Arvada Care and Rehabilitation Center

Inspectors wroteBased on observations, interviews, and record review, the facility failed to store, prepare, distribute, and serve food under sanitary conditions to prevent the potential for food borne illness for all residents who receive meals from the main kitchen. Specifically, the facility failed to ensure:-The food preparation area and kitchen were maintained under sanitary conditions; -Pans were air dried thoroughly before stacking and storing;-Perishable food was labeled properly with the type of food and expiration date; -Expired food was removed from storage areas by the expiration date; and,-Grease drained from the grease trap was not left in open containers stored in the food.

Inspectors wroteBased on record review and interviews, the facility failed to ensure residents had the right to refuse to participate in occupational therapy activities for one (#2) resident reviewed for resident rights out of 12 sample residents. Specifically, the facility failed to ensure Resident #2 was allowed to refuse occupational therapy services.

Inspectors wroteBased on record review, observations and interviews, the facility failed to develop and implement a baseline care plan which included the instructions needed to provide effective and person-centered care for four (#9, #24, #201 and #39) of five residents reviewed for baseline care plans out of 32 sample residents. Specifically, the facility failed to ensure pertinent medical information was included on Resident #9, Resident #24, Resident #201 and Resident #39's baseline care plans within 48 hours of admission.

Inspectors wroteBased on observations, interviews and record review, the facility failed to maintain an infection control program designed to provide a safe, sanitary and comfortable environment to help prevent the development and transmission of disease on two of two units. Specifically, the facility failed to: -Ensure enhanced barrier precautions (EBP) were followed during wound care; -Ensure high touch surfaces in resident rooms were cleaned; and, -Ensure residents' personal hygiene items in shared bathrooms were labeled and stored in a sanitary manner.

Inspectors wroteBased on observations, record review and interviews, the facility failed to ensure one (#40) of four residents who required respiratory care received care consistent with professional standards of practice out of 32 sample residents. Specifically, the facility failed to maintain, clean, sanitize and properly store Resident #40's bilevel positive airway pressure (BiPAP) mask and machine. Finings include: I. Facility policy and procedure The Non Invasive Respiratory policy, revised November 2024, was provided by the nursing home administrator (NHA) on 3/10/25 at 6:18 p.m. It read in pertinent part, It is the policy of this facility to provide non-invasive ventilation as per physician's order and current standards of practice. BiPAP is a respiratory therapy intervention that delivers an inhale pressure and an exhale pressure to provide a patent airway. [...]

Inspectors wroteBased on observations, record review and interviews, the facility failed to ensure one (#201) of two residents reviewed for pain out of 32 sample residents had an effective pain management regimen in a manner consistent with professional standards of practice, resident-centered care plans and resident preferences. Specifically, the facility failed to ensure Resident #201's pain was managed appropriately and consistently to meet the resident's stated level of acceptable pain.

Inspectors wroteBased on observations and interviews, the facility failed to post, in a form and manner accessible and understandable to residents, information on how to file a complaint with the State Agency. Specifically, the group interview revealed the facility failed to: -Ensure residents knew where the required posting on how to file a complaint with the State Agency was located; -Ensure all required information was included on the posting; and, -Ensure that residents were able to easily access and read the information on the posting.

Inspectors wroteBased on record review and interviews, the facility failed to ensure each resident had the right to formulate an advanced directive for one (#1) of three residents reviewed for advanced directives out of 10 sample residents. Upon Resident #1's admission to the facility on [DATE], a licensed practical nurse (LPN) #3 interviewed Resident #1 and filled out the advanced directive paper form with the necessary information indicating the resident chose to be a DNR (do not resuscitate) status. LPN #1 did not record the resident's DNR status in Resident #1's electronic medical records (EMR) as he was required to do. On [DATE] the medical provider discussed the decision to be a DNR status with Resident #1 and her family. The nurse practitioner (NP) signed the advanced directives paper form and returned the form to the nurse's station where the forms were kept for the facility staff to follow-up. [...]

Inspectors wroteBased on observations, record review and interviews, the facility failed to provide person-centered quality care for one (#1) of three residents out of seven sample residents. Specifically, the facility failed to follow up on physician's orders in a timely manner for a wound vacuum (a medical device utilized to assist with wound healing) for Resident #1.

Inspectors wroteBased on observations, interviews and record review, the facility failed to maintain an infection control program designed to provide a safe, sanitary and comfortable environment to prevent the development and transmission of disease and infection in two out of two units. Specifically, the facility failed to: -Ensure resident rooms were cleaned in a sanitary manner; -Ensure manufacturer recommended surface contact times were followed for effective disinfection; -Ensure that oxygen tubing and nasal cannulas were stored off the floor, in a clean bag and replaced when contaminated; and, -Ensure that intravenous (IV) tubing was stored between antibiotic administrations in a clean and sanitary manner.

Inspectors wroteBased on record review and interviews, the facility failed to ensure each residents had the right to formulate an advanced directive for two (#1 and #28) of 18 residents reviewed for advanced directives out of 25 sample residents. Specifically, the facility failed to: -Ensure the medical orders for scope of treatment forms (MOST), used as an advance directive by the facility, were accurate, matched the physician's orders and were signed and dated by the resident and physician for Residents #1 and #28; and, -Ensure completion of the MOST form was according to directions for healthcare professionals for verbal orders including signed, dated, with a witness and not to exceed 30 days for Resident #28.

Inspectors wroteBased on observations, record review, and interviews, the facility failed to ensure residents who were unable to carry out activities of daily living (ADLs) received the necessary services and assistance for bathing for two (#1 and #28) out of three residents reviewed for ADLs out of 25 sample residents. Specifically, the facility failed to provide bathing for Resident #1 and #28 to maintain personal hygiene.

Inspectors wroteBased on record review and interviews, the facility failed to ensure two (#5 and #146) of four residents received treatment and care in accordance with professional standards of practice out of 25 sample residents. Specifically, the failed to ensure: -Resident #146 had neurological assessments started in a timely manner after an unwitnessed fall; and, -Resident #5 blood pressure and pulse were monitored and parameters were in place prior to receiving a blood pressure medication.

Inspectors wroteBased on observations, and interviews, the facility failed to ensure the medication error rate was not greater than five percent. Specifically, the facility's medication error rate was 10.3 percent with three errors out of 29 opportunities.

Inspectors wroteBased on observations and interviews, the facility failed to ensure drugs and biologicals were labeled and stored properly with one of two medication carts and in one of two neighborhoods. Specifically, the facility failed to lock medication carts when left unattended by licensed personnel and left loose medication on the medication carts.

Inspectors wroteBased on record reviews and interviews, the facility failed to ensure that the medical record was complete and accurate in keeping with accepted standards of practice for one (#146) out of 25 sample residents. Specifically, the facility failed to ensure that Resident #146 registered nurse (RN) assessment was documented in the medical record following a fall.

Inspectors wroteBased on interviews and record review, the facility failed to ensure one (#8) of three residents reviewed for respiratory care of 24 sample residents were provided respiratory care consistent with professional standards of practice. Specifically, the facility failed to ensure physician orders and a care plan were in place for Resident #8, who required a continuous positive airway pressure (CPAP) machine.