Canyon West of Cascadia

Inspectors wroteBased on observation, interview, and review of the Idaho Food Code, the facility failed to appropriately store, distribute, and label foods. This deficient practice had the potential to affect all residents who received meals prepared in the facility's kitchen. This placed residents at risk for potential contamination and use of spoiled foods, and adverse health outcomes including food-borne illnesses.

Inspectors wroteBased on observation, record review, and staff interview, it was determined the facility failed to ensure nurse staffing information was accurate and posted daily for each shift. This failed practice had the potential to affect all residents residing in the facility and their representatives, visitors, and others who wanted to review the facility's staffing levels.

Inspectors wroteBased on observation, record review, policy review, and resident and staff interview, it was determined the facility failed to ensure residents were assessed for safety to self-administer medication. This was true for 1 of 1 resident (Resident #2) reviewed for self-administration of medication. This failure created the potential for adverse outcomes if Resident #2 self-administered inhaler medication and received too much or too little of the medication.

Inspectors wroteBased on record review, policy review, SOM Appendix PP, and staff interview, it was determined the facility failed to ensure comprehensive centered care plans' interventions were implemented. This was true for 1 of 20 residents (Resident #2) whose care plans were reviewed. This failure created the potential for harm should Resident #2 experience complications and receive inappropriate or inadequate care.

Inspectors wroteBased on review of records, policy review, and staff interviews, it was determined the facility failed to ensure residents' comprehensive care plans were revised timely and as needed. This was true for 2 of 20 residents (#8 and #11) whose care plans were reviewed. This deficient practice created the potential for residents to receive inappropriate or inadequate care due to inaccurate information in their care plans.

Inspectors wroteBased on observation, record review, resident and staff interviews, it was determined the facility failed to ensure physician's orders for bowel care were followed. This was true for 1 of 4 residents (Resident #8) reviewed for bowel care management. This deficient practice created the potential for residents to experience discomfort related to constipation.

Inspectors wroteBased on policy review, observation, record review, and interviews, it was determined the facility failed to provide respiratory services as ordered by the physician. This was true for 2 of 6 Residents (#1 and #20), and providing oxygen without a physician's order for 1 of 6 residents (Resident #89), whose records were review for respiratory services. This failure created the potential for residents to experience increased fatigue and low oxygen levels, or having oxygen provided without physician oversight.

Inspectors wroteBased on record review and staff interviews, it was determined the facility failed to have an RN on duty for at least 8 consecutive hours a day. This created the potential for harm if routine and/or emergency nursing services went unmet and had the potential to affect all residents residing at the facility.

Inspectors wroteBased on observation, record review and staff interview, it was determined the facility failed to ensure medications were stored securely. This was true for 1 of 1 resident (Resident #5) whose medication was observed in the room with no physician orders, and a medication cup with pills observed on the medication cart unattended. This deficient practice created the potential for harm if residents picked up and took medication not prescribed to them.

Inspectors wroteBased on observation, staff interviews and record review, it was determined the facility failed to ensure an Enhance Barrier Precaution was implemented. This was true for 1 of 1 resident (Resident #89) whose medication administration was observed. This deficient practice created the potential for the spread of infection and its associated complications.

Inspectors wroteBased on staff interview and record review, it was determined the facility failed to provide the required Registered Nurse (RN) coverage for two of 92 days (8/18/24 and 8/25/24), reviewed for weekend staffing. This failure placed the residents at risk for inadequate assessments, delay in care and services by an RN, unmet care needs, and diminished quality of life.

Inspectors wroteBased on observation and staff interview, it was determined the facility failed to ensure kitchen equipment was maintained, cleaned, and sanitized. These deficiencies had the potential to affect the 71 residents who consumed food prepared by the facility. This placed residents at risk for potential foodborne illnesses and adverse health outcomes due to contaminated food services equipment.

Inspectors wroteBased on observation, policy review, and staff interview, it was determined the facility failed to ensure infection control practices were consistently implemented as they related to environmental cleaning. Failure to ensure the shower rooms were cleaned and disinfected to maintain a sanitary environment was true for 1 of 3 showers observed. This failure had the potential to impact all residents, staff, and guests in the facility.

Inspectors wroteBased on observation, and resident and staff interview, it was determined the facility failed to protect and promote the rights of residents to be treated with respect and dignity in a manner that promoted enhancement of their quality of life. This was true for 1 of 18 residents (Resident #63). This deficient practice created the potential for psychosocial harm if residents felt they were not treated with dignity and respect.

