E.a. Hawse Healthcare Center

Inspectors wroteBased on record review, observation and staff interview, the facility failed to provide a complete and accurate medical record for a resident in the areas of [NAME] Virginia POST Form, care plan, and PASSR. This is true for Resident's #4, #6, #9 and #17. Facility Census 54.

Inspectors wroteBased upon observation, resident interviews, staff interviews and record review. the facility failed to maintain an effect pest control program for flies. This failed practice had the potential to affect many residents in the facility. Facility census: 54.

Inspectors wroteBased on record review and staff interview, the facility failed to inform the resident or their representative in advance of treatment risks and benefits, options, and alternatives for an anti-depressant medication prior to the administration of the medication. This failed practice did not allow the resident to be provided an informed choice. Resident identifier: #31. Facility census: 54.

Inspectors wroteBased on observation, record review and staff interview, the facility failed to ensure a resident's comprehensive care plan was revised upon change in physician's orders in regards to a perimeter mattress. This is true for Resident #5. Facility Census: 54.

Inspectors wroteBased on record review and staff interview, the facility failed to have a Registered Nurse (RN) on duty for 8 hours per day for seven days a week on 01/01/26. This failed practice had the opportunity to lead to residents not receiving the care and treatment only an RN can provide, and could affect multiple residents. Facility census: 54.

Inspectors wroteBased on record review, and staff interview, the facility failed to provide activities of daily living (ADL's) to maintain good personal hygiene for dependent residents. This is true for 0ne (1) of three (3) residents reviewed for ADL care. Resident Identifiers: #20, #17, #33, #23, #16 and #34. Facility census: 54.

Inspectors wroteBased on record review and staff interviews, the facility failed to ensure Resident #18's environment remained as free of accident hazards as possible; and that each resident received adequate supervision and assistance devices to prevent accidents. Resident #18 had a care plan for nonskid footwear which were not in place at the time of a fall. The Central Supply closet which contained harmful chemicals was not secured by a locking door. Resident identfieir: #18. Facility census: 54.

Inspectors wroteThe facility failed to serve food in a safe sanitary manner in regards to hand washing after coughing and touching soiled items and storing medical ice packs in the freezer in the residents pantry. This has the potential to affect all resident that gets their nutrition form the kitchen. Facility census: 54. Findings Included: a) Resident Pantry During the tour on 11/11/24 at 12:20 PM to the Resident pantry found multiple medical Ice packs stored in resident freezer. An interview 11/11/24 at 12:20 PM with the Dietary Manager confirmed the medical ice packs should not be stored with resident food. [...]

Inspectors wroteBased on observation, and interview, the facility failed to ensure that residents were treated with dignity and respect, as demonstrated by leaving urinary catheter bags uncovered. This was a random opportunity for discovery during the Long-Term Care Survey Process. Resident identifiers #47 and #257. Facility census: 54.

Inspectors wroteBased on resident interview, record review, and staff interview, the facility failed to promote self-determination and honor resident preferences regarding bathing/showers. This was true for two (2) out of five (5) residents reviewed under choices. Resident identifiers: #23 and #33. Facility census: 54.

Inspectors wroteBased on record review and interview, facility failed to develop a baseline care plan that addressed the risks associated with catheter-related urinary tract infections (CAUTI) and did not implement any protocols for the care of the in-dwelling catheter. Additionally, the facility failed to notify the physician, and obtain orders for the care of the indwelling catheter for a newly admitted resident This was a random opportunity for discovery. Resident Identifier: Resident #257. Facility Census: 54.

Inspectors wroteBased on observation, interview, and record review, the facility failed to revise and update the care plan based on the changing preferences and needs of the resident. Resident identifier: #16. Facility Census: 54.

Inspectors wroteBased on record review and staff interview, the facility failed to provide a resident with a discharge summary that was completed by all departments and failed to ensure it included follow-up dates and times for medical appointments. This was true for one (1) of two (2) residents reviewed under the discharged pathway. Resident identifier: #56. Facility census: 54.

Inspectors wroteBased on observation, interviews, and record review, the facility failed to notify the physician, and obtain orders for the care of the indwelling catheter, for a newly admitted resident. Resident identifier: #257. Facility Census: 54.

Inspectors wroteBased on record review and staff interview, the facility failed to obtain laboratory services to meet the needs of its residents. This deficient practice had the potential to affect one (1) of five (5) residents reviewed for the care area of unnecessary medications. Resident identifier: #15. Facility census: 54.

Inspectors wroteBased on record review and staff interview, the facility failed to ensure an admission assessment was completed with an antipsychotic and residents reviewed during the long-term care survey process had a Physician Orders for Scope of Treatment (POST) form completed per directions specified by the [NAME] Virginia Center for End-of-Life Care in conjunction with the [NAME] Virginia Health Care Decisions Act (16-30-1). The POST forms were unsigned by the Resident or Medical Power of Attorney (MPOA). Resident identifiers: Resident #31and #15. Facility census: 54. Findings Included: a) Resident #31 Record review on 11/11/24 at 2:55 PM found, a POST Form patient information and section F health care provider on Resident #31's chart was completed with the Physicians Full name, Licenses number and phone number. The POST was dated 06/14/24. [...]

Inspectors wroteBased on observation and staff interview, the facility failed to respect resident dignity. Four (4) residents requiring assistance with dressing were noted to have on non-skid socks that had the residents names either on the top or on the side of the sock. This practice was not inconspicuous and could readily be seen by any visitor. This was a random opportunity for discovery. Resident identifiers: #8, #13, #44, and #41. Facility Census: 47.

Inspectors wroteBased on observation, review of facility documentation, and staff interview, the facility failed to ensure drugs and biologicals, used in the facility, were stored, and administered in accordance with current accepted professional practices. This was true for medications stored in one (1) of two (2) medication carts and one (1) of one (1) medication storage rooms inspected. The facility failed to ensure medications were dated when opened and put in to use, failed to ensure medications being stored for use after the manufacturer's use by date, were discarded and not administered to residents and failed to ensure medications were stored at the proper manufacturer's temperature requirement. This deficient practice was identified during a random opportunity for discovery and had the potential to affect more than a limited number of residents. Facility census:

Inspectors wroteBased on observation and staff interview, the facility failed to ensure the and privacy of Resident #27 during a treatment. This was a random opportunity for discovery. Resident identifier: #27. Facility census: 47.

Inspectors wroteBased on observation and staff interview, the facility failed to provide a safe, clean, comfortable, and homelike environment. The facility failed to ensure resident rooms were in good repair. These were random opportunities for discovery. Room identifiers: B09A and B05A. Facility census: 47.

Inspectors wroteBased on medical record review and staff interview, the facility failed to provide evidence a the long-term care Ombudsman was provided a Notice of Transfer for a resident who had acute hospital transfers/discharges. This had the potential to affect all residents being transferred or discharged . Resident identifier: #45. Facility census: 47.

Inspectors wroteBased on observation, record review, and staff interview, the facility failed to provide an environment free from accident hazards over which it had control. The facility failed to ensure matches and a reusable razor with blade were kept in a secure place, not accessible to residents. A book of matches and a reusable razor with a double edge intact blade was observed on the bed of a resident with impaired cognition. This deficient practice was found to be true during a random opportunity for discovery and had the potential to affect a limited number of residents. Resident identifier: Resident #21. Facility census: 47.

Inspectors wroteBased on observation and staff interview, the facility failed to provide food services in accordance with professional standards. The facility failed to ensure food was labeled. This practice had the potential to affect a limited number of residents. Facility census: 47.