Future Care Irvington

Inspectors wroteBased on observation and facility staff interview, it was determined the facility failed to ensure residents had access to their call bell. This was evident for 7 Residents (#7, #18, #39, #133, #109, #112, #47) of 65 residents included during the surveyor's initial tour of the facility during the recertification survey.

Inspectors wroteNumber of residents sampled: Number of residents cited: Based on observations and interviews it was determined that the facility staff failed to report and complete maintenance concerns on Unit 1 South in a timely manner. This deficient practice was widespread on Unit 1 South and was discovered during the recertification survey.

Inspectors wroteBased on observation, facility staff interview and review of facility policy it was determined that the facility failed to maintain an effective infection prevention and control program. This was found to be evident for 7 of 7 residents reviewed for infection control practices and was widespread on Unit 1 South.

Inspectors wroteNumber of residents sampled: Number of residents cited: Based on observation and an interview with facility staff, it was determined that the facility failed to maintain a resident's privacy by having their foley catheter bag uncovered. This was evident for 1 (Resident # 170) of 3 residents reviewed during the annual recertification survey.

Inspectors wroteBased on interviews and record review it was determined that the facility failed to develop and implement a comprehensive care plan to meet the need of a Resident. This was found evident of 1 (Resident #8) out of 65 residents reviewed during the survey.

Inspectors wroteBased on observation, record review and interview, it was determined that the facility failed to 1) reassess the effectiveness of the interventions and review/revise them (Resident #25) and 2) failed to invite a resident to attend and participate in their care plan meeting (Resident #186). This was found on review of 65 resident's care plans.

Inspectors wroteNumber of residents sampled: Number of residents cited: Based on observations and interviews it was determined that the facility staff failed to practice according to professional nursing standards as evidenced by a nurse removing a pain patch from a resident and placing it on the windowsill. This deficient practice was evidenced in 1 (#18) in 1 resident observed with a pain patch that was not properly discarded. This deficient practice occurred during the recertification survey.

Inspectors wroteBased on record review and interview, it was determined that the facility failed to provide necessary services to maintain good personal hygiene for dependent Residents. This was found evident in 1(Resident #77) out of 3 Residents reviewed for Activity of Daily Living (ADL) cares.

Inspectors wroteNumber of residents sampled: Number of residents cited: Based on observations, record reviews, and staff interviews, it was determined that the facility failed to ensure oxygen therapy was set up in accordance with professional standards of practice. This was evident for 1 (Resident #122) out of 3 residents reviewed for respiratory care during the annual survey.

Inspectors wroteNumber of residents sampled: Number of residents cited: Based on review of narcotic counts, it was determined that the facility failed to ensure that narcotic medications were consistently accurate. This was evident for 2 of 6 medication carts reviewed for accuracy and completeness of controlled medication storage and documentation.

Inspectors wroteNumber of residents sampled: Number of residents cited: Based on observation and facility staff interview, it was determined that the facility failed to properly label bulk medications with the date that included month, day and year and to properly date multi-dose insulin injectable pens when they are opened. This was evident for 3 of 6 medication carts that were reviewed.

Inspectors wroteNumber of residents sampled: Number of residents cited: Based on observation, interview, and record review, it was determined that the facility failed to provide sugar substitute as specified by the ordered diet. This was found to be evident for 1 (#86) out of 3 residents investigated for food preferences.

Inspectors wroteBased on medical record review and staff interview, facility staff failed to follow a resident's plan of care to prevent injury to resident while providing care. This resulted in harm to Resident #6. This was evident for 1 of 3 residents reviewed for falls during a complaint survey. After the incident, the facility developed, initiated and completed a plan of correction to prevent further injuries to residents while providing care. Therefore, this deficiency will be cited as past non-compliance. The date of correction was 8/18/23.

Inspectors wroteBased on observation of dry goods in the kitchen on 5/30/23 at 9:15 AM, and foods stored in the freezer, the facility failed to label four food items in the freezer with the date. This was evident for 8 items in the freezer, pasta, and can goods in the dry storage areas.

Inspectors wroteBased on interviews and review of medical records, and resident interviews, it was determined that the facility failed to: 1) update a care plan to reflect the current needs of the resident, and 2) involve the resident in the care planning process. This was evident of 4 (Residents #80, #97, #142 and #148) of 7 residents reviewed for care planning during an annual and complaint survey.

