Diversicare of Hutchinson

Inspectors wroteThe facility reported a census of 37 residents. The sample included seven residents, with one resident reviewed for dementia (progressive mental disorder characterized by failing memory, confusion), care, and services. Based on observation, record review, and interviews, the facility failed to initiate a dementia plan of care that identified and honored Resident (R) 1's desire for physical engagement, which included direction to staff on how to identify voluntary engagement, and how to monitor for potential negative outcomes associated with physical engagement.

Inspectors wroteThe facility had a census of 70 residents. Based on observation and interview, the facility failed to ensure a clean, safe, homelike environment for the residents who ate in the dining room and the residents who resided on two of the four resident halls.

Inspectors wroteThe facility identified a census of 71 residents. The sample included 18 residents, with five residents reviewed for falls and accidents. Based on observation, record review, and interviews, the facility failed to implement grip strips in front of Resident (R) 20's toilet and failed to implement anti-rollbacks on his wheelchair. This deficient practice placed R20 at risk for future preventable falls. Findings Include: [...]

Inspectors wroteThe facility identified a census of 71 residents. The sample included 18 residents, with three residents reviewed for trauma-informed care (treatment or care directed to prevent re-experiencing or reducing the effects of traumatic events). Based on observation, record review, and interviews, the facility failed to identify trauma-based triggers related to Resident (R) 7 and R62 posttraumatic stress disorder (PTSD - a mental disorder characterized by an acute emotional response to a traumatic event or situation involving severe environmental stress) and failed to implement individualized interventions to prevent re-traumatization. These deficient practices placed R7 at risk for decreased psychosocial well-being and ineffective treatment.

Inspectors wroteThe facility had a census of 70 residents. The sample included 18 residents, with two reviewed for side rails. Based on observation, record review, and interview, the facility failed to assess the actual rail being used to assure safety for Resident (R) 8 and R62. This deficient practice placed R8 at risk for preventable injury.

Inspectors wroteThe facility had a census of 70 residents. The sample included 18 residents, with five reviewed for unnecessary medications. Based on observation, record review, and interview, the facility failed to ensure the Consultant Pharmacist identified and reported an inappropriate indication for the use of an antipsychotic medication (a class of medications used to treat any major mental disorder characterized by a gross impairment in reality testing and other mental emotional conditions) for one of five sampled residents, Resident (R) 5. This deficient practice placed the resident at risk for unnecessary medications and related side effects.

Inspectors wroteThe Facility had a census of 70 residents. The sample included 18 residents, with five reviewed for unnecessary medications. Based on observation, record review, and interview, the facility failed to ensure Resident (R) 5 had an approved diagnosis or a physician-documented rationale which included risks versus benefits for R5's use of Rexaulti (an antipsychotic class of medication used to treat mental conditions which cause a break from reality), and R 36's Seroquel (an antipsychotic medication)s used to treat major mental conditions which cause a break from reality). The facility further failed to ensure R20 had a 14-day stop date for the use of Ativan (an antianxiety medication). This deficient practice placed the residents at risk for unnecessary medications and related complications.

Inspectors wroteThe facility had a census of 70 residents. Based on observation, interview, and record review, the facility failed to dispose of expired medications in a timely manner. This deficient practice placed residents at risk to receive ineffective medication.

Inspectors wroteThe facility identified a census of 64 residents, which included one resident reviewed for accidents and identified 12 residents that were confused and independently mobile. Based on observation, interview, and record review the facility failed to ensure cognitively impaired Resident (R)1 remained free from accident hazards when on 07/15/24 at approximately 10:15 AM, R1 left the facility through an unsecured gate in the west courtyard. R1 remained unsupervised until Law Enforcement Officers (LEO) contacted R1 outside of a local business, located approximately 2.8 miles away from the facility, at 11:10 AM (55 minutes after R1 left the facility unsupervised and without staff knowledge). R1 did not return to the facility until approximately 11:25 AM (one hour and 10 minutes after R1 left the facility). [...]

