Anderson County Hospital Ltcu

Inspectors wroteThe facility identified a census of 27 residents. The sample included 12 residents. Based on observation, record review, and interviews, the facility failed to provide direct, interactive activities based on resident preferences for the residents on weekends. This deficient practice placed the affected residents at risk for decreased psychosocial well-being, boredom, and isolation. Findings Included: - A review of the facility's Activity Calendars for December 2024, January 2025, and February 2025 was completed. The calendars revealed religious services provided at 09:00 AM and 03:15 PM for Saturdays but lacked staff-led activities. The calendars revealed a devotional group was held at 09:00 AM on Sundays. The calendar revealed the residents were provided music and coloring pages on Sundays but lacked staff-led activity groups. [...]

Inspectors wroteThe facility had a census of 27 residents. The sample included 12 residents, with two reviewed for accidents. Based on observation, record review, and interview, the facility failed to secure 15 pressurized medical oxygen tanks in a safe, locked area, and out of reach of the nine cognitively impaired independently mobile residents. This deficient practice placed the residents at risk for preventable accidents and injuries. Findings Included: - On 02/11/25 at 07:20 AM, an inspection of the facility's oxygen storage room revealed that the door was not secured. An inspection of the room revealed 15 full supplemental oxygen cylinders in the storage rack. The door closed and locked upon exit. On 02/13/25 at 08:22 AM the facility identified it had nine cognitively impaired independently mobile residents. [...]

Inspectors wroteThe facility identified a census of 27 residents. The sample included 12 residents, with five residents reviewed for unnecessary medications. Based on observation, record review, and interviews, the facility failed to ensure the Consultant Pharmacist (CP) recommendations were acknowledged and/or acted upon for Resident (R) 2, R20, and R25. The facility failed to ensure the CP identified and reported the non-approved indication for R10's antipsychotic (a class of medications used to treat major mental conditions that cause a break from reality) medication. These deficient practices placed the residents at risk for unnecessary medication use and physical complications.

Inspectors wroteThe facility identified a census of 27 residents. The facility identified four residents on Enhanced Barrier Precautions (EBP - infection control interventions designed to reduce transmission of resistant organisms that employ targeted gown and glove use during high contact care). Based on record reviews, observations, and interviews, the facility failed to implement adequate hand hygiene. This deficient practice placed the residents at risk for infectious diseases.

Inspectors wroteThe facility identified a census of 27 residents. The sample included 12 residents, with two residents sampled for discharge. Based on observation, record review, and interview, the facility failed to provide a written notice of transfer as soon as practicable to Resident (R) 13 and their representative. This deficient practice had the risk of miscommunication between the facility and resident/family and possible missed opportunities for healthcare service for R13. Findings Included: [...]

Inspectors wroteThe facility identified a census of 27 residents. The sample included 12 residents with two residents sampled for discharge. Based on observation, record review, and interview, the facility failed to provide a bed hold with the required information to Resident (R) 13 or their family representative when R13 transferred to the hospital. This deficient practice placed R13 at risk for impaired ability to return to the facility or his same room.

Inspectors wroteThe facility identified a census of 27 residents. The sample included 12 residents, with one reviewed for dementia (a progressive mental disorder characterized by failing memory, and confusion) care. Based on interviews, record reviews, and observations, the facility failed to provide dementia-related care services for Resident (R) 10 to promote the resident's highest practicable level of well-being. This deficient practice placed R10 at risk for decreased quality of life, isolation, and impaired dignity. Findings Included: [...]

Inspectors wroteThe facility identified a census of 27 residents. The sample included 12 residents, with five residents reviewed for unnecessary medications. Based on observation, record review, and interviews, the facility failed to ensure a gradual dose reduction (GDR) was attempted or documented as contraindicated by the physician with a supporting rationale for risk versus benefit for Resident (R) 20 and R25's antipsychotic (a class of medications used to treat major mental conditions that cause a break from reality) medication. The facility also failed to ensure R10's antipsychotic medication had a Centers for Medicare and Medicaid (CMS) approved indication or the required risk versus benefit physician documentation. These deficient practices placed these residents at risk for unnecessary medications and adverse side effects.

Inspectors wroteThe facility identified a census of 27 residents. The sample included 12 residents, with two residents reviewed for hospice. Based on observation, record review, and interviews, the facility failed to ensure a coordinated plan of care, which coordinated care and services provided by the facility with the care and services provided by hospice, was developed and available for Resident (R) 22. This placed the resident at risk for inappropriate end-of-life care. Finding Included: [...]

Inspectors wroteThe facility reported a census of 25 residents. The sample included one resident reviewed for elopement. Based on observation, interview, and record review, the facility failed to provide adequate supervision to prevent the elopement (when a cognitively impaired resident leaves the facility without the knowledge or supervision of staff) of cognitively impaired Resident (R)1, who had a history of falls. On 01/30/24, Certified Nurse Aide (CNA) M heard the facility doorbell ring and used her access badge to let the visitor out of the facility but failed to ensure only the visitor exited. R1 followed the visitor out and exited the facility unsupervised on 01/30/24 at 10:26 AM. [...]

Inspectors wroteThe facility identified a census of 23 residents. The sample included three residents identified as at risk for falls. Based on record review, observation, and interview, the facility failed to ensure Resident (R)1 received adequate supervision and assistance to prevent a serious injury accident. On 11/14/23 at approximately 08:14 AM during an assisted transfer, staff failed to ensure R1's wheelchair brakes were locked. R1 slid to the floor, complained of right hip pain, and was transferred to a local hospital for evaluation and treatment. An x-ray revealed R1 sustained a proximal right femur (long bone in the leg and closer to the hip joint) fracture. R1 was subsequently transferred to a metropolitan hospital for an orthopedic (medical specialty specializing in bones) consult and surgical repair of the hip fracture. [...]

Inspectors wroteThe facility reported a census of 20 residents and identified 12 of those residents with controlled medications stored in the medication cart. Based on interview and record review, the facility failed to perform an accurate system for the count of the number of controlled medications (medications that can cause physical and mental dependence) in the medication cart, increasing the risk for diversion of the medications.

Inspectors wroteThe facility reported a census of 20 residents with 12 selected for review, including five residents reviewed for influenza vaccinations. Based on interview and record review, the facility failed to provide consent forms to allow the resident or the resident's representative the opportunity to refuse the influenza immunization for the five residents, Resident (R)1, R5, R8, R11, and R19.

Inspectors wroteThe facility reported a census of 20 residents. The sample contained 12 residents, with one resident reviewed for limited range of motion. Based on observation, interview, and record review, the facility failed to provide interventions to promote maintenance of range of motion and prevent decline in the right hand, for the one sampled resident, Resident (R) 8.

Inspectors wroteThe facility reported a census of 20 residents. The sample contained 12 residents, with two residents reviewed for accidents. Based on observation, interview and record review, the facility failed to ensure safe mobility to prevent accidents when the facility failed to provide foot pedals to the wheelchair, while transporting one of the two sampled residents, dependent Resident (R) 9.

Inspectors wroteThe facility reported a census of 20 residents with twelve selected for review, including one Resident (R)5, reviewed for respiratory care. Based on observation, interview, and record review, the facility failed to change R5's oxygen tubing in a timely manner. This practice increased the risk of Resident (R)5 developing a respiratory infection.