Inspectors wroteBased on observations, record review, and interviews of facility staff it was determined the facility failed to ensure that tube feedings were managed appropriately according to professional standards. This was evident for 4 residents (#142, #156, #12 and #123) out of 4 residents who were observed to have tube feedings in place.

Inspectors wroteBased on observation, medical record review and interview it was determined that the facility failed to ensure the accuracy of medical orders/records and bathing documentation. This was evident for 1 (Resident #142) out of 2 residents that were reviewed for bowel and bladder, 1 (Resident #24) out of 9 residents reviewed for pressure ulcer/injury, and 1 (Resident #41) out of 1 resident that was reviewed for neglect.

Inspectors wroteBased on interview and review of medical records it was determined that the facility failed to obtain a resident's advanced directives. This was found evident for 1 of 3 residents (Resident #367) reviewed for advanced directives during an annual and complaint survey. Advanced Directive: A written statement of a person's wishes regarding medical treatment, often including a living will, made to ensure those wishes are carried out should the person be unable to communicate them to a doctor. It is a legal document in which a person specifies what actions should be taken for their health if they are no longer able to make decisions for themselves because of illness or incapacity.

Inspectors wroteBased on record review, staff, and resident interviews it was determined that the facility failed to ensure that a resident was free from verbal abuse. This was found to be evident for 1 (Resident # 115) out of 2 residents reviewed for verbal abuse.

Inspectors wroteBased on interviews and reviews of the Facility Reported Incident (FRI) investigation documentation it was determined the facility failed to thoroughly investigate allegations of abuse. This was evident for 2 (Resident # 115 and # 21) out of 4 residents reviewed for abuse.

Inspectors wroteBased on record reviews and interviews it was determined that the facility failed to provide notification in writing of a resident's transfer to the hospital. This was evident for 2 (# 113 and # 51) out of 2 residents reviewed for transfer notifications.

Inspectors wroteBased on observations, interviews, and record reviews, it was determined that the facility failed to: 1) develop comprehensive care plans for, 1) oxygen therapy and 2) behaviors related to psychiatric diagnoses. This was found to be evident for 2 (# 125 and # 157) out of 9 residents reviewed for comprehensive care plans.

Inspectors wroteBased on interviews with staff and medical record review it was determined that the facility failed to follow-up on a physician's order. This was found evident of 1 of 6 Residents (Resident #97) reviewed for positioning during an annual and complaint survey.

Inspectors wroteBased on medical record review and interview it was determined that the facility failed to ensure interventions were implemented to prevent significant weight loss for a resident who was receiving enteral nutrition (receiving feeding through an artificial tube, not by mouth.). This was evident for 1 out of 5 residents reviewed for nutrition.

Inspectors wroteBased on observation, interviews with Resident and staff, review of facility's policy, and of medical records it was determined that the facility failed to follow professional standards for a resident receiving oxygen by: a) administrating oxygen without an order, and b) administrating oxygen at an inaccurate rate. This was found evident of 1 of 7 Residents (Resident #131) reviewed for respiratory care during an annual and complaint survey.

Inspectors wroteBased on record reviews, observations, and interviews it was determined the facility failed to ensure a resident's orders for life sustaining treatment were valid and reviewed by the physician during the facility's admission process. This was evident for 1 out of 3 residents reviewed for advanced directives.

Inspectors wroteBased on interviews with staff and record review it was determined that the facility failed to: 1) comprehensively review behavioral health medications, and 2) contact psychiatric services for a resident who had an order to see a Psychiatrist. This was evident for 2 (Resident # 124 and #157) out of 8 residents reviewed for behavioral health during the annual and complaint survey.

Inspectors wroteBased on observations, interviews, and review of policies and procedures, the facility failed to: 1) ensure that staff performed hand hygiene, and 2) to sanitize equipment between residents. This was evident for 3 (# 28, # 29, and # 38) out of 8 staff observed during the annual and complaint survey.

Inspectors wroteBased on observation, record review and interview it was determined that the facility failed to ensure posting of the most recent survey results. This was evident during surveyor review of a complaint during the facility's annual survey.

