Braxton Healthcare Center

Inspectors wroteBased on observation and staff interview the facility failed to promote a dignified dining experience. These were random opportunities for discovery. Resident identifiers: #1, #3, #6, #8, #9, #14, #20, #24, #26, #38, #61 and #62. Facility Census: #65 Findings Include a) Resident #8 and #62 On 04/21/25 beginning at 11:15 AM during observation of the noon meal in the dining room it was observed that staff were not distributing meals to all residents seated together at an individual table. Resident #8 and #62 were sitting together at a table in the dining room. Resident #62 was served their meal at 11:25 AM. Resident #8 did not received a meal. Staff continued serving meals at various tables throughout the dining room. At 11:50 AM Resident #8 left the dining room. At 11:58 AM it was confirmed with Licensed Practical Nurse #82 that Resident #8 had left without a meal. [...]

Inspectors wroteBased upon record review and staff interview, the facility failed to complete SNF ABN, Form CMS-10055 and send to the resident or resident's representative in a timely manner. This was true for 1 (one) of 3 (three) residents reviewed during the annual survey process. Resident identifier: #20. Facility census:

Inspectors wroteBased upon record review and staff interview, the Facility failed to ensure preadmission screening and resident review (PASARR) was updated and completed with new diagnoses of Dementia (Non-Alzheimer's) and Alzheimer's . This was true for one (1) of five (5) residents reviewed. Resident identifier: #38. Facility censes: 65.

Inspectors wroteBased on record review and staff interview, the facility failed to ensure Residents #24 and #53's care plans included sensory and one (1) on one (1) activities, even though the residents were receiving them. This was true for two (2) of 21 resident care plans reviewed during the survey process. Resident identifiers: #24, #53. Facility census: 65.

Inspectors wroteBased on record review and staff interview, the facility failed to accurately document the completion of behavior monitoring for Resident #18. This was true for one (1) of five (5) residents reviewed for unnecessary medications during the survey process. Resident identifier: 18. Facility census: 65.

Inspectors wroteBased on medical record review and staff interview, the facility failed to provide evidence a resident's representative was provided a written Notice of Transfer/Discharge when a resident was discharged from the facility. This was true for five (5) of five (5) residents reviewed for hospitalizations in the long-term care survey process. Resident identifiers: #1, #39, #48, #23, and #52. Facility census: 54.

Inspectors wroteBased on medical record review and staff interview, the facility failed to provide evidence residents and/or resident representatives were provided written Bed Hold Notice when transferred from the facility to the hospital. Additionally, the facility had no evidence a written notice of bed hold was reviewed with residents / resident representatives upon admission. This was true for five (5) of five (5) residents reviewed for hospitalizations in the long-term care survey process. Resident identifiers: #1, #39, #48, #23, and #52. Facility census: 54. Findings Included: a) Resident #1 A medical record review completed on 07/11/23 at 8:56 AM, identified the following details: -Resident #1 was transferred to the hospital on 4/26/23. -There was no evidence of a written bed hold notice being provided to resident and/or resident's representative. [...]

Inspectors wroteBased on observation and staff interview, the facility failed to ensure medications were stored under proper temperatures, in accordance with current accepted professional practices and manufacturer's instruction for storage. This was true for one (1) of one (1) medication storage rooms inspected. Facility census: 54.

Inspectors wroteBased on observation, record review, and staff interview, the facility failed to establish and maintain an infection prevention and control program designed to help prevent the development and transmission of communicable diseases and infections. The facility did not properly dispose of personal protective equipment (PPE) after use. This deficient had the potential to affect more than a limited number of residents. Additionally, the facility failed to ensure the infection surveillance line listing was accurate and complete for two (2) of three (3) residents reviewed for antibiotics. Resident identifiers: #212 and #24. Facility census: 54.

Inspectors wroteBased on observation and staff interview, the facility failed to preserve the resident's dignity by not changing his clothing when it was soiled with food. Resident Identifier: #19. Facility census: 54.

Inspectors wroteBased on observation and staff interview, the facility failed to provide a safe, clean, comfortable, and homelike environment for one (1) of 18 resident rooms observed during the long-term care survey process. Resident identifier: #39. Facility census: 54.

Inspectors wroteBased on medical record review and staff interview, the facility failed to accurately complete a discharge tracking form for Resident #59, when he was discharged home on [DATE]. Resident identifier: #59. Facility census: 54.

