Galena Nursing & Rehab Center

Inspectors wroteBased on observation, interview, and record review, the facility failed to notify the Long-Term Care Ombudsman in writing of Resident (R) 41's discharge to the community.

Inspectors wroteThe facility failed to provide appropriate activity of daily living (ADL) cares for three dependent Residents (R ) 3, R24, and R9, who had long, jagged, dirty nails.

Inspectors wroteBased on interview and record review, the facility failed to ensure two Residents (R)3 and R9 remained free from unnecessary medications related to blood pressure medication.

Inspectors wroteBased on observation, interview, and record review, the facility failed to utilize Enhanced Barrier Precautions (EBP-infection control interventions designed to reduce transmission of resistant organisms which require targeted gown and glove use during high contact care) when providing direct care for Resident (R) 13 and 7 who had wounds and R1 for catheter care. Findings Included: - On 06/22/2026 at 11:27 AM, R1 rested in bed with the urinary catheter collection bag directly on the floor. The collection bag contained approximately 400 milliliters (mLs) of dark brown, tea colored urine. The door into R1's room had signage that read, This room is under Enhanced Barrier Precautions. The signage educated staff further on what to wear for Personal Protective Equipment (PPE) when in contact with wounds, urinary catheters, and infections, which included gown and gloves. [...]

Inspectors wroteBased on observation, record review, and interview, the facility failed to provide housekeeping and maintenance services to ensure a safe and sanitary environment in the facility laundry. This created the risk of impaired safety and cleanliness.

Inspectors wroteBased on interviews and record review, the facility failed to ensure Resident (R) 1 remained free from abuse. On 03/21/26 at around 10:30-11:00 PM Certified Nurse Aide (CNA) M identified bruising on R1's right leg and reported it to Licensed Nurse (LN) G. LN G determined the bruising was probably from the wheelchair but did not report the bruises of unknown origin to the administrator. Around 04:20 AM on 03/22/26, CNA M reported to LN G that R1 had vaginal bleeding. LN G instructed the CNA to apply antifungal powder or cream but did not assess the area. The resident remained in her room with her representative, the alleged perpetrator (AP), with the door closed. At 06:00 AM, LN G told LN H and LN I that R1 had some vaginal bleeding. At 08:00 AM, CNA O provided peri care to R1 and identified dried blood on R1's labia and reported to LN I. [...]

Inspectors wroteBased on record reviews and interviews, the facility failed to ensure staff identified Resident (R) 1's signs of physical and sexual abuse, and report to the Administrator immediately and the appropriate state entities within the required time. On 03/21/22 at around 10:30-11:00 PM Certified (CNA) M and CNA N identified bruising on R1's right leg and reported it to Licensed Nurse (LN) G. LN G spoke to the resident's representative, the alleged perpetrator (AP), who offered a rationale for the injury which LN G accepted without investigation. Around 04:20 AM on 03/22/26, CNA M reported to LN G that R1 had vaginal bleeding. LN G instructed the CNA to apply topical cream but failed to assess the area. LN G did not document the bruising, the conversation with the AP or the change in condition of R1's vaginal area and failed to report bruising or vaginal bleeding to Administrative Staff A. [...]

Inspectors wroteThe facility failed to implement protective measures after injuries of unknown origin and signs of potential sexual abuse were identified to prevent further abuse. On 03/21/22 at around 10:30-11:00 PM Certified (CNA) M and CNA N identified significant bruising on R1's right leg and reported it to Licensed Nurse (LN) G. R1 was unable to state how she obtained the injuries. LN G spoke to the resident's representative, the alleged perpetrator (AP), who confirmed he did not know where the bruising came from but offered a rationale for the injury which LN G accepted without further investigation. Staff left R1 in the room with the AP. Around 04:20 AM on 03/22/26, CNA M reported to LN G that R1 had vaginal bleeding. LN G did not assess R1 but instructed the CNA to apply an antifungal to R1's peri area. [...]

Inspectors wroteThe facility reported a census of 39 residents with 15 residents sampled, including 6 residents reviewed for activities of daily living (ADLS). Based on observation, interview, and record review, the facility failed to provide necessary ADL cares for four sampled resident, Resident (R)16 was not shaven, R6 had dirty clothes, R29 did not get showered, and R17 received no feeding assistance. This deficient practice placed the affected residents at risk for impaired quality of life, weight loss and poor hygiene.

