Diversicare of Larned

Inspectors wroteThe facility reported a census of 44. Based on observation, interview and record review the facility failed to provide adequate infection control practices related to 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), hand hygiene and sanitizing shared equipment.

Inspectors wroteThe facility had a census of 44 residents. The sample included 12 residents with one reviewed for missing personal property. Based on observation, record review, and interview, the facility staff failed to document and promptly resolve Resident (R) 7's grievance when she reported to staff she had missing clothing items.

Inspectors wroteThe facility reported a census of 45 residents. The sample included 12 residents with two residents reviewed for facility discharge. Based on interview and record review e facility failed to complete a recapitulation of Resident (R) 47's stay in the facility.

Inspectors wroteThe facility identified a census of 44 residents. The sample included 12 residents. Based on observation, interview, and record review, the facility failed to develop a comprehensive care plan for Resident (R) 1's antipsychotic (a class of medications used to treat major mental conditions which cause a break from reality) medication and R31's activities of daily living (ADLs) for a dependent resident.

Inspectors wroteThe facility reported a census of 44 residents. The sample included 12 residents with one resident reviewed for activities of daily living (ADLs). Based on observation, interviews, and record review the facility failed to offer and provide assistance with nail care and facial hair removal for Resident (R) 31.

Inspectors wroteThe facility reported a census of 44 residents. Based on observation, interview and record review the facility failed to provide a safe, functional, and sanitary environment in the laundry area.

Inspectors wroteThe facility reported a census of 46 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 46 residents. Based on interview and record review, the facility failed to electronically submit to Centers for Medicare and Medicaid Services, (CMS) complete and accurate direct care staffing information, including information for agency and contract staff, based on payroll and other verifiable and auditable data in a uniform format according to specifications established by CMS {i.e., Payroll Base Journal (PBJ)}, related to licensed nursing staff coverage 24 hours a day.

Inspectors wroteThe facility reported a census of 46 residents with 16 residents sampled. Based on observation, record review and interview the facility failed to review and revise the care plan for three sampled Residents (R)27 regarding revising the care plan to include an intervention following one fall, R 33 regarding revising the care plan to include staff instruction for verbalizations of suicidal tendencies, and R 2 regarding revising the care plan to include interventions following multiple falls.

Inspectors wroteThe facility reported a census of 46 residents with 16 selected for review which included five residents reviewed for unnecessary medications. Based on record review and interview, the facility failed to follow up on pharmacy recommendations in a timely manner for two Residents (R)2 and R29, of the five sampled residents, and failed to ensure pharmacy reviews for October 2023 and November 2023 for the five sampled residents R15, R23, R2, R29 and R27 .

Inspectors wroteThe facility reported a census of 46 residents which included 16 residents sampled with one resident reviewed for dignity. Based on observation, interview, and record review, the facility failed to ensure the dignity/privacy of the one sampled resident (R)9, with a catheter/urine collection bag, with the lack of a cover for the urine collection bag to prevent full visualization of the resident's urine.

Inspectors wroteThe facility reported a census of 46 residents with 16 selected for review which included five residents reviewed for unnecessary medications. Based on observation, interview and record review, the facility failed to ensure one resident (R)15, of the five residents reviewed, received laxatives for lack of bowel movement as ordered by the physician.

Inspectors wroteThe facility reported a census of 46 residents. The sample included 16 residents, which included four residents sampled for accidents. Based on observation, interview, and record review, the facility failed to thoroughly investigate to identify causal factors of falls and/or initiate/implement immediate, appropriate interventions to prevent further falls for three sampled dependent residents, including Resident (R)15, related to a lack of wheelchair pedals for support while staff propelled the resident; R27, who experienced a fall with an inappropriate intervention; and for the multiple falls experienced by cognitively impaired R2, with the most recent fall resulting in major injury with two fractured (broken bone) vertebrae (bones of the spine).

Inspectors wroteThe facility reported a census of 46 residents which included 16 residents. The facility failed to maintain an effective infection control program to prevent cross contamination and the prevention infection related to urinary catheter care and services provided to one sampled Resident (R )9 with a urinary catheter/urine collection bag.

Inspectors wroteThe facility census totaled 47 residents with all residents receiving meals from one main kitchen. Based on observation, interview, and record review the facility failed to prepare and serve food in a sanitary manner by the failure to change gloves when handling ready to eat food items and the failure to maintain clean cooking equipment that worked properly to prepare meals.

Inspectors wroteThe facility reported a census of 47 residents with 13 sampled, including two for hospitalization. Based on observation, interview, and record review the facility failed to send a copy of the facility-initiated hospitalization transfer/discharge notice to the representative of the Office of the State Long-Term Care Ombudsman for Resident (R) 47. Findings Include: - Review of R47's Minimum Data Set (MDS) tracking form documented the resident discharged to the hospital on [DATE] and returned to the facility on [DATE]. Review of R47's Medical Record lacked evidence of written notification of the facility-initiated hospitalization transfer/discharge to R47's Office of the State Long-Term Care Ombudsman. On 03/07/22 at 04:09 PM R47 sat in his room in his recliner with his legs elevated, his walker next to his chair and all needed items within reach. [...]

Inspectors wroteThe facility reported a census of 47 residents with 13 sampled, which included two for hospitalization. Based on observation, interview, and record review the facility failed to provide a copy of the facility bed hold policy to Residents (R) 47 and R34 or their representative when they transferred out of the facility to the hospital. Findings Included: - Review of R47's Minimum Data Set (MDS) tracking form documented the resident discharged to the hospital on [DATE] and returned to the facility on [DATE]. Review of R47's Medical Record lacked evidence of written notification of the facility-initiated transfer to the hospital, which included a bed hold given to R47 or his representative. On 03/07/22 at 02:09 PM R47 ambulated with his walker to the bathroom with staff assistance. [...]

Inspectors wroteThe facility reported a census of 47 residents, with 13 in the sample, and Resident (R) 18 reviewed for Preadmission Screening and Resident Review (PASARR). Based on observation, interviews, and record review the facility failed to obtain a Care Assessment Screening for R18 upon admission.

Inspectors wroteThe facility reported a census of 47 residents with 13 selected for review, which included one resident reviewed for discharge. Based on interview and record review the facility failed to document a recapitulation of the resident's stay upon discharge for Resident (R) 52.