Aspire Senior Living Webb City

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure nurse aides (NA) were not used more than four months without completing required training and evaluations when the facility did not have an effective process in place to ensure certified nurse aide (CNA) training programs were completed timely for NAs resulting in eleven NAs (NA Q, NA T, NA I, NA K, NA AA, NA B, NA W, NA S, NA R, NA C, and NA U) working longer than four months in the facility without completing the CNA training course. The facility census was 106. [...]

Inspectors wroteBased on record review and interviews, the facility failed to implement an antibiotic stewardship program that develops, promotes, and implements a facility wide system that monitors the use of antibiotics, reduces the risk of adverse events associated with antibiotic use, and failed to develop and implement protocols that ensure residents prescribed an antibiotic are utilizing the appropriate one. The facility census was 106. [...]

Inspectors wroteDuring an interview on 12/09/25, at 4:12 P.M., the Administrator said he/she did not know about antibiotic stewardship. Infection control is reviewed in Quality Assurance and Performance Improvement (QAPI) meetings. Nurses should be conducting daily meetings that address a variety of topics. [...]

Inspectors wroteBased on interview and record review, the facility failed to fully implement their abuse and neglect prevention policies, when the facility failed to complete a criminal background check (CBC), an employee disqualification list (EDL - a list of individual prohibited from working in a long-term care facility in Missouri due to a finding of abuse or neglect) check, and a Nurse Aide (NA) Registry (list of individual with a Federal Indicator (a marker given to a potential employee who has committed abuse, neglect, or misappropriation of property against residents) prohibiting them from working in a certified facility) check for ten sampled staff (Certified Nursing Assistant (CNA) A, Nursing Assistant (NA) B, NA C, Registered Nurse (RN) D, Dietary Aide (DA) E, Certified Medication Technician (CMT) F, Licensed Nurse Practitioner (LPN) G, Laundry Aide (LA) H, NA I, and Dietary Manager (DM)). [...]

Inspectors wroteBased on observation, interviews, and record review, the facility failed to ensure medications were labeled and stored per standards of practice when insulin pens were not properly labeled and dated, including pens for seven residents (Resident #47, #35, #4, #83, #22, #7, and #33). The facility also failed to maintain the medication storage refrigerator at the recommended temperatures, per manufactures recommendations, for multiple medications stored in the refrigerator for use. The facility had a census of 106.1. [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to maintain a complete and effective infection prevention and control program when the facility failed to ensure staff were educated on enhanced barrier precautions (EBP - infection control interventions designed to reduce transmission of resistant organisms that employs targeted gown and glove use during high contact resident care activities); failed to ensure staff wore appropriate protective personal equipment (PPE) when providing catheter (flexible tubing that is used to drain urine from the bladder) care for one resident (Resident #46) and when accessing a percutaneous endoscopic gastrostomy (PEG - a tube inserted through the abdominal wall in the stomach to provide nutrients) tube for one resident (Resident #62). [...]

Inspectors wroteBased on observation, record review, and interviews, the facility failed to ensure a medication error rate of less than 5% when staff made two errors out of 29 opportunities resulting in an 6.9% error rate when facility staff failed to administer one medication as ordered and administered an incorrect dosage of a medication to one resident (Resident #47). The facility had a census of 106. Based on observation, record review, and interviews, the facility failed to ensure a medication error rate of less than 5% when staff made two errors out of 29 opportunities resulting in an 6.9% error rate when facility staff failed to administer one medication as ordered and administered an incorrect dosage of a medication to one resident (Resident #47). The facility had a census of 106. [...]

Inspectors wroteBased on interview and record review, the facility failed to ensure all allegations of possible abuse were reported immediately to manage and with in two hours to the Survey Agency (DHSS - Department of Health and Senior Services) when staff failed to report and an allegation of abuse involving one resident (Resident #1) until the following day. The facility census was 101. Review of the facility policy Abuse and Neglect, dated 10/24/22, showed the following:-Each employee has an obligation to immediately report any incident or allegation that could constitute an instance of abuse or neglect, or an injury of unknown origin to the Director of Nursing (DON) or the department supervisor and that individual will notify the Administrator;-Each employee should report to the supervisor and follow-up with the supervisor to confirm it has been addressed. [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to promote and facilitate each resident's right of self-determination through support of resident choice when staff failed to honor resident preferences for showers for three residents (Resident #1, #2, and #3). The facility census was 103. Review of the facility policy titled, Hygiene and Grooming, dated 10/01/10, showed the following:-Good hygiene and grooming help prevent the spread of infection and promote the resident's feeling of self-worth and dignity;-Guidelines for provision of hygiene and grooming services are shower, tub, or complete bed bath, as needed; [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to provide each resident with a nourishing, well-balanced diet that met the daily nutritional needs of the residents when the facility failed to prepare and serve meals for the residents per the facility approved menu and failed to make an nutritionally adequate substitutions to the menu. The facility census was 102. Review showed the facility did not provide a policy regarding serving sizes or nutritional values. 1. Review of the facility's February 2025 Dietary Menu showed staff were to serve the following on 02/21/25, at lunch, to the residents: -Chili, 6 ounces (oz); -Baked potato, 1 each.; -Crackers, 2 packages; -Spiced peaches, 4 oz.; -Iced tea, 8 oz.; -Water, 8 oz. Observation on 02/21/25, at 12:08 P.M., showed the following: -The surveyor requested a test tray of a resident meal; [...]