Inspectors wroteThe facility identified a census of 39 residents. The sample included 15 residents with one sampled for dialysis (a procedure where impurities or wastes were removed from the blood). Based on observation, interview, and record review, the facility failed to address necessary dialysis assessments, care, and services on Resident (R) 143's baseline care plan. This deficient practice had the risk of adverse outcomes and dialysis complications for R143 due to uncommunicated care needs.

Inspectors wroteThe facility reported a census of 39 residents, with 15 residents included in the sample. Based on observation, record review, and interview, the facility failed to complete a comprehensive care plan for one of the residents sampled, Resident (R)16, to include staff instruction for the use of foot pedals while propelling the resident in his wheelchair.

Inspectors wroteThe facility identified a census of 39 residents, with 15 residents sampled, including two residents reviewed for quality of care. Based on record review, interview, and observation, the facility failed to ensure Resident (R) 5 had adequate care when the facility did not monitor R5's weights and notify the provider of weight fluctuations as ordered. This deficient practice placed the resident at risk for health complications.

Inspectors wroteThe facility reported a census of 39 residents with 15 residents sampled including four residents reviewed for accidents. Based on observation, record review and interview, the facility failed to ensure a safe environment free from accident hazards for Resident (R)16 when staff failed to have foot pedals in place when staff propelled the resident in the chair. This placed R16 at risk for avoidable accidents.

Inspectors wroteThe facility identified a census of 39 residents with 15 sampled. Based on observation, interview, and record review, the facility failed to provide care and services to maintain acceptable parameters of nutritional status by failing to properly follow the plan of care for Resident (R) 17. Also, the facility failed to properly assess nutritional status for R143. This deficient practice had the potential to negatively affect the residents physical well-being and nutritional status.

Inspectors wroteThe facility identified a census of 39 residents. The sample included 15 residents with one sampled for dialysis (a procedure where impurities or wastes were removed from the blood) review. Based on observation, interview, and record review, the facility failed to provide the necessary dialysis assessment, care, and services for Resident (R) 143. This deficient practice had the risk for adverse outcomes and dialysis complications for R143.

Inspectors wroteThe facility identified a census of 39 residents. The sample included 15 residents with five reviewed for unnecessary medications. Based on observation, record review, and interviews, the facility failed to ensure blood pressure monitoring was conducted related to the use of midodrine (a medication used to increase blood pressure) for Resident (R)143. This placed R143 at risk of complications related to abnormal blood pressure.

Inspectors wroteThe facility reported a census of 39 residents. The sample included 15 residents. Based on interviews, record reviews, and observation, the facility staff failed to implement Enhanced Barrier Precautions (EBP a set of infection control measures that use gowns and gloves to reduce the spread of multidrug-resistant organisms [MDROs] in nursing homes) for Resident (R) 5 who had a foley catheter (a flexible tube inserted through a narrow opening into a body cavity, particularly the bladder, for removing fluid) and for R37 who received a tube feeding (administration of nutritionally balanced liquefied foods or nutrients through a tube) and wound care. Additionally, R7, who had an ostomy (a surgical procedure that creates an opening in the abdomen to allow waste or urine to pass out of the body) lacked EBP in place. [...]

Inspectors wroteThe facility reported a census of 39 residents with 15 residents sampled. Based on observation, interview, and record review, the facility failed to inspect Resident (R)6's bed frame and mattress, as part of a regular maintenance program to identify areas of possible entrapment. This placed the resident at risk for injuries.

Inspectors wroteThe facility reported a census of 42 residents. Based on interview and record review, the facility failed to conduct Quality Assurance Performance Improvement (QAPI) leadership meetings with the medical director in attendance at least quarterly as required.

Inspectors wroteThe facility reported a census of 42 residents. Based on observation, interview and record review, the facility failed to maintain a clean, comfortable and homelike environment in two resident shower rooms for the residents of the facility.

Inspectors wroteThe facility reported a census of 42 residents. Based on observation, interview and record review, the facility failed to maintain an effective infection control program with the failure to ensure proper storage of glucometer and insulin pen storage for a resident in transmission-based precautions for COVID-19, to prevent the spread of infection to the residents of the facility.

Inspectors wroteThe facility reported a census of 42 residents with 15 selected for review, which included one resident reviewed for abuse. Based on observation, interview and record review, the facility failed to report one Resident (R)96 allegation of abuse to the state agency as required.

Inspectors wroteThe facility reported a census of 42 residents with 15 residents sampled including five residents reviewed for unnecessary medications. Based on observation, record review and interview, the facility failed to monitor two Residents (R)10 and R 32 for use of antipsychotic medications (drugs used to treat psychosis-related conditions and symptoms).