Aviata at North Fort Myers

Inspectors wroteBased on observation and interview with the Dietary Manager, the facility failed to store food in an appropriate manner in accordance with guidelines of the FDA (Food and Drugs Administration) Food Code to ensure food was stored wrapped or in covered containers, labeled and dated, and arranged in a manner to prevent cross contamination.

Inspectors wroteBased on record review, and staff interviews, the facility failed to ensure the clinical record of 1 (Resident #11) of 2 residents reviewed for accurate documentation was completely and accurately documented.

Inspectors wroteBased on observation, record review and staff interviews, the facility failed to ensure fall prevention interventions were implemented for 1 (Resident #53) of 3 residents reviewed who sustained multiple falls at the facility.

Inspectors wroteBased on staff interviews and record review, the facility failed to ensure ongoing communication with the dialysis center related to the ongoing assessment of a dialysis resident before and after each dialysis treatment for 1 (Resident #128) of 1 resident receiving dialysis.

Inspectors wroteBased on record review and interviews, the facility failed to have documentation of a performance review and in-service education based on the outcome of the review for 1 (Staff E) of 4 Certified Nursing Assistants (CNAs) reviewed.

Inspectors wroteBased on record review and staff interviews, the facility failed to have documentation of dementia management training for 2 (Staff E and Staff D) of 4 Certified Nursing Assistants (CNAs) reviewed.

Inspectors wroteBased on observation, record review, residents, staff and contractor's interview, the facility failed to have an effective pest control program to ensure a pest free environment in residents' rooms and in the kitchen of the food serving establishment.

Inspectors wroteBased on observation, record review, residents and staff interviews, the facility failed to provide housekeeping, and maintenance services to maintain a clean, comfortable and pest free environment in all 3 ([NAME], [NAME] and [NAME]) of 4 units observed. The facility failed to maintain the walk-in refrigerator and freezer in a clean and sanitary mannerThe

Inspectors wroteBased on observations, record review, review of facility's policies and procedures, resident and staff interviews, the facility failed to ensure 1 (Resident #2) of 1 resident reviewed for dialysis received care and services to meet her needs.

Inspectors wroteBased on record review, review of facility's policies and procedures, and staff interviews, the facility failed to report a resident's injury of unknown origin to the Agency for Health Care Administration within the required time for 1 (Resident #3) of 3 residents' incidents reviewed.

Inspectors wroteBased on record review, resident and staff interviews, the facility failed to obtain necessary medical follow-up appointment for 1 (Resident #2) of 3 residents reviewed.

Inspectors wroteBased on resident and staff interviews and record reviews the facility failed to follow Physician orders to ensure the health and safety of one resident, Resident #1, of 4 residents reviewed for significant medication errors.

Inspectors wroteBased on record review, facility policy review, and staff interview the facility failed to provide the advance beneficiary notice to 2 (Residents #24, and #27) of 3 sampled residents reviewed.

Inspectors wroteBased on observation, resident and staff interviews and record review the facility failed to provide a safe, sanitary, and homelike environment in 3 (Canterbury, Buckinham and [NAME]) of 4 halls, as evidenced by dry wall damage in resident's rooms, damaged resident furnishings and rusted resident equipment. Failure to identify and complete needed repairs could cause safety and sanitary hazards to vulnerable residents.

Inspectors wroteBased on observation, review of facility policies and procedures, clinical record review and staff and resident interviews, the facility failed to follow procedures to thoroughly evaluate and analyze the fall incidents, for 1(Resident #19) of 2 residents. The facility also failed to ensure smoking material including lighters were securely stored for 1 (Resident #71) of 25 residents identified by the facility as currently smoking.

Inspectors wroteBased on observation, interview, record review, and facility policy review the facility failed to maintain ongoing, effective communication with dialysis centers and failed to ensure 2 (Residents #176 and #63) of 2 sampled residents receiving dialysis received appropriate care and services before and after dialysis treatments. The facility failed to have documentation of an agreement with the dialysis centers providing treatment to Residents #176 and #63.

Inspectors wroteBased on record review, and interview the facility policy the facility failed to ensure nursing staff were competent to provide care and services to 2 (Residents #176 and #63) of 2 sampled residents receiving dialysis.

Inspectors wroteBased on record review, review of facility's policy and procedure, and staff interviews, the facility failed to ensure the accuracy of a Pre-admission Screening and Resident Review (PASRR) and make the necessary corrections for 1(Resident #37) of 1 resident with admitting diagnoses of mental illness.

Inspectors wroteBased on observation, record review, review of facility policy and procedure review, and interviews, the facility failed to develop and implement a comprehensive individualized care plan for 4 (Residents #37, #104, #18, and #102) of 26 residents reviewed.

Inspectors wroteBased on observation, review of facility policy and procedure, review of the clinical record and staff interview, the facility failed to follow their policy and procedure and physician orders for the use of oxygen for 1 (Resident #273) of 1 resident reviewed for oxygen use. The facility failed to have a system in place to ensure the oxygen concentrator filters were removed and cleaned per the manufacturers recommendation. The facility had 19 residents with oxygen concentrators.

Inspectors wroteBased on observation, review of facility policies and procedures, and resident and staff interviews, the facility failed to maintain an effective pest control program and a sanitary environment free from pests for 3 (Residents #23, #51 and #49) of 26 sampled residents.

Inspectors wroteBased on observation, record review and interview, the facility failed to ensure care according to industry standards by not following physician's orders for quarterly lab draws for 1 (Resident #31) of 1 resident reviewed for seizures. Not following physician's orders for quarterly lab values puts a resident with seizure disorder at risk of seizures and hospitalization by not ensuring therapeutic levels of the seizure medication are within the bloodstream.

Inspectors wroteBased on observation, record review and interview the facility failed to maintain the kitchen and nourishment room equipment in a safe and clean manner. The facility failed to ensure kitchen staff contain hair to prevent contamination of food.

Inspectors wroteBased on record review, Resident, staff, and Practitioners interviews, the facility failed to ensure 1 (Resident #92) of 6 resident reviewed for unnecessary medications was free of significant medication errors.

Inspectors wroteBased on observation, review of facility policy and procedure, and staff interview, the facility failed to maintain medications secured in locked treatment carts to limit access to unauthorized personnel in 3 (Canterbury, [NAME], and [NAME]) of 4 units of the facility.

Inspectors wroteBased on observation, interview and record review, the facility failed to provide appropriate services and interventions for the management of contractures for 1 Resident (Resident #92) of 5 residents reviewed with limited range of motion.

Inspectors wroteBased on observation, record review, resident and staff interview the facility failed to document and follow up on grievances and ensure staff provided care and services to prevent skin injuries to 1 (Resident #94) of 1 resident observed with multiple skin tears to the hands.