility failed to maintain an infection prevention and control program to help prevent the transmission of communicable diseases and infections, relative to enhanced barrier precautions (EBP; refers to an infection control intervention designed to reduce transmission of multidrug-resistant organisms [MDRO], for 4 of 4 residents observed on EBP, Resident ID #s 12, 13, 22 and 65.

Inspectors wroteBased on surveyor observation and record review, the facility failed to protect identifying information for 7 current residents listed in the facility's survey results binder for 2 of 4 surveys reviewed.

Inspectors wroteBased on surveyor observation and staff interview, it has been determined that the facility failed to properly store and serve food under sanitary conditions relative to serving temperatures of a potentially hazardous food item, improper cooling procedures, sanitation of the main kitchen, and infection control practices.

Inspectors wroteBased on record review and staff and resident interview, it has been determined that the facility failed to ensure the resident has the right to choose his or her attending physician for 3 out of 4 residents reviewed related to physician choice, Resident ID #s 2, 3, and 5.

Inspectors wroteBased on surveyor observation, record review and staff interview, it has been determined that the facility failed to store, prepare, distribute, and serve food in accordance with professional standards for food service safety relative to the main kitchen and for 1 of 3 nursing unit kitchenettes.

Inspectors wroteBased on surveyor observation, record review, and staff interview, it has been determined that the facility failed to ensure a resident who is at risk for pressure ulcers receives the necessary treatment and services, consistent with professional standards of practice, to promote healing, prevent infection, and prevent new ulcers from developing for 1 of 4 residents reviewed with an actual pressure ulcer (localized damage to the skin and/or underlying soft tissue usually over a bony prominence), Resident ID #67.

Inspectors wroteBased on record review and staff interview, it has been determined that the facility failed to ensure that nursing staff have the appropriate competencies and skill sets to provide nursing and related services to assure resident safety and attain or maintain the highest practicable physical well-being of each resident, as determined by resident assessments and individual plans of care for 2 of 2 Registered Nurses (RNs) reviewed, Staff B and Staff D and 4 of 6 Nursing Assistants (NAs) reviewed, Staff E, F, G and H.

Inspectors wroteBased on surveyor observation, record review, and staff interview, it has been determined that the facility failed to ensure that the menus meet the nutritional needs of the residents in accordance with established national guidelines, that are reviewed by the facility's dietitian or other clinically qualified nutrition professional for nutritional adequacy.

Inspectors wroteBased on record review and staff interview it has been determined that the facility failed to develop, implement, and maintain an effective training program for annual training for existing employees consistent with their expected roles, relative to education involving abuse, resident rights, infection control, dementia, behavioral health management, trauma informed care, communication and QAPI (Quality Assurance and Performance Improvement), per the facility assessment, for 8 of 8 employees, Staff B, D, E, F, G, H, S and T. .

Inspectors wroteBased on surveyor observation, record review, and staff interview, it has been determined that the facility failed to ensure that services being provided meet professional standards of quality relative to following physician's orders for 1 of 1 resident reviewed for obtaining and documenting weights on dialysis treatment days, Resident ID # 61, 1 of 10 residents reviewed with a pressure relieving device, Resident ID #62, and 1 of 2 residents reviewed who receives TED [thrombo-embolis deterrent- a type of compression stocking designed to help prevent blood clots and swelling in the legs] stockings daily, Resident ID # 67.

Inspectors wroteBased on surveyor observation, record review, and staff interview, it has been determined that the facility failed to ensure residents with limited range of motion receive appropriate treatment to prevent further decline in range of motion for 3 of 4 residents reviewed, Resident ID #s 18, 61 and 70.

Inspectors wroteBased on surveyor observation, record review, and staff interview, it has been determined that the facility failed to ensure residents that are fed through a feeding tube receive the appropriate treatment and services to prevent complications for 1 of 1 resident reviewed receiving nutrition via a gastrostomy tube (a feeding tube that delivers nutrition, hydration and medication to your stomach through the abdomen), Resident ID #197.

