Athens Health and Rehabilitation LLC

Inspectors wroteBased on interviews, record reviews and a review of a facility policy titled, Abuse Prevention, the facility failed to ensure resident narcotic medications were not missing. This deficient practice affected RI #87, #48, #222, #223 and #224, five of five residents who were investigated for missing narcotic medication. Findings Include: A review of a facility policy titled Abuse Prevention, with an effective date of [DATE] , revealed: The following are definitions of specific types of abuse: . D) Misappropriation of Resident/ . Property means the deliberate misplacement, exploitation, or wrongful, temporary or permanent use of a resident's . belongings or money without the resident's consent . (1) RI #87 was admitted to the facility on [DATE]. A diagnosis included Encounter for other specified aftercare. [...]

Inspectors wroteBased on interview, record review and review of a facility policy titled, Change in Medical Condition of Resident/Guest(s), the facility failed to ensure Resident Identifier (RI) #272's family/responsible party was notified of a new order written on 4/19/19, for Depakote DR (Delayed Release) 125 MG (milligrams) sprinkle by mouth at hour of sleep. This deficient practice affected RI #272, one of 25 sampled residents. Finding Include: A facility policy title: Change in Medical Condition of Resident/Guest (s), with an effective date of 11/28/2016 revealed the following: .STANDARD: Notification . legal representative, or interested family member, should occur promptly, according to federal regulations, when there is a change in the resident/guest (s) condition, . *A need to alter treatment . to commence a new form of treatment . [...]

Inspectors wroteBased on interview, record review and review of a facility policy titled Medication Orders, the facility failed to ensure Resident Identifier (RI) # 272 received additional Lasix for three days, as ordered. This deficient practice affected RI #272, one of 25 sampled residents. Finding Include: A facility policy title: Medication Policies Prescriber Medication Orders dated 03/11 revealed the following, Policy Medications are administered only upon the clear, complete, and signed order of a person lawfully authorized to prescribe. Procedures 1. Elements of the Medication Order . (4) Time or frequency of administration. RI #272 was admitted to the facility on [DATE]. A diagnosis included Chronic Diastolic (congestive) Heart Failure. The Physician Orders List included the order for additional Lasix for RI #272, with an order start date of 4/24/19 and a stop date of 4/26/19. [...]

Inspectors wroteBased on observations, interview, record review and review of a facility policy titled, Oxygen Administration , the facility failed to ensure oxygen masks and distilled water bottles were dated. This deficient practice had the potential to effect Resident Identifier (RI) #105, RI #274 and RI #275, three of three residents observed for oxygen therapy. Findings Include: A review of the facility policy titled, Oxygen Administration, effective date 12/08/2005, revealed, . Process: . 11. Cannula's and masks should be changed weekly . 14. O2 cannula/mask should be stored in a plastic bag when not in use. 1) RI #105 was re-admitted to the facility on [DATE]. A diagnosis included End Stage Real Disease. Physician Orders included an order, dated of 7/24/19, for O2 (Oxygen) at 2 L/M (Liter per Minutes) via NC (Nasal Cannula) as needed for SOB (Shortness of Breath). [...]

Inspectors wroteBased on observation, interviews, record review and a review of the facility's policy and procedure titled, Person Centered Care Plans, the facility failed to ensure staff developed a comprehensive care plan for a regular diet with nectar thickened liquids. This deficient practice affected RI (Resident Identifier) #24, 1 of 29 sampled residents. Findings Include: Review of the facility's policy titled Person Centered Care Plans dated November 2016 states, PURPOSE: Person centered care plans of care are developed by the interdisciplinary team, to coordinate and communicate care approaches approaches and goals of the resident,,,. RI #24 was readmitted to the facility on [DATE] with a diagnosis Hemiplegia following a Cerebral Infarct Affecting the Right Dominant Side and Dysphagia. [...]

Inspectors wroteBased on observations, staff interviews, medical record reviews, review of [NAME] and Perry's Fundamentals of Nursing, Ninth Edition and a facility policy titled Medication Administration Guidelines, the facility failed to ensure licensed nursing staff, Employee Identifier (EI) #14, followed Resident Identifier (RI) #25's Physician Orders dated July 2018, for REFRESH LIQUIGEL 1% EYE DROPS INSTILL TWO DROPS IN BOTH EYES THREE TIMES A DAY FOR DRY EYES. This deficient practice affected RI #25, one resident observed receiving eye drops. Finding Include: 1. A review of [NAME] and Perry's Fundamentals of Nursing, ninth edition, with a copyright date of 2017, Chapter 23, Legal Implications in Nursing Practice, page 311, documented: . Health Care Providers' Orders . Nurses follow health care providers' orders unless they believe that the orders are in error . [...]

Inspectors wroteBased on record review, interview and a review of the facility's policy titled, Discharge Summary and Plan of Care, the facility failed to ensure licensed staff completed a discharge summary for RI (Resident Identifier) #113's discharge from the facility. This was evident during the review of 1 of 4 discharges. Findings Include: The facility's policy titled Discharge Summary and Plan of Care dated 11/28/16 states: Purpose: Appropriate discharge planning and communication of necessary information to the continuing care provider, after discharge of a resident/guest from the facility, help the new care provider understand the resident/guests goals and needs. The process in this policy includes what the dscharge smmary should include which is: [...]

Inspectors wroteBased on observation, interviews and record review, the facility failed to ensure the nails of Resident Identifiers (RI) #3 and #31 were maintained in a trimmed condition. This affected two of five sampled residents for whom an observation of the feet and toes was made.

Inspectors wroteBased on observations of medication storage on 3 of 5 units, and review of the facility's policy titled Medication Storage, Storage of Medications and Biologicals, the facility failed to ensure that medications that were expired were not available for use. Expired medications were located on one of the three units observed.

Inspectors wroteBased on observations, interviews, and a review of the facility policies titled Hand Hygiene, Blood Glucose/PT/INR Machine Cleaning Guidelines, and Using Gloves, this facility failed to ensure that infection control practices were utilized to prevent the spread of infection. This deficient practice had the potential to affect 3 of 3 residents, RI #'s 57, 49 and 313.