Chariton Specialty Care

Inspectors wroteBased on observations, clinical record review, provider interview and staff interviews, the facility failed to follow physician orders while administering medications through a feeding tube for 1 of 1 residents reviewed for tube feeding (Resident #38). The facility reported a census of 33 residents.

Inspectors wroteBased on clinical record review, observations, facility policy review, resident and staff interviews, the facility failed to ensure staff provided therapy prescribed restorative nursing services to maintain a resident's ability to walk and transfer for 1 of 1 sampled residents (Resident #20). The facility reported a census of 33.

Inspectors wroteBased on observation, food temperatures during food service and resident interview, the facility failed to serve food at an acceptable temperature during one of three meals sampled. The facility reported census was 40.

Inspectors wroteBased on record review, staff interviews, and policy review, the facility failed to develop a personalized Care Plan for 4 of 12 residents (#2, #7, #16, and #24) reviewed for Care Plans. The facility reported a census of 32 residents.

Inspectors wroteBased on observation, staff interview, guidance from the 2022 US Food and Drug Administration (FDA) Food Code, and facility policy review, the facility failed to use proper sanitation and glove use during lunch service. The facility reported a census of 32 residents.

Inspectors wroteBased on clinical record review, staff interview, and instructions of CMS form 10123-NOMNC, the facility failed to appropriately provide a Notice of Medicare Non Coverage (NOMNC) to 2 of 3 (Resident #35 and #36) residents reviewed for Beneficiary Notification. The facility reported a census of 32 residents.

Inspectors wroteBased on clinical record review, staff interview, guidance from the 2024 Resident Assessment Instrument (RAI) Manual, and facility policy review, the facility failed to complete a Significant Change Minimum Data Set (MDS) Assessments following a significant change within federal guidelines for 1 of 5 residents (Res #4) reviewed for significant change. The facility reported a census of 32 residents.

Inspectors wroteBased on observation, resident and staff interviews, and clinical record review, the facility failed to follow the physician's orders for 1 of 12 residents (Resident #7) reviewed. The facility reported a census of 32 residents.

Inspectors wroteBased on observation, facility menu review, and staff interviews, the facility failed to follow the posted menu and serve the appropriate portions for 3 of 3 residents who received pureed diets (Resident #9, #23, #29).

Inspectors wroteBased on observations, resident and staff interviews, clinical record review, and policy review, the facility failed to implement infection control practices to prevent urinary tract infection (UTI) for 2 of 2 residents (Resident #26 and #21) reviewed. The facility reported a census of 32.

Inspectors wroteBased on observation, policy review and staff interview the facility failed to follow practices of safe food handling during 2 of 2 meals observed. The facility reported a census of 71 residents.

Inspectors wroteBased on observations and staff interviews and the facility policy review, the facility failed to maintain a clean, free from possible hazards, and homelike environment. The facility reported a census of 71 residents.

Inspectors wroteBased on clinical record review, policy review, staff and resident interview, the facility failed to ensure one of one allegation of abuse was reported to the appropriate State Agency (SA). Resident #2 reported an allegation that Staff D, Certified Nursing Aide (CNA) was rough with Resident #21 during cares. Staff interviews confirmed the facility Administrator and the Director of Nursing (DON) were notified of Resident #2's allegation involving Staff D, CNA with no evidence the allegation was reported to the SA. Staff D remained actively working with access to all residents. The facility reported a census of 42 residents.

Inspectors wroteBased on clinical record review, policy review, staff and resident interview, the facility failed to prevent further potential abuse by failing to separate the alleged perpetrator from the alleged victim pending an investigation of an abuse allegation. Resident #2 reported an allegation that Staff D, Certified Nursing Aide (CNA) was rough with Resident #21 during cares. Staff interviews confirmed the facility Administrator and the Director of Nursing (DON) were notified of Resident #2's allegation involving Staff D, CNA with no evidence the alleged perpetrator was immediately separated from the alleged victim pending the allegation investigation. Staff D remained actively working with access to all residents. The facility reported a census of 42 residents.

Inspectors wroteBased on observation, record review, staff interview, and policy review, the facility failed to provide the necessary services to maintain personal and oral hygiene for 2 of 12 residents reviewed (#20 & #21). The facility reported a census of 42 residents.

Inspectors wroteBased on clinical record review, physician, family and staff interviews and policy review, the facility failed to provide necessary assessment, treatment, and services to promote healing of skin injuries, prevent infection, and prevent additional skin damage. The facility failed to implement appropriate interventions with follow-up measures for wound care and physician notification. The facility failed to seek a higher level of care to provide treatment for the wounds that failed to heal. Resident #1 obtained a puncture to the left posterior calf identified on 6/1/23, progressed to a large venous ulceration that became infected with bacteria with purulent green drainage and a strong odor and the right lower leg wound became infected with bacteria as well. [...]

Inspectors wroteBased on staff interview, employee record review, and facility internal investigation notes, the facility failed to employ competant nursing staff to care for the residents. The facility reported a census of 42.

Inspectors wroteBased on record review, observations, resident and staff interviews and policy review, the facility failed to provide Activity of Daily Living (ADL) care to 3 out of 3 residents reviewe, (Resident #6, #9 and #10). The facility was not providing oral hygiene for residents. The facility reported a census of 42 residents.