Capitol House Nursing and Rehab Center

Inspectors wroteBased on record review and interviews, the facility failed to ensure each resident's drug regimen was free of unnecessary medications. The facility failed to ensure direct care nursing staff documented monitoring results of psychotropic medications for side effects and effectiveness for 1 (#10) of 6 residents reviewed for unnecessary medications.

Inspectors wroteBased on interviews and record review, the facility failed to develop and implement an individualized, resident-centered Care Plan with interventions which included the appropriate level and number of staff required for safe bed mobility and ADL care performed while in bed for 1 (#101) of 4 residents reviewed for ADLs.

Inspectors wroteBased on observation, interviews, and record review, the facility failed to ensure services provided met professional standards of quality by failing to ensure nursing staff verified, accurately administered, and accurately documented enteral feedings for 1 (#7) of 2 residents reviewed for enteral feeding.

Inspectors wroteBased on interviews and record review, the facility failed to provide each resident with adequate supervision and assistance in order to prevent accidents by failing to ensure each resident was assessed to determine the appropriate level and number of staff required for safe bed mobility and ADL care performed while in their bed for 1 (#101) of 4 residents reviewed for ADLs.

Inspectors wroteBased on observation, interviews, and record review, the facility failed to ensure a resident fed by enteral means received treatment and services to prevent complications by failing to administer enteral feedings as ordered by the physician for 1 (#7) of 2 residents reviewed for enteral feeding.

Inspectors wroteBased on observations, interviews, and record review, the facility failed to ensure drugs used in the facility were stored in accordance with currently accepted professional principles. The facility failed to ensure medication carts were free of expired multi-dose insulin which was available for resident use. This deficient practice was observed on 1 (Cart 1) of 3 medication carts reviewed.

Inspectors wroteBased on record review, observation and interviews, the facility failed to maintain accurate records in accordance with accepted professional standards and practices for 1 (#5) of 3 residents reviewed for Pressure Ulcers. The facility failed to ensure nursing staff accurately documented physician orders and wound care provided for Resident #5's Left Heel Pressure Ulcer.

Inspectors wroteBased on observations and interviews, the facility failed to store and prepare food under sanitary conditions by failing to ensure: 1. Ceiling vents in the kitchen were clean, free of rust and debris; 2. Ceiling tiles (6) in the kitchen and (2) in the adjacent Dining areas were free from water stains. The deficiency had the potential to affect 64 residents who were served meals from the kitchen.

Inspectors wroteBased on record reviews and interviews, the facility failed to notify the State's Long-Term Care Ombudsman of discharges in writing for 1 (Resident #97) of 1 (Resident #97) sampled residents reviewed for transfer and discharge requirements.

Inspectors wroteBased on interviews and record reviews, the facility failed to ensure a resident's discharge assessment was completed and transmitted for 1 (#82) of 2 (#82 and #88) residents reviewed for Resident Assessment.

Inspectors wroteBased on observations, interviews, and record reviews, the facility failed to develop and implement a comprehensive person-centered care plan which met the needs of 2 (#26 and #84) of 24 residents reviewed in the final sample. The facility failed to: 1. Ensure Resident #26 was care planned for his preference of a daily bath; and 2. Ensure Resident #84's soft mitt or splint was in place on right hand at all times This deficient practice had the potential to affect a current census of 97 residents.

Inspectors wroteBased on observations, interviews, and record review, the facility failed to ensure a resident with a Pressure Ulcer and at high risk for Pressure Ulcer development received care consistent with professional standards of practice and based on the comprehensive assessment by failing to ensure an air mattress was properly implemented for 1 (#54) of 3 (#45, #54, #150) residents reviewed with Pressure Ulcers.

Inspectors wroteBased on observation, interviews, and record review the facility failed to administer parenteral fluids consistent with professional standards of practice for 1 of 1 (#300) resident reviewed for IV (Intravenous) therapy. The facility failed to monitor and flush a vascular device according to professional standards. The deficient practice had the potential to affect all residents who may require IV antibiotic or fluid therapy.

Inspectors wroteBased on record review and interviews, the facility failed to maintain accurate records in accordance with accepted professional standards and practices for 1 (#26) of 3 (#10, #19, and #26) residents reviewed for Activities of Daily Living (ADL). The facility failed to ensure nursing staff accurately documented Resident #26's baths.

Inspectors wroteBased on interviews and record reviews, the facility failed to meet Hospice requirements by failing to maintain a system to ensure a hospice resident's Clinical Binder contained documentation of Hospice Nurse Visit notes for 1 (#81) of 1 resident reviewed for hospice care. This deficient practice had the potential to affect any of the residents receiving hospice services in the facility.

Inspectors wroteBased on observation, interviews, and record review, the facility failed to maintain an infection prevention and control program designed to provide a safe and sanitary environment to help prevent the development and transmission of communicable infection by failing to ensure staff performed appropriate infection control practices during and after incontinence care for 1 (#61) of 3 (#19, #37, and #61) residents observed for incontinence care.

Inspectors wroteBased on observations and interviews, the facility failed to ensure maintenance services were provided to maintain a safe, clean, comfortable, and homelike environment for 4 of 4 (#R1, #R2, #R3 and #R4) residents' rooms observed for environmental concerns. The facility failed to ensure A/C (air conditioning) window units were clean, free of debris, and received regular maintenance

Inspectors wroteBased on observation, interviews, and record review, the facility failed to store food in accordance with professional standards for food service safety. This had the potential to affect 78 residents who were served meals from the kitchen.

Inspectors wroteBased on observation, interviews, and record review, the facility failed to ensure each resident was treated with respect and dignity in a manner and in an environment that promotes maintenance or enhancement of his or her quality of life for 1 (#82) of 2 (#59 and #82) sampled residents reviewed for dignity. The facility failed to ensure staff communicated with the resident, and explained the care to be provided.

Inspectors wroteBased on interviews and record review, the facility failed to ensure alleged violations involving neglect were reported immediately to the Administrator and within 24(twenty four) hours after the allegations were made to the state agency for 1of 1 (#70) residents reviewed for neglect.

Inspectors wroteBased on interviews and record reviews, the facility failed to ensure a resident's assessment accurately reflected the discharge status for 1(#97) of 5 (#52, #64, #82, #97 and #450) residents reviewed for hospitalizations.

Inspectors wroteBased on record review and interviews, the facility failed to ensure a resident with an identified mental health diagnosis was referred for a Preadmission Screening Resident Review (PASRR) Level II evaluation as required for 1(#4) of 3(#4, #77, and #90) sampled residents records reviewed for PASRR.

Inspectors wroteBased on observation, record review and interview the provider failed to ensure the care plan was implemented for 1 ( #70) of 4 (#67, #70, #77, and #299) residents sampled for Pressure Ulcers were turned and repositioned every 2 hours per Physician Orders.