Inspectors wroteBased on surveyor observation, record review, and staff interview, it has been determined that the facility failed to provide respiratory care consistent with professional standards of practice for 1 of 2 residents reviewed for respiratory care, Resident ID #49.

Inspectors wroteBased on record review and staff interview, it has been determined that the pharmacist failed to report irregularities to the attending physician, the facility's Medical Director, and the Director of Nursing Services (DNS) for 1 of 8 residents reviewed for monthly drug regimen reviews, Resident ID #59.

Inspectors wroteBased on record review and staff interview, it has been determined that the facility failed to ensure that residents are free of any significant medication errors for 1 of 4 residents reviewed receiving insulin, Resident ID #59 and 1 of 4 residents reviewed receiving an Antipsychotic medication (medications that mainly treat psychosis and, related conditions and symptoms), Resident ID #74.

Inspectors wroteBased on surveyor observation and staff interview, it has been determined that the facility failed to store drugs and biological's in accordance with currently accepted professional principles relative to 1 of 2 medication rooms observed, 2 of 2 medication carts observed on unit 2, and 2 residents observed with medications at the bedside, Resident ID #s 22 and 63.

Inspectors wroteBased on surveyor observation, record review, and staff interview, it has been determined that the facility failed to maintain medical records that are accurately documented in accordance with professional standards and practices for 2 of 4 residents reviewed with a splint (a device used to prevent decreased range of motion), Resident ID #s 61 and 70, and 1 of 2 residents reviewed who has an order for TED stockings (thrombo-embolis deterrent- a type of compression stocking designed to help prevent blood clots and swelling in the legs) daily, Resident ID #67.

Inspectors wroteBased on surveyor observation and staff interview, it has been determined that the facility failed to provide a safe, sanitary, and comfortable environment for residents, staff and the public related to the basement conference room.

Inspectors wroteBased on surveyor observation, record review, and staff interview, it has been determined that the facility failed to ensure residents receive and consume food in the appropriate form, for 1 of 3 residents observed with physician orders for a mechanical soft diet, Resident ID #39.

Inspectors wroteBased on record review and staff interview it has been determined that the facility failed to ensure that residents receive adequate supervision to prevent an accident for 1 of 3 residents reviewed for elopement, Resident ID #1.

Inspectors wroteBased on surveyor observation, record review, and staff interview, it has been determined that the facility failed to ensure it stores, distributes, and serves food in accordance with professional standards for food safety relative to the main kitchen and 1 of 3 unit kitchenettes.

Inspectors wroteBased on record review and staff interview, it has been determined that the facility failed to ensure that services provided meet professional standards of quality for 2 of 7 residents reviewed relative to physician orders, Resident ID #s 49 and 85.

Inspectors wroteBased on surveyor observation, record review, and staff interview, it has been determined that the facility failed to provide necessary treatment and services, consistent with professional standards of practice, to promote wound healing and prevent new ulcers from developing for 2 of 5 residents reviewed with pressure ulcers (a localized injury to the skin and/or underlying skin usually over a boney prominence), Resident ID #s 37 and 73.

Inspectors wroteBased on surveyor observation, record review, and staff interview, it has been determined that the facility failed to ensure that the residents receive treatment relative to foot care for 2 of 8 residents observed, Resident ID #s 81 and 80.

Inspectors wroteBased on surveyor observation, record review, and staff interview, it has been determined that the facility failed to store and label drugs and biological's in accordance with currently accepted professional principles for 2 of 3 medication carts reviewed, and 2 of 3 medication rooms reviewed.

Inspectors wroteBased on record review, and staff interview it has been determined that the facility failed to provide or obtain from an outside resource, emergency dental services for 1 of 1 resident reviewed for dental pain, Resident ID #49.

Inspectors wroteBased on record review and staff interview, it has been determined that the facility failed to ensure that all alleged violations are thoroughly investigated for 1 of 1 residents reviewed who was noted to have bruising to his/her genital area, Resident ID #85.

Inspectors wroteBased on surveyor observation, record review, and staff interview, it has been determined that the facility failed to ensure that each resident receives necessary respiratory care and services that are in accordance with professional standards of practice for 1 of 5 residents reviewed for respiratory care, Resident ID #49.