Alpine Nursing Home Inc

Inspectors wroteBased on clinical record review and staff interview, the facility failed to inform the resident or the resident's appointed representative, in advance, of the care to be furnished by the physician or other provider, of the risks and benefits of proposed care or treatment alternatives relative to the ordering of, and administration of, psychotropic medications (a prescription drug designed to alter brain chemistry thus affecting a person's mind, emotions, and behavior) for 5 of 5 residents reviewed for unnecessary medications, Resident ID #s 1, 3, 4, 5 and 30, and for 1 of 1 resident reviewed for mood and behavior, Resident ID #28.

Inspectors wroteBased on clinical record review and staff interview, the facility failed to ensure that each resident's written plan of care includes both the most recent hospice plan of care and a description of the services furnished by the long term care facility to attain or maintain the resident's highest practicable physical, mental, and psychosocial well-being, relative to 3 of 3 residents reviewed who receive hospice services, Resident ID #s 2, 6, and 30.

Inspectors wroteBased on clinical record review and staff interview, the facility failed to establish an Infection Prevention and Control Program (IPCP) that must include, at a minimum, an antibiotic stewardship program which includes antibiotic use protocols and a system to monitor antibiotic use to ensure that residents who require an antibiotic, are prescribed the appropriate antibiotic for 5 of 5 residents reviewed for antibiotic use, Resident ID #s 6, 19, 29, 42 and 44.

Inspectors wroteBased on clinical record review and staff interview, the facility failed to ensure the resident's medical record includes documentation that the resident either received the pneumococcal vaccination or did not receive the vaccination due to medical contraindications or refusal, for 3 of 3 resident's reviewed who had consented to the vaccination, Resident ID #s 39, 42 and 44.

Inspectors wroteBased on clinical record review and staff interview, the facility failed to conduct a comprehensive assessment of a resident within 14 calendar days after admission, excluding readmission in which there is no significant change in the resident's physical or mental condition, relative to 2 of 3 residents reviewed for readmission after hospitalization, Resident ID #s 6 and 29.

Inspectors wroteBased on clinical record review and staff interview, the facility failed to complete a Significant Change in Status Assessment (SCSA) within 14 days after there had been a significant change in the resident's physical or mental condition, for 2 of 3 residents reviewed for hospice services, Resident ID #s 2 and 30.

Inspectors wroteBased on surveyor observation, clinical record review, and staff interview, the facility failed to provide respiratory care consistent with professional standards of practice for 1 of 3 residents reviewed for oxygen therapy, Resident ID #33.

Inspectors wroteBased on record review and staff interview, the facility failed to provide prorated interest for residents whom the facility is holding personal funds in a single interest-bearing account relative to 2 of 4 residents reviewed, Resident ID #s 15 and 46.

Inspectors wroteBased on record review and staff interview, it has been determined that the facility failed to provide a dietary menu that meets the nutritional needs of residents in accordance with established national guidelines.

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.

Inspectors wroteBased on surveyor observation, record review and staff interview, it has been determined that the facility failed to ensure that services provided meet professional standards of quality relative to following a physician's order for 1 of 1 resident reviewed for apical pulse (AP- a heartbeat measurement by listening with a stethoscope to the left center of the chest. This is the most accurate evaluation of a person's heart rate, particularly when an abnormality is detected), Resident ID #8.

Inspectors wroteBased on record review and staff interview, it has been determined that the facility failed to ensure that residents who are trauma survivors receive trauma informed care in accordance with professional standards of practice and account for the resident's experiences and preferences for 5 of 15 residents reviewed for Trauma Informed Care, Resident ID #s 22, 26, 31, 50 and 51.

Inspectors wroteBased on surveyor observation, record review and staff interview it has been determined that the facility failed to ensure 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 5 of 5 Medication Technicians (MTs) reviewed relative to obtaining an apical pulse (AP- a heartbeat measurement by listening with a stethoscope to the left center of the chest. This is the most accurate evaluation of a person's heart rate, particularly when pulse an abnormality is detected) for Staff A, D, E, F, and G.

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 2 of 2 residents reviewed for respiratory care, Resident ID #s 2 and 23.

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 2 residents reviewed relative to oxygen therapy, Resident ID #s 2 and 23.

Inspectors wroteBased on surveyor observation, record review, and staff interview, it has been determined that the facility failed to conduct appropriate infection control practices relative to personal protective equipment (PPE) and hand hygiene for 2 of 2 staff members, Staff D and E, observed during care of COVID-19 positive residents, Resident ID #s 40 and 41.

Inspectors wroteBased on surveyor observation, record review and staff interview, it has been determined that the facility failed to ensure that the assessment accurately reflected the resident's status for 1 of 1 resident reviewed for hand contractures (shortening of muscles, tendons, skin, and nearby soft tissues that causes the joints to shorten and become very stiff), Resident ID #23.