Dexter House Healthcare

Inspectors wroteBased on record review, and interviews, the facility failed to provide care and services consistent with professional standards of practice for one Resident (#95) who required renal dialysis (a life sustaining treatment that helps the body remove extra fluids and waste products from the blood when the kidneys are not able to) out of a total sample of 25 residents. Specifically, for Resident #95 the facility failed to ensure nursing scheduled medications around his/her dialysis days.

Inspectors wroteBased on observations, interviews, and record reviews for three Residents (#70, #46, and #34) out of five residents observed, the facility failed to ensure it was free from a medication error rate of greater than 5%. Three out of four nurses observed made four errors out of 25 opportunities resulting in a medication error rate of 16%. Specifically,a.) For Resident #70, Nurse #1 administered the incorrect form of multiple vitamin.b.) For Resident #46, Nurse #2 administered the incorrect form of aspirin, and she did not follow manufacture's recommendations and crushed a medication that indicated do not crush. [...]

Inspectors wroteBased on observation and interview, the facility failed to properly follow food storage and food handling practices to prevent the risk of foodborne illness in accordance with professional standards for food service safety. Specifically, the facility failed to properly store food items in the kitchen to prevent the risk of foodborne illness.

Inspectors wroteBased on record review and interview, the facility failed to obtain informed consent from the responsible party of one Resident (#11) out of a total sample of 25 residents.

Inspectors wroteBased on observations, record review and interviews, the facility failed to ensure one Resident (#84) was assessed for and free from restraints out of a total sample of 25 residents. Specifically, the facility failed to ensure Resident #84 was free from a restraint in the form of bolsters that ran from the head of the bed to the foot of the bed on both sides to keep the Resident in bed.

Inspectors wroteBased on observation, record review and interview, the facility failed to ensure standards of quality of care were implemented for one Resident (#110) out of a total sample of 25 residents. Specifically, the facility failed to ensure a treatment was in place for a non-pressure wound of the left, first toe and ensure the treatment orders were completed as written.

Inspectors wroteBased on observations, record review and interview, the facility failed to follow recommendations of the wound doctor and implement the plan of care for one Resident (#110) out of a total sample of 25 Residents. Specifically, the facility failed to ensure Resident #110's feet were offloaded as recommended by the wound doctor and the plan of care.

Inspectors wroteBased on observations, record review, and interviews, the facility failed to ensure enteral nutrition provided via a gastrostomy tube (a tube surgically inserted through the abdominal wall directly into the stomach with the purpose of delivering food, typically in the form of liquid formula) was provided according to professional standards for two Residents (#36, #8) out of a total sample of 25 Residents. Specifically, the facility failed to ensure a tube feeding was labeled and dated when opened for Residents #38 and #8.

Inspectors wroteBased on observation and interview, the facility failed to properly store and dispose of medication on one unit. Specifically, a medication was found behind a broken radiator that was easily accessible to the residents on the unit.

Inspectors wroteBased on records reviewed and interviews, for one of three sampled residents (Resident #2), the Facility failed to ensure he/she was free from a significant medication error, when on 08/07/25, Nurse #1 administered Epinephrine (hormone that increases adrenaline) to him/her instead of Glucagon (hormone that increases blood glucose level), in error.

Inspectors wroteBased on observations and staff interviews, the facility failed to follow infection control standards of practice for the cleaning of shared resident equipment.

Inspectors wroteBased on observation and interview, the facility failed identify and minimize areas of possible entrapment in resident beds. Specifically: 1.) For Resident #62, out of a total of 19 sampled residents, the facility failed to minimize a gap between the headboard and mattress end of the Resident's bed. 2.) The facility failed to conduct routine inspections of all bed frames and mattresses to identify possible areas of entrapment for 72 resident beds.

Inspectors wroteBased on observation, policy review, and interview the facility failed to provide a dignified dining experience for two Residents (#1 and #34) out of a total sample of 19 residents. Specifically, the facility failed to ensure that staff members were not standing over Resident #1 and Resident #34 while providing feeding assistance.

Inspectors wroteBased on observation, record review and interview, the facility failed to 1.) implement the plan of care related to keeping the call light within reach for one Resident (#50), and 2.) failed to develop a care plan related to a history of suicide attempts for one Resident (#11) out of a total of 19 sampled residents.

Inspectors wroteBased on record review and interview, the facility failed to ensure medications were administered as ordered for one Resident (#72) out of a total of 19 sampled residents. Specifically, nursing staff failed to administer insulin per the physicians' sliding scale order.

Inspectors wroteBased on observation, record review and interview, the facility failed to provide assistance with meals for two Residents (#21 and #59), out of a total of 19 sampled residents.

Inspectors wroteBased on observation, record review, and interview the facility failed to ensure all drugs and biologicals were stored in a safe and secure manner. Specifically, the facility failed for Resident #73, to ensure topical medications were not left unattended in the Resident's room.

Inspectors wroteBased on interview and record review the facility failed to obtain routine and 24-hour emergency dental care for one Resident (#11) out of a total sample of 19 residents. Specifically, the facility failed to provide dental services after Resident #11 had voiced that his/her dentures were ill-fitting, and failed to implement the dentist's recommendations for follow-up appointments.

Inspectors wroteBased on interview and observation, the facility failed to ensure its laundry room dryer drums, which processed all of the Facility residents' clothing and linens, were free of debris and maintained in safe operating condition, for two of two functioning dryers.

Inspectors wroteBased on observation and interview the facility failed to adhere to safe practices for food storage, increasing the risk for food borne illness. Specifically, the facility's walk-in refrigerator had ready to eat deli meat and thawed ground meat that was beyond the timeframe in which to serve.