Arabella Health & Wellness of Meridian

Inspectors wroteBased on interviews, record review, and facility policy review, the facility failed to ensure residents' rights to be free from abuse and neglect when the facility failed to protect Resident A from neglect by failing to initiate the admission process after the resident arrived at the facility following surgical repair of a left hip fracture, and failed to protect Resident #23 from verbal abuse by a Certified Nurse Aide (CNA), for two (2) of (19) sampled residents. [...]

Inspectors wroteBased on observations, interviews, record review, and facility policy review, the facility failed to provide sufficient nursing staff with the appropriate competencies and skill sets to meet residents' assessed needs, resulting in delays in providing incontinent care for two (2) of (18) residents reviewed for Activities of Daily Living (ADLs). Residents #10 and #34. This deficient practice had the potential to affect all residents residing in the facility who depended on staff for nursing care and assistance with activities of daily living. Findings Include:A review of the facility's policy, Nursing Services and Sufficient Staff, revised 2/19/26, revealed, .Policy: [...]

Inspectors wroteBased on observation, staff interview, record review, and facility policy review, the facility failed to ensure the medication error rate was five (5) percent (%) or less for three (3) of (35) medication opportunities. Medication error rate of 8.57% Findings Include: A review of facility policy titled, Medication Administration revised on 2/19/26, revealed, Policy: Medications are administered by licensed nurses.as ordered by the physician and in accordance with professional standards of practice .Policy Explanation and Compliance Guidelines.24. Correct any discrepancies and report to nurse manager. Resident #15On 07/22/26 at 9:31 AM, during a medication pass observation, Licensed Practical Nurse (LPN) #4 prepared medications for Resident #15. [...]

Inspectors wroteBased on interview, record review, and facility policy review, the facility failed to ensure controlled substances were securely stored and accessible only to authorized personnel for one (1) of (4) medication storage areas reviewed (Director of Nursing's office). Narcotic medications were left unsecured in the Director of Nursing's office, allowing an unauthorized maintenance employee to access, remove, and destroy controlled substances.

Inspectors wroteBased on interview, record review, and facility policy review, the facility failed to ensure residents' right to a dignified and comfortable environment by failing to effectively address ongoing disruptive behaviors that interfered with other residents' ability to rest for two (2) of four (4) residents reviewed for resident rights. Resident #2 and Resident #3.

Inspectors wroteBased on observation, interviews, record review, and facility policy review, the facility failed to ensure residents' rights regarding privacy and confidentiality were maintained related to posting of signage on resident walls that included personal health information for two (2) of four (4) residents reviewed for resident rights. Resident #52 and Resident #15.

Inspectors wroteBased on interview, record review, and facility policy review, the facility failed to submit the comprehensive Minimum Data Set (MDS) assessment within the required timeframe for one (1) of seventeen (17) sampled residents. Resident #46.

Inspectors wroteBased on observation, interview, record review, and facility policy review, the facility failed to implement care plan interventions related to Enhanced Barrier Precautions (EBP) for one (1) of 17 care plans reviewed.

Inspectors wroteBased on observation, interview, record review, and facility policy review, the facility failed to ensure a significant medication error did not occur when a nurse administered a routine dose of insulin three (3) hours past the prescribed time without notifying the physician for one (1) of six (6) residents reviewed for medication administration, Resident #32.

Inspectors wroteBased on observation, interviews, record review, and facility policy review, the facility failed to implement its infection prevention and control program to prevent the potential spread of infection for two (2) of seventeen (17) sampled residents, as evidenced by staff failed to follow Enhanced Barrier Precautions (EBP) when providing catheter care by not donning a gown (Resident #53) and failed to ensure personal items and clean linen were stored appropriately to avoid contamination (Resident #15).

