Buchanan Healthcare Center

Inspectors wroteBased on observations, interviews, record review, and review of the policy titled, Safe Food Handling, and Frozen Food Storage and Disposal Policy, the facility failed to ensure that potentially hazardous foods were discarded after their expiration dates and properly labeled in three of seven refrigerators and freezers. This deficient practice had the potential to adversely affect 43 residents who received meals from the kitchen.

Inspectors wroteBased on observations, staff interviews, record review, and review of the facility policy titled, Laundry Services Policy, the facility failed to ensure staff followed approved Infection Control procedures while handling soiled linen in one of one laundry areas. The deficient practice increased the risk of cross contamination and spread of infection among residents and staff.

Inspectors wroteBased on observations, staff interviews, record review, and review of facility policy, Call Light Access Policy, the facility failed to ensure that the call light is placed within the immediate reach for one of 14 sampled residents (R) (R8). The deficient practice had the potential to cause a negative physical, verbal, or psychosocial outcome for R8.

Inspectors wroteBased on observations, staff interviews, and review of the facility policy titled, Wheelchair Cleaning and Maintenance Policy, the facility failed to ensure one resident's (R) (R18) wheelchair was maintained in a sanitary manner from 32 wheelchairs actively used by residents.

Inspectors wroteBased on record review and staff interview, the facility failed to complete a Significant Change Assessment for two of eight residents (R) (R5 and R29) receiving hospice services after electing hospice services. The sample size was 21 residents.

Inspectors wroteBased on observations, staff interviews, record review, and review of the facility policies titled, Administering Medications through an Enteral Tube and 'facility name' Healthcare Policy, the facility failed to ensure that one of one resident (R) (R29) sampled received adequate hydration via the gastrostomy tube (G-tube-feeding tube).

Inspectors wroteBased on staff and family interviews, and review of facility documents titled, Facility Assessment Tool 2024 and the PBJ (payroll-based journal) Staffing Data Report Quarter 1 2024 (October 1, 2023, through December 31, 2023), the facility failed to ensure that the facility had adequate nursing staff. The deficient practice had the potential to affect the care provided to the 49 residents that resided in the facility.

Inspectors wroteBased on observations and resident and staff interviews, the facility failed to serve meals that were palatable and attractive for one of 48 residents (R) (R248) who receive a regular diet from the kitchen. The facility census was 49 residents.

Inspectors wroteBased on observations, staff interviews, record review, and review of the facility policy titled, Safe Food Handling, the facility failed to store, prepare, distribute and serve food in accordance with professional standards for food service safety. Specifically, kitchen shelves were not clean and sanitary; kitchen staff failed to discard food in the reach-in refrigerators and freezer by the use by date to include leftovers; kitchen staff failed to label/date opened food items in the reach-in refrigerator/freezer and dry storage area; kitchen staff failed to discard rotting vegetables in the dry storage area; dishwasher water was not reaching required temperatures; and kitchen staff failed to use a recipe when preparing pureed foods. The deficient practices had the potential to affect 48 of 49 residents receiving an oral diet.

Inspectors wroteBased on observations and staff interviews, the facility failed to ensure the dumpster area was properly maintained and free from debris. The deficient practice had the potential to attract pests and transfer microorganisms.

Inspectors wroteBased on observations, staff interviews, and record review, the facility failed to maintain effective pest control in the kitchen and in one of two food pantries. The deficient practice had the potential to affect all 48 residents receiving oral feedings. The facility census was 49 residents.

Inspectors wroteBased on observations, staff interview, and record review, the facility failed to provide a safe, clean, comfortable, homelike environment in 20 of 20 resident rooms on the East and [NAME] halls. Specifically, door frames were chipped and scuffed, one with rusted metal sticking out, and the doors had holes and peeling paint with chipped, rough wood exposed. Loose vinyl baseboards were also observed in several rooms.

Inspectors wroteObservation on 4/2/2024 at 12:50 pm, the hot water in the sink located in R298's bedroom, room [ROOM NUMBER], was observed to be very hot to the touch. Based on observations, staff interview, and record review, the facility failed to keep the residents free of accident hazards as evidenced by water temperatures below 110 degrees Fahrenheit (F) in 10 of 20 resident rooms on two of two halls, and one doorway with a rusted piece of metal sticking out from the bottom of the door. The deficient practices had the potential to cause injury to residents residing in these rooms.

Inspectors wroteBased on record review and staff interviews, the facility failed to ensure level II (two) Preadmission Screening and Resident Reviews (PASRR) were completed for two of 18 (R) (R31 and R19) sampled residents. The deficient practice had the potential for R31 and R19 not to receive needed services.

Inspectors wroteBased on record review and staff interviews, the facility failed to develop a care plan for one of 18 sampled residents (R) (R43) related to wound care and failed to follow a care plan for one of 18 sampled residents (R) (R18) related to oxygen (O2) therapy. The deficient practice had the potential to cause R43 and R18 to not receive treatment and/or care according to their needs.

Inspectors wroteBased on observations, staff interviews, record review, and review of the facility policy titled, Wound Treatment Management, the facility failed to follow the doctor's order for one of 18 sampled residents (R) (R 43) reviewed for pressure ulcers. Specifically, the facility failed to consistently apply boots to the heels of R43 to relieve pressure to a stage four and deep tissue pressure ulcer.

Inspectors wroteBased on observations, staff interviews, record review, and a review of the facility policy titled, Physicians/Practitioner Orders, the facility failed to provide necessary respiratory care consistent with professional standards of practice for one of six residents (R) (R18) receiving oxygen therapy. Specifically, oxygen (O2) saturations were not checked as ordered by the physician to determine if PRN (as needed) O2 therapy was indicated. In addition, the facility failed to properly store O2 tubing while not in use. The deficient practice had the potential to cause respiratory distress and respiratory infection.

Inspectors wroteBased on observations, staff interviews, and record review, the facility failed to ensure accurate assessment for the use of bed side rails for one of 18 sampled residents (R) (R42).