Crestpark Helena, LLC

Inspectors wroteNumber of residents sampled: Number of residents cited: Based on observation, interview and facility policy review, it was determined that the facility failed to provide and maintain a safe and sanitary environment to help prevent the development and transmission of communicable disease and infections for three of three meal services observed.

Inspectors wroteNumber of residents sampled: Number of residents cited: Based on record review and interview, it was determined that the facility failed to monitor the continued need for an as needed (PRN) medication order for psychotropic drugs after 14 days, per the regulation, for one (Resident #9) of one resident reviewed for unnecessary drug administration.

Inspectors wroteBased on observations, interviews and record reviews, it was determined the facility failed to ensure maintenance services were provided for a safe, clean, comfortable and homelike environment, to maintain the quality of life for the residents by reviewing the water temperature for one of three bathroom sinks tested.

Inspectors wroteNumber of residents sampled: Number of residents cited: Based on observation and interviews, the facility failed to ensure that daily staffing was posted in a prominent place readily accessible to residents, staff, and visitors.

Inspectors wroteNumber of residents sampled: Number of residents cited: Based on record review, interview and facility policy review, it was determined the facility failed to ensure Minimum Data Set (MDS) information was transmitted electronically within 14 days after completion of the assessment for two (Residents #16 and #30) of two resident assessments reviewed.

Inspectors wroteBased on observation and interview, the facility failed to ensure dietary staff performed hand hygiene during the preparation of a meal and during the meal service, and failed to ensure food was properly stored and labeled after it was opened in 1 of 1 kitchen (Census 36). This had the potential to affect 33 residents who received meals from the kitchen.

Inspectors wroteBased on record review, interview, and observations, the facility failed to ensure the bedside commode in a resident ' s room was emptied in a timely manner for 1 (Resident #187) of 1 resident with a bedside commode and failed to ensure care plan interventions were followed regarding seizure precautions by installing padded bedrails for 1 (Resident #1) of 1 sample mix resident.

Inspectors wroteBased on observation, record review, and interview, the facility failed to ensure the medication error rate was less than 5 percent (%) during the medication administration observation of 3 (Residents #10, #27 and #32) of 5 (Residents #7, #8, #27, #29 and #32) residents who received medications from 3 Licensed Practical Nurses (LPNs).

Inspectors wroteBased on observation, record review, and interview, the facility failed to ensure the facility remained free of a significant medication error for 1 (Resident #10) of 5 (Residents #7, #8, #10, #27 and #32) residents observed during the medication administration observation.

Inspectors wroteBased on observations and interviews, the facility failed (1) to ensure the ceiling was in good repair in 1 (Resident #9) resident's room, (2) to ensure the two sofas and a chair in the dayroom were in good repair, free of tears, cracks, and holes, and (3) to ensure the tables, benches, and seating on the patio were in good repair without holes, tears and cracks in the seats.

Inspectors wroteBased on observation, record review, and interview, the facility failed to ensure a comprehensive assessment was completed to provide the resident with the proper type of call light to accommodate the physical limitations of 1 (Resident #1) of 1 sampled resident. This failed practice had the potential to negatively impact resident care and safety due to the inability of the resident to alert staff.

Inspectors wroteBased on observations and interviews, the facility failed to ensure the container used to store controlled substances was permanently affixed in Medication room [ROOM NUMBER].

Inspectors wroteBased on observation, and interview, the facility failed to ensure the heating system was in good working order for 1 (room [ROOM NUMBER]) failed to ensure a clean, sanitary homelike environment for 5 (Rooms 105,108, 109, 110 and 116) of 15 (Rooms 101, 103, 105, 108, 109, 110, 112, 113, 114, 115, 116, 126, 201, 214 and 217) resident rooms and bathrooms observed.

Inspectors wroteBased on interview, and record review, the facility failed to develop and implement a Quality Assurance Performance Improvement (QAPI) Plan to include identification of problems, implementation of corrective actions, documentation, review, and analyze and tracking of the data.

Inspectors wroteBased on observation, and interview, the facility failed to ensure resident personal care equipment was properly cleaned and stored to prevent potential cross-contamination between residents. The failed practice had the potential to affect all 35 residents who resided in the facility as documented on the Room-Bed List provided by the Administrator on 04/11/23 at 12:00 PM.

Inspectors wroteBased on observation, and interview, the facility failed to ensure personal hygiene items were stored in a sanitary manner for 4 (Rooms #108, #109, #112 and #113) of 14 (Rooms #101, #103, #105, #108, #109, #110, #112, #113, #114, #115, #116, #201, #214 and #217) resident bathrooms observed.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure a resident's urinary catheter drainage bag was kept in a privacy bag to promote dignity for 1 (Resident #11) of 5 (Residents #1, #11, #13, #15 and #28) sampled residents who had catheters as documented on the Matrix provided by the Administrator on 04/11/2023.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure resident's right to self-determination, as evidenced by the lack of accommodation of a resident's choice to be escorted out of the facility to watch the cats for 1 (Resident #14) of 40 (Residents #1, #2, #3, #4, #5, #6, #7, #8, #9, #10, #11, #12, #13, #14, #15, #16, #17, #18, #19, #20, #21, #22, #23, #24, #25, #26, #27, #28, #29, #30, #31, #32, #33, #34, #35, #36, #37, #38, #39 and #40) residents that relied on the facility to maintain the highest practicable level of autonomy.

Inspectors wroteBased on observation, and interview, the facility failed to ensure medical devices were plugged into a properly grounded electrical outlet and not into a power strip for 1 (Resident #15) of 15 (Residents #1, #6, #9, #11, #12, #13, #15, #21, #22, #28, #30, #31, #35, #36 and #38) sampled residents utilizing pressure relief air mattresses; and failed to maintain an environment free from hazards, as evidenced by a cable cord lying on the floor, running from one resident room, through the bathroom, into the adjoining room for 2 (rooms [ROOM NUMBERS]) rooms of 15 (room [ROOM NUMBER], 103, 105, 10, 109, 110, 112, 113, 114, 115, 116, 126, 201, 214 and 217) resident rooms and bathrooms observed.

Inspectors wroteBased on observation, and interview, the facility failed to adequately maintain and repair the resident call light system to ensure there was a functioning communication system between the residents and nursing staff for 1 (Resident #19) of 1 sampled resident during the survey.