Chase County Care and Rehab

Inspectors wroteThe facility reported a census of 35 residents. Based on observation, record review, and interview, the facility failed to store and prepare food in one of one kitchen under sanitary conditions. This deficient practice placed the residents of the facility at risk for food borne illnesses.

Inspectors wroteThe facility reported a census of 35 residents. The sample included 13 residents. Based on interviews, record reviews and observation, the facility failed to ensure a safe environment in all areas of the facility including those used by visitors and staff. This deficient practice created a risk for impaired safety and cleanliness.

Inspectors wroteThe facility reported a census of 35 residents; the sample included 13 residents. Based on interviews, record review and observation, the facility failed to ensure a safe, clean home-like environment in the resident's rooms. This deficient practice placed the residents at risk for safety and decreased comfort.

Inspectors wroteThe facility reported a census of 35 residents. There were 13 residents included in the sample. Based on observation, record review and interview, the facility failed to review and revise the care plans for Resident (R) 16 regarding non-pharmacological interventions for pain, placing the resident at risk for unrelieved pain due to uncommunicated care needs.

Inspectors wroteThe facility reported a census of 35 residents. The sample included 13 residents. Based on interviews, record reviews and observation, the facility staff failed to implement adequate and acceptable infection control practices for Resident (R) 38 and R4 with regard to urinary catheter (a tube inserted into the bladder to drain the urine into a collection bag) tubing and drainage bags resting on the floor. The facility failed to ensure staff implemented proper Enhanced Barrier Precautions (EBP-infection control interventions designed to reduce transmission of resistant organisms which employ targeted gown and glove use during high contact care) personal protective equipment (PPE) with cares. This deficient practice placed the resident at risk for infections.

Inspectors wroteThe facility reported a census of 35 residents. Based on observation, record review and interview, the facility failed to display accurate, publicly accessible staffing information that contained the number of actual nursing hours worked on a daily basis, for the 35 residents who resided in the facility.

Inspectors wroteThe facility reported a census of 33 residents with four residents selected for review. Based on interview and record review, the facility failed to conduct reference checks for five of five employees reviewed to ensure no abuse to the residents of the facility.

Inspectors wroteThe facility reported a census of 32 residents. Based on interview and record review, the facility failed to complete an annual performance review at least once every 12 months for five of the five Certified Nurse Aides (CNA) reviewed, CNA M, N, O, P and Q, to ensure adequate appropriate cares and services provided to the residents of the facility.

Inspectors wroteThe facility reported a census of 32 residents. Based on observation, record review and interview, the facility failed to prepare and serve food under sanitary conditions, to the residents of the facility appropriately to prevent the potential for food borne bacteria.

Inspectors wroteThe facility reported a census of 32 residents. Based on observation, interview, and record review, the facility failed to electronically submit to Centers for Medicare and Medicaid Services (CMS) with complete and accurate direct staffing information, based on payroll and other verifiable and auditable data in a uniform format according to specifications established by CMS (i.e. Payroll Base Journal (PBJ), related to licensed nursing staffing information, when the facility failed to accurately report 24 hour per day Licensed Nurse coverage on 24 dates between 01/01/23 and 12/31/23. Findings Included: - Review of the Payroll Base Journal (PBJ) Staffing Data Report for fiscal year (FY), Quarter 1 2023 (October 1-December 31) revealed a lack of License Nurse (LN) for 24 hours/seven days a week 24 hour/day on the following dates: [...]

Inspectors wroteThe facility reported a census of 32 residents. Based on observation, interview and record review, the facility failed to maintain an effective infection control program that would ensure infection surveillance for infections and determine the causative organism when cultured to prevent the spread of infections amongst the residents.

Inspectors wroteThe resident reported a census of 32 residents. Based on observation, interview, and record review, the facility failed to provide a safe, functional, sanitary, and comfortable environment in the kitchen for residents and staff.

Inspectors wroteThe facility reported a census of 32 residents. Based on observation, interview, and record review, the facility failed to maintain a clean, comfortable and homelike environment on one of three resident hallways of the facility.

Inspectors wroteThe facility reported a census of 32 residents with 15 selected for review which included three residents reviewed for transfer to hospital. Based on interview and record review, the facility failed to issue a Bed Hold (a document that indicates a resident's desire to keep their bed available and indicates financial implications if any apply) as required for one Resident (R)13 of the three residents reviewed for transfer to a hospital.

Inspectors wroteThe facility reported a census of 32 residents with 15 residents sampled. Based on interview and record review, the facility failed to accurately complete a Minimum Data Sets (MDS) for two Residents (R)3, regarding documentation for falls and R 33, regarding discharge.

Inspectors wroteThe facility reported a census of 32 residents with 15 residents included in the sample. Based on observation, record review and interview, the facility failed to review and revise the care plans for one sampled Resident (R)3, regarding fall interventions.

Inspectors wroteThe facility reported a census of 32 residents with 15 selected for review. Based on observation, interview and record review, the facility failed to ensure one sampled Resident (R)137 received appropriate treatment to bilateral (both sides) lower extremity cellulitis (skin infection caused by bacteria) and received proper ear care.

