Andbe Home, Inc

Inspectors wroteBased on observation, interview, and record review, the facility failed to store, prepare, and serve food in a sanitary manner for the residents who reside in the facility and receive meals from the facility kitchen.

Inspectors wroteBased on observation, record review, and interviews. The facility failed to ensure their Quality Assessment and Assurance (QAA) Committee adequately identified deficient areas of practice to develop and implement appropriate plans of action to correct the deficient practices.

Inspectors wroteBased on record review and interview, the facility failed to provide Resident (R)42 or their representative the completed Centers for Medicare and Medicaid (CMS) Skilled Nursing Facility Advanced Beneficiary Notices (ABN) form 10055 or the CMS Notice of Medicare Non-Coverage (NOMOC) form 10123, and failed to provide R6 and R7 with the CMS 10055 form.

Inspectors wroteBased on observation, interview, and record review, the facility failed to obtain a stop date for three sampled residents, Resident (R) 13, R31, and R5, as needed (PRN) Ativan/lorazepam (a medication that calms and relaxes people).

Inspectors wroteBased on observation, interview, and record review, the facility failed to complete a recapitulation (a concise summary of the resident's stay and course of treatment in the facility) for Resident (R) 38.

Inspectors wroteBased on observation, interview, and record review, the facility failed to apply the standards of practice as related to a change of condition for Resident (R) 4, who had a history of vasovagal response (a reflex of the involuntary nervous system that causes a sudden drop in heart rate and blood pressure, often leading to fainting or lightheadedness) when staff failed to follow the care plan on the use of a full-body mechanical lift and instead used a sit-to-stand lift. R4 lost consciousness and staff failed to contact the physician or family and did not assess R4 after the initial incident.

Inspectors wroteBased on observation, interview, and record, the facility failed to accurately investigate a root cause and implement effective interventions to prevent falls for Residents (R) 7 and R31, who had numerous falls.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure Resident (R) 6 received the necessary care and services to prevent an ongoing insidious weight loss when staff failed to notify the physician of the weight loss and failed to ensure the physician received the dietician's recommendations for an appetite stimulant.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure Resident (R) 41 received care and services for dialysis (a procedure where impurities or wastes are removed from the blood) consistent with professional standards of practice, which included a contract for service, nursing assessments, or ongoing communication and collaboration with the dialysis facility.

Inspectors wroteBased on observation, record review, and interview, the facility failed to adhere to infection control procedures related to Enhanced Barrier Precautions (EBP -an infection control intervention designated to reduce transmission of resistant organisms that employs targeted gown and glove used during high contact resident care activities), when emptying the indwelling catheter for Resident (R)8.

Inspectors wroteBased on interviews and record review, the facility failed to conduct a thorough facility-wide assessment to determine the resources necessary to care for residents competently during both day-to-day operations and emergencies.

Inspectors wroteThe facility had a census of 34 residents. Based on observation, interview, and record review the facility failed to ensure an environment free from accident hazards when the facility failed to ensure water temperatures in areas with resident access and in Resident (R)18, R17, R25, R1, and R4's rooms remained at a safe temperature when temperatures above 140 degrees Fahrenheit (F) were recorded. This common area and sink were open to the center hallway and accessible to any independently mobile residents. The facility identified seven independently mobile, cognitively impaired residents. This placed twelve residents in immediate jeopardy. The excessively high hot water temperatures of 128-139 degrees F were also recorded in resident room sinks, placing an additional seven residents at risk for burns. [...]

Inspectors wroteThe facility had a census of 34 residents. The sample included 12 residents. Based on observation, record review, and interview the facility failed to store, prepare, distribute, and serve food in accordance with professional standards for food service safety for the 34 residents who received their meals from the facility's kitchen. This placed the 34 residents at risk for foodborne illness.

Inspectors wroteThe facility had a census of 34 residents. Based on interviews and record review the facility failed to implement a water management program for the Legionella disease (Legionella is a bacterium spread through mist, such as from air-conditioning units for large buildings. Adults over the age of 50 and people with weak immune systems, chronic lung disease, or heavy tobacco use are most at risk of developing pneumonia caused by Legionella). This placed the residents in the facility at risk for Legionella pneumonia

Inspectors wroteThe facility had a census of 34 residents. The sample included 12 residents. Based on observation, interview, and record review the facility failed to dispose of expired medications appropriately. This deficient practice placed residents at risk of receiving ineffective medication.

Inspectors wroteThe facility had a census of 34 residents. The sample included 12 residents. Based on observation, interview, and record review the facility failed to promote care in a manner to maintain and enhance dignity and respect when staff stood over two residents, Resident (R) 5 and R33, while assisting them to eat. This placed the residents of the facility at risk for impaired dignity.

Inspectors wroteThe facility had a census of 34 residents. The sample included 12 residents with two reviewed for urinary catheter (a tube inserted into the bladder to drain urine) or urinary tract infection (UTI). Based on observation, record review, and interview, the facility staff failed to ensure sanitary catheter care for Resident (R)11. This placed the resident at risk for infection and catheter-related complications.

Inspectors wroteThe facility had a census of 34 residents. The sample included 12 residents. Based on observation, interview, and record review the facility failed to ensure Resident (R) 5 received the required staff assistance with meals in an uninterrupted manner that promoted intake. This deficient practice placed the resident at risk for weight loss.

Inspectors wroteThe facility had a census of 34 residents. The sample included 12 residents. Based on observation, record review, and interview, the facility failed to ensure adequate pain management was available for Resident (R) 27 who had chronic pain. This placed the resident at risk for unrelieved pain.

Inspectors wroteThe facility had a census of 34 residents. Based on observation, record review, and interview the facility kitchen staff failed to provide food prepared by methods that conserve nutritive value, flavor, and appearance when dietary staff failed to follow a recipe while preparing the pureed diet. This placed the resident at risk for impaired nutrition.

Inspectors wroteThe facility had a census of 40 residents. The sample included 13 residents. Based on observation, record review and interview the facility failed to prevent the development and transmission of infections by not handling and transporting residents' linens in a safe, sanitary manner. This placed the residents at increased risk for communicable disease and infections.

Inspectors wroteThe facility had a census of 40 residents. The sample included 13 residents, with six reviewed for activities of daily living (ADLs). Based on observation, record review, and interview, the facility failed to provide scheduled bathing for four sampled residents, Resident (R) 8, R34, R3, and R21. This placed these residents at risk for skin problems and poor hygiene.

Inspectors wroteThe facility had a census of 40 residents. The sample included 13 residents with two reviewed for pressure ulcers. Based on observation, record review and interview, the facility failed to involve the physician in the care and treatment of a pressure ulcer (localized injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure) for one sampled resident, Residents (R) 91. This placed the resident at risk for a worsening wound and infection.