Columbine Care Center

Inspectors wroteBased on observations and interviews, the facility failed to ensure residents were treated with respect and dignity was provided in a manner and in an environment that promoted maintenance or enhancement of his or her quality of life in one of one dining rooms. Specifically, the facility failed to ensure the residents did not have to wait in a long line to place their meal orders prior to entering the dining room and being seated for meals.

Inspectors wroteBased on interviews and record review, the facility failed to ensure one (#59) of three sample residents received notification of changes in eligibility for Medicare or Medicaid covered services, what the resident's financial responsibility may be, and their appeal rights. Specifically, the facility failed to ensure Resident #59 were provided with a Notice of Medicare Non-Coverage (NOMNC) when their skilled nursing benefits ended timely.

Inspectors wroteBased on observations, record review and interviews, the facility failed to store, prepare and serve food in a sanitary manner. Specifically, the facility failed to: -Ensure potentially hazardous foods were monitored, held and cooled at appropriate temperatures; and, -Ensure dish room sanitation was maintained and dish room walls were a smooth cleanable surface.

Inspectors wroteBased on observations and interviews, the facility failed to maintain an infection control program designed to provide a safe, sanitary and comfortable environment to help prevent the development and transmission of diseases. Specifically, the facility failed to: -Ensure the facility had a way to test water for the growth of Legionella by using expired Legionella test kits; -Ensure staff properly disposed of personal protective equipment (PPE) when the facility had an outbreak of COVID-19; and, -Ensure staff properly maintained respiratory supplies by failing to change oxygen cannulas weekly for two residents when the facility had an outbreak of COVID-19. Cross-reference F882 infection preventionist qualifications

Inspectors wroteBased on record review and interview, the facility failed to designate an interim infection preventionist (IP) that completed specialized training in infection prevention and control. Specifically, the full-time IP was on leave from the facility from 9/13/23 to 9/29/23 and 10/4/23 to 10/9/23. On 9/13/23 a resident tested positive for COVID-19, which led to a facility outbreak of COVID-19. From 9/13/23 to 10/2/23, twenty residents tested positive for COVID-19. The interim IP had not completed the education and training requirement prior to assuming the duties of the position.

Inspectors wroteBased on record review and staff interviews, the facility failed to ensure four (#44, #103, #203 and #47) of seven out of 28 sample residents were provided services that meet professional standards of quality. Specifically, the facility failed to: -Clarify physician's orders and obtain dose information prior to administration of topical skin medication for Residents #44, #103 and #203; -Hold Digoxin (to treat heart failure) when Resident #47's heart rate was below 60; and, -Ensure consents and black box warnings were in place for the use of antidepressants before administration for Resident #47.

Inspectors wroteBased on observations, interviews and record review, the facility failed to provide services by qualified persons for one (#105) out of 10 residents reviewed for falls out of 28 sample residents. Specifically, the facility failed to ensure Resident #105 was assessed by a registered nurse (RN) after a fall.

Inspectors wroteBased on observations, record review and interviews, the facility failed to ensure two (#17 and #47) of 10 residents who required respiratory care received the care consistent with professional standards of practice out of 28 sample residents. Specifically, the facility failed to: -Ensure a physician's order was in place for the use of oxygen for Resident #17; and, -Ensure Resident #17 and Resident #47 received oxygen therapy as ordered.

Inspectors wroteBased on observations, record review and staff interviews, the facility failed to ensure the dietary department followed safe practices to prevent the potential contamination of food and the spread of foodborne illness, in one of one kitchens Specifically the facility failed: -To ensure the food was stored and labeled properly, and to discard leftover food after the use by date; -To ensure jewelry was not worn during food serving; -To ensure appropriate hand hygiene by food service staff; and, -To ensure the dishwasher maintained sufficient levels of sanitizing solution.

Inspectors wroteBased on observations and staff interviews, the facility failed to maintain a sanitary, orderly, and comfortable environment for residents in 12 of 22 resident rooms, three of three hallways. Specifically, the facility: -Failed to ensure walls, floors, and walls were repaired, painted and properly maintained and resident rooms were clean; and, -Failed to ensure oxygen concentrators were plugged into electrical outlets instead of a power strip.

Inspectors wroteBased on observations, interviews and record review, the facility failed to ensure drugs and biologicals were labeled and stored in accordance with accepted professional standards, in one of two medication carts. Specifically, the facility: -Failed to discard an expired bottle of nitroglycerin tablets; -Failed to date a Novolog flex pen when opened; and, -Failed to date a Breo inhaler when opened.

Inspectors wroteBased on record review and interviews, the facility failed to develop and implement a COVID-19 staff vaccination process to address all facility staff, including unvaccinated staff who provided care, treatment and other services to the facility and/or residents. Specifically, the facility failed to have a process for tracking and securely documenting the COVID-19 vaccination status of all staff and agency staff.

Inspectors wroteBased on observations, record review and staff interviews, the facility failed to provide an ongoing program to support residents in their choice of activities, designed to meet the interests of and support the physical, mental, and psychosocial well-being of each resident, encouraging both independence and interaction in the community for one (#34) of two residents reviewed for activities out of 17 sample residents. Specifically, the facility failed to ensure Resident #34 was invited and encouraged to attend activities of her preference.

Inspectors wroteBased on observations, record review and interviews, the facility failed to ensure one (#35) of five residents reviewed for quality of care out of 17 sample residents received the highest practicable treatment and care in accordance with professional standards of practice and the comprehensive person-centered care plan. Specifically, the facility failed to ensure ted hose (stockings to help prevent blood clots) were placed on Resident #35 in the morning and taken off in the evening as prescribed by the provider.

Inspectors wroteBased on observations, record review and interviews, the facility failed to ensure residents who needed respiratory care were provided such care, consistent with professional standards of practice for one (#15) of three residents reviewed for the use of supplemental oxygen of 17 sample residents. Specifically, the facility failed to ensure oxygen was administered according to physician orders for Resident #15.

Inspectors wroteBased on record review and interviews, the facility failed to ensure a proper pneumococcal immunization program for two (#30 and #39) of five residents reviewed for pneumococcal vaccine administration out of 17 sample residents. Specifically, the facility failed to offer and provide the pneumococcal vaccine to Resident #30 and Resident #39.