Inspectors wroteThe facility reported a census of 32 residents with 15 residents sampled, including five residents reviewed for accidents. Based ON observation, interview, and record review, the facility failed to initiate an appropriate intervention following one non-injury fall for Resident (R)3, to prevent further falls.

Inspectors wroteThe facility reported a census of 32 residents with 15 selected for review, which included six residents reviewed for unnecessary medications. Based on observation, interview and record review, the facility failed to ensure timely follow-up of the pharmacist's recommendations for two of the six sampled Residents (R)7 and R3.

Inspectors wroteThe facility reported a census of 32 residents with a sample of 15 residents, including six residents reviewed for unnecessary medications. Based on observation, interview and record review, the facility failed to prevent two residents from unnecessary medications, including Resident (R)19, regarding giving medication outside of parameters and R 7, regarding the pharmacy consultant's recommendation to acquire labs.

Inspectors wroteThe facility reported a census of 30 residents with eight residents selected for review and one resident reviewed for neglect. Based on observation, interview, and record review, the facility neglected Resident (R)1 when they left him unattended at a clinic during an out of town appointment on 08/29/23. R1 exited the clinic with clinic staff then left the premises around 04:00 PM to 04:30 PM. R1 was later found by facility staff 1.8 miles away from the clinic on 08/29/23 at 06:19 PM.

Inspectors wroteThe facility reported a census of 30 residents. Based on observation, interview, and record review, the facility failed to maintain an effective infection control program with the failure to clean the nebulizer kit (device which changes liquid medication into a mist easily inhaled into the lungs) for Resident (R)3 and R4 after use. These practices increased the risk of R3 and R4 for developing a respiratory infection.

Inspectors wroteThe facility reported a census of 30 residents with eight selected for review including five reviewed for Influenza and Pneumococcal Immunizations. Based on record review and interview, the facility failed to obtain immunization status for Resident (R)1 and failed to provide additional immunization to R5.

Inspectors wroteThe facility reported a census of 25 residents. Based on observation, interview, and record review, the facility failed to store drugs and biologicals in a locked compartment.

Inspectors wroteThe facility reported a census of 25 residents. Based on observation, interview, and record review the facility failed to provide sanitary food preparation and storage for the residents of the facility.

Inspectors wroteThe facility reported a census of 25 residents. Based on observation, interview, and record review the facility failed to provide housekeeping and maintenance services to ensure a safe and sanitary environment for resident and staff in the laundry.

Inspectors wroteThe facility reported a census of 25 residents. Based on observation, interview, and record review, the facility failed to provide housekeeping and maintenance services to maintain a sanitary, orderly, and comfortable interior in the room designated as the beauty shop.

Inspectors wroteThe facility reported a census of 25 residents. Based on observation, interview, and record review, the facility failed to maintain a medication error rate of less than five percent. Observation of 29 physician ordered medications revealed four medications in error, resulting in a medication error rate of 13.79%. These errors affected Resident (R)28, R23, and R130.

Inspectors wroteThe facility reported a census of 25 residents with 14 sampled, which included two residents reviewed for choices. Based on observation, interview, and record review, the facility failed to provide choices for dependent Resident (R)7 related to his preferences for frequency of bath/shower.

Inspectors wroteThe facility reported a census of 25 residents which included 14 residents sampled for review. Based on observation, interview, and record review, the facility failed to complete a significant change Minimum Data Set (MDS) for one selected Resident (R)22 after the resident experienced a change of condition in at least two or more activities of daily living (ADLs) with a significant change in the resident's physical or mental condition, that had an impact on more than one area of the resident's health status

Inspectors wroteThe facility reported a census of 25 residents which included 14 residents sampled for review which included one Resident (R)22 reviewed for Increase/Prevent Decrease in Mobility. Based on observation, interview, and record review, the facility failed to ensure resident (R)22 received needed treatment/care to maintain Range of Motion (ROM) an/or Mobility and/or to prevent further decline in ROM/Mobility.

Inspectors wroteThe facility reported a census of 25 residents. The sample of 14 residents included one resident (R)4 for respiratory care. Based on observation, interview, and record review, the facility failed to provide R 4 needed respiratory care, consistent with professional standards of practice related to nebulizer treatment/care (an electrically powered machine that turns liquid medication into a mist so that it can be breathed directly into the lungs through a face mask or mouthpiece).

Inspectors wroteThe facility reported a census of 25 resident with 14 residents sampled which included five residents sampled for unnecessary medications. Based on observation, interview, and record review, the facility failed to act upon the pharmacist's recommendation in a timely manner to resolve identified irregularities for two residents, Resident (R)4 related to a recommended medication change and gradual dose reduction (GDR) of an antipsychotic medication for R 4 and R 9, related to GDR for psychoactive medications and recommended lab work. Findings Included: - Review of the Resident's (R)4's, Physician Orders, dated 04/13/22, revealed diagnoses which included lewy body dementia (a disease associated with abnormal deposits of a protein in the brain. [...]