Inspectors wroteBased on observation, and resident and staff interview, it was determined the facility failed to ensure the residents had a homelike environment. This was true for 4 of 4 residents (#5, #13, #49, #55) observed dining with plastic cutlery. This deficient practice created the potential for psychosocial harm if residents felt isolated when they were not provided the same homelike environment as other residents.

Inspectors wroteBased on record review and staff interview, it was determined the facility failed to ensure a resident was provided quality care when they were not administered their medications as ordered. This was true for 1 of 18 residents (Resident #7) whose bowel records and medication administration records were reviewed. This failure placed Resident #7 at risk for harm if she were to suffer discomfort or complications from constipation, such as bowel obstruction.

Inspectors wroteBased on policy review, record review, staff interview, and review of the State Survey Agency's Long Term Care Reporting Portal, it was determined the facility failed to ensure residents were free from abuse for 4 of 16 residents (#10, #13, #999, and #42) reviewed for abuse. This resulted in the potential for residents to be subjected to ongoing abuse.

Inspectors wroteBased on record review, policy review, and staff interview, it was determined the facility failed to ensure residents' comprehensive MDS assessments were completed prior to the required completion date. This was true for 4 of 16 residents (#3, #6, #41, and #42) whose comprehensive MDS assessments were reviewed. This failure created the potential for harm if the care was not provided due to a delay in completion of the comprehensive MDS assessments.

Inspectors wroteBased on record review, policy review, and staff interview, it was determined the facility failed to ensure residents were provided with baths or showers consistent with their needs. This was true for 4 of 16 residents (#3, #19, #46, and #217) reviewed for activities of daily living. This failure created the potential for residents to experience embarrassment, isolation, decreased sense of self-worth, and/or skin impairment due to lack of personal hygiene.

Inspectors wroteBased on policy review, record review, resident and staff interview, it was determined the facility failed to inform residents, their representatives, and families by 5 PM the next calendar day following the occurrence of an identified COVID-19 infected staff member or cluster of staff who were infected with COVID-19. This was true for 8 of 16 resident (#3, #6, #19, #38, #43, #45, #52 and #55) whose records were reviewed for COVID-19 related notifications. This failure had the potential to deprive residents, their representatives, or families of having the opportunity to choose whether residents remained in the facility and being informed of the extent of COVID-19 cases in the facility.

Inspectors wroteBased on policy review, record review, resident and staff interview, it was determined the facility failed to ensure residents were offered the COVID-19 vaccine and residents' records documented residents and/or their representatives were educated of the risks and benefits of the vaccine. This was true for 2 of 5 residents (#28 and #166) whose records were reviewed for COVID-19 vaccination. The facility failed to document and maintain records that staff were offered the COVID-19 vaccine, educated on the risks and benefits of the vaccine, and their decision to consent to, or refuse the vaccine. This was true for 4 of 5 staff (CNA #1, CNA #2, CNA #3, LPN #1) whose were reviewed for COVID-19 vaccinations. [...]

Inspectors wroteBased on policy review, record review, and staff interview, it was determined the facility failed to ensure one resident with a tracheostomy (an opening in the trachea through the front of the neck below the vocal cords providing an artificial airway to help with breathing when the usual route is blocked or reduced) received tracheostomy care and tracheal suctioning consistent with professional standards of practice. This was true for 1 of 1 residents (Resident #215) reviewed for tracheostomy care and tracheal suctioning. This failure placed Resident #215 at risk for respiratory failure, hypoxia (low oxygen in the blood), life-threatening bronchial spasms (when muscles in the throat contract and narrow the airway), and infection.

Inspectors wroteBased on policy review, record review, and staff interview, it was determined the facility failed to ensure the Infection Preventionist obtained certification in infection control through a nationally recognized Infection Preventionist program. This failure had the potential to impact all 63 residents regarding infection control due to inadequate oversight of infection control practices in the facility consistent with current standards of practice for infection prevention and control.

Inspectors wroteBased on policy review, record review and staff interview, it was determined the facility failed to ensure residents' records documented residents were offered, consented to, and received the pneumococcal vaccine. This was true for 2 of 5 residents (#28 and #166) reviewed for immunizations. This failure placed residents at risk of severe illness or death, should they contract Pneumococcal (bacterial) pneumonia infection.