Inspectors wroteThe facility reported a census of 57 residents. The facility had one main kitchen where food was stored and prepared serving one dining room. Based on observation, interview, and record review the facility failed to properly store food in the main kitchen refrigerators and freezers due to boxes placed directly on the floor and foods left uncovered; failed to discard expired foods and failed to store opened food products in accordance with professional standards for food service safety, to prevent food borne illness to the residents.

Inspectors wroteThe facility census totaled 57 residents residing on four halls in the facility. Based on observation, record review, and interview, the facility failed to provide a safe, clean, comfortable, and homelike environment by the failure to repair walls where they were scuffed into the dry wall and paint missing on three out of four halls and elevated noise levels on the two south halls that were unacceptable to residents voicing complaints about noise levels.

Inspectors wrote- R25's pertinent diagnoses from the Electronic Health Record (EHR) documented schizoaffective disorder (a chronic mental health condition characterized primarily by symptoms of schizophrenia, such as hallucinations or delusions, and symptoms of a mood disorder, such as mania and depression) and major depressive disorder (a serious mood disorder involving one or more episodes of intense psychological depression or loss of interest or pleasure that lasts two or more weeks). Review of 25's annual Minimum Data Set (MDS), dated [DATE] documented a brief interview for mental status (BIMS) of 15, indicating intact cognition. The resident received an antipsychotic (class of medications used to treat psychosis and other mental emotional conditions) medication and an antidepressant medication seven out of seven days in the look-back period. [...]

Inspectors wroteThe facility reported a census of 57 residents with 17 selected for review. Based on interview, observation, and record review, the facility failed to protect the privacy and dignity of Resident (R)33 and R14 when certified nurse aide (CNA) P, and Licensed Nurse (LN)H entered R33's room without knocking.

Inspectors wroteThe facility reported a census of 57 residents with 17 selected for review, including two residents for participation in care planning. Based on interview and record review, the facility failed to include Residents (R)14 and 49 in their care planning.

Inspectors wroteThe facility reported a census of 57 residents which included 17 selected for review. Based on interview and record review, the facility failed to accurately complete a comprehensive assessment on resident (R)33, related to the resident's cognition.

Inspectors wroteThe facility census totaled 57 residents with 17 included in the sample. Based on interview, record review the facility failed to revise the care plans for two residents by the failure to care plan injury and treatment to Resident (R11) shoulder injury and R 165's facility acquired pressure ulcer.

Inspectors wroteThe facility reported a census of 57 residents, with 17 sampled, including two residents sampled for activities of daily living (ADL). Based on observation, interview, and record review, the facility failed to provide care consistent with standard of practice for Resident (R) 165 and R 163 to maintain good grooming and personal hygiene. - The 03/23/23 Electronic Health Record (EHR) documented R 163 had the following diagnosis of orthopedic aftercare (aftercare following a joint replacement). The 02/14/23 admission Minimum Data Set (MDS) documented a brief interview for mental status (BIMS) of 13, indicating intact cognition. The assessment noted that it was very important for R 163 to choose what to wear and to choose between a shower or a bath. R 163 required extensive assistance of one staff for all ADL. R 163 was totally dependent on one staff for bathing. [...]

Inspectors wroteThe facility reported a census of 57 residents, with 17 sampled, including two residents sampled for pressure ulcers. Based on observation, interview, and record review, the facility failed to provide care consistent with professional standards to prevent pressure ulcers (PU, a localized injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination with shear and/or friction) by failure to perform skin assessments to identify a pressure area for Resident (R) 165, allowing an unstageable (full thickness tissue loss in which actual depth of the ulcer is completely obscured) pressure ulcer to develop.

Inspectors wroteThe facility reported a census of 57 residents with 17 selected for review which included one resident for accident hazards. Based on observation, interview and record review, the facility failed to provide a safe environment when staff placed a call light out of the reach of Resident (R)33.

