Arbor Care Centers-Countryside LLC

Inspectors wroteLicensure Reference Number 175 NAC 12-006.05Based on record review and interview; the facility failed to follow 1 (Resident 1) of 4 sampled residents' consent to not publish photographs of the resident. The facility census was 32.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.10(D)Based on record review and interview; the facility failed to ensure 1 resident (Resident 4) of 4 sampled was free of significant medication errors. The facility had a census of 36.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.12(D)(i)(2)Based on record review and interview; the facility failed to accurately account for narcotic medications. This had the potential to affect all residents receiving narcotic medications in the facility. The facility sample size was 4 and the census was 36.

Inspectors wroteLicensure Reference Number 175 12-006.10(A)(ii) Licensure Reference Number 175 NAC 12-006.10(A)(iii) Licensure Reference Number 175 12-006.10(C) Based on record review and interview; the facility failed to ensure 1 (Resident 4) of 4 sampled residents records had accurate documentation of medication administration. The facility census was 36.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.09G and 175 NAC 12-006.02(A) Based on record review and interview, the facility failed to complete the required discharge notifications to the State Ombudsman when residents were transferred or discharged from the facility and complete discharge summaries for Residents 37 and 39. The sample size was 2 and the facility census was 38.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.18(B)(D) Based on observation, record review and interview; the facility failed to implement Enhanced Barrier Precaution (EBP-involved gown and glove use during high-contact resident care activities for residents known to be colonized or infected with a multidrug resistant organism (MDRO-bacteria that have become resistant to certain antibiotics) as well as those at increased risk for MDRO, residents with wounds or indwelling medical devices) during toileting assistance for Resident 2, catheter cares for Resident 10 and wound care for Resident 7; failed to provide cleaning of resident care equipment to prevent cross-contamination and or potential infections for Resident 10 and failed to complete gloving and hand hygiene at appropriate intervals during the provision of care for Residents 1,7,10 and 41. [...]

Inspectors wroteLicensure Reference Number 175 NAC 12-006.04(B)(i)Based on record review and interview; the facility failed to ensure 4 out of 5 staff had the required initial training within 2 weeks of employment which included resident rights, emergency preparedness, abuse and neglect and dementia care. This had the potential to affect all residents of the facility. The facility census was 38.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.05(21)Based on observation, record review and interview; the facility failed to ensure Resident 10's dignity by not covering the urinary drainage bag. The sample size was 3 and the facility census was 38.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.12Based on record review and interview; Residents 8 and 9 did not have the required consent for the use of psychotropic medications (any drug that affects brain activities associated with mental processes and behavior. Psychotropic drugs include but are not limited to the following categories: antipsychotics, antidepressants, anti-anxiety and hypnotics). The sample size was 13 and the facility census was 38.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.05(G)Based on record review and interview, the facility failed to ensure Resident 25 received the required face to face physician evaluations to continue the use of PRN (as needed) antipsychotic (used to treat psychotic disorders/symptoms) medications. The sample size was 5 and the facility census was 38.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.09(H)(i)(3)Based on record review and interview, the facility failed to provide bathing assistance to Resident 45 at intervals to meet the resident's needs. The sample size was 13 and the facility census was 38.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.09Based on observation, record review and interview; the facility failed to provide evidence of follow up evaluations and condition assessments to identify potential complications following a fall for Resident 10 and failed to follow physician's orders for treatment of a foot ulcer for Resident 7. The sample size was 13 and the facility census was 38.

