Alliance Health at Baldwinville

Inspectors wroteBased on observation, interviews, and record review, the facility failed to follow professional standards of practice for food storage and environmental cleaning of the facility's main kitchen. Specifically, the facility failed to ensure that:-food items were properly dated, stored, and/or discarded timely in the main kitchen-clean and sanitary surfaces were maintained in the walk-in refrigerator, walk-in freezer, and food preparation areas, placing the facility residents at risk for contamination and foodborne illnesses.

Inspectors wroteBased on observations, interviews, and record review, the facility failed to ensure that it was appropriate and safe for medications to be self-administered for one Resident (#68) out of a total sample of 18 residents. Specifically, the facility failed to assess Resident #68 for the self-administration and safe and proper storage of two topical medications, placing the Resident at risk of inappropriately self-administering the medications and not storing the medications in his/her room in a safe and secure manner.

Inspectors wroteBased on observations, interview, and record review, the facility failed to ensure that activities of daily living (ADL's - activities related to personal care which includes washing, dressing, and personal hygiene [combing hair, applying makeup, washing/drying face and hands, and shaving]) were provided for one Resident (#84) of one applicable resident, out of a total sample of 18 residents. Specifically, the facility staff failed to assist Resident #84 with facial hair removal when the Resident required assistance for ADL care of personal hygiene due to weakness and impaired cognitive and communication skills.

Inspectors wroteBased on observations, interviews, and record review, the facility failed to provide care and services consistent with professional standards of practice for indwelling urinary catheters (a soft, flexible tube that drains urine from the bladder into a drainage bag) for one Resident (#58) of three applicable residents, out of a total sample of 18 residents. Specifically, for Resident #58, the facility staff failed to ensure that the Resident's urinary drainage bag was positioned off the floor to decrease the risk of contamination and increasing the Resident's risk for indwelling urinary catheter infections.

Inspectors wroteBased on interviews and record review, the facility failed to ensure that the Notice of Medicare Non-Coverage (NOMNC: notice issued to a resident who is receiving benefits under Medicare Part A when all covered services end) was accurately issued for one Resident (#95) out of three applicable residents, out of a total sample of 18 residents. Specifically, for Resident #95, the facility failed to ensure that a paper copy of the NOMNC was provided to the Resident's responsible party as required.

Inspectors wroteBased on observation, interviews, and records reviewed, the facility failed to coordinate an assessment with the PASRR program when a significant change in mental status was determined for one Resident (#3) out of a total sample of 18 residents. Specifically, the facility failed to refer Resident #3 to the PASRR program for a Level II Resident Review in a timely manner when the Resident: -Had a previous negative PASRR screening for serious mental illness (SMI). -Experienced aggressive behaviors. -Required in-patient psychiatric hospitalization. -Was newly diagnosed with bipolar disorder. -Required newly prescribed antipsychotic medication to be administered.

Inspectors wroteBased on observation, interview, and record review, the facility failed to adhere to infection control standards to prevent the transmission of communicable diseases and infections within the facility on one unit (Unit One) out of a total of two units affecting two Residents (Residents #3 and #6). Specifically, the facility failed to ensure that Personal Protective Equipment (PPE) used to touch surfaces in a resident's environment who had an active COVID-19 (a highly contagious respiratory disease) infection was changed in accordance with professional standards of practice prior to touching surfaces in another resident's environment who was not infected or was recently recovered with COVID-19 placing the non-infected resident at increased risk of contracting COVID-19 infection.

Inspectors wroteBased on interview, record and policy review, the facility failed to implement updated timing guidance for Pneumococcal Vaccinations and ensure that Pneumococcal Vaccinations were offered and administered as consented to for three Residents (#62, #46 and #6), of 5 applicable residents reviewed, out of a total sample of 18 residents. Specifically, the facility failed to: 1. Ensure the facility policy relative to Pneumococcal Vaccination was reviewed and updated to include current Centers for Disease Control and Prevention (CDC) guidance. 2. For Resident #62, afford the opportunity to consent to or decline the Pneumococcal Vaccine when the Resident was admitted to the facility. 3. For Resident #46, administer the most up-to-date Pneumococcal Vaccine when he/she was eligible and had given consent. 4. [...]

Inspectors wroteBased on observation, interview, record and policy review, the facility failed to provide care consistent with professional standards of practice relative to ensuring interventions ordered and/or recommended for the treatment of an existing wound were implemented for one Resident (#73) of two applicable residents with pressure ulcers reviewed, out of a total sample of 18 residents, with a pressure ulcer (injury to the skin and underlying tissue resulting from prolonged pressure to the skin). Specifically, the facility failed to ensure that: 1. A specialty (pressure reducing) mattress was at the correct setting as ordered by the Physician, 2. Pressure relief devices (heel booties) were implemented as ordered by the Physician, 3. Recommendations from the Wound Physician for lab work were reviewed by the facility staff for implementation.

Inspectors wroteBased on observation, interview, record and policy review, the facility failed to ensure that Transmission Based Precautions (TBP: used in addition to Standard Precautions for patients who may be infected or colonized with certain infectious agents for which additional precautions are needed to prevent infection transmission) were implemented for one Resident #65, out of a total sample of 18 residents. Specifically, the facility staff failed to reduce the potential spread of infection by ensuring that Contact Precautions (precautions intended to prevent transmission of infectious agents which are spread by direct and indirect contact with the patient or the patient's environment) were followed relative to the use of the required personal protective equipment (PPE) for Resident #65 who was diagnosed with and was actively being treated for an infection.