Inspectors wroteBased on observation, interview, and record review, the facility staff failed to ensure food was protected from potential contamination at all times when staff failed to keep non-food contact services clean and free from debris. The facility census was 102. Review of the facility's policy titled Sanitation Principles, dated 02/01/02, showed the following information: -The purpose of the policy was to prevent the spread of bacteria that may cause food borne illnesses; -Food service areas should be maintained in a clean and sanitary manner; -The current Food Code should be utilized as guidelines for the department; -Utensils, counters, shelves, and equipment should be kept clean; -Cleaning schedule should developed and posted by the Food Service Manager (FNS) for the routine cleaning of all kitchen surfaces, equipment and utensils. [...]

Inspectors wroteBased on observation, interview, and record review, the facility staff failed to ensure the baseboards, walls, and windows were clean and free of dirt. The facility census was 102. Review of the facility's policy titled Sanitation Principles, dated 02/01/02, showed the following information: -The purpose of the policy was to prevent the spread of bacteria that may cause food borne illnesses; -Food service areas should be maintained in a clean and sanitary manner; -The current Food Code should be utilized as guidelines for the department; -Utensils, counters, shelves, and equipment should be kept clean; -Cleaning schedule should developed and posted by the Food Service Manage (FNS) for the routine cleaning of all kitchen surfaces, equipment and utensils. [...]

Inspectors wroteBased on observations, interview, and record review, the facility failed to provide an ongoing program of activities to meet the interests of and support the mental and psychosocial well-being for all residents when the facility failed to have an Activity Director, a complete activity program, or activity calendars for the residents including seven residents (Resident #5, Resident #6, Resident #8, Resident #9, Resident #10, Resident #12, and Resident #13) identified as feeling activities were important. The facility census was 102. 1. Review of Resident #8's face sheet showed: -admission date of 11/08/16; -Diagnoses included anoxic brain injury (a condition where the brain is deprived of oxygen for a prolonged period, leading to damage or death of brain cells), major depressive disorder, anxiety disorder, and high blood pressure. [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure all residents received care and treatment in accordance with professional standards of practice when facility nursing staff failed to provide appropriate fall follow up assessments, including neurological assessments (evaluation of the functioning of the nervous system, identifying any abnormalities or neurological deficits.) for four residents (Resident #1, Resident #3, Resident #4, and Resident #7) after each resident sustained a fall with potential for head injury. The facility census was 102. Review of the facility policy titled, Incidents and Accidents, dated 11/10/24, showed the following: -The resident environment to remain as free of accident hazards as is possible, however, when an accident occurs, prompt response and reporting occurs; -Examples include falls or resident observed on the floor; [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure all residents maintained acceptable parameter of nutritional status when staff failed to implement and document recommended, care planned, or ordered, weekly resident weights for three residents (Resident #1, Resident #2, and Resident #3) and failed to provide meal assistance to two residents (Resident #1 and #2). The three resident has been identified as having weight loss. The facility census was 102. Review of the facility policy titled, Weight Management, dated 10/01/10, showed the following: -Purpose was the maintenance of adequate nutrition and hydration is necessary for the resident to maintain health and prevent complications such as malnutrition and pressure sores; -Residents should be weighed monthly unless there is a problem that warrants a deviation from that routine; [...]

Inspectors wroteBased on observation, interview, and record review, facility staff failed to serve appetizing and palatable meals when kitchen staff overcooked and under seasoned foods served to residents, including two residents (Resident #6 and #5) who would not eat food/meals at times due to the poor palatability. The facility had a census of 102. Review of the facility policy, Hot and Cold Food Holding, dated 05/25/12, showed the following: -Purpose was to ensure optimal quality of foods held prior to and during meal service; -Foods should not be held on the steam table longer than 30 minutes prior to start. Review of the facility policy, Food Taste Test, dated 01/2002, showed the following: -Foods with a distinctively good taste and appearance help promote the resident/guest(s) dietary intake; -Foods should be tasted prior to meal service to test the quality of the food; [...]

