Fountain View Rehabilitation and Nursing LLC

Inspectors wroteBased on record review and interviews, the facility failed to ensure residents received adequate supervision and intervention to prevent physical abuse for one (#4) of four residents reviewed for abuse out of nine sample residents. Specifically the facility failed to protect Resident #4 from physical abuse by Resident #3.

Inspectors wroteBased on observations and interviews, the facility failed to promote care for residents in a manner and in an environment that maintains or enhances each resident's dignity and respect in full recognition of his or her individuality. Specifically, the facility failed to maintain residents' dignity and ensure call lights were answered timely.

Inspectors wroteBased on interviews and review of the facility Dietary Manager job qualifications, the facility failed to have a Certified Dietary Manager and/or full time Dietitian oversight to perform the functions of the kitchen and nutrition services for all 83 residents receiving food from the kitchen. This failure increased the potential that the residents would not be provided the diets specific to their needs and basic kitchen sanitation would not be maintained.

Inspectors wroteBased on observations, interviews, and policy review, the facility failed to maintain the kitchen in a sanitary condition and failed to maintain temperature and sanitizer logs for the dish machine. This failure increased the risk of contamination of food served to all 83 residents who received food from the kitchen.

Inspectors wroteBased on record review, interview, and facility policy review, the facility failed to 1.) develop care plans with measurable goals for seven of 23 sampled residents (Resident (R) 8, 9, 14, 37, 57, 69, 286) and 2.) failed to develop care plans to address vision and hearing and/or dental status for two of 23 sampled residents (R286 and R9). This had the potential for the residents to have unmet care needs.

Inspectors wroteBased on interview, review of the facility's Controlled Drugs Count Record/Date sheets, and policy review, the facility failed to ensure a narcotic count was consistently completed at each shift change on four of four medication carts. Failure to properly account for the narcotics had the potential to result in missing narcotic medication.

Inspectors wroteBased on observation and interview, the facility failed to serve the preplanned portion sizes during the lunch service on 13 of 13 trays observed out of a total of 83 trays plated for lunch. This failure increased the potential of residents not receiving the preplanned nutritional diet.

Inspectors wroteBased on record review, interviews, and policy review, the facility failed to provide a written notice of transfer/discharge for two of two residents/representatives (Resident (R) 21 and R17) reviewed for hospitalization out of a total sample of 23 residents. This failure had the potential to cause uncertainty regarding the reason for transfer/discharge, the effective date of the transfer/discharge, and information on how to appeal the discharge.

Inspectors wroteBased on record review, interviews, and policy review, the facility failed to provide a written notice of the bed hold policy for two of two residents/representatives (Resident (R) 21 and R17) reviewed for hospitalization out of a total sample of 23 residents. This failure had the potential to cause uncertainty regarding returning to their own room at the facility after hospitalization.

Inspectors wroteBased on interviews, record review, and policy review, the facility failed to provide activities other than television for one of three residents (Resident (R) 59) reviewed for Transmission Based Precautions (TBP) out of a total sample of 23 residents. This failure had the potential to cause feelings of boredom and further isolation from others.

Inspectors wroteBased on observations, interviews, and record review the facility failed to store, prepare, distribute, and serve food in a sanitary manner in the main kitchen. Specifically, the facility failed to: -Ensure food was labeled and dated; -Ensure the kitchen was clean and sanitary; -Ensure cooked food items were monitored and cooled properly; -Ensure dishes were dried properly; and, -Ensure cutting boards were free from deep groves.

Inspectors wroteBased on observations, interviews and record review, the facility failed to ensure residents were provided prompt efforts by the facility to follow up on grievances. Specifically, the facility failed to provide resolutions to residents' missing clothing and items.

Inspectors wroteBased on interviews, observations and record review the facility failed to honor resident choices for one (#52) of five reviewed for self-determination out of 29 sample residents. Specifically, the facility failed to: -Ensure Resident #52 received showers consistently according to their choice of frequency; and, -Ensure Resident #52's preferences were included in his plan of care.

Inspectors wroteBased on record review and interviews, the facility failed to develop and implement an effective discharge plan for one (#21) of three reviewed for discharge planning out of 29 sample residents. Specifically, the facility failed to: -Ensure the discharge planning process was documentented in Resident #21's medical record; and, -Ensure Resident #21 was informed of the discharge planning process.

Inspectors wroteBased on observations, record review, and interviews, the facility failed to ensure one (#52) of two residents who required respiratory care received the care consistent with professional standards of practice out of 29 sample residents. Specifically, the facility failed to: -Ensure Resident #52's continuous positive airway pressure (CPAP) machine was cleaned and stored appropriately; and, -Ensure a care plan was in place to include the use, settings, cleaning, disinfecting and storage of Resident #52's CPAP.

Inspectors wroteBased on record review and interviews, the facility failed to ensure two (#81 and #52) of five residents were free from unnecessary psychotropic medications out of 29 sample residents. Specifically, the facility failed to: -Ensure consents were obtained and contained black box warnings for the usage of psychotropic medications for Resident #81; -Ensure a gradual dose reducation (GDR) for Resident #52's and Resident #81's use of antipsychotic medications or provide substantial documentation by the prescribing physician on why a GDR of the resident's medication was contraindicated; -Identify and monitor targeted behaviors for psychotropic medications for Resident #52; and, -Ensure Resident #52 had a personalized planned of care for his prescribed antipsychotic medication.

Inspectors wroteBased on observations, and interviews, the facility failed to provide choices for five (#219, #61, #62, #12, and #43) of nine residents reviewed for choices out of 31 sample residents. Specifically, the facility failed to ensure daily meal choices were provided and honored for Resident #219, #61, #62, #12 and #43.