Franklin Nursing Home

Inspectors wroteBased on observation, interview, and record review, the facility failed to be adequately equipped to allow residents to call for staff assistance through a communication system which relays the call directly to a staff member or a centralized staff work area from each resident's bedside for 4 of 12 residents (Residents # 1, # 2, #3 and # 4) reviewed for call lights. The facility failed to ensure Resident # 1 had an operating call light system. The facility failed to ensure the call light system was accessible to Residents # 2, # 3 and # 4. These failures could place residents at risk of not being able to call for staff assistance to meet care needs or at risk of injury, pain, hospitalization, and a diminished quality of life.

Inspectors wroteBased on observations, interviews, and record reviews the facility failed to ensure that residents received housekeeping services to maintain a sanitary and comfortable interior for 1 of 8 residents (Resident #22). The facility failed to ensure that housekeeping attendants cleaned and sanitized the interior of the bathroom cabinet in Resident #22's bathroom. This failure could result in potential cross contamination and illness for residents.

Inspectors wroteBased on interviews and record reviews, the facility failed to ensure that the comprehensive care plan was reviewed and revised by the interdisciplinary team after each assessment for 2 (Resident #9 and Resident #37) of 6 residents reviewed for care plans. The facility failed to update Resident #9's and Resident #37's care plan to reflect current activity needs for in room activities. This failure could place residents at risk for not receiving necessary services or having important needs identified and met.

Inspectors wroteBased on observations, interview and record review, the facility failed to ensure a resident who was unable to carry out activities of daily living received the necessary services to maintain good nutrition, grooming, and personal and oral hygiene for two of eight residents (Resident# 9, and Resident #37) reviewed for ADL care. The facility failed to ensure Resident #9's and Resident # 37's nails were cleaned, and did not have any rough edges. This failure could place residents at risk of not receiving services or care, diminished quality of life, and decreased self-esteem.

Inspectors wroteBased on observation, interview and record review the facility failed to provide, based on the comprehensive assessment and care plan and the preferences of each resident, an ongoing program to support residents in their choice of activities, both facility sponsored group and individual activities, and independent activities, designed to meet the interests of and support the physical, mental, and psychosocial well-being of each resident, encouraging both independence and interaction in the community for two of eight residents (Resident # 9, and Resident #37) reviewed for activities. The facility failed to provide Resident #9, and Resident #37 in room activities on the dates of 8/11/2025 thru 8/31/2025. This failure could place residents at risk for boredom, depression, and a diminished quality of life.

Inspectors wroteBased on observations, interviews, and record reviews the facility failed to ensure that a resident who needs respiratory care, including tracheostomy care and tracheal suctioning, is provided such care, consistent with professional standards of practice, the comprehensive person-centered care plan, the residents' goals and preferences for 1 of 2 (Resident #1) reviewed for respiratory care.

Inspectors wroteBased on observation, interview, and record review the facility failed to ensure, in accordance with State and Federal laws, the facility stored all drugs and biologicals in locked compartments under proper temperature controls and permitted only authorized personnel to have access to the keys for one of one nurses' treatment cart reviewed for medication storage. The facility failed to ensure Resident #1's prescription shampoo was stored in the locked treatment nurse cart and instead was stored in the open shower room. This failure could place residents at risk of misuse of medications leading to harm .

Inspectors wroteBased on observation, interviews, and record review the facility failed to ensure residents unable to conduct activities of daily living (ADLs) received the necessary services to maintain good grooming and personal hygiene for three of eight (Resident #17, Resident #31, and Resident #46) residents reviewed for ADL care. The facility failed to ensure Resident #17, Resident # 31, and Resident #46 nails were cleaned and smooth around the edges. These failures placed residents at risk of a decline in their hygiene, at risk of skin breakdown, loss of dignity and decline in quality of life.

Inspectors wroteBased on observation, interviews, and record reviews, the facility failed to treat residents with respect and dignity and care for them in a manner and in an environment that promoted maintenance or enhancement of their quality of life for one (Resident # 53) of eight residents reviewed for resident rights. The facility failed to treat Resident #53 with respect and dignity when the staff was standing while feeding Resident #53 on 08/13/2024. This failure could place residents at risk for decreased quality of life, increased anxiety, and unmet needs.