Inspectors wroteBased on observation and record review, the facility failed to maintain an effective infection control program when staff failed to administer the required two step tuberculosis (TB - a communicable disease that affects the lungs characterized by fever, cough, and difficulty breathing) screening test for four sampled staff members (Dietary Aide B, Nurse Aide (NA) C, Licensed Practical Nurse (LPN) D and LPN E). The facility census was 108. Review of the facility's policy titled Infection Prevention and Control Manual, dated 09/01/17, showed the following: -Purpose to prevent the spread of tuberculosis in resident/guest(s) and employees; -Employees are screened for TB at the time of employment; [...]

Inspectors wroteBased on interview, observation, and record review, the facility failed to protect the residents' right to be free from verbal and physical abuse for three of four residents (Residents #15, #43, and #44) when Resident #15 was physically and verbally abused by Resident #55; when Resident #43 was physically abused by Resident #55; and when Resident #44 was verbally abused by a staff member. 1. Review of Resident #55's Facesheet, undated, showed the following: -admission date of 07/06/23; -Diagnoses included dementia with agitation, major depressive disorder, cognitive communication deficit, and Alzheimer's disease with late onset. Review of the resident's quarterly Minimum Data Set (MDS - a federally mandated assessment tool completed by facility staff), dated 10/04/23, showed the following: [...]

Inspectors wroteBased on interview and record review, the facility failed to ensure bed frames and bed rails, if present, were inspected and maintained per the Manufacturer's Instructions for Use (MIFU) to minimize the risks of bed malfunction or resident injury. This failure had the potential to affect 109 of 109 residents that used a bed. Review showed the facility did not provide a policy regarding maintenance of bed/bed rails. 1. Review of the form Resident Beds: Annual Maintenance - Resident Beds/Wheelchairs, showed the following; -OEM [Original Equipment Manufacturer] PM [Preventative Maintenance] Recommendations -Lubricated bed adjusting mechanisms; -Make sure wheels, castors, and locks are operable; -Check all electrical components/wiring for safety and proper operation; -Check all components for beds/wheelchairs for wear and tear; [...]

Inspectors wroteBased on observation, record review, interview, and facility policy review, the facility failed to ensure that alternatives to bed rails were attempted prior to the use of bed rails, failed to document reasons for failure of alternatives, and failed to advise residents and/or resident representatives (RR) of the risks and/or benefits of rail use with informed consent signed prior to the installation of bed rails for three of three residents (Resident #24, #34, and #54) reviewed for bed rail use. Review of the facility policy titled, Resident Beds and Bed Safety Rails Program, effective 10/28/19, showed the policy did not address the assessment items, attempted alternatives with documented reasons for failure, and getting an informed signed consent prior to the installation of the bed rails. 1. Review of Resident #24's Face Sheet showed the following: [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure foods were served at palatable temperatures for four supplemental residents (Resident #75, #17, #6 and #4) when hot food was not hot at the point of service for hall trays. Review of the facility policy titled, Food Preparation Guidelines, section Food Preparation and Handling, dated 08/10/18, showed the following: -Food should be palatable, attractive, and at the proper temperature, as determined by the type of food, to ensure resident/guest(s) satisfaction. 1. Review of the resident council minutes, dated 12/28/23, showed the residents expressed concerns with the temperature of food on hall trays. A resolution was not indicated in the minutes. It was noted the Dietary Manager was present during the meeting. During an interview on 01/29/24, at 12:37 P.M., Resident #75 said the food was lousy. [...]

Inspectors wroteBased on observations, record review, and interview, the facility failed to ensure food was prepared and served in accordance with professional standards when one counter area in the kitchen was broken and had a porous surface and when one staff member was observed to handle ready to eat food with bare hands while assisting one supplemental resident (Resident #89) with their meal. 1. Review of the United States Food and Drug Administration (FDA) 2022 Food Code showed multi-use food-contact surfaces shall be smooth, free of breaks, cracks, chips, pits, and similar imperfection. Observations during the initial kitchen tour on 01/29/24, at 9:18 A.M., showed the following: -A large section (over a foot in length) of a prep area counter edge was observed to have an exposed porous surface. The surface of the counter had multiple small rough divots on the surface. [...]

