Bethany Home of Rhode Island

Inspectors wroteBased on record review and staff interview, the facility policy for food brought in from an outside source failed to ensure safe and sanitary storage, handling, and consumption.

Inspectors wroteBased on record review, and resident and staff interview, it has been determined that the facility failed to ensure that self-administration of medications was clinically appropriate for 1 of 1 resident observed with an insulin pump (a computerized device that delivers a continuous dose of insulin to people with diabetes to manage blood sugar levels), Resident ID #9.

Inspectors wroteBased on surveyor observation, record review, and staff interview, it has been determined that the facility failed to ensure that residents receive treatment and care in accordance with professional standards of practice, relative to 1 of 1 resident reviewed for an insulin pump (a computerized device that delivers a continuous dose of insulin to people with diabetes to manage blood sugar levels) utilization, Resident ID #9, 1 of 2 residents reviewed with parameters for medication administration, Resident ID #22, 1 of 1 resident reviewed related to anticonvulsant symptom monitoring, Resident ID #4, and 1 of 2 residents reviewed related to antipsychotic symptom monitoring, Resident ID #16.

Inspectors wroteBased on record review, and resident and staff interview, it has been determined that the facility failed to ensure that licensed nurses have the specific competencies, and skill sets necessary to provide quality care and respond to each resident's individualized needs for 1 of 1 resident reviewed who uses an insulin pump (a computerized device that delivers a continuous and precise dose of insulin to people with diabetes to manage blood sugar levels), Resident ID #9.

Inspectors wroteBased on record review and staff interview, it has been determined that the facility failed to ensure that resident records are complete and accurately documented, relative to blood sugar monitoring for 1 of 1 resident reviewed, Resident ID #9.

Inspectors wroteBased on surveyor observation, record review, and staff interview, it has been determined the facility failed to protect identifying information about complainants or residents that were identified in the survey results binder.

Inspectors wroteBased on record review and staff interview, it has been determined that the facility failed to ensure that each resident receives adequate supervision to prevent an accident while ambulating for 1 of 1 resident reviewed for falls who sustained significant injuries, multiple fractures of his/her vertebral bones of the spine, Resident ID #1.

Inspectors wroteBased on record review and staff interview, it has been determined that the facility failed to provide a written notice of transfer or discharge to the Office of the State Long-Term Care Ombudsman for 2 of 2 residents who were transferred to the hospital, Resident ID #s 16 and 77.

Inspectors wroteBased on surveyor observation, record review, and staff interview, it has been determined that the facility failed to implement and maintain an effective, comprehensive, data-driven, Quality Assurance and Performance Improvement (QAPI) program that focuses on indicators of the outcomes of care and quality of life. Additionally, the facility failed to identify that trauma informed care assessments were not being completed, or that enhanced barrier precautions were not being followed appropriately for resident's with multi drug resistant organisms (MDROs) or indwelling medical devices.

Inspectors wroteBased on surveyor observation, record review, and staff interview, it has been determined that the facility failed to maintain an infection prevention and control program to help prevent the transmission of communicable diseases and infections by failing to place residents on Enhanced Barrier Precautions (EBP; involves using gown and gloves during high-contact resident care activities) for 2 of 2 residents reviewed for a Multi-Drug Resistant Organism (MDRO) infection, Extended Spectrum Beta Lactamase (ESBL-an infection that is resistant to multiple antibiotics) Resident ID #s 17 and 18. Additionally, the facility failed to conduct an annual review of written standards, policies, and procedures and update the infection control program as necessary.

Inspectors wroteBased on surveyor observation, record review, and staff interview it has been determined that the facility failed to respect the residents right of personal privacy for 3 of 3 residents reviewed relative to indwelling medical devices (devices that enter inside the body), Resident ID #s 16, 77 and 179.

Inspectors wroteBased on record review and staff interview, it has been determined that the facility failed to ensure that nursing staff have the appropriate competencies and skill sets to provide nursing and related services to assure resident safety and attain or maintain the highest practicable physical well-being of each resident, as determined by resident assessments and individual plans of care related to Enhanced Barrier Precautions for 7 of 7 nursing staff reviewed.

Inspectors wroteBased on surveyor observation, record review, and staff interview, it has been determined that the facility failed to ensure that residents receive treatment and care in accordance with professional standards of practice relative to physician's orders for 1 of 1 resident reviewed with a physician's order for a lidocaine patch, Resident ID #179.

Inspectors wroteBased on record review and staff interview, it has been determined that the facility failed to ensure that residents who are trauma survivors, receive culturally competent, trauma-informed care in accordance with professional standards of practice and accounting for residents experiences, and preferences, in order to eliminate, or mitigate triggers that may cause re-traumatization of the resident for 1 of 1 resident reviewed with the history of trauma, Resident ID #21.

Inspectors wroteBased on record review and staff interview, it has been determined that the facility failed to ensure a resident's drug regimen is free from significant medication errors for 1 of 1 resident reviewed with a gradual dose reduction recommendation, Resident ID #7.

Inspectors wroteBased on surveyor observation, record review, and staff interview, it has been determined that the facility failed to ensure that food is stored and distributed, in accordance with professional standards for food service safety, relative to the main kitchen.

Inspectors wroteBased on surveyor observation, record review and staff interview, it has been determined that the facility failed to meet professional standards of quality relative to following physician orders for 1 of 3 residents reviewed for wearing [NAME] stockings (stockings that improve blood flow in the legs), Resident ID #22.

Inspectors wroteBased on record review and staff interview, it has been determined that the facility failed to ensure that residents who are trauma survivors, receive culturally competent, trauma-informed care in accordance with professional standards of practice and accounting for residents experiences, and preferences, in order to eliminate, or mitigate triggers that may cause re-traumatization of the resident for 3 of 12 residents reviewed for Trauma Informed Care, Resident ID #'s 3, 15, and 16.

Inspectors wroteBased on record review and staff interview, it has been determined that the facility failed to ensure that a resident's drug regimen is free from unnecessary drugs for 1 of 5 residents reviewed related to pharmacy recommendations, Resident ID #3.