Diversicare of Haysville

Inspectors wroteBased on observation, record review, and interview, the facility failed to accurately identify risks and provide interventions and adequate supervision to prevent an elopement for Resident (R) 1. On 05/16/2026, staff assessed R1's elopement risk during a Health Status Evaluation and inaccurately assessed R1 with the inability to leave the facility unattended therefore no risk was identified. On 05/28/2026 at around 01:50 PM, residents alerted Licensed Nurse (LN) G that R1 was outside on the East side of the building. LN G brought R1 back inside and assisted R1 into dry clothes. The facility was on [NAME] roads with posted speeds up to 35 miles per hour. The area also included other hazards such as a leaning fence with loose boards and nails on the ground. There was densely wooded tree line to the south and west of the facility. [...]

Inspectors wroteBased on observation, record review, and interviews, the facility failed to ensure Resident (R) 1, R2, R3, R4, R5, R6, R7, R8, and R9 remained free from misappropriation when facility staff diverted 187 hydrocodone, Oxycodone, and/or Percocet (potent semi-synthetic opioid analgesics and antitussive used to treat severe pain) between 02/01/2025 to 10/30/2025.

Inspectors wroteBased on observation, record review, and interview, the facility failed to ensure an accurate reconciliation of controlled medications (substances that have an accepted medical use, and have a potential for abuse, ranging from low to high, and may also lead to physical or psychological dependence) was completed.

Inspectors wroteThe facility identified a census of 84 residents which included four residents. Based on observation, interview, and record review, the facility failed to maintain an effective infection control program that included Enhanced Barrier Precautions (EBP - infection control interventions designed to reduce transmission of resistant organisms which employ targeted gown and glove use during high contact care) and failed to implement adequate infection control and hand hygiene measures during wound care for one resident in the facility, Resident (R) 1. This deficient practice placed R1 at risk for wound infection and related complications. Findings Included: - During an observation on 05/20/25 at 11:20 AM, Licensed Nurse (LN) G entered R1's room to perform wound care. LN G performed hand hygiene and donned clean gloves but did not don a gown. LN G removed the old dressing from R1's leg wound. [...]

Inspectors wroteThe facility identified a census of 81 residents. The sample included 21 residents. Based on observations, interviews, and record reviews, the facility failed to ensure staff possessed the appropriate skills and knowledge to safely handle, store, and administer resident medications. This deficient practice placed the residents at risk for potential medication errors and side effects.

Inspectors wroteThe facility reported a census of 81 residents. The sample included 21 residents. Based on record review and interviews, the facility failed to submit accurate staffing information to the federal regulatory agency through Payroll Based Journaling (PBJ - Staffing Data Report), when the facility failed to submit accurate weekend staffing coverage hours. This placed the residents at risk for unidentified and ongoing inadequate staffing.

Inspectors wroteThe facility identified a census of 81 residents. The sample included 21 residents, with five residents reviewed for dignity. Based on observation, interview, and record review, the facility failed to provide a dignified care environment for Resident (R) 9, R14, R27, and R130. This deficient practice placed the residents at risk for impaired dignity and quality of life. Findings Included: - On 03/10/24 at 09:10 AM, R9 (a severely cognitively impaired resident) was assisted by an unidentified staff member in her room. R9 sat on the side of her bed in her room. R9's bedside table was positioned in front of her with her breakfast. R9 had only underwear on her lower half. R9 fell asleep as she sat on the side of her bed with her head against the wall. Her leg and groin area were left exposed. [...]

Inspectors wroteThe facility had a census of 81 residents. The sample included 21 residents, with two reviewed for accidents. Based on observation, record review, and interview, the facility failed to ensure the safe storage of medications, pressurized oxygen cylinders, and chemical agents from eleven cognitively impaired independently mobile residents. The facility additionally failed to ensure Resident (R) 130's bed remained at a safe height per her care-planned interventions. This deficient practice placed the affected residents at risk for preventable accidents and injuries. Findings Included: - On 03/10/25 at 07:04 AM, an initial walkthrough of the facility was completed: An inspection of the supplemental oxygen storage closet revealed that the entry door was unlocked. The closet contained 79 fully compressed oxygen cylinder tanks stored in floor racks. [...]

Inspectors wroteThe facility identified a census of 81 residents. The sample included 21 residents, five medication carts and three medication rooms. Based on observation, record review, and interviews, the facility failed to properly store medications in three of the five medication carts. The facility also failed to label medication in one of the five medication carts. This placed the residents at risk for adverse outcomes or ineffective medication regimens.

