Belaire Health Care Center

Inspectors wroteBased on record review, facility activity calendar, and resident and staff interviews, the facility failed to ensure group activities were planned for outside of the facility to meet the needs of residents who expressed that it was important to them to attend group activities outside of the facility for 4 of 4 residents reviewed for activities (Resident #31, #44, #78, and #80). During interview, Resident #44 cried when speaking about his inability to enjoy his retirement because he was not able to do things outside such as eating at a restaurant, going to a baseball game, going out to see Christmas lights, socializing, going into a store and being able to touch items and shop for himself. [...]

Inspectors wroteBased on observations, record reviews, and resident and staff interviews, the facility failed to provide incontinence care when a resident requested (Resident #44). The facility also failed to provide a privacy cover for urinary drainage bag which allowed the urinary drainage bag contents to be visible (Resident #31). This deficient practice was for 2 of 6 residents reviewed for dignity (Residents #44 and Resident #31).1. Resident #44 was admitted on [DATE] with diagnoses which included cerebrovascular accident (stroke), hypertension (high blood pressure), unspecified mood disorder, recurrent major depressive disorder. [...]

Inspectors wroteBased on record reviews, and Hospital Case Manager, Emergency Medical Services (EMS) Transporter, and staff interviews, the facility failed to allow a resident to return to the first available bed at the facility after being sent to the hospital for a medical and psychiatric evaluation. The resident remained in the hospital for over two weeks despite being cleared to return to the nursing home on the same day. This deficient practice was evidenced for 1 of 3 residents reviewed for transfer and discharge (Resident #92).

Inspectors wroteBased on record review and staff interviews, the facility failed to ensure a Preadmission Screening and Resident Review (PASRR) Level II was completed for two residents with new mental health diagnoses for 2 of 3 residents (Resident #37 and #6) reviewed for PASRR.

Inspectors wroteBased on observations, record review, and staff interviews, the facility failed to post cautionary signage outside of resident room that indicated the use of oxygen for 1 of 8 residents reviewed for respiratory care (Resident #95).

Inspectors wroteBased on record review, and staff, Resident Representative, and Home Health Nurse interviews, the facility failed to include discharge instructions for a daily surgical wound dressing change for 1 of 3 sampled residents with wound care (Resident #1).

Inspectors wroteBased on record review, and staff, and orthopedic office Practice Manager interviews, the facility failed to provide care for a surgical wound as ordered by the consultant orthopedic physician for a daily surgical dressing for 1 of 3 sampled residents with wound care (Resident #1).

Inspectors wroteBased on record reviews and staff interviews the facility failed to ensure a Preadmission Screening and Resident Review (PASRR) application was completed for a resident admitted with mental health diagnoses for 2 of 2 residents (Resident #12 and #55) reviewed for PASRR.

Inspectors wroteBased on record review, family, staff, Nurse Practitioner (NP), Physician's Assistant (PA), and physician (MD) interviews, the facility failed to communicate with Resident #1's Medical Provider about intermittent loose stools following an order for polyethylene glycol (a medication used to treat occasional constipation and soften stool) with a history of Clostridium difficile (a bacterial infection in the colon which have symptoms that range from diarrhea to life-threatening damage to the colon), also known as C-difficile. The facility failed to notify the medical provider of an abnormal stool culture for a resident with C-difficile. [...]

Inspectors wroteBased on record review and family, staff, Nurse Practitioner (NP), Physician Assistant (PA), and physician (MD) interviews, the facility failed to complete comprehensive assessments and determine the need for medical interventions for a resident who continued to experience loose stools post antibiotic treatment for Clostridium Difficile (C-Difficile) which ended on 10/24/23. (C-difficile is a bacterium that causes an infection of the colon. Symptoms can range from diarrhea to life-threatening damage to the colon.). The afternoon of 11/07/23 the resident had a significant change in condition including increased lethargy and confusion, low blood pressure, spitting out her pills and hollering out. There was no comprehensive assessment completed to determine if there was the need to seek medical attention. [...]

Inspectors wroteBased on observation, record review, resident and staff interviews the facility failed to maintain the dignity of residents by failing to provide enough size 3X briefs for 4 of 4 residents that wore 3X briefs (Residents #8, #55, #40, and #28). This resulted in residents experiencing fear of embarrassment, physical discomfort, not participating in activities, feeling upset, bothered, and crying. This practice affected all residents that wore size 3X briefs.

Inspectors wroteBased on observation, record review, resident and staff interviews the facility failed to order and provide enough size 3X briefs for 4 of 4 residents that wore 3X briefs (Residents #8, #55, #40, and #28). The residents reported the facility was often out of 3X briefs and the 2X briefs were too small, hurt my stomach, uncomfortable, too tight, rubbed and sometimes made my skin soreand they leaked. Resident #55 was observed wearing a 2X brief that fit tightly around her waist and there was a reddened area where the brief was fastened. This practice affected all residents that wore size 3X briefs.

Inspectors wroteBased on record review, observations and staff interviews, the facility failed to accurately enter the code status as full code in the Care Plan for 1 of 3 sampled residents (Resident #35) and the facility failed to revise the Care Plan for 1 of 1 sampled resident to include fluid restrictions and non-compliance with fluid restrictions (Resident #64).

Inspectors wroteBased on observation, record review and staff interviews, the facility failed to provide correct portions of pureed foods per the menu for 2 of 3 residents with a diet order for pureed foods (Resident #42 and #27). This failure had the potential to affect residents receiving pureed food.

Inspectors wroteBased on observation, record review, and interviews with resident and staff, the facility failed to maintain wheelchair armrests in good repair for 2 of 5 residents reviewed for mobility device (Resident #177 and #180).

Inspectors wroteBased on observations, record review, and staff interviews the facility failed to remove 1 blister card of discontinued and expired promethazine, medication used for nausea and vomiting, for 1 of 5 medication carts (North medication cart #1) and 1 bottle of expired cranberry juice extract from 1 of 2 medication storage rooms (North medication storage room).

Inspectors wroteBased on observations, staff interviews and record review, the facility failed to provide 2 of 2 sampled residents with double portions per their preference (Residents #1 and #7).