Azria Health Wichita

Inspectors wroteThe facility had one main kitchen and two kitchenette/serving areas. Based on observation, record review, and interview, the facility failed to ensure foods in the kitchen were properly labeled and stored. The facility failed to ensure food service areas, refrigerators, counters and cabinets in the kitchenettes were clean.

Inspectors wroteThe facility reported a census of 65 residents. The sample included 16 residents. Based on observation, interview and record review, the facility failed to use appropriate infection control practices related to hand hygiene, respiratory equipment, Enhanced Barrier Precautions (EBP-infection control interventions designed to reduce transmission of resistant organisms which employ targeted gown and glove use during high contact care), and indwelling catheter (tube placed in the bladder to drain urine into a collection bag) care.

Inspectors wroteThe facility identified a census of 65 residents. The sample included 16 residents with five residents sampled for unnecessary medications. Based on observation, interview, and record review, the facility failed to inform Resident (R) 27 or her representative about the risk and benefits of taking an antianxiety (a class of medications that calm and relax people), antidepressant (a class of medications used to treat mood disorders), and antipsychotic (a class of medications used to treat major mental conditions that cause a break from reality).

Inspectors wroteThe facility had a census of 65 residents. The sample included 16 residents with three residents reviewed for hospitalization. Based on observation, interview, and record review, the facility failed to issue written notification as soon as practicable for transfers, for Resident (R) 5, R9, and R50.

Inspectors wroteThe facility reported a census of 65 residents; the sample included five residents reviewed unnecessary medications. Based on observation, interview, and record review revealed the facility failed to monitor and respond to Resident (R) 27's lack of bowel movements.

Inspectors wroteThe facility reported a census of 65 residents; the sample included 16 residents which included one resident reviewed for communication-sensory. Based on observation, interview, and record review the facility failed to provide necessary hearing treatments and failed to maintain the hearing devices for Resident (R) 21.

Inspectors wroteThe facility identified a census of 91 residents. The sample included 19 residents with one resident received for an intravenous catheter (IV-catheter placed in a vein to administer medications or fluids directly into the bloodstream). Based on observation, record review, and interviews, the facility failed to provide IV care and services consistent with standards of practice when staff did not assess, identify and take actions for Resident (R) 69's soiled IV dressing and failed to use adequate infection control practices during IV medication administration.

Inspectors wroteThe facility identified a census of 65 residents. The sample included 16 residents with five sampled residents reviewed for unnecessary medications. Based on observation, record review, and interview, the facility failed to ensure the Consultant Pharmacist (CP) identified and reported when Resident (R) 3's antihypertensive medications were given outside of the physician ordered hold parameters.

Inspectors wroteThe facility identified a census of 65 residents. The sample included 16 residents with five sampled residents reviewed for unnecessary medications. Based on observation, record review, and interview, the facility failed to ensure staff held Resident (R) 3's antihypertensive medications per physician's orders when R3's blood pressure (BP) and pulse measurements were outside of the physician ordered parameters.

Inspectors wroteThe facility identified a census of 65 residents. The sample included 16 residents with three sample residents reviewed for Hospice services. Based on record review and interview. The facility failed to ensure the collaboration of care between Resident (R) 7 and R50's hospice provider and the facility which included the hospice provider contact information, the services the hospice provider would provide to the residents, the supplies, equipment and medications the hospice provider would provide, as well as how often hospice staff members would visit the facility.

Inspectors wroteThe facility reported a census of 65 residents. Based on observation, interview, and record review, the facility failed to ensure the posted daily nurse staffing sheets included accurate and identifiable information to include the actual hours worked, as required.

Inspectors wroteThe facility reported a census of 68. The sample included 4 residents in the sample for reviews of misappropriation of medications. Based on observations, interview and record review the facility failed to ensure Resident (R) 1 remained free from misappropriation of medications, when on 02/04/24 Licensed Nurse D removed R1's second card of three with 45 tablets of hydrocodone (medications used for pain) 10-325 milligrams (mg) from the facility. The deficient practice placed R1 at risk for missed medication, unrelieved pain, and further misappropriate of medications.

Inspectors wroteThe facility reported a census of 64 residents. The facility identified one central kitchen with two satellite kitchens and two dining areas. Based on observation, interview, and record review, the facility failed to provide sanitary food preparation and storage of food to prevent the spread of food borne illness to the residents of the facility.

Inspectors wroteThe facility reported a census of 64 residents. Based on observation, interview, and record review, the facility failed to maintain and/or dispose of garbage and refuse properly in a sanitary condition to prevent the harborage and feeding of pests.

Inspectors wroteThe facility reported a census of 64 residents and identified 11 residents as confused and self-mobile. Based on observation, record review, and interview, the facility failed to ensure the environment was free of accident hazards for these 11 residents, including failure to keep hazardous chemicals out of reach. Furthermore, the facility failed to maintain a safe environment when staff utilized a gait belt to secure Resident (R)1's door to remain in the open position.

