Derby Health & Rehabilitation, LLC

Inspectors wroteThe facility identified a census of 61 residents. The sample included 15 residents with three residents reviewed for hospitalization. Based on observation, record review, and interviews, the facility failed to provide a written notification of transfer for facility-initiated transfers to Resident (R) 22, R77, and R78 and/or their representative for all applicable transfers/discharges. The facility further failed to notify the State Long Term Care Ombudsman (LTCO) of transfers/discharges for R22, R77, and R78.

Inspectors wroteThe facility reported a census of 61 residents; the sample included five residents reviewed unnecessary medications. Based on observation, interview, and record review revealed the facility failed to obtain physician-ordered orthostatic blood pressures as part of an evaluation following complaints of dizziness and lightheadedness.

Inspectors wroteThe facility reported a census of 69 residents. The sample included seven residents with three residents reviewed for accident hazards. Based on observation, interview and record review, the facility failed to ensure an environment free from accident hazards for two residents, Resident (R)1 and R2 when staff failed to provide adequate hands-on stabilization of the resident from the second staff member during full body mechanical lift transfers. This deficient practice placed R1 and R2 at risk for accidents and injuries related to mechanical lift transfers.

Inspectors wroteThe facility had a census of 61 residents. The sample included 15 residents. Based on observation, interview, and record review the facility failed to ensure hazardous chemicals were stored safely. This placed the five residents identified by the facility as cognitively impaired and independently mobile at risk for accidents and hazard-related injuries.

Inspectors wroteThe facility had a census of 61 residents. Based on observation, interview, and record review the facility failed to store, prepare, and serve food in a sanitary manner for residents in two of four kitchens and dining rooms. This deficient practice placed residents at risk for food-borne illness.

Inspectors wroteThe facility had a census of 61 residents. The sample included 15 residents. Based on record review and interview, the facility failed to provide Resident (R)8, R11, and R160, or their representative, the completed Centers for Medicare and Medicaid (CMS) Skilled Nursing Facility Advanced Beneficiary Notices (ABN) Form 10055. This placed the resident at risk of uninformed decisions about their skilled services.

Inspectors wroteThe facility identified a census of 61 residents. The sample included 15 residents. Based on observation, record review, and interview, the facility failed to ensure residents remained free from abuse when multiple residents' medications were misappropriated. This deficient practice placed all residents who had controlled medications stored in the facility at risk for further misappropriation and impaired care related to missing or stolen medications.

Inspectors wroteThe facility had a census of 61 residents. The sample included 15 residents of which two were reviewed for the gastrostomy tube (G-tube: surgical creation of an artificial opening into the stomach through the abdominal wall) feeding management. Based on observation, record review, and interview, the facility failed to provide G-tube care per the physician's orders for Resident (R)41 when staff failed to administer the required amount of water prior to the nutritional feeding through the G-tube. This placed the resident at risk for G-tube related complications.

Inspectors wroteThe facility had a census of 61 residents. The sample included 15 residents with five reviewed for unnecessary drugs. Based on observation, interview, and record review the facility failed to ensure the Consultant Pharmacist identified and reported Resident (R) 47's blood pressure medication administered outside the physician-ordered blood pressure parameters. This deficient practice placed R47 at risk for unnecessary medications and related complications.

Inspectors wroteThe facility had a census of 61 residents. The sample included 15 residents with five reviewed for unnecessary drugs. Based on observation, interview, and record review the facility failed to hold Resident (R) 47's blood pressure medication per the physician-ordered blood pressure parameters. This deficient practice placed R47 at risk for unnecessary medications and related complications.

Inspectors wroteThe facility reported a census of 69 residents with 20 residents sampled, including four residents reviewed for accidents. Based on interview, record review and observation, the facility failed to initiate the planned intervention for one of the four sampled, Resident (R)2, with the use of a motion alarm placed under the resident in bed/chair/wheelchair, to prevent further falls.

Inspectors wroteThe facility reported a census of 69 resident with 20 selected for review which included three residents reviewed for urinary catheter/urinary tract infections. Based on observation, interview and record review, the facility failed to ensure sanitary catheter care for two of the three sampled resident's (R)30 and R55, to prevent urinary tract infections.

Inspectors wroteThe facility reported a census of 69 residents with two residents reviewed for labeling of insulin pens. Based on observation, interview and record review, the facility failed to ensure correct expiration dating/labeling of insulin (a medication used to lower blood sugar levels) for sampled residents (R) 29 and R17.

Inspectors wroteThe facility reported a census of 69 residents. Based on observation, interview and record review, the facility failed to ensure the daily staff postings included the actual hours worked by the nursing staff as required.