Boulder Canyon Health and Rehabilitation

Inspectors wroteBased on observations and interviews, the facility failed to provide a safe, sanitary, functional and comfortable environment for residents, staff and the public in three of four shower rooms. Specifically, the facility failed to ensure shower rooms were maintained in safe, sanitary and working condition.

Inspectors wroteBased on observations and interviews, the facility failed to ensure adequate outside ventilation by means of windows or mechanical ventilation in three out of four shower rooms. Specifically, the facility failed to ensure the ventilation fans in the shower rooms were operational.

Inspectors wroteBased on observations and interviews, the facility failed to provide a safe, clean, sanitary and comfortable environment on the secured unit. Specifically, the facility failed to:-Ensure the blinds in the secured unit's common area and in residents' rooms were in good repair;-Ensure lights in the residents' bathrooms were working properly; -Ensure each resident had hand towels available for use in their bathrooms; and,-Ensure maintenance and patchwork was completed in a timely manner on the secured unit and in residents' rooms.

Inspectors wroteBased on record review and interviews, the facility failed to ensure one (#3) of two residents diagnosed with a mental disorder or psychosocial adjustment difficulty received appropriate treatment and services to attain the highest practicable mental and psychosocial wellbeing out of 43 sample residents. Specifically, the facility failed to ensure Resident #3, who expressed suicidal ideations, was provided psychosocial support.

Inspectors wroteBased on observations, record review and interviews, the facility failed to provide one (#94) resident of five sample residents with a nourishing, palatable and well-balanced diet that meets his or her daily nutritional and special dietary needs, taking into consideration the preferences out of 43 sample residents. Specifically, failed to provide Resident #94 a nourishing, well-balanced diet that met his daily nutritional dietary needs, taking into consideration the resident's vegan preferences.

Inspectors wroteBased on observations and interviews, the facility failed to maintain an effective infection prevention and control program to provide a safe, sanitary, and comfortable environment to prevent the development and transmission of disease, including COVID-19 in one of four shower rooms and one resident room. Specifically, the facility failed to:-Ensure the sharps container in the 600 hallway shower room was not overfilled;-Ensure staff members wore the appropriate personal protective equipment (PPE) when entering Resident #68's room, who was COVID-19 positive; and,-Ensure visitors were encouraged to wear N-95 masks when entering a COVID-19 positive resident room.

Inspectors wroteBased on observations, record review and interviews, the facility failed to maintain an infection control program designed to provide a safe, sanitary and comfortable environment to help prevent the development and transmission of disease. Specifically, the facility failed to: -Follow transmission-based precautions when entering and exiting droplet precaution rooms; and, -Ensure vital signs machines were sanitized between each use to prevent the spread of infection.

Inspectors wroteBased on observations, record review and interviews, the facility failed to ensure one (#9) of three residents received treatment and care in accordance with professional standards of practice out of 12 sample residents. Specifically, the facility failed to: -Ensure the emergency crash cart containing essential resuscitation equipment and a backboard was utilized during a resuscitation attempt for Resident #9; -Ensure a timely call was placed to emergency medical services (EMS) for immediate assistance when Resident #9 experienced a life threatening change of condition; and, -Ensure a licensed nurse remained with Resident #9 until EMS arrived.

Inspectors wroteBased on observations and interviews the facility failed to provide a comfortable and homelike environment for the residents on three of five units in the facility. Specifically, the facility failed to: -Residents were provided with clean washcloths and hand towels in their rooms on the West, Flatiron and North units; and, -Ensure holes in the residents' bathroom doors and ceiling were fixed.

Inspectors wroteBased on interviews, observations and record review, the facility failed to ensure residents who were unable to carry out activities of daily living (ADLs) received the necessary services to maintain personal hygiene for five (#66, #24, #72, #54 and #26) of eight residents reviewed for ADLs out of 38 sample residents. Specifically, the facility failed to: -Ensure Residents #66, #24, #72, #54 and #26, who required assistance with bathing, were showered or bathed according to their preferences in order to maintain personal hygiene; -Provide Resident #24 assistance with shaving; and, -Provide Resident #54 assistance with shaving and nail care.

Inspectors wroteBased on observations, record review and interviews the facility failed to maintain an infection control program designed to provide a safe, sanitary and comfortable environment to help prevent the development and transmission of disease and infection on four of five units. Specifically, the facility failed to: -Wear the appropriate personal protective equipment (PPE) when entering transmission based precaution rooms (entire memory care unit with COVID-19 outbreak); -Follow infection control practices when administering feeding via jejunostomy tube (J-tube); and, -Ensure residents personal hygiene items were labeled.

Inspectors wroteBased on observations, record review and interviews, the facility failed to ensure all drugs and biologicals were properly stored in two of five medication carts. Specifically, the facility failed to ensure expired or discontinued medications were removed from medication carts in a timely manner.

Inspectors wroteBased on observation, record review and interviews, the facility failed to consistently provide activities of daily living (ADL) support for four (#29, #23, #7, and #92) of 10 dependent residents reviewed for ADL care out of 41 sample residents. Specifically, the facility failed to: -Provide or offer showers according to the bathing schedule or provide fingernail cleaning and trimming for dependent and diabetic Residents #29 and #23; and, -Provide timely incontinence care and reposition Residents #7 and #92 who were dependent on staff for all cares.

Inspectors wroteBased on record review, observations and staff interviews, the facility failed to ensure food items were stored and served under sanitary conditions. Specifically, the facility failed to ensure: -The snack/nourishment refrigerators on two of three units were maintained and food items were dated, labeled, and discarded before the expiration date; and, -Opened containers of potentially hazardous foods or leftovers were dated and used within seven days or according to facility policy to prevent potential foodborne illness.

Inspectors wroteBased on record review and interviews, the facility failed to ensure one (#51) of seven residents reviewed of 41 sample residents received treatment and care in accordance with professional standards of practice and the comprehensive person-centered care plan. Specifically, the facility failed to timely schedule a computed tomography (CT) scan for Resident #51 as it was recommended one week after the fall. CT scan was completed a month after a fall revealing a pelvic fracture.

Inspectors wroteBased on record review and interviews, the facility failed to ensure one (#18) of five sample residents reviewed for respiratory services out of 41 sample residents received respiratory care consistent with professional standards of practice, the comprehensive person-centered care plan, and the resident's goals and preferences. Specifically, the facility failed to ensure Resident #18 who had a tracheostomy was routinely assessed by a respiratory therapist (RT).

Inspectors wroteBased on observations and staff interviews, the facility failed to maintain an infection control and prevention program designed to provide a sanitary environment to help prevent the development and transmission of communicable diseases and infections in one out of three units. Specifically, the facility failed to provide wound care and tracheostomy care to Resident #18 in a sanitary manner.

Inspectors wroteBased on observations and interviews, the facility failed to provide sufficient space to accommodate residents during meal times. Specifically, the facility failed to accommodate residents during meals on the memory care unit.