Inspectors wroteBased on interview, record review, and observation, the facility staff failed to protect residents from possible injury when staff failed to have a process in place to ensure hot food and beverages were served at a safe temperature and failed to put sufficient interventions and oversight in place to prevent a second food burn for one resident (Resident #51). The facility census was 102. The administrator was notified on 10/20/2021, at 1:10 P.M., of an Immediate Jeopardy (IJ) which began on 10/14/2021. The IJ was removed on 10/21/2021, as confirmed by surveyor onsite verification. Record review of the facility policy titled Incidents and Accidents, dated 11/10/2014, showed the following: -The resident environment remains as free of accident hazards as is possible, however when an accident occurs, prompt response and reporting occurs. [...]

Inspectors wroteBased on record review, observation and interview, the facility failed to store and prepare food in accordance with professional standards of practice and protect from possible contamination when staff did not follow proper hand hygiene, skillets had non-stick coating peeling from the inside surface, frozen food was allowed to be kept thawed, wire storage shelves where dishes were stored were fuzzy with lint, dented cans were not placed in designated area in the dry pantry, and the ice machine did not have the required air gap to prevent backflow into the ice. The facility census was 102. 1. Record review of the Missouri Food Code for the Food Establishments of the State of Missouri, dated June 3, 2013, showed the following: [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure all residents were treated with dignity and respect when two residents (Resident #71 and Resident #247) were left exposed in view of other residents and staff and when the facility failed to provide a dignity bag for one resident (Resident #146) with a catheter (a sterile tube used to drain urine). The facility census 102. Record review of the facility's policy, titled Federal Rights of Residents/Guests, dated 11/28/2016, showed the following: - The resident/guest has the right to a dignified existence, self-determination, and communication with and access to persons and services inside and outside the facility; - The resident/guest has the right to personal privacy and confidentiality of his or her personal and medical records; [...]

Inspectors wroteBased on record review, observation, and interview, the facility failed to maintain a clean, comfortable, homelike environment on the special care unit (SCU-a locked memory care unit) when P-TACs (filter for air conditioners) were lying on the ground and were fuzzy and dirty, fluorescent light fixtures were missing covers; and on 400 hall the fluorescent lights were dirty with dead bugs. The facility census was 102. Record review showed the facility did not provide a policy regarding maintaining the cleanliness of the home. 1. Observation on 10/19/2021, at 9:23 A.M., of the SCU showed the following P-TAC filters for the air conditioning units lying on the floor underneath the air conditioner units. The filters were dirty with fuzzy lint and dust: -room [ROOM NUMBER]; -room [ROOM NUMBER]; -room [ROOM NUMBER]; -room [ROOM NUMBER]; -SCU dining room; -SCU television/common area. [...]

Inspectors wroteBased on interview and record review, the facility failed to document checking the Nurse Aide (NA) Registry prior to the start date of six out of ten sampled staff to ensure they did not have a Federal Indicator (a marker given to a potential employee who has committed abuse, neglect, or misappropriation of property against residents) prohibiting them to work in a certified facility. The facility census was 102. Record review of the facility's policy titled Abuse, Neglect, Misappropriation of Resident/Guest Property, Suspicious Injuries of Unknown Source, Exploitation, dated August 12, 2016, showed the following: -The facility will not knowingly employ any individual who has been found guilty by a court of law of abusing, neglecting, or mistreating resident(s)/guest(s). [...]

Inspectors wroteBased on record review and interview, the facility failed to notify the resident and the resident's representative in writing of a transfer or discharge and failed to provide the ombudsman (a resident advocate who provides support and assistance with problems and/or complaints regarding the facility) a copy of the notification for three residents (Resident #16, Resident #32, and Resident #80). The facility census was 102. Record review of the facility policy titled, Transfer, Discharge, and Therapeutic Leaves (including AMA), dated 11/28/2016, showed procedures for non-emergency transfer or discharges should include: -A licensed nurse should complete discharge summary and should be coordinated by the social service designee; -Notify the resident in writing and the legal representative of transfer or discharge and the reasons for the transfer or discharge; [...]

Inspectors wroteBased on record review and interview, the facility failed to notify the resident and the resident's representative in writing of the bed hold policy when transferring three residents (Resident #16, Resident #32, and Resident #80) to the hospital. The facility census was 102. Record review of the facility's bed hold policy, dated 6/26/19, showed procedures for emergency transfer should include: -A copy of resident/guest bed hold and admission policies/ transfer to hospital notice should be provided upon transfer by assigned nurse to resident and/or representative of resident. 1. Record review of Resident #16's face sheet showed the following: -admission date of 12/7/07; -discharged to the hospital on [DATE]. Record review of the resident's nurses' progress notes showed the following information: [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to document identification and use of possible alternatives prior to use of side rails; failed to document assessing risk versus benefits of side rail use; failed to obtain informed consent for the use of side rails prior to installation; failed to get a physician's order for the use of side rails; and/or failed to complete ongoing assessments to ensure the side rails are appropriate for use for three residents (Resident #20, #36, and #40). The facility's census was 102. Record review of the facility's Bedrail Use Policy, dated 1/1/2019, showed the following information: -Bedrails may be used to help a resident/guest position or turn him/herself. Provide instructions to the resident/guest as needed. The interdisciplinary team should determine if the clinical benefits outweigh the risk of device/bedrail; [...]

