F W Huston Medical Center

Inspectors wroteThe facility had a census of 38 residents. Based on observation, interview, and record review, the facility failed to store unexpired medication in the emergency kit as required, and staff failed to discard or destroy expired medications. This deficient practice placed residents of the facility at risk of receiving ineffective medications.

Inspectors wroteThe facility identified a census of 38 residents. The facility had one main dining room and kitchen. Based on observations, record review, and interview, the facility failed to properly label and store food and failed to perform hand hygiene during meal tray pass. This deficient practice had the risk of spreading foodborne illness to all affected residents.

Inspectors wroteThe facility had a census of 38 residents. The sample included 12 residents. Based on observation, record review, and interview, the facility failed to maintain a Quality Assessment and Assurance Committee (QA&A) that had the required membership in attendance. This placed the resident with a lack of quality care.

Inspectors wroteThe facility had a census of 38 residents. The sample included 12 residents. Based on observation, record review, and interview, the facility failed to provide a safe environment free of chemical hazards for cognitively impaired, independently mobile residents. This placed residents at risk of possible injury.

Inspectors wroteThe facility had a census of 38 residents. The sample included 12 residents, with five residents reviewed for immunizations: Resident (R) 4, R10, R14, R19, and R37, to include pneumococcal (a disease that refers to a range of illnesses that affect various parts of the body and are caused by infection) vaccinations. Based on record review and interviews, the facility failed to offer, obtain an informed declination, or a physician documented contraindication for the pneumococcal PCV20 vaccination per the latest guidance from the Centers for Disease Control and Prevention (CDC). This placed the residents at risk for pneumococcal infection and related complications.

Inspectors wroteThe facility identified a census of 38 residents. The sample included 12 residents, with two residents reviewed for hospitalization. Based on observation, record review, and interviews, the facility failed to provide a written notification of transfer to Resident (R) 1 or their representative for all applicable transfers/discharges. The facility failed to ensure the written notification of transfers given to R1 had the required information. The facility further failed to notify the State Long Term Care Ombudsman (LTCO) of transfers/discharges for R1. This deficient practice had the risk for miscommunication between the facility and resident/representative and possible missed opportunities for healthcare services for R1 and placed R1 at risk for impaired rights.

Inspectors wroteThe facility identified a census of 38 residents. The sample included 12 residents, with one resident reviewed for bathing. Based on observations, record review, and interviews, the facility failed to provide consistent bathing for Resident (R) 32. This deficient practice had the risk for poor hygiene and decreased self-esteem and dignity for R32.

Inspectors wroteThe facility had a census of 38 residents. Based on observation, record review, and interview, the facility failed to submit complete and accurate staffing information through Payroll-Based Journal (PBJ) as required. This deficient practice placed the residents at risk for unidentified and ongoing inadequate nurse staffing.

Inspectors wroteThe facility identified a census of 37 residents. Based on record and interview, the facility failed to provide a Registered Nurse (RN) for at least eight consecutive hours, seven days a week. This placed all residents in the facility at risk for decreased quality of care.

Inspectors wroteThe facility had a census of 37 residents. Five Certified Nurse Aide's (CNA) were reviewed for performance evaluations and required in-service training. Based on record review and interview, the facility failed to ensure three of the five CNA staff reviewed had the required yearly performance evaluations completed. This placed the residents at risk for inadequate care.

Inspectors wroteThe facility identified a census of 37 residents. The sample included 12 residents. Based on observation, record review, and interviews, the facility failed to identify a significant change in the physical condition and complete a comprehensive Significant Change Minimum Data Set (MDS) for Resident (R) 20. This deficient practice placed R20 at risk of unidentified care needs.

Inspectors wroteThe facility identified a census of 37 residents. The sample included 12 residents. Based on observation, record review, and interviews, the facility failed to revise Resident (R) 4's comprehensive person-centered care plan to include her right-hand splint. This deficient practice placed R4 at risk of worsening contracture (abnormal permanent fixation of a joint or muscle), along with loss of independence.

Inspectors wroteThe facility identified a census of 37 residents. The sample included 12 residents with two resident reviewed for positioning and mobility. Based on observation, record review, and interviews, the facility failed to provide care and services to prevent a decrease in range of motion (ROM)/mobility and/or development of contractures (abnormal fixation of a joint or muscle) for Resident (R) 4. The deficient practices placed R4 at risk of loss of ability to perform activities of daily living (ADLs) and development or worsening of contractures.

Inspectors wroteThe facility identified a census of 37 residents. The sample included 12 with two reviewed for nutrition. Based on observation, interviews, and record review, the facility failed to provide consist weekly weight monitoring as identified on Resident (R)14's nutritional plan of care and physician's orders. This deficient practice placed R14 at risk for complication related to weight loss and malnutrition (condition that develops when the body is deprived of vitamins, minerals and other nutrients).

Inspectors wroteThe facility identified a census of 37 residents. The sample included 12 residents with five residents sampled for unnecessary medication review. Based on observations, record review, and interviews, the facility failed to ensure Resident (R) 35's diclofenac sodium gel (topical medication used to treat joint pain and inflammation) had a dosage for administration. This deficient practice had the risk for physical complications and unnecessary medication usage.

Inspectors wroteThe facility identified a census of 37 residents. The sample included 12 residents with five residents reviewed for unnecessary medications. Based on observation, record review, and interviews, the facility failed to document the non-pharmacological interventions used, and a rational for continued use of psychotropic (alters mood or thought) medication with no gradual reduction for Resident (R)6. The facility also failed to ensure an appropriate indication for use or documented physician rationale which included the multiple unsuccessful attempts for nonpharmacological symptom management and risk versus benefit for the continued use of antipsychotic (class of medications used to treat major mental conditions which cause a break from reality testing) for R25. This deficient practice placed these residents at risk for unnecessary psychotropic medication and related complications.

Inspectors wroteThe facility identified a census of 31 residents. The sample included 12 residents. One resident, (R) 24, was reviewed for transfer and discharge. Based on record review and interview, the facility failed to provide written notice of discharge to R24's representative and the Ombudsman when R24 was discharged to an acute care facility.

Inspectors wroteThe facility identified a census of 31 residents. The sample included 12 residents, with five residents reviewed for accidents. Based on observation, record review, and interviews, the facility failed to implement appropriate interventions aimed at preventing falls for Resident (R) 22, who was identified as a high fall risk. R22 from 10/06/21 to 02/19/22 had seven fall occurrences, which resulted in minor injury five of seven occurrences. This deficient practice placed R22 at risk for injuries related to falls.

Inspectors wroteThe facility identified a census of 31 residents. The sample included 12 residents with two residents reviewed for activities of daily living (ADLs) care. Based on observations, record reviews, and interviews, the facility failed to follow Resident (R) 28's toileting schedule resulting in increased episodes of overnight incontinence. This deficient practice placed the resident at risk for increased incontinence, impaired psychosocial well-being, and skin breakdown.

Inspectors wroteThe facility identified a census of 31 residents. The sample included 12 residents. Based on observation, record review, and interviews, the facility failed to develop and implement the core elements of antibiotic stewardship to ensure an effective infection prevention and control program for the residents of the facility.