Inspectors wroteThe facility identified a census of 81 residents. The facility identified seven residents on Enhanced Barrier Precautions (EBP - infection control interventions designed to reduce transmission of resistant organisms that employ targeted gown and glove use during high contact care) and one person on contact precautions (safeguards designed to reduce the risk of transmission of microorganisms by direct or indirect contact). Based on record reviews, observations, and interviews, the facility failed to ensure to Resident (R) 130's Foley catheter (a tube inserted into the bladder to drain urine into a collection bag) tubing was off the floor. The facility additionally failed to store R38 respiratory equipment in a sanitary manner. [...]

Inspectors wroteThe facility identified a census of 81 residents. The sample included 21 residents, with one resident reviewed for self-administration of medication. Based on observation, record review, and interviews, the facility failed to ensure safe and appropriate self-administration of medication for Resident (R) 22. This deficient practice placed R22 at risk for unnecessary medication side effects and self-administration errors.

Inspectors wroteThe facility reported a census of 81 residents. The sample included 21 residents, with four reviewed for accommodation of needs. Based on interviews, observations, and record review, the facility failed to ensure Resident (R) 3 and R66 had the appropriate call light or other method to communicate their needs. This deficient practice placed the residents at risk for preventable accidents and injuries. Findings Included: - The Medical Diagnosis section within R3's Electronic Medical Records (EMR) included diagnoses of dysphagia (difficulty swallowing), muscle weakness, need for assistance with care, intellectual disabilities (a significantly below-average score on a test of mental ability or intelligence and limitations in the ability to function in areas of daily life), and obesity (severely overweight). [...]

Inspectors wroteThe facility identified a census of 81 residents. The sample includes 21 residents, with five residents reviewed for resident funds. Based on observation, record review, and interviews, the facility failed to provide and or ensure resident funds accounts were accessible 24 hours a day seven days a week. This deficient practice placed residents at risk for decreased psychosocial well-being. Findings Included: - On [DATE] at 10:13 AM, Resident Council members Resident (R) 19, R53, and R65 reported the only way residents could access their money in their trust accounts was through Administrative Staff B. They reported that they were only aware that money withdrawals occurred Monday through Friday from 11:00 AM to 12:00 PM during the day. She stated we set a time because residents would be in my office all day long. [...]

Inspectors wroteThe facility identified a census of 81 residents. The sample included 21 residents, with one reviewed for abuse and/or neglect. Based on record review and interview, the facility failed to ensure Resident (R) 35 was free from abuse when R35's medication was misappropriated from the facility medication cart. This placed the residents at risk for both physical and psychosocial negative outcomes.

Inspectors wroteThe facility identified a census of 81 residents. The sample included 21 residents, with one reviewed for abuse and/or neglect. Based on record review and interview, the facility failed to submit a full investigation of a reportable occurrence for Resident (R) 35 to the appropriate state agency within twenty-four hours as required for misappropriation of R35's missing controlled substance. This placed the residents at risk for unidentified and ongoing abuse and /or neglect.

Inspectors wroteThe facility identified a census of 81 residents. The sample included 21 residents, with three sampled residents reviewed for hospitalization. Based on observation, record review, and interview, the facility failed to ensure that Resident (R) 14 and R54 and their representative received written notification of transfer, as soon as practicable to R14 and R54 or their representative for their facility-initiated transfer. This deficient practice had the risk of miscommunication between the facility and resident/family and possible missed opportunities for healthcare service for R14 and R54.

Inspectors wroteThe facility identified a census of 81 residents. The sample included 21 residents, with three sampled residents reviewed for hospitalization. Based on observation, record review, and interview, the facility failed to provide a bed hold policy to Resident (R) 14 and R54 or their representatives when they transferred to the hospital. This deficient practice had the risk of impaired ability for R14 and R54 to return to the facility and their previous rooms.

Inspectors wroteThe facility identified a census of 81 residents. The sample included 21 residents. Based on observation, record review, and interviews, the facility failed to provide consistent weekend activities on Sundays to promote socialization. This deficient practice placed the affected residents at risk for decreased psychosocial well-being, boredom, and isolation.

Inspectors wroteThe facility identified a census of 81 residents. The sample included 21 residents with one resident reviewed for quality of care. Based on observation, record review, and interviews, the facility failed to follow a physician's order for daily weights to monitor for congestive heart failure (CHF - a condition with low heart output and the body becomes congested with fluid) for Resident (R) 2. This deficient practice placed R2 at risk for delay in treatment related to fluid overload and untreated illness.

Inspectors wroteThe facility identified a census of 81 residents. The sample included 21 residents, with one reviewed for dementia (a progressive mental disorder characterized by failing memory, and confusion) care. Based on interviews, record reviews, and observations, the facility failed to provide dementia-related care services for Resident (R) 12 to promote the resident's highest practicable level of well-being. This deficient practice placed R12 at risk for decreased quality of life, isolation, and impaired dignity. Findings Included: [...]

