Chateau St. James Rehab and Retirement

Inspectors wroteBased on observations, interviews, and record reviews, the facility failed to:1. Ensure weighted sandbag (weighted base to prevent something from tipping over) located on a resident's intravenous pole (pole to hold fluids or equipment), and enteral feeding pump (equipment used to deliver liquid nutrition) was maintained in a sanitary manner (Resident #12); and,2. Ensure a resident's wheelchair was maintained in a sanitary manner (Resident #43). This deficient practice was identified for 2 (Resident #12, Resident #43) of 61 sampled resident rooms observed for environmental requirements.

Inspectors wroteBased on interviews and record reviews, the facility failed to ensure staff had ongoing communication and collaboration with the resident's dialysis provider regarding the resident's dialysis care and services for 1 (Resident #7) of 1 sampled resident investigated for dialysis requirements.

Inspectors wroteBased on observations, interviews, and records review, the facility failed to administer a resident's enteral feeding (intake of food through a tube placed in the stomach) as ordered by the physician for 1 (Resident #25) of 1 sampled resident investigated for enteral nutritional requirements.

Inspectors wroteBased on observations, interviews, and record reviews the facility failed to ensure a resident's care plan was revised to reflect a resident's individualized needs following a significant change in condition. This deficient practice was identified for 1 (Resident #2) of 5 (Resident #1, Resident #2, Resident #3, Resident #4, Resident #5) sampled residents reviewed for quality of care.

Inspectors wroteBased on observations, interviews, and record reviews, the facility failed to: 1) obtain settings for Continuous Positive Airway Pressure (CPAP) administration (Resident #1); and, 2) follow a physician's order for oxygen administration (Resident #2). This deficient practice was identified for 2 (Resident #1, Resident #2) of 3 (Resident #1, Resident #2, Resident #5) sampled residents reviewed for respiratory care in a total sample of 5.

Inspectors wroteBased on observations, interviews, and record reviews, the facility failed to: 1. Ensure residents identified as unsafe smokers did not have access to smoking materials while not being supervised (Resident #36); and, 2. Implement new individualized fall prevention interventions and/or increase supervision to prevent future falls for 1 (Resident #1) of 4 (Resident #1, Resident #34, Resident #35, and Resident #56) sampled residents reviewed for falls.

Inspectors wroteBased on interview, observation, and record review, the facility failed to perform proper hand hygiene while preparing coffee for residents.

Inspectors wroteBased on record reviews, and interviews the facility failed to identify and include the infection-causing organism for resident infections into their infection control surveillance for 4 (Resident #38, Resident #41, Resident #66, and Resident #75) of 5 (Resident #30, Resident #38, Resident #41, Resident #66, and Resident #75) sampled resident reviewed for infection surveillance.

Inspectors wroteBased on interviews and record review, the facility failed to publicly post the required contact information for the current State Long-Term Care Ombudsman.

Inspectors wroteBased on observation, record review, and interview, the facility failed to post the results of previous surveys in an area accessible to residents and/or resident's responsible parties.

Inspectors wroteBased on observation and interview, the facility failed to ensure their daily posted nurse staffing information included the required information for 5 of 5 daily nurse staffing information postings revealed for nurse staffing information requirements.

Inspectors wroteBased on observation, record review, and interviews, the facility failed to ensure a resident dependent on staff for activities of daily living (ADL) received nail care. This deficient practice was identified for 1 (Resident #3) of 3 (Resident #1, Resident #2, and Resident #3) sampled residents.

Inspectors wroteBased on record reviews and interviews, the facility failed to ensure the Ombudsman was notified of hospital transfers/discharges by failing to complete and submit the Emergency (ER) Transfer Log to the Ombudsman in a timely manner as required for 2 (Resident #44 and Resident #50) of 3 (Resident #44, Resident #50, and Resident #73) residents reviewed for hospitalizations.

Inspectors wroteBased on record review and interviews, the facility failed to: 1. Administer a resident's insulin per physician's order for 1 (Resident #44) of 5 (Resident #12, Resident #27, Resident #40, Resident #44, and Resident #75) sampled residents reviewed for unnecessary medications, and 2. Coordinate care and communicate changes in a resident's condition for 1 (Resident #140) of the 1 (Resident #140) residents sampled residents reviewed for hospice care services.

Inspectors wroteBased on observations, interviews, and record reviews, the facility failed to ensure: 1. Hot water temperatures were maintained below 120 degrees Fahrenheit for 4 (Room r, Room t, Room u, Room v) of 20 (Room a', Room b, Room c, Room d, Room e, Room f, Room g, Room h, Room i, Room j, Room k, Room l, Room m, Room r, Room s, Room t, Room u, Room v, Room aa, and Room bb) resident rooms observed for hot water temperatures; and 2. Hot water temperatures were maintained below 120 degrees Fahrenheit for 1 (Shower Room p) of 3 (Shower Room n, Shower Room o, and Shower Room p) facility shower rooms observed.

Inspectors wroteBased on observations and interviews the facility failed to ensure: 1. Linen was handled and stored per facility policy; 2. Staff performed hand hygiene during peri-care for 1 (Resident #59) of 4 (Resident #3, Resident #18, Resident #59, and Resident #75) sampled residents observed for peri-care; and 3. Staff performed hand hygiene during medication administration for 1 (S10Agency Licensed Practical Nurse) of 2 (S10Agency Licensed Practical Nurse and S28Licensed Practical Nurse) nurses observed for medication administration.

Inspectors wroteBased on observations and interviews, the facility failed to protect a resident's dignity during personal care for 3 (Resident #18, Resident #59, Resident #75) of 3 (Resident #18, Resident #59, Resident #75) sampled residents investigated for resident privacy.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure a dependent resident was provided with incontinence care for 1 (Resident #18) of 6 (Resident #9, Resident #18, Resident #19, Resident #20, Resident #27, and Resident #140) sampled residents investigated for activities of daily living. Review of Resident #18's Electronic Medical Record (EMR) revealed, in part, Resident #18 had hemiplegia (paralysis to one side of the body) following a cerebral infarction (disruption in blood supply to a part of the brain causing tissue to die) affecting the right dominant side and hemiplegia following cerebral infarction affecting the left non dominant side. [...]

Inspectors wroteBased observation, interview, and record review the facility failed to ensure staff was available at all times to provide care and services to meet the residents' needs for 1 [S23Certfied Nursing Assistant (CNA)] of 4 (S23CNA, S24CNA, S25CNA, and S26CNA) CNAs observed on the night shift from 10:00 p.m. to 6:00 a.m. on 12/12/2023.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure a medication cart was locked when unattended for 1 (Medication Cart w) out of 3 medication carts (Medication Cart w, Medication Cart x, and Medication Cart y) observed.