Inspectors wroteBased on interview and record review, the facility failed to ensure all nurses had appropriate competencies when the facility failed to verify two out of three sampled nurses had a valid license to work in the state of Missouri prior to hire. The facility census was 102. 1. Record review of Licensed Practical Nurse (LPN) CC's personnel records showed the following: -Hire/start date of 9/07/2021; -The facility did not document verifying LPN CC had a valid Missouri nurse's license until 10/22/2021 (45 days after the LPN's hire/start date). 2. Record review of LPN DD's personnel records showed the following -Hire/start date of 9/16/2021; -The facility did not document verifying LPN DD had a valid Missouri nurse's license until 10/22/2021 (36 days after the LPN's hire/start date). 3. [...]

Inspectors wroteBased on observation, record review, and interview, the facility failed to maintain an infection control program that provided a safe and sanitary environment for all residents during a Coronavirus Disease 2019 (COVID-19, an infectious disease caused by severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2)) pandemic when staff failed to wear personal protective equipment (PPE) facemasks appropriately around multiple residents; failed to use appropriate hand hygiene after performing incontinent care for four residents (Resident #21,Resident #47, Resident #71, and Resident #79); and failed to clean equipment used by multiple residents between uses. The facility census was 102. Record review of the Centers for Disease Control and Prevention (CDC) Covid Data Tracker showed the facility's county's transmission rate of substantial from 10/18/2021 through 10/28/2021. 1. [...]

Inspectors wroteBased on observation and interview, the facility failed to provide a safe, functional, sanitary, and comfortable environment for residents, staff and the public by failing to keep the facility grounds free of trash and debris and by failing to keep light fixtures in the kitchen area clean. The facility census of was 102. 1. Observations around the exterior of the facility on 10/19/21, starting at 10:55 A.M., showed the following: -Outside the kitchen exit there were six milk crates placed in several areas, some turned on their side. In the same are there were numerous cigarette butts on the ground (pavement and in grassy areas) and a bulk-storage container with 24 red and yellow onions without a lid. Some of the onions had large sections that were discolored (green, black. and white); [...]

Inspectors wroteBased on interview and record review, the facility failed to ensure one resident's (Resident #346) records accurately and consistently indicated the resident's wishes regarding his/her code status (the level of medical interventions a resident wishes to have if their heart or breathing stops). The facility census was 102. Record review of the facility's Advanced Directive Policy, dated 10/1/2010, showed the following: -When a Do Not Resuscitate (DNR- a status that means a resident does not want his/her life to be saved in the event that his/her heart or breathing stops) order is decided upon, the DNR order must be entered into the resident's medical record. 1. Record review of Resident #346's face sheet showed an admission date of 10/4/2021. Record review of the resident's medical record showed a signed DNR form (purple sheet) in the paper chart. [...]

Inspectors wroteBased on interview, record review, and observation, the facility staff failed to perform an initial wound assessment, delayed obtaining a wound treatment, and did not perform weekly wound assessments following an accidental burn for one resident (Resident #51). The facility census was 102. Record review of the facility's policy titled Incidents and Accidents, dated 11/10/2014, showed the following: -Examples of incidents include but are not limited to falls, burns, medication errors, skin tears, bruises, altercations or unusual combative behavior, attempted elopements, treatment errors, equipment malfunctioning causing injury to residents, adverse reaction to diet or medication, and smoking infractions; -Staff should notify the resident's physician and obtain orders for care, including any indicated diagnostics (x-rays, laboratory orders); [...]

Inspectors wroteBased on observation, record review, and interview, the facility failed to post the abuse and neglect hotline number in a manner that residents and family could see. The abuse/neglect hotline number was six to seven feet high and in very small print. The facility also failed to post the Medicare/Medicaid contact information in a prominent location for residents and family members to access. The Medicare and Medicaid information was posted in an alcove off of 400 hall near the employee time clock. The facility census was 102. Record review showed the facility did not provide a policy regarding posting the abuse/neglect number or the Medicare/Medicaid information. 1. Observation on 10/18/2021, at 12:42 P.M., showed the abuse and neglect contact information was posted across from the nurses' station in the center area of the facility. [...]