Inspectors wroteThe facility identified a census of 81 residents. The sample included 21 residents, with six residents reviewed for unnecessary medications. Based on observation, record review, and interviews, the facility failed to ensure the physician reviewed and addressed the Consultant Pharmacist (CP) recommendations for Resident (R) 61's as needed psychotropic medication (alters mood or thought). The facility also failed to ensure the CP identified and reported irregularities regarding lack of dosing instructions for Voltaren (topical pain reliever medication) gel and the lack of monitoring antihypertensive (a class of medication used to treat high blood pressure) medications for R54. The facility also failed to ensure the CP identified and reported irregularities regarding lack of documentation of R14's oxygen saturation monitoring. [...]

Inspectors wroteThe facility identified a census of 81 residents. The sample included 21 residents, with five sampled residents reviewed for unnecessary medications. Based on observation, record review, and interview, the facility failed to ensure that Resident (R) 14's oxygen (O2) saturation was monitored and documented as physician ordered. The facility failed to ensure staff monitored and documented R54's pulse for her antiarrhythmic (medications used to treat abnormal heart rhythms) and R54's blood pressure for her beta blocker (a medication used to treat high blood pressure and other cardiac conditions). This deficient practice placed these residents at risk for unnecessary medication administration and related complications.

Inspectors wroteThe facility identified a census of 81 residents. The sample included 21 residents, with six residents reviewed for unnecessary medications. Based on observation, record review, and interviews, the facility failed to ensure the as needed (PRN) psychotropic (alters mood or thought) medication had a 14-day stop date or a specified duration with supporting physician documentation for Resident (R) 61's PRN psychotropic medications. This placed R61 at risk for unnecessary medication administration and possible adverse side effects.

Inspectors wroteThe facility identified a census of 81 residents. The sample included 21 residents, with five reviewed for immunization status. Based on record reviews, and interviews, the facility failed to offer or obtain informed declinations, consent, or a physician-documented contraindication for the Pneumococcal Conjugate Vaccine (PCV20- vaccination for bacterial infections) pneumococcal (type of bacterial infection) vaccination for Resident (R) 32. The facility also failed to administer PCV20 for R54 who had given consent. This placed these residents at increased risk for acquiring, transmitting, or experiencing complications from the pneumococcal disease.

Inspectors wroteThe facility reported a census of 88 residents with 13 selected for review including two residents reviewed for sexual abuse, Resident (R)4 and R5. Based on observation, interview, and record review, the facility failed to prevent sexual abuse on 09/26/23 at approximately 07:00 PM when Dietary Staff (DS) BB failed to immediately separate R4 away from R5, after DS BB saw R4 lift R5's dress. After witnessing the incident, DS BB went into the kitchen and told DS CC, which left R4 and R5 unsupervised, as no other staff were in the dining room at that time. DS CC stated when she walked out of the kitchen, she saw R4 had R5's dress pulled up with one hand and R4's other hand was on R5's thigh, and R5 seemed flustered and irritated. DS CC went to get the nurse on R5's hall, which again left R4 and R5 unsupervised. [...]

Inspectors wroteThe facility reported a census of 88 residents. Based on observation, record review, and interview, the facility failed to provide housekeeping and maintenance services to maintain a sanitary, orderly, and comfortable interior in the resident rooms, shower rooms, and hallways, for all of the residents of the facility.

Inspectors wroteThe facility reported a census of 88 residents. The 13 residents sampled included eight residents reviewed for resident funds. Based on observation, record review, and interview, the facility failed to safeguard cash in the facility safe located in the business office, for two of the eight residents reviewed resulting in theft of cash for R6 in the amount of $2,300 and for R7 in the amount of $4,000. The facility replaced the missing cash for these two residents but this practice left any other resident who placed cash or valuables in the facility safe at potential for loss.

Inspectors wroteThe facility reported a census of 88 residents with 13 selected for review, including five residents reviewed for personal funds accounts, Resident (R)9, R10, R11, R12, and R13. Based on record review and interview, the facility failed to provide notification to the five selected residents, who received Medicaid benefits, when the amount in their trust account reached $200.00 less than the SSI (Supplemental Security Income) resource limit (Limit is $2,000) to prevent loss of eligibility for Medicaid or SSI.

Inspectors wroteThe facility reported a census of 87 residents, with 18 residents sampled, including five residents reviewed for nutrition. Based on observation, interview and record review, the facility failed to provide adequate nutritional interventions for Resident (R)3, to maintain her body weight, and prevent a significant weight loss of 6.85% (percent) in less than one month.

