Canton Center for Nursing and Healing LLC

Inspectors wroteBased on observation, record review, staff interviews, and review of the facility's policies titled, Refrigeration and Freezers, and Food Receiving and Storage, the facility failed to ensure that food was stored, labeled, dated, and discarded in accordance with professional standards and facility policy. The deficient practice increased the potential for foodborne illness for 89 residents receiving oral diets from the kitchen. Findings Include:Review of the policy titled, Refrigeration and Freezers, dated April 2024 documented, This facility will ensure safe refrigerator and freezer maintenance, temperatures and sanitation and will observe food expiration guidelines. Documented in Guidelines:.2. Monthly tracking sheets for all refrigerators and freezers will be posted to record temperatures.7. All food shall be appropriately dated to ensure proper rotation by expiration dates. [...]

Inspectors wroteBased on observations, record review, staff interviews, and review of the facility's policy titled Controlled Substance Administration & Accountability, the facility failed to implement professionally accepted standards for the dispensing, accountability, and reconciliation of controlled substances for one of four medication carts. Specifically, the Controlled Drug Records were missing signatures following the admis ration of controlled substances and shift to shift reconciliation. The deficient practice could result in inaccurate accountability of controlled substances and increase the risk of diversion or unauthorized use.

Inspectors wroteBased on observations, record review, staff and resident interviews, and review of the facility's policy titled, Resident Nutrition Services, the facility failed to ensure that food was served palatable, appetizing, and at acceptable temperatures for one of 18 sampled resident (R) (R106). The deficient practice had the potential to affect all residents receiving meals from the kitchen.

Inspectors wroteBased on observations, record review, staff interviews, and review of the facility's policy titled, Medication Administration, the facility failed to ensure a complete and accurate Medication Administration Record (MAR) for one of four medication carts. The deficient practice increased the risk for false representation and compromised accountability for the MAR documentation.

Inspectors wroteBased on observations, record review, staff interviews, and the facility's policy titled Handwashing/Hand Hygiene, the facility failed to follow accepted evidence-based standards of practice for infection control procedures for one of five residents (R) (R26). Specifically, the facility failed to perform hand hygiene during wound care. The deficient practice increased the risk of the transmission of pathogens and the development of healthcare-associated infections for R26.

Inspectors wroteBased on record review, resident family and staff interviews, and review of the facility policy titled, Notification, the facility failed to notify the responsible party of a change in medication and to provide a psychiatric evaluation for one of 50 sampled residents (R) (R2).

Inspectors wroteBased on record review and resident family and staff interviews, the facility failed to document behavior monitoring correctly and follow up administration of antidepressant medication for one of 50 sampled Residents (R) (R2) related to the use of antidepressant medication.

Inspectors wroteBased on observations, staff interviews, and review of facility policy, the facility failed to ensure that medications and supplies were not expired in one of one medication rooms and two of six medication carts. The facility also failed to ensure one treatment cart, and two of six medication carts were secured when not being used by staff. The deficient practices increased the risk of residents receiving expired medications and/or access to medications from the medication cart and had the potential to result in residents being subject to unsafe or ineffective treatment or adverse effects leading to serious illness.

Inspectors wroteBased on record review, staff interviews, and review of facility policy, the facility failed to properly document the transfer/discharge for one of three residents (Resident (R) 102) reviewed for discharge from a sample 34 residents. The deficient practice had the potential for the resident and/or resident representative to be uninformed on the transfer and appeal process.

Inspectors wroteBased on staff interviews, record review, and facility policy review, the facility failed to complete a baseline care plan within 48 hours of admission for two of 34 sampled residents (Resident (R) 66 and R99). The deficient practice had the potential to disrupt continuity of care and communication among nursing home staff and the residents.

