Bella Terra Lagrange

Inspectors wroteBased on observation, interview, and record review, the facility failed to follow their infection control policies and practices when staff failed to wear personal protective equipment and perform hand washing when entering and exiting a resident room and failed to ensure the posting of correct isolation procedure instruction. This affected one of three residents reviewed (R4) for infection control. This has potential to affect all 27 residents residing on the first-floor unit.

Inspectors wroteBased on interview and record review, the facility failed to offer staff the Covid-19 immunization vaccine and have written documentation of it. This applies to all 97 residents in the facility reviewed for immunizations in the sample of 24.

Inspectors wroteBased on interview and record review, the facility failed to provide to a resident and/or their representative in writing for the reason of transfers to the hospital, and failed to notify the ombudsman of the transfers. This applies to 4 of 4 residents (R4, R46, R70, and R75) reviewed for discharge in a sample of 24.

Inspectors wroteBased on interview and record review, the facility failed to conduct required care plan meetings and invite residents to participate in their care plan meetings. This applies to 4 of 4 residents (R20, R32, R69 and R79) reviewed for care planning in a sample of 24.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure a resident's IV (intravenous) antibiotic therapy bag was labeled. This applies to 1 of 1 resident (R81) reviewed for IV's in sample of 24.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure medications are labeled and stored securely. This applies to 8 of 8 residents (R5, R8, R19, R35, R81, R101, R102 and R247) reviewed for medication storage in a sample of 24. 1. On 03/27/25 at 12:51 PM, a first-floor medication cart was reviewed with V10 LPN (Licensed Practical Nurse). The hydrocodone- acetaminophen 5/325 mg (Milligram) medication card for R101 had one tablet blister that had been taped closed. The medication card had a count of 30 tablets. R101's current physician orders include hydrocodone- acetaminophen 5/325 mg one tablet every four hours as needed for pain. V10 LPN stated once the blister is opened it should be wasted not taped back, but she was not sure why it should not be taped. [...]

Inspectors wroteBased on observations, interviews, and record reviews, the facility failed to implement infection control measures while providing resident care and with the handling of soiled linen. This applies to 6 out of 7 residents (R3, R6, R47, R77, R15, R72) reviewed for infection control in a sample of 24.

Inspectors wroteBased on observations, interviews and record reviews, the facility failed to ensure residents were treated with dignity while providing care. This applies to 2 of 2 residents (R3 and R47) reviewed for dignity in a sample of 24.

Inspectors wroteBased on interview and record review, the facility failed to provide the resident and/or their representative of the facility bed hold policy in writing. This applies to 1 of 1 resident (R75) reviewed for discharge in a sample of 24.

Inspectors wroteBased on observation, interview and record review the facility failed to provide ADL (Activities of Daily Living) assistance for residents who require assistance to maintain their cleanliness and comfort. This applies to 3 of 5 residents (R14, R46 and R395) reviewed for ADLs in a sample of 24.

Inspectors wroteBased on interview and record review, the facility failed to follow physician's orders and subsequently a colonoscopy had to be rescheduled. This applies to 1 of 3 residents (R23) reviewed for following physician's orders for outpatient procedures.

Inspectors wroteBased on interview and record review, the facility failed to send a resident to the hospital emergency department via 911 after a change in condition. This applies to 1 of 3 residents (R1) reviewed for change in condition in the sample of 6.

Inspectors wroteBased on observation, interview and record review the facility failed to ensure a resident was free from sexual abuse. This applies to 1 of 3 residents (R1) reviewed for sexual abuse in the sample of 4.

Inspectors wroteBased on interview and record review the facility failed to follow their abuse policy by completing background checks on 1 of 3 new hires, (V3), reviewed for background checks. This applies to all residents residing in the facility.

Inspectors wroteBased on observation, interview and record review, the facility failed to maintain resident room air temperatures at a comfortable temperature. This applies to 9 of 9 residents (R1-R8 and R11) reviewed for homelike environment in a sample of 11.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure residents' call lights were within their reach for 2 of 4 residents (R3 and R4) reviewed for call lights in the sample of 4.

Inspectors wroteBased on observation, interview, and record review, the facility failed to provide personal privacy during provisions of Activities of Daily (ADL) care. This applies to 4 of 6 residents (R40, R11, R22, and R7) reviewed for privacy in the sample of 20.

Inspectors wroteBased on observation, interview, and record review, the facility failed to assist residents identified as needing assistance with personal hygiene and oral care. This applies to 4 of 10 residents (R7, R14, R16, R17) reviewed for ADL (Activities of Daily Living) care in the sample of 20.

Inspectors wroteBased on observation, interview, and record review, the facility failed to follow their policy for Enhanced Barrier Precautions. The facility also failed to follow their policy for hand hygiene and glove use during provisions of care. This applies to 6 of 20 residents (R7, R17, R22, R44, R58, and R80) in the sample of 20.

Inspectors wroteBased on interview and record review, the facility failed to ensure residents were offered pneumococcal vaccination in accordance with their policy and CDC (Center for Disease Control) guidelines. This applies to 5 of 9 residents (R7, R26, R29, R32, and R46) reviewed for immunizations in the sample of 20.

Inspectors wroteBased on observation, interview, and record review, the facility also failed to ensure medication was not left at a resident's bedside for self-administration without a self-administration assessment and a physician's order. This applies to 1 of 20 residents (R2) reviewed for quality of care in the sample of 20.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure that one resident's ace wraps to his legs were applied according to doctor's order. This applies to 1 of 20 residents (R24) reviewed for quality of care in the sample of 20.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure the indwelling urinary catheter tube was secured to the resident to prevent potential tugging or pulling. This applies to 3 of 4 residents (R7, R22, and R57) reviewed for urinary catheter care in the sample of 20.

Inspectors wroteBased on observation, interview, and record review, the facility failed to check placement and flush a gastrostomy tube prior to enteral feeding, and to position a resident in fowler's position during enteral feeding. This applies to 2 of 5 residents (R80 and R58) reviewed for tube feeding in the sample of 20.

Inspectors wroteBased on observation, interview, and record review, the facility failed to administer medications as ordered. There were 25 opportunities and 2 errors, resulting in an 8% medication error rate. This applies to 1 of 5 (R30) residents reviewed for medication administration in the sample of 20.