Inspectors wroteBased on staff interview, record review, and facility policy review, the facility failed to provide written notification of transfer to a resident or the Resident Representative (RR) for one (1) of two (2) residents reviewed for hospitalization. (Resident #28) Findings Include: Review of the facility's, Bed Hold Policy and Procedure, revised 12/23, revealed, Policy: Before a resident transfers to the hospital or goes on a therapeutic leave, the facility will provide the resident and their representative written Explanation of the .hospitalization policy. This notice will specify the .reason for transfer/hospitalization and the facility policy regarding .hospitalization .Procedure .4. The provision of this form to the resident upon hospital transfer .will be documented in the electronic medical record by the nursing staff. 5. [...]

Inspectors wroteBased on staff interview, record review, and facility policy review, the facility failed to provide written notification of bed hold to a resident or the Resident Representative (RR) for one (1) of two (2) residents reviewed for hospitalization. Resident #28 Findings Include: Review of the facility's, Bed Hold Policy and Procedure, revised 12/23, revealed, .Before a resident transfers to the hospital or goes on a therapeutic leave, the facility will provide the resident and their representative written Explanation of the Bed-Hold policy .This notice will specify the duration of the bed hold .and the facility policy regarding bed-hold periods .Procedure .4. The provision of this form to the resident upon hospital transfer .will be documented in the electronic medical record by the nursing staff. 5. [...]

Inspectors wroteBased on interview, record review, and facility policy review, the facility failed to complete Quarterly Minimum Data Set (MDS) assessments for four (4) of 15 residents sampled. Resident #3, Resident #21, Resident #27, Resident #51 Findings Include: A review of the facility's policy, MDS, RAPS (Resident Assessment Protocols), And Care Plan Documentation revised 02/01/10, revealed, .It is the policy of (Proper Name of Facility) to provide documentation in the medical record for MDS . A review of the Centers for Medicare and Medicaid (CMS) Long-Term Care Facility Resident Assessment Instrument (RAI) 3.0 User's Manual, dated October 2019, revealed, .The Quarterly assessment is an OBRA (Omnibus Budget Reconciliation Act) non-comprehensive assessment for a resident that must be completed at least every 92 days following the previous OBRA assessment of any type. [...]

Inspectors wroteBased on observation, interview, and facility policy review, the facility failed to ensure an enteral feeding pump was operated by licensed staff one for (1) of two (2) residents observed with Percutaneous Endoscopic Gastrostomy (PEG) tube feedings, Resident #15. Findings Include: Review of the facility's Enteral Feeding Record Policy, undated, revealed, It is the policy of this facility that enteral feedings will be done as follows .Feedings are to be delivered by a licensed nurse, Charge Nurse, Medication Nurse, Treatment Nurse . During an observation, on 12/05/23 at 10:36 AM, Certified Nurse Assistant (CNA) #1, entered Resident #15's room to provide incontinent care. CNA #2 placed the resident's enteral feeding pump on hold. [...]

Inspectors wroteBased on interview, record review, and facility policy review, the facility failed to ensure residents were free from verbal abuse and intimidation for one (1) of four (4) residents reviewed for abuse. Resident #1 Findings Include: Review of a current facility's policy, Abuse/Neglect, undated, revealed, Purpose: To prohibit mistreatment, neglect, and abuse of residents .Definitions: Abuse is the willful infliction of . intimidation .Identification of incidents which need to be investigated A. Physical/Mental Abuse .5. Verbal . Record review of the Facility Reported Incident (FRI) revealed that the incident occurred on 9/26/23 at approximately 2:02 PM in the hallway. Licensed Practical Nurse (LPN) #1 responded upon hearing Nurse Aide (NA)/Orderly saying, take your ass on down the hall to Resident #1. LPN #1 indicated that the NA was confronting Resident #1 in the middle of the hallway. [...]

Inspectors wroteBased on observation, staff interviews, record reviews, and facility medication disposal memo, the facility failed to remove expired medications from the medication cart and medications storage room for one (1) of three (3) medication carts and one (1) medication storage room observed.

Inspectors wroteBased on observation, interviews, record reviews, and facility policy review, the facility failed to prevent the possible spread of infection as evidenced by the nurse entering an isolation room without donning Personal Protective Equipment ( PPE) for one (1) of three (3) medication observations, Resident #17.