Inspectors wrote- Resident (R) 25's diagnoses included neuromuscular dysfunction of bladder (dysfunction of the urinary bladder caused by a lesion of the nervous system), and urinary tract infection (Infection of any part of the urinary system, including kidneys, ureters, bladder, and urethra). The Significant Change Minimum Data Set (MDS) dated [DATE], revealed a Brief Interview for Mental Status (BIMS) score of 15, indicating intact cognition. The resident was dependent for all cares and had an indwelling urinary catheter (insertion of a catheter into the bladder to drain the urine into a collection bag). The 11/03/23 Urinary Incontinence and Indwelling Catheter Care Area Assessment (CAA), dated 11/03/23, revealed the resident required a urinary catheter. The care plan, dated 10/13/23, revealed the resident required a urinary catheter. [...]

Inspectors wroteThe facility reported a census of 64 residents and identified 11 residents as confused and self-mobile. Based on observations, interviews, and record review, the facility failed provide a safe environment for 11 residents by the failure to ensure that Resident (R)25 and R1's rooms remained free of unsecured medications, when the facility failed to secure medications in both residents' rooms. This deficient practice had the potential to create an accidental ingestion of medications to these confused, mobile residents.

Inspectors wroteThe facility reported a census of 64 residents. The facility identified one central kitchen with two satellite kitchens and two dining areas. Based on observation, interview, and record review, the facility failed to provide food that was palatable, attractive and at a safe and appetizing temperature.

Inspectors wroteThe facility reported a census of 64 residents which included 16 residents sampled. Based on observation, interview and record review, the facility failed to provide a sanitary and safe environment to prevent cross contamination and infection related to provision appropriate use of personal protective equipment (PPE) for 13 residents (R)1, R 4, R 11, R 19, R 25, R 26, R 37, R 38, R 40, R 48, R 50, R 55, and R 57, which required enhanced barrier precautions to be in place and available for nine residents with catheters (R 1, R 26, R 11, R 55, R19, R 37, R 50, R 04, R 25), five residents with wounds (R 38, R 40, R 19, R 50, and R 25), two residents with percutaneous enteral gastrostomy tube (PEG- artificial opening through the abdominal wall where a catheter is placed to supply nutrition), (R 37 and R 48), four residents (R 55, R 38, R 48, and R 57 of the 13 identified residents that [...]

Inspectors wroteThe facility reported a census of 64 residents that included 16 residents sampled. Based on observation, record review and interview, the facility failed to maintain Resident (R)20's dignity when staff talked to the resident in a demeaning manner, for R25, when staff failed to close a window when providing incontinence cares, and for R50, that failed to cover the resident's urinary catheter collection bag when in public view.

Inspectors wroteThe facility had a census of 64 residents, which included 16 residents sampled, including one resident reviewed for accommodation of needs related to assistive devices. Based on observation, record review, and interview, the facility failed to ensure Resident (R)11's call light remained within his reach.

Inspectors wroteThe facility reported a census of 64 residents which included 16 residents sampled for review. Based on observation, interview and record review, the facility failed to track grievances through to their conclusions and provide prompt efforts to resolve a grievance filed by a resident (R)20 regarding the behavior of staff, offer or provide written grievance decisions to the resident regarding his or her grievance, and to offer or provide a summary of the pertinent findings or conclusions regarding the resident's concerns(s), a statement as to whether the grievance was confirmed or not confirmed, any corrective action taken or to be taken by the facility as a result of the grievance.

Inspectors wroteThe facility reported a census of 64 residents which included 16 residents sampled, which included two residents reviewed for comprehensive care plan development. Based on interview, observation, and record review, the facility failed to develop a comprehensive, individualized person-centered care plan for Resident (R) 25 related to the use of grab bar use for bed mobility and for R27 to include the use of oxygen and oxygen related equipment. This deficient practice placed the residents at risk for uncommunicated care needs.

Inspectors wroteThe facility reported a census of 64 residents with 16 residents included in the sample. Based on observation, interview, and record review, the facility failed to provide necessary services to decrease the risk of a urinary tract infection when staff failed to use proper hand hygiene and Enhanced Barrier precautions (EBP) when providing urinary catheter care for resident (R)1 and R25.

Inspectors wroteThe facility reported a census of 64 residents with 16 residents sampled, including three residents reviewed for respiratory care. Based on observations, record reviews, and interviews, the facility failed to properly clean and store a nebulizer (a device for administering inhaled medications) for Resident (R)28 and R11 in accordance with the standards of care. In addition, the facility failed to place a date label on the oxygen tubing for R27. This deficient practice placed the residents at risk of respiratory complications that could also have a negative impact on the resident's psychosocial wellbeing.

Inspectors wroteThe facility reported a census of 64 residents which included 16 residents sampled, which included one resident reviewed for bed rail safety. Based on interview, observation, and record review, the facility failed to assess Resident (R)25 for safety and risk of entrapment from bed rail use and failed to ensure R25 obtained informed documented consent from the resident or resident representative prior to installation of the siderails. This deficient practice placed R25 at a risk for uninformed decisions related to the risks and benefits associated with the use of side rails and placed the resident at risk due to possible injury due to bed rail use.

