Crowne Health Care of Mobile

Inspectors wroteBased on observations, record review and interviews, the facility failed to ensure Employee Identifier (EI) #5, the treatment nurse, did not date and initial Resident Identifier (RI) #67's dressings after the dressings had been placed over the resident's wounds during the wound care observation on 09/18/19. This affected RI #67, one of one residents observed for wound care. Findings Include: RI #67 was admitted to the facility on [DATE] and readmitted on [DATE], with the diagnosis of Pressure Ulcers. On 09/18/19 at 11:11 a.m., the surveyor observed EI #5 provide wound care for RI #67. EI #5 removed the dressings from RI #67's left ischial and sacrum areas, provided wound care to both wounds, covered the wounds with border foam dressings, then wrote the date and initialed the dressings with a black marker. [...]

Inspectors wroteBased on interviews, record review, a facility policy titled, Grievances/Concerns and review of Resident Identifier (RI) #644's RESIDENT /SPONSOR CARE PLAN INPUT SHEET, the facility failed to promptly ensure a Grievance/Concern Report was initiated when RI #644's sponsor brought a concern/grievance to the facility on [DATE]. This affected RI #644, one of two residents sampled for grievances. Findings Include: RI #644 was admitted to the facility on [DATE]. Review of a facility policy titled, Grievances/Concerns with a revised date of 11/16, revealed the following: . POLICY: . The Facility will promptly investigate grievances/concerns . in an effort to seek a resolution . PROCEDURES: . 2. The Facility's Social Services Director will serve as the designated Grievance Official with the responsibility for overseeing the grievance process; [...]

Inspectors wroteBased on observation, record review and interviews, the facility failed to ensure Employee Identifier (EI) #5, the treatment nurse, cleaned/sanitized a pair of scissors after removing the scissors from the pocket of her uniform, and before using the scissors to cut a Kling wrap that was on the inside of Resident Identifier (RI) #67's sacral pressure ulcer during the wound care observation on 09/18/19. This affected RI #67, one of one residents observed for wound care. Findings Include: RI #67 was admitted to the facility on [DATE] and readmitted on [DATE], with the diagnosis of Pressure Ulcers. RI #67's Quarterly Minimum Data Set (MDS) assessment with an Assessment Reference Date (ARD) of 08/01/19, identified RI #67 as having pressure ulcers during this assessment period. [...]

Inspectors wroteBased on an interview, review of Non-Controlled Record of Medication Destruction forms and a review of a facility policy titled, Disposal of Medications, Non-Controlled Medication Destruction, the facility failed to ensure the May 2019, June 2019, and August 2019, Non-Controlled Record of Medication Destruction forms contained the two required signatures. This was noted on three of the nine months of Non-Controlled Record of Medication Destruction forms reviewed. Findings Include: A review of a facility policy titled, Disposal of Medications, Non-Controlled Medication Destruction, dated 01/12, revealed: .3. The registered nurse and/or pharmacist witnessing the destruction, or their preparation for environmental service pickup, ensures that the following is entered on the Record of Medication Destruction form .J. [...]

Inspectors wroteBased on observations, interviews, medical record review, and review of the facility's procedure titled Procedure for Diet/Supplement/Thickener Orders Matching the Dietary Tray Card and Matching the Tray Served, the facility failed to ensure Resident Identifier (RI) #48's physician's orders for double portions with all meals was followed. This affected one of 41 sampled residents whose physician's orders were reviewed. Findings Include: A review of the facility's procedure titled, Procedure for Diet/Supplement/Thickener Orders Matching the Dietary Tray Card and Matching the Tray Served, dated 12/12, revealed the following: . 5. The CNA (Certified Nursing Assistant) serving a meal tray makes sure the tray card matches the food served on the tray and/or obtains any items not served per the tray card. RI #48 was re-admitted to the facility on [DATE] with diagnoses including: [...]

Inspectors wroteBased on observations, interviews, medical record review, and review of the facility's procedure titled Procedure for Diet/Supplement/Thickener Orders Matching the Dietary Tray Card and Matching the Tray Served, the facility failed to ensure Resident Identifier (RI) #48 received double portions with all meals, which created the potential for altered nutritional status. This affected one of eight sampled residents reviewed for nutrition. Findings Include: A review of the facility's procedure titled, Procedure for Diet/Supplement/Thickener Orders Matching the Dietary Tray Card and Matching the Tray Served, dated 12/12, revealed the following: . 5. The CNA (Certified Nursing Assistant) serving a meal tray makes sure the tray card matches the food served on the tray and/or obtains any items not served per the tray card. [...]

Inspectors wroteBased on observation, interview, medical record review and a review of the facility's policies titled, Incontinent Care ., Glove Use and Hand Hygiene, the facility failed to ensure licensed staff washed her hands after removing soiled gloves and before leaving the room while performing incontinence care. Further, licensed staff contaminated the disposable wipes container with soiled gloves while performing incontinence care. This affected Resident Identifier (RI) #43, one of one resident observed during incontinence care. Findings Include: A review of the facility's policy titled, Incontinent Care ., with a revised date of 12/2012, revealed the following: . PROCEDURE: . 9. Remove and dispose of gloves, wash hands. Apply clean gloves . 12. Remove gloves and wash hands prior to leaving the room. [...]

Inspectors wroteBased on observations, interview, a review of the facility policy titled, Dish Clearing and Cleaning Safety, a review of an undated/untitled facility policy, and a review of the 2013 Food Code, the facility failed to ensure: 1) a total of 120 meal trays were not observed wet and stored on top of each other in a clean area of the kitchen and 2) a dinner plate with a chipped area on the rim of it and four dinner plates with rough edges were stored on a shelf in the kitchen. These failures had the potential to effect all 128 residents receiving meals from the dietary department. Findings Include: 1) A review of an undated/untitled facility policy revealed the following: . Procedure: .10 . Remove the dishes, inspect for cleanliness and dryness, and put them away if clean . [...]