Inspectors wroteBased on surveyor observation during facility environmental observations it was determined that the facility staff failed to provide housekeeping and maintenance services necessary to maintain a sanitary, orderly, and comfortable interior. This was observed on 2 of 4 resident units.

Inspectors wroteBased on medical record review and interview with staff it was determined that the facility staff failed to provide a written notice for emergency transfers to the resident and/or the resident representative. This was found to be evident for 2 out of 13 residents (Resident #106 and #113) reviewed for a facility-initiated transfer during the investigative portion of the survey.

Inspectors wroteBased on review of the medical record and staff interview, it was determined that the facility staff failed to provide the resident or their representative with a written notice of bed-hold policy, at the time of the resident transfer for hospitalization. This was evident for 1 of 13 residents (Resident #106) reviewed for hospitalization during an annual recertification survey.

Inspectors wroteBased on medical record review it was determined that the facility failed to ensure the Pain Tool 2.1 assessment accurately reflected the resident's status. This was evident for 1 of 5 residents (Resident #144) reviewed for Pain Management.

Inspectors wroteBased on medical record review and interview it was determined the facility staff failed to review and revise the care plan for Resident (#45) to reflect accurate and current interventions. This was evident for 1 of 1 residents reviewed for care plans during the annual survey process.

Inspectors wroteBased on review of a closed medical record, it was determined that the facility staff failed to provide a resident with a completed discharge summary before the resident was discharged home. This was evident for 1 of 1 resident (Resident #172) reviewed for discharge during an annual recertification survey.

Inspectors wroteBased on observation, medical record review and interview it was determined the facility staff failed to provide grooming and personal hygiene services. This is evident for 1 of 2 residents (Resident #107) selected for review for Activities of Daily Living (ADL) care during the annual survey process.

Inspectors wroteBased on medical record review and interview, it was determined the facility staff failed to provide care to Residents (#45 and #108) in order to obtain or maintain optimal level of well-being. This was evident for 2 of 61 residents selected for review of quality of care during the annual survey.

Inspectors wroteBased on medical record review and interview, it was determined the facility staff failed to ensure a snack was provided to Resident (#151). This was evident for 1 of 8 residents selected for review of nutrition during the annual survey process.

Inspectors wroteBased on medical record review and interview it was determined the facility staff failed to thoroughly assess the need for pain medication and follow the physicians' orders for administration of that pain medication for residents. This was evident for 2 of 4 residents (Resident #68 and #92) selected for review of pain management during the annual survey.

Inspectors wroteBased on review of employee files and staff interview, it was determined that the facility failed to perform an annual performance review for a Geriatric Nursing Assistant (GNA #8). This was identified for 1 of 2 GNA staff members reviewed during a complaint investigation.

Inspectors wroteBased on medical record review and interview, it was determined the facility staff failed to act upon the consultant pharmacist recommendation in a timely manner for Resident (#151). This was evident for 1 of 61 residents selected for review of medication review and 1 of 61 selected for review during the annual survey process.

Inspectors wroteBased on observation and interviews of facility staff, it was determined that food service employees failed to ensure that equipment was maintained and safe food handling practices were followed to reduce the risk of foodborne illness. This deficient practice has the potential to affect all residents.

Inspectors wroteBased on medical record review and staff interview, it was determined the facility staff failed to maintain the medical record in the most complete and accurate form for a resident. This was evident for 1 of 61 residents (Resident #92) selected for medical record review during the annual survey process.

Inspectors wroteBased on observation and interview it was determined that the facility staff failed to provide a safe, sanitary environment to prevent the development and transmission of disease and infection. This was evident during the initial tour of the nursing units and was found to be evident for 2 out of 2 residents (Resident #46 and #106) reviewed during the investigative portion of the survey. The Findings Include: 1. On 02/21/19 01:30 PM, an observation revealed that outside Resident #46's room was a container that contained items necessary for isolation precautions, gowns, masks, and gloves. Nurse #14 was observed walking into the room and not washing or sanitizing his/her hands and without the proper isolation precautions such as gown and gloves that was required to prevent the transmission of disease and infection. Medical record review on 02/21/19, revealed: [...]