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure all drugs and biologicals, were in locked compartments and inaccessible to unauthorized staff, visitors , and residents for 3 of 3 medication carts reviewed for medication storage. The facility failed to prevent Medication Cart #1 and Medication Cart #2 being unattended and unlocked near the nurse's desk and one medication cart unlocked and unattended approximately 15 feet away from the right side of nurse's desk on 08/15/2024 between 1:30 AM to 1:43 AM . This failure could allow residents unsupervised access to prescription and over-the-counter medications.

Inspectors wroteBased on observation, interview and record review, the facility failed to store, prepare, distribute food in accordance with professional standards for food service safety for one of one kitchen reviewed for kitchen sanitation. The facility failed to ensure the Maintenance Supervisor K wore a hair net and beard net and the Administrator wore a hair net while standing over large bowl of approximately 15 uncooked chicken breasts in the sink on 08/13/2024. These failures could place residents who were served from the kitchen at risk for health complications, foodborne illness, and decreased quality of life.

Inspectors wroteBased on observations, interviews, and record review, the facility failed to maintain an Infection Control Program designed to ensure hand hygiene procedures were followed by staff in the direct care of one ( Resident #1) of four residents reviewed for infection control. The facility failed to ensure CNA F sanitized or washed her hands prior to touching contaminated surfaces (floor and chair) prior to touching Resident #1's food and prior to feeding Resident #1 on 08/13/2024. These failures could place residents at risk of cross contamination which could result in physical illness.

Inspectors wroteBased on interview, observation, and record review the facility failed to request Nursing Facility Specialized Services for habilitative therapies for two (Resident #1 and Resident #2) of three residents reviewed for PASRR services. The facility failed to provide specialized services to Resident #1 and Resident #2. due to the facility not submitting the Nursing Facility Specialized Services (NFSS) request form in the LTC Portal. This failure could place residents at risk of not receiving specialized PASRR services to enhance the resident's highest level of functioning and could contribute to a decline in physical, mental, psychosocial well-being and quality of life.

Inspectors wroteBased on observation, interview and record review, the facility failed to store, prepare, distribute and serve food in accordance with professional standards for food service safety for one of one kitchens reviewed for sanitation. The Director of Food and Nutrition failed to ensure all food items were labeled, dated, and properly stored. CK H failed to wash her hands after handling dirty dishes. These failures could place residents at risk of foodborne illness.

Inspectors wroteBased on observation, interviews, and record review the facility failed to place most recent survey readily accessible to residents in a place most frequented by most residents have the most recent survey for 5 of 5 residents reviewed for resident group meeting. The facility failed to have the survey manual readily accessible for the residents to view the survey manual. This failure could place residents at risk of not being able to fully exercise their rights to be informed of the facility's survey citation history.

Inspectors wroteBased on observation, interview, and record review the facility failed to ensure residents unable to conduct activities of daily living (ADLs) received the necessary services to maintain good grooming and personal hygiene for four of 15 residents (Resident #23, Resident #28, Resident #45, and Resident #48) reviewed for quality of life. The facility failed to ensure Resident#23's, Resident #28's, Resident #45's, and Resident #48's fingernails were trimmed and cleaned. These failures could place residents at risk for poor hygiene, dignity issues and decreased quality of life.

Inspectors wroteBased on observation, interview, and record review the facility failed to ensure residents received services in the facility with reasonable accommodation of each resident's needs for 2 of 12 residents (Resident # 45, and Resident #23) reviewed for call lights in that Resident #45's and Resident #23's call lights were on the floor and not in reach. This failure could affect all residents who needed assistance with activities of daily living and could result in needs not being met.

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure all residents with pressure ulcers received necessary treatment and services, consistent with professional standards of practice, to promote healing, prevent infection and prevent new ulcers from developing for one (Resident #37) of eight residents reviewed for pressure ulcers. The facility failed to promptly assess the size of Resident t#37's pressure ulcers. The facility failed to promptly input orders for would care for Resident #37's pressure ulcers. These failures could place residents at risk of worsened pressure ulcers.

Inspectors wroteBased on observation, interview, and record review the facility failed to establish and maintain an infection prevention and control program designed to provide a safe, sanitary, and comfortable environment and to help prevent the development and transmission of communicable diseases and infections for 2 of 5 residents (Residents #7 and #9) reviewed for infection control. A) CNA E and F failed to practice appropriate hand hygiene and infection control techniques during incontinent care for Resident #7 B) CNA G and D failed to practice appropriate hand hygiene and infection control techniques during incontinent care for Resident #9 These failure could place residents at risk for developing infections.