Inspectors wroteThe facility reported a census of 87 residents. Based on observation, record review, and interview, the facility failed to prepare and serve food under sanitary conditions, to the residents of the facility appropriately to prevent the potential for food borne bacteria.

Inspectors wroteThe facility reported a census of 87 residents. Based on observation, record review and interview, the facility failed to provide necessary maintenance services for the kitchen floor to provide a safe, functional and sanitary environment.

Inspectors wroteThe facility census totaled 87 residents with 18 residents included in the sample. Based on observation, interview, and record review the facility failed to review and revise care plans for four sampled residents including, interventions to prevent further falls for Resident (R)73, behaviors for the use of an antipsychotic medication for R29, with instructions for the dialysis communication sheet for R72, and for Activities of Daily Living needs of R3.

Inspectors wroteThe facility census totaled 87 residents with 26 residents residing one hall, and one bath house used to bathe those 26 residents. Based on observation, interview, and record review the facility failed to ensure call light accessibility to these 26 residents when they received showers in this one shower room. The shower area lacked a cord on the two call lights located in the shower and the call light next to the toilet making them inaccessible to residents receiving showers and staff providing showers, in case of emergency.

Inspectors wroteThe facility reported a census of 87 residents with 18 residents sampled, including three residents reviewed for dignity. Based on observation, interview and record review, the facility failed to treat two residents with respect and dignity including Resident (R)3, by leaving the resident exposed to others in the hallway while she rested in bed and (R) 29, wearing soiled clothing.

Inspectors wroteThe facility reported a census of 87 residents with 18 included in the sample including one reviewed for hospitalization. Based on interview and record review the facility failed to provide a copy of the facility bed hold policy to Resident (R) 73 or his representative with hospital transfer.

Inspectors wroteThe facility reported a census of 87 residents with 18 residents sampled. Based on interview and record review, the facility failed to complete a individualized comprehensive care plan for one Resident (R)3, regarding the use of oxygen.

Inspectors wroteThe facility census totaled 86 residents with 18 included in the sample. Based on observation, interview, and record review the facility failed to ensure planned and implemented interventions following a fall by one sampled resident (R) 73, to prevent further falls and potential injury.

Inspectors wroteThe facility reported a census of 87 residents with 18 residents sampled, including three residents reviewed for respiratory care. Based on observations, record reviews, and interviews, the facility failed to appropriately administer oxygen to Resident (R)138 as ordered. In addition, the facility failed to properly store the nebulizer (a device for administering inhaled medications) and to correctly store distilled water used for oxygen humidification for R78. These deficient practices could lead to possible respiratory complications and/or infections.

Inspectors wroteThe facility reported a census of 87 residents with 18 residents sampled, including one resident reviewed for dialysis. Based on observation, interview, and record review, the facility failed to ensure appropriate adequate communication between the dialysis center and the facility, for the one Resident (R)72, regarding a lack of regular dialysis communication sheets, with the facility.

Inspectors wroteThe facility reported a census of 87 residents with 18 residents in the sample which included five residents reviewed for unnecessary medications. Based on observation, interview and record review, the facility failed to ensure two of the five sampled residents, including Resident (R) 8 and R18 were appropriately and timely monitored for side effects of extrapyramidal (abnormal involuntary body movements caused by medications) symptoms due to antipsychotic (a class of medication used to treat psychosis and other mental emotional conditions) medication use.

Inspectors wroteThe facility census totaled 87 residents with 18 residents included in the sample. Based on observation, interview, and record review the facility failed to honor Resident (R) 14's dietary food choices when the resident requested no pork be served and the facility continued to serve her pork.

Inspectors wrote- Resident (R) 78's diagnoses from the Electronic Health Record (EHR) included chronic obstructive pulmonary disease (COPD - a progressive and irreversible condition characterized by diminished lung capacity and difficulty or discomfort in breathing) acute (sudden) and chronic (persisting for a long period) and respiratory failure (a condition in which respiratory function is inadequate to maintain the body's need for oxygen supply and/or carbon dioxide removal while at rest). The 03/08/23 admission Minimum Data Set (MDS) documented brief interview for mental status (BIMS) of 15, indicating intact cognition. The resident required limited or extensive assistance of one staff for most cares and received the use of oxygen (O2). The 04/29/23 quarterly MDS documented a BIMS of 12, indicating moderately impaired cognition and the resident continued to receive oxygen. [...]

Inspectors wroteThe facility census totaled 78 residents with 18 in the sample. Based on observation, interview, and record review the facility failed to ensure a sanitary environment when Certified Nurse Aide (CNA) staff did not change gloves and perform hand hygiene when going from dirty to clean areas, during two observation of incontinence care for Resident (R) 44.