Inspectors wroteThe facility reported a census of 67 residents, with three residents included in the sample. Based on observation, interview, and record review, the facility failed to provide adequate supervision and ensure a safe environment on 11/20/23, when the facility sent cognitively impaired dependent Resident (R)1 to R2's medical appointment. The facility mixed up R2 and R1's identity and dropped off R1 at the front doors of a medical clinic, alone, for R2's appointment. R1 did not have any identification on him and did not know why he was at the appointment. The facility did not know R1 was out of the facility until the medical clinic staff called the facility to point out the facility dropped off the incorrect resident.

Inspectors wroteThe facility had a census of 59 residents. The sample included 18 residents with one reviewed for pressure ulcers. Based on observation, interview, and record review, the facility failed to initiate effective interventions according to standards of care to prevent the development of a right dorsal (the back, or upper surface of the foot) foot, facility acquired Stage 3 pressure ulcer (full-thickness loss of skin, in which subcutaneous fat may be visible in the ulcer and granulation tissue may be present) for Resident (R)2.

Inspectors wroteThe facility had a census of 59 residents. The sample included 18 residents. Based on observation, record review, and interview the facility failed to store, distribute and serve food in accordance with professional standards for food service safety for the 59 residents who resided in the facility and received their food from the facility kitchen and two kitchenettes, when staff failed to use safe food handling, failed to dispose of expired food items, failed to disinfect a thermometer between food items when checking the temperatures of the food, and failed to wear a hair net in the kitchen during the preparation a meal.

Inspectors wroteThe facility had a census of 59 residents. The sample included 18 residents. Based on observation, interview, and record review the facility staff failed to treat Resident (R) 4 and R16 with dignity when staff checked their blood pressure (test measures the pressure in your arteries as your heart pumps) and administered their insulin (a medication used to regulate blood sugar levels) at the dining room table, with nine other residents able to view them during meal service and dining. The staff also failed to close the bedroom curtain to promote dignity and privacy, while R8 sat on a bed pan.

Inspectors wroteThe facility had a census of 59 residents. The sample included 18 residents with two reviewed for hospitalization. Based on observation, interview, and record review the facility failed to provide the resident or resident representative with written information regarding the facility bed hold policy, when R18 transferred to the hospital. This placed R18 at risk for not being permitted to return and resume residence in the nursing facility.

Inspectors wroteThe facility had a census of 59. The sample included 18 residents. Based on observation, interview, and record review the facility failed to provide care in a timely manner for Resident (R) 54 when facility staff did not answer her call light (used to request assistance) for 28 minutes. This deficient practice placed R54 at risk to not have care or assistance in a timely manner.

Inspectors wroteThe facility had a census of 59 residents. The sample included 18 residents with two reviewed for pain. Based on observation, interview, and record review the facility failed to provide interventions during wound care to manage Resident (R) 2's distress and pain. This placed the resident at risk for prolonged and unnecessary pain or distress.

Inspectors wroteThe facility had a census of 59 residents. The sample included 18 residents with one reviewed for dialysis (blood purifying treatment given when kidney function is not optimum). Based on observation, interview, and record review the facility failed to obtain communication from the dialysis center regarding Resident (R) 33's health status with each procedure. This deficient practice placed R33 at risk for unmet needs due to lack of information regarding the resident's health status during the dialysis procedures.

Inspectors wroteThe facility had a census of 59 residents. The sample included 18 residents with five reviewed for unnecessary medications. Based on observation, interview, and record review the facility failed to follow up on the Consultant Pharmacist request for an appropriate diagnosis for the use of Seroquel, an antipsychotic (a drug used to treat psychotic disorders) medication for Resident (R) 13. This deficient practice placed R13 at risk for adverse effects related to the use of antipsychotic medication.

Inspectors wroteThe facility had a census of 59 residents. The sample included 18 residents with five reviewed for unnecessary medications. Based on observation, interview, and record review the facility failed to ensure Resident (R) 13 did not receive antipsychotic (a drug used to treat psychotic disorders) medication without an appropriate diagnosis. This deficient practice placed R13 at risk for adverse effects related to the use of antipsychotic medication.

Inspectors wroteThe facility had a census of 59 residents. The sample included 18 residents. Based on observation, interview, and record review the facility failed to provide thorough infection control during a wound dressing change for Resident (R) 21 and failed to update their Infection Control policies annually. This deficient practice placed R21 at increased risk for infection.

Inspectors wroteThe facility had a census of 59 residents. The sample included 18 residents. Based on observation and interview the facility failed to provide sufficient space in one of two dining areas to accommodate residents' needs.

Inspectors wroteThe facility had a census of 59 residents. The sample included 18 residents. Based on observation, interview, and record review, the facility failed to post the actual scheduled working hours for nursing staff directly responsible for resident care per shift.