Arbors at Mifflin

Inspectors wroteBased on medical record review, interview, and facility policy review the facility failed to ensure antibiotics were administered as ordered and the physician was notified when the antibiotics were not available for administration. This deficient practice affected one resident (Resident #25) out of two residents reviewed for antibiotic medication orders. The facility's census was 87. Findings Include: A review of Resident #25's medical record revealed admission date 10/03/24 with diagnoses including but not limited to urinary tract infection (UTI), infection of prosthetic hip joint, osteoarthritis, and major depression disorder. Resident #25 required assistance from staff to complete Activities of Daily (ADL) tasks including transfers by a mechanical lift. Resident #25 had intact cognition with a Brief Interview of Mental Status (BIMS) score of 15 out of 15 dated 10/10/24. [...]

Inspectors wroteBased on observations, staff interviews, and policy review, the facility failed to datemark potentially hazardous food items in the walk-in cooler and maintain kitchen utensils in a safe and sanitary condition. This had the potential to affect all residents who reside in the facility and receive food from the kitchen. The facility census was 85.

Inspectors wroteBased on medical record reviews, review of facility admission packet, and staff interviews, the facility failed to ensure the resident's advance directives were clearly identified in their medical record. This affected two (Residents #36 and #129) of 24 residents reviewed for advance directives. The facility census was 85.

Inspectors wroteBased on record review and facility staff interview, the facility failed to provide the Skilled Nursing Facility Advanced Beneficiary Notice (SNFABN) for Resident #48 and the SNFABN and Notice of Medicare Non-Coverage (NOMNC) was not filled out correctly for Resident #16. This affected two (Residents #16 and #48) of two residents reviewed for discharged from skilled therapy but remained in the facility. The facility census was 85.

Inspectors wroteBased on observation, staff interview, record review, and facility policy review, the facility failed to ensure a resident had physician orders for oxygen use and failed to safely store the resident's oxygen. This affected three (Residents #17, #41, and #69) of five residents reviewed for respiratory care. The facility identified 23 resident who utilized supplemental oxygen. The facility census was 85.

Inspectors wroteBased on observation, staff interview, record review, and policy review, the facility failed to ensure Resident #16 was free from a significant medication error. This affected one (Resident #16) of six residents reviewed for medication administration. The facility census was 85.

Inspectors wroteBased on observation, resident and staff interviews, record review, and policy review, the facility failed to follow the menu and give residents the appropriate food. This affected three (Residents #28, #39, and #134) of six residents who had their meals and meal tickets reviewed. The facility census was 85.

Inspectors wroteBased on observations, staff interviews, record review, and policy review, the facility failed to ensure appropriate transmission based precautions (TBP) were implemented for Resident #36. This affected one (Resident #36) of one resident reviewed for transmission based precautions. The facility identified only one resident on transmission based precautions. The facility census was 85.

Inspectors wroteTHE FOLLOWING DEFICIENCY REPRESENTS AN INCIDENT OF PAST NON-COMPLIANCE THAT WAS SUBSEQUENTLY CORRECTED PRIOR TO THIS SURVEY. Based on closed medical record review, staff interview, and review of the facility policy, the facility failed to initiate Cardiopulmonary Resuscitation (CPR) or call 911 for Emergency Medical Services (EMS) for Resident #69, who was found unresponsive, without a pulse/heartbeat and was identified as a full code status. This resulted in Immediate Jeopardy and the potential for serious life-threatening harm, negative health outcomes, and/or death when Resident #69 did not receive CPR and EMS was not contacted for medical services assistance. Resident #69 subsequently expired. This affected one resident (Resident #69) of three (#69, #70, and #71) residents reviewed for death in the facility. The facility census was 68 residents. [...]

Inspectors wroteBased on medical record review, observation, staff and resident interview, and policy review, the facility failed to ensure residents were free from physical restraint. This affected one resident (#68) of one resident reviewed for a physical restraint. The facility census was 79.

Inspectors wroteBased on medical record, observation, and staff and resident interview, the facility failed to ensure a resident who required assistance was provided with nail care. This affected one resident (#57) of two residents reviewed for activities of daily living care. The facility census was 79.

Inspectors wroteBased on medical record review, staff interview, review of the dialysis communication record, and policy review, the facility failed to ensure residents who received dialysis treatments were monitored per physician orders. This affected one resident (#239) of one resident reviewed for dialysis. The facility census was 79.

Inspectors wroteBased on medical record review, physician and staff interview, and policy review, the facility failed to ensure residents prescribed antibiotics had an adequate indication for use. This affected two residents (#10 and #80) out of eight residents reviewed. The facility census was 79.

Inspectors wroteBased on observation, interview, and policy review, the facility failed to maintain appropriate infection control measures during resident personal care. This affected one resident (#22) of two residents observed for personal care. The facility census was 79.

Inspectors wroteBased on medical record review, observation, staff and resident interview, and policy review, the facility failed to ensure call lights within resident's reach. This affected one resident (#42) of two residents reviewed for the accessibility of call lights. The facility census was 79.

Inspectors wroteBased on medical record review, review of resident personal funds statement, staff interview, and review of facility policy, the facility failed to ensure a resident's legal Guardian was notified when her account exceeded her Social Security Income (SSI) resource limit. This affected one Resident (#74) of eight reviewed for management of funds. The facility census was 80.

Inspectors wroteBased on medical record review, observation, and staff interview, the facility failed to ensure a resident's bathroom had adequate lighting and was maintained in good repair. This affected one (#74) of one resident reviewed for environment. The facility census was 80.

Inspectors wroteBased on medical record review, resident interview, staff interview, and review of facility policy, the facility failed to complete a concern form and provide evidence of follow up regarding missing items. This affected one Resident (#34) of one resident reviewed for personal property. The facility census was 80.

Inspectors wroteBased on medical record review, observation, staff interview, and policy review, the facility failed to implement physician ordered preventative pressure ulcer interventions. This affected one (#48) of three residents reviewed for pressure ulcers. The facility census was 80.

Inspectors wroteBased on medical record review, observation, and staff interview, the facility failed to ensure appropriate monitoring was completed for a resident with a indwelling foley catheter. This affected one Resident (#63) of one reviewed for catheter care. The facility census was 80.

Inspectors wroteBased on medical record review, resident interview, staff interview, and facility policy review, the facility failed to ensure medications were timely acquired for a newly admitted resident. This affected one (#235) of three new admissions reviewed. The facility census was 80.