Inspectors wroteBased on record review, staff interviews, and review of facility policy, the facility failed to ensure that one of three residents (Resident (R) 99) reviewed for dependency on staff for activities of daily living (ADLs) received baths/showers and personal hygiene from a sample of 34 residents. The deficient practice had the potential to promote further deterioration of R99's ADLs and hygiene.

Inspectors wroteBased on observations, staff interviews, record review, and facility policy review, the facility failed to ensure that a resident with a urinary catheter bag was properly positioned in a manner to prevent potential urinary tract infections due to contamination and ensure an order was in place for the use of a catheter for one of two residents (Resident (R) 66) reviewed for urinary catheters and urinary tract infections out of a total sample of 34 residents. The deficient practice had the potential for increased risk of infection and a diminished quality of life for R66.

Inspectors wroteBased on observations, record review, resident and staff interviews, and review of facility policy, the facility failed to ensure that one of six residents (Resident (R) 9) with nutritional problems in a total sample of 34 was offered a substitute meal after refusing the meal on the menu.

Inspectors wroteBased on observations, staff interviews, record review, and review of the facility policies titled, Handwashing/Hand Hygiene, Medication Administration, Glucometer Disinfection, and PPE Source Control, the facility failed to ensure and maintain effective infection control practices for four of 44 sampled residents (R) (R32, R186, R187, and R188). Specifically, the facility failed to properly perform hand hygiene between residents, to properly clean glucometers after each use, by not wearing proper PPE, to properly clean blood pressure cuff in between use on residents, and by not allowing the proper dwell (kill) time when cleaning glucometers in between residents. The deficient practice had the potential to affect all facility residents.

Inspectors wroteBased on observations and staff interviews, the facility failed to provide a safe, clean, comfortable, homelike environment for four of 52 resident rooms (room [ROOM NUMBER], room [ROOM NUMBER], room [ROOM NUMBER], and room [ROOM NUMBER]) on two of four halls (100 Hall and 400 Hall). Specifically, resident rooms contained soiled ceiling return air filter grilles, stained floor tile, and a footboard not secured to a bed. Observation on 1/2/2024 at 1:15 pm and 1/5/2024 at 9:00 am in room [ROOM NUMBER] revealed the bathroom ceiling return air vent was soiled with dust debris and stained floor tile with reddish-brown marks. Observation on 1/2/2024 at 1:26 pm and 1/5/2024 at 9:10 am in room [ROOM NUMBER] revealed the bathroom ceiling return air vent was soiled with dust debris. [...]

Inspectors wroteBased on record review and staff interview, the facility failed to provide the services of a Registered Nurse (RN) for at least eight consecutive hours a day, seven days a week for two days in August 2023, and one day in September 2023.

Inspectors wroteBased on observations, resident and staff interviews, record review and review of facility policy titled Comprehensive Care Plans, the facility failed to ensure that specialty needs related to oxygen (O2) use were on the care plan for one of 44 sampled residents (R) (R30).

Inspectors wroteBased on observations, resident and staff interviews, record review, and review of the facility policy titled, Activities of Daily Living, the facility failed to provide fingernail care to one of 42 sampled residents (R) (R64).

Inspectors wroteBased on observations, staff interviews, record review, and review of the facility policies titled, Oxygen Administration and Medication Administration, the facility failed to provide care and services that met the needs and followed professional standards of practice for three of 44 sampled residents (R) (R29, R181, and R57). Specifically, oxygen (O2) was provided without an order and the proper signage for O2 was not displayed for R29, medications were not provided as prescribed on admission, nor were obtaining orthostatic (while standing) vital signs as ordered for dizziness for R181, and the facility did not ensure that all doses of anticoagulant (anti blood clotting) medication were given as ordered for R57.

Inspectors wroteBased on record review and staff interview, and review of the facility policy titled, Use of Psychotropic Medications, the facility failed to ensure that psychotropic medications were ordered for 14 days as needed (PRN) with the prescribing physician's rationale and a stop date documented for one of 44 sampled residents (R) (R50).