Inspectors wroteLicense Reference Number 175 NAC 12-006.18(A)Based on record review and interview; the facility failed to have evidence Resident 4 and 7 were up to date and/or offered/given pneumococcal vaccinations. The sample size was 5 and the facility census was 38.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.04(F) Based on record review and interview the facility failed to provide the required 8 hours of Registered Nurse (RN) coverage daily. The sample size was 14 and the facility census was 34.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.12(A)(vi) Based on record review and interview; the facility failed to follow the pharmacist's recommendations to address irregularities in medication regimens for Resident's 1 and 27. The sample size was 5 and the facility census was 34.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.18(B) Based on observation, record review, and interview the facility failed to implement Enhanced Barrier Precautions (EBP-an infection control interventions designed to reduce transmission of Multi-Drug-Resistant Organisms (MRDO's) that employed targeted gown and glove use during high contact resident care activities) during the provision of care for Residents 20 and 25 and failed to maintain ongoing evidence of antibiotic surveillance in the facility.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.09(I) Based on observation, record review and interview; the facility failed to implement interventions to prevent potential falls for Resident 27. The total sample size was 3 and the facility census was 34.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.09(H) Based on record review and interview; the facility failed to ensure Resident 1's long term use of an antibiotic had a clinical rationale for continued use or an ordered duration of use. The sample size was 5 and the facility census was 34.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.18 Based on record review and interview; the facility failed to follow the facility Antibiotic Stewardship Policy for Resident 1 to ensure all antibiotics ordered had stop dates and or documented clinical rationale for ongoing use.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.04(A)(iii)(3)(c) Based on record review and interview the facility failed to evaluate adverse finding regarding criminal background checks for 3 of 5 sampled staff to protect residents from potential abuse. The facility census was 34.

Inspectors wroteBased on observation, record review and interview; the facility failed to complete the required staff posting of nursing hours. This had the potential to affect all facility residents. The facility census was 34.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.02(H) Based on record review and interview: the facility failed to investigate an allegation of potential abuse/misappropriation/exploitation for Resident 2 and then to submit the results of the investigation to the State Agency. The sample size was 4 and the facility census was 39.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.09D7 Based on observation, record review and interview; the facility failed to implement fall interventions for Residents 3 and 16, to assess causal factors and to develop new interventions and/or revise current interventions to prevent ongoing falls for Resident's 3, 14, 15, and 16. The sample size was 4 and the facility census was 32.

Inspectors wroteLICENSURE REFERENCE NUMBER 175 NAC 12-006.05 (21) Based on interview and record review; the facility failed to address Resident 85's anxiety, health concerns and behaviors in a manner to promote and maintain the resident's dignity. The sample size was 3 and the census was 32.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.051 Based on record review and interview, the facility failed to provide the required advance notifications prior to discharge from Medicare services for 2 (Resident 4 and 185) of 3 sampled residents. The facility census was 32.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.04A3b Based on record review and interview, the facility failed to ensure background checks through the State Nurse Aide (NA) registry were completed on 5 of 7 employees. The facility census was 32.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.09D1c Based on observations, record review and interview; the facility failed to provide assistance with shaving, oral hygiene and nail care for Resident 15, who required assistance with activities of daily living. The sample size was 3 and the facility census was 32.

Inspectors wroteLICENSURE REFERENCE NUMBER 175 NAC 12-006.09 Based on observation, interview, and record review; the facility failed to follow physician's orders related to surgical wound care for 1 (Resident 17) of 3 sampled residents. The facility identified a census of 32 at the time of survey.

Inspectors wroteBased on interview and record review; the facility failed to prevent potential COVID-19 infection as the facility failed to provide evidence that a COVID-19 vaccination was offered and refused, and that education was provided for the refusal of the COVID-19 vaccine for 1 (Resident 17) of 5 sampled residents. The facility census was 32.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.09D2a Based on observations, interviews and record review, the facility failed to implement interventions to prevent Resident 1's pressure sore from developing and worsening and failed to implement interventions to prevent the potential development of a pressure sore for Resident 8. The sample size was 2. The facility census was 31.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.09D Based on observations, interview and record review, the facility failed to ensure physician's orders were followed for 2 residents (Resident 8 and 12) related to Resident 8's pressure relief cushion and Resident 12's nutritional supplement. The total sample size was 13 and the facility census was 31.

Inspectors wroteLicensure Reference Number 175 NAC 12-006.12E7 Based on observations, interview and record review, the facility failed to ensure multiuse medications were dated when opened for 2 residents (Resident 7 and 13). The total sample size was 13. The facility census was 31.