Inspectors wroteBased on record review and staff interview, the facility failed to complete a new Pre-admission Screening (PAS) for one (1) of one (1) residents reviewed for the category of PASARR (Pre-admission Screening Resident Review), during the long-term care survey process. Resident identifier: #16. Facility census 54.

Inspectors wroteBased on record review and staff interview, the facility failed to monitor the resident's pain in accordance with current professional standards of practice. This deficient practice had the potential to affect one (1) of one (1) residents reviewed for the care area of pain. Resident identifier: #27. Facility census: 54.

Inspectors wroteBased on observation, record review and staff interview, the facility failed to ensure menus were developed and prepared to meet resident choices including their nutritional needs and preferences for one (1) of five (5) reviewed under the food care area. Resident #53 did not receive an entree when there was a known dislike to the item on the menu. Resident identifier: #53. Facility census: 54.

Inspectors wroteBased on observation and staff interview, the facility failed to provide food at a safe and appetizing temperature. This had the potential to affect more than a limited number of residents. Resident identifier: #42. Facility census: 54.

Inspectors wroteBased on record review and staff interview, the facility failed to provide COVID-19 immunization booster to a resident who consented to the immunization. This deficient practice had the potential to affect one (1) of five (5) residents reviewed for the care area of immunizations. Resident identifier: #48. Facility census: 54.

Inspectors wroteBased on facility documentation and staff interview, the facility failed to have a certified Infection Preventionist. This failed practice had the potential to affect all residents residing at the facility. Facility census: 58.

Inspectors wroteBased on observations and staff interview, the facility failed to ensure a negative air flow in the laundry to prevent contamination of clean linens. This practice had the potential to affect more than a limited number of residents residing in the facility. Facility census: 58.

Inspectors wroteBased on observation, resident interview, staff interview and facility documentation, the facility failed to remove a sign of personal care from a previous resident's room when discharged and failed to ensure staff were seated when feeding assistance was provided. These were random opportunities for discovery. Resident identifiers: Residents #207 and #15. Facility census: 58.

Inspectors wroteBased on record review and staff interview, the facility failed to ensure one (1) of 25 residents reviewed during the long-term care survey process had a Physician Orders for Scope of Treatment (POST) form completed per directions specified by the [NAME] Virginia Center for End-of-Life Care in conjunction with the [NAME] Virginia Health Care Decisions Act (16-30-1). The POST forms were unsigned by the Resident or Medical Power of Attorney (MPOA). Resident identifier: Resident #24. Facility census: 58. Findings Included: a) Resident #24 Record review on 04/11/22 at 2:16 PM found, a POST Form on Resident #24's chart was unsigned by the Resident or MPOA. The POST form was dated 09/10/18. During an interview on 04/12/22 at 8:53 AM with the Administrator, confirmed Resident #24's POST form was incomplete without a Resident or MPOA signature. .

Inspectors wroteBased on review of facility documentation, and staff interview, the facility failed to ensure all allegations involving abuse, neglect, exploitation, or mistreatment, including injuries of unknown source and misappropriation of resident property, were reported immediately to all officials in accordance with State law and failed to report the results of all investigations in accordance with State law. The facility failed to report the allegation immediately and results of the investigation within five (5) working days to Law Enforcement related to misappropriation of resident medications. This failed practice was identified through a random opportunity for discovery and had the potential to affect more than a limited number of residents in the facility. Employee identifier: LPN #100. Census: 58.

Inspectors wroteBased on staff interview and medical record review, the facility failed to develop comprehensive person-centered care plans to meet the psychosocial needs of the residents. Resident (R) #8 and R #31's care plans lacked measurable goals and non-pharmacological interventions to assist in dealing with anxiety and depression. This is true for two (2) of five (5) residents reviewed for unnecessary medications. Resident identifiers: Residents #8 and #31. Facility census: 58.

Inspectors wroteBased on observation and staff interview, the facility failed to provide assistance with eating for a dependent resident. This was a random opportunity for discovery. Resident identifier: #19. Facility census: 58.

Inspectors wroteBased on observation and staff interview, the facility failed to provide the services, care and equipment to assure a resident's maintains and/or improves to their highest level of range of motion (ROM) and mobility. This was a random opportunity for discovery. Resident identifier: Resident #9. Facility census: 58.