Inspectors wrote- R 15's signed physician orders dated 03/01/23 revealed the following diagnoses- hypertension (elevated blood pressure) atherosclerotic heart disease (where the arteries become narrowed and hardened due to buildup of plaque (fats) in the artery wall.), and depression (abnormal emotional state characterized by exaggerated feelings of sadness, worthlessness, and emptiness). The Annual Minimum Data Set (MDS) dated [DATE] revealed a Brief Interview for Mental Status (BIMS) score of eight indicating moderate cognitive impairment. The resident had no behaviors and received antipsychotic and antidepressant medications. The Care Area Assessment (CAA) dated 10/07/22 revealed: Cognitive Loss CAA triggered secondary to orientation, memory, and recall deficits noted during BIMS interview. Contributing factors include dementia. [...]

Inspectors wroteThe facility reported a census of 57 residents with 17 residents selected for review, that included six residents reviewed for unnecessary medications. Based on observation, interview and record review, the facility failed to ensure Resident (R)25 and R14 were 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 and for R29 when the facility failed to have a stop date on an as needed (PRN) psychotropic (classes of medications that affect the mind, mood or mental processes) medication.

Inspectors wroteThe facility reported a census of 57 residents. Based on observation, interview, and record review, the facility failed to post the daily staffing document in a conspicuous place readily accessible to residents and visitors. In addition, the facility failed to ensure the daily staff posting included the actual hours worked by the nursing staff as required as well as the facility's name.

Inspectors wroteThe facility had a census of 47 residents. Based on observation, interview, and record review the facility failed to provide maintenance services to maintain a sanitary, orderly, and comfortable interior which included three of four hallways and two of 39 resident rooms.

Inspectors wroteThe facility census totaled 47 residents with 12 in the sample and five residents reviewed for unnecessary medications. Based on interview, observation and record review the facility failed to ensure the consultant pharmacist identify and report an irregularity concerning Resident (R)15 use of as needed (PRN) Ativan (antianxiety medication). [...]

Inspectors wroteThe facility reported a census of 47 residents with 12 sampled including two for indwelling urinary catheters (insertion of a catheter into the bladder to drain the urine into a collection bag). Based on observation, interview, and record review the facility failed to promote dignity when staff failed to provide a dignity bags for the indwelling urinary catheter drainage bags for Resident (R) 44 and R148.

Inspectors wroteThe facility reported a census of 47 residents with 12 sampled, which included two for respiratory care. Based on observation, interview, and record review the facility failed to provide respiratory care consistent with professional standards of practice for Resident (R) 33 by the failure of staff to change oxygen tubing and store oxygen tubing sanitarily. The facility further failed to store oxygen tubing sanitarily for R15.

Inspectors wrote- R16's pertinent diagnoses from the Physician's Orders in the Electronic Health Record (EHR) dated 08/03/21 documented type two diabetes mellitus (DM, when the body cannot use glucose, not enough insulin made or the body cannot respond to the insulin) and peripheral vascular disease (PVD, abnormal condition affecting the blood vessels). The 07/21/21admission Minimum Data Set (MDS) documented a Brief Interview for Mental Status (BIMS) score of 14, indicating intact cognition. R16 received anticoagulant medication six times in the seven-day look back period. The 08/03/21 Care Plan for R16 instructed staff to administer medications and monitor for side effects as ordered by the physician. The Physicians Orders documented an order on 07/15/21 for R16 for Xarelto (blood thinner) 20 milligrams (mg) daily and an order on 07/16/21 for aspirin 81 mg daily. [...]

Inspectors wroteThe facility reported a census of 47 residents, with five reviewed for unnecessary medications. Based on observation, interview, and record review the facility failed to follow up on the consultant pharmacists' recommendations for a gradual dose reduction (GDR) for the ordered Citalopram (antidepressant medication), for Resident (R)33, for the recommended stop date for the as needed (PRN) Ativan (antianxiety medication) ordered for R15, and for the GDRs for Trazadone, Mirtazapine, and Zoloft (antidepressant medications), received by R38.