Az - Rio Vista Post Acute and Rehabilitation

Inspectors wroteBased on interviews, clinical record review, and review of policy and procedure, the facility failed to ensure one of three sampled residents (#6) was provided written notice of discharge as soon as practicable prior to discharge, that the written notice included date and location of discharge, as well as contact information for the state long term care ombudsman, and that the notice of discharge was also sent to the state long term care ombudsman prior to discharge. The deficient practice could result in residents and their representatives being unaware of their appeal and advocacy rights and could prevent the ombudsman from reviewing and advocating for safe and appropriate discharge planning before the discharge occurred.-

Inspectors wroteBased on observation, interviews, review of clinical record, and review of facility policy and procedure, the facility failed to ensure quality of care was provided, including that a physician order for a wheelchair cushion was followed, for one of three sampled residents (#10). The deficient practice could lead to skin breakdown or discomfort to the resident.

Inspectors wroteBased on observation, clinical record review, staff interviews, and review of facility policy, the facility failed to ensure one (#4) of three sampled residents was provided respiratory care consistent with professional standards and highest practicability of care. The deficient practice could result in respiratory complications.

Inspectors wroteBased on observation, clinical record review, resident and staff interviews, and review of facility policy, the facility failed to ensure one (#5) of three sampled residents' choices regarding personal hygiene care were considered and honored in regard to shower preferences. The deficient practice could result in residents not having their choice in personal preferences that are significant to them.

Inspectors wroteBased on observation, clinical record review, staff interviews, and review of facility policy, the facility failed to ensure one (#2) of four residents reviewed for pressure ulcers was provided care and services to prevent and safely treat pressure ulcers. The deficient practice could result in the development and worsening of pressure ulcers.

Inspectors wroteBased on observation, staff and resident interviews, and facility policy, the facility failed to ensure medication were not left unsecured at bedside for two sample residents (#105 & #67). The deficientpractice of unattended medications does not align with accepted professional standards of practice and may result in undesirable medication-induced harm.

Inspectors wroteBased on clinical record review, resident and staff interviews, and policy review, the facility failed to ensure a Peripherally Inserted Central Catheter (PICC) line was discontinued when not required prior to, or at time of, discharge for one of three Residents (#1). The deficient practice could result in residents utilizing the PICC line inappropriately or getting infection if not prope.

Inspectors wrote-Resident #66 was admitted on [DATE] with diagnoses of cerebral infarction, hemiplegia and hemiparesis affecting right dominant side, aphasia, epilepsy unspecified, type 2 diabetes mellitus, atrial fibrillation, unspecified dementia and anxiety disorder. The care plan initiated on October 21, 2021 included that resident was on anticoagulant therapy related to atrial fibrillation. Interventions included to take/give medication at the same time each day. The current comprehensive care plan included an intervention to administer medications as ordered and to monitor/document for side effects and effectiveness. Review of the physician orders revealed the following morning medications: -Aspirin (nonsteroidal anti-inflammatory) 81 mg (milligrams) give 1 tablet by mouth one time a day for DVT (deep vein thrombosis) prophylaxis; [...]

Inspectors wroteBased on clinical record review, resident and staff interviews, facility documentation and policy review, the facility failed to ensure that assessments consistently identified and accurately described the skin condition for one resident (#2). The deficient practice could result in resident not receiving the appropriate care and services according to their needs. Findings Include: Resident #2 was readmitted on [DATE] with diagnoses of abscess of bursa to right shoulder, cellulitis of right upper limb, end stage renal disease (ESRD), type 2 diabetes and anemia. The care plan dated February 17, 2023 included the resident had potential for pressure ulcer development related to right shoulder abscess, s/p (status post-surgical debridement, morbid obesity, and had a wound to the right shoulder. [...]

Inspectors wroteBased on personnel file review, staff interviews and facility documentation and policy review, the facility failed to ensure that evidence of training to safely and effectively carry out the functions of the food and nutrition services were not expired for two staff members (#92 and #132). The deficient practice could result in dietary not having the appropriate skills to carry out their functions and responsibilities.

Inspectors wroteBased on clinical record review, staff interviews, and policy reviews, the facility failed to ensure care and services were provided to prevent the development of pressure ulcer for one resident (#262) and failed to ensure the pressure ulcer was thoroughly assessed consistently. The deficient practice could result in residents developing pressure ulcers and has the potential for inadequate or inaccurate or inappropriate treatment and subsequent deterioration of pressure ulcer.

Inspectors wroteBased on observation, staff interviews and review of facility documentation, policies and procedures, the facility failed to ensure that staff were consistently screened for COVID-19 upon entry to the facility and prior to working their shift. The deficient practice could result in the spread of infection to residents and staff.

Inspectors wroteBased on observation, clinical record review, resident and staff interviews, and facility policy, the facility failed to ensure an ongoing activity was provided based on the comprehensive assessment and preferences for one resident (#462). The deficient practice could result in the not having meaningful activities based on the resident's interest and preferences. Findings Include: Resident #462 was admitted to the facility on [DATE] with diagnoses of orthopedic aftercare, unilateral primary osteoarthritis, left hip and presence of left artificial hip joint. A nursing progress note dated February 16, 2022 revealed the resident was alert and oriented x 4 and was able to make needs known. An activity admission evaluation dated February 17, 2022 revealed the resident was alert and oriented to person, place and time with adequate communication and cognition skills. [...]

Inspectors wroteBased on observations, clinical record review, resident and staff interviews and facility policy and procedure review, the facility failed to ensure care and assistance with the use of hearing aids was provided to one resident (#65). The deficient practice could lead to the resident not able to hear and maintain hearing abilities resulting in difficulty in communication.