Glens Falls Center for Rehabilitation and Nursing

Inspectors wroteBased on observation, record review and interviews during the recertification survey from [DATE] to [DATE], the facility did not ensure safe and appropriate labeling and storage of all medications for 1 of 3 units for medication labeling and storage. Specifically, the medication cart B located on the South Unit contained an expired bottle of Oyster Shell Calcium 500 Milligram tablet; 4 insulin Kwik pens were not labeled with expiration dates after opening; and 1 Ipratropium bromide nasal spray, 1 Fluticasone nasal spray, 1 bottle of Geri-Lanta; 2 bottles of Tussin stock medications, and 1 antifungal cream were not labeled in accordance with facility policy. This was evidenced by: The facility Medication Administration Policy, dated 12/2019, documented the expiration date on the medication label would be checked prior to administering. [...]

Inspectors wroteBased on observation and staff interviews during the recertification and abbreviated survey from 12/07/2023 to 12/18/2023, the facility did not store, prepare, distribute, or serve food in accordance with professional standards for food service safety in the central kitchen and 2 (South and East Units) of 3 nourishment rooms on resident units. Specifically, (a) in the main kitchen, the oven was soiled with food debris, the steamer was soiled, and the inside of the microwave was soiled; (b) in the South Unit nourishment room, the refrigerator gasket was soiled and had a large amount of dried liquid on top of the refrigerator; (c) and in the East Unit nourishment room, the freezer was soiled on the bottom interior and on the freezer door. This was evidenced by: [...]

Inspectors wroteBased on observations, record reviews and staff interview during a Recertification Survey from 12/07/2023 to 12/18/2023, the facility did not ensure residents were assessed by the interdisciplinary team to determine a residents' ability to safely administer their own medications if clinically appropriate for 2 of 2 (Resident #'s 34 and 41) residents reviewed. Specifically, Resident #34's medications were observed on their overbed table on 12/12/2023, and Resident #41's bedtime medications were observed at their bedside on 12/07/2023; there was no documented evidence that Resident #'s 34 and 41 were assessed to determine their ability to safely self-administer medications, or for physician orders for self-administration of medications. This was evidenced by: [...]

Inspectors wroteBased on record review and staff interviews during the recertification survey and abbreviated survey (Case #NY00320404) from 12/07/2023 to 12/18/2023, the facility did not report an injury of unknown origin for 1 (Resident #110) of 7 residents reviewed. Specifically, Resident #110 had a distal fibula fracture (broken calf bone) diagnosed on [DATE] after an x-ray was ordered by their physician in response to a complaint of ankle pain on 7/10/2023. The facility did not report the fracture to the State Survey Agency. This was evidenced by: The Resident Abuse Policy and Procedure, dated 2/2019, documented the following: Notify the local law enforcement and appropriate State Agency(s) immediately (no later than 2 hours after allegation/identification of allegation). Resident #110 was admitted to the facility with diagnoses of chronic kidney disease, morbid obesity, and diabetes. [...]

Inspectors wroteBased on observations, record review, and staff interviews during a recertification survey from 12/07/2023 to 12/18/2023, the facility did not ensure that residents who require dialysis receive such services, consistent with professional standards of practice, the comprehensive person-centered care plan, and the resident's goals and preferences, for 1 of 1 (Resident #10) residents reviewed for dialysis. Specifically, the facility did not ensure nursing consistently completed, reviewed, and logged dialysis communication sheets for Resident # 10 between 11/08/2023 and 12/11/2023. This was evidenced by: Resident #10 was admitted to the facility on [DATE] with the diagnoses of end-stage renal disease and right foot ulcer with methicillin-resistant staphylococcus aureus (known as MRSA, a group of gram-positive bacteria that is a cause of staph infection with resistance to some antibiotics). [...]

Inspectors wroteBased on record review and staff interviews during the recertification survey and abbreviated survey (Case #NY00320404) from 12/07/2023 to 12/18/2023, the facility did not investigate all alleged violations of abuse, neglect, exploitation, misappropriation of resident property, and mistreatment, including injuries of unknown source for 1 (Resident #110) of 7 residents reviewed. Specifically, the facility did not initiate an investigation to determine the root cause of a distal fibula fracture (broken calf bone) discovered on 7/11/2023 after an x-ray was performed for Resident #110's complaint of ankle pain. This was evidenced by: The Resident Abuse Policy and Procedure dated 2/2019 documented the all allegations of suspected neglect, abuse, mistreatment, or any injury of unknown origin were to be promptly and thoroughly investigated by facility management. [...]

Inspectors wroteBased on observation, record review, and interviews during the recertification survey dated 10/24/2022 through 11/1/2022, the facility did not store, prepare, distribute and serve food in accordance with professional standards for food service safety in the main kitchen and 2 of 3 nourishment kitchens. Specifically, the concentration of quaternary ammonium compound chemical sanitizing rinse (QAC) exceeded that required by the manufacturer; one food temperature thermometer was not in calibration; the can opener and holder, slicer, edge of reach-in refrigerator door, and ceiling in dishwashing machine room in the main kitchen and the microwave oven and refrigerator in the [NAME] Unit nourishment kitchen were soiled with food particles or splatters; and the kitchen janitor closet wall and South Unit nourishment room wall required repair. This is evidenced as follows: [...]

Inspectors wroteBased on record review and interviews during the recertification survey dated 10/24/2022 through 11/1/2022, the facility did not ensure the appropriate discharge information was documented in the resident's record for one (1) (Resident #109) of two (2) residents reviewed for transfer/discharge. Specifically, for Resident #109, the facility did not ensure the resident's record included documentation regarding the resident's discharge from the facility and did not ensure that when upon request the facility submitted an Against Medical Advice (AMA) form signed by Resident #109, the record included documentation the resident received education on what it meant to leave the facility Against Medical Advice (AMA), documentation regarding when or how the resident left the facility or documentation of notifications made when the resident left the facility.

Inspectors wroteBased on record review and interview conducted during the recertification survey dated 10/24/2022 through 11/1/2022, the facility did not ensure the development of comprehensive person-centered care plans, that included measurable objectives and time frames to meet the resident's medical, nursing, and mental and psychosocial needs that were identified in the comprehensive assessment, for 2 (Resident #s 259 and #361) of 22 residents reviewed for comprehensive care plans (CCP). Specifically, for Resident #259, the facility did not ensure a CCP was developed to address the resident's activities of daily living (ADLs) and for Resident #361, did not ensure a CCP was developed to address the resident's pain management. This is Evidenced By: [...]

Inspectors wroteBased on record review and interviews during the recertification survey, the facility did not ensure the resident and their representative were provided with a summary of the baseline care plan for 8 (Resident #s 10, 17, 25, 43, 66, 92, 97, 103 and 114) of 10 residents reviewed for baseline care plans. Specifically, the facility did not document that a baseline care plan was provided to Resident #s 10, 17, 25, 66, 92, 97, 103, and #114, and their representatives to review and sign. Subsequently, Resident #s 10, 17, 25, 66, 92, 97, 103, and #114, and their representatives were unaware of treatment plans and interventions to ensure the residents' physical, psychosocial, and emotional needs were met. This is evidence by: The Policy and Procedure dated 1/2020, documented a baseline plan of care to meet the resident's immediate needs shall be developed within 48 hours of their admission. [...]

Inspectors wroteBased on observation, interview and record review during a recertification survey, the facility did not establish and maintain an infection prevention and control program designed to help prevent the development and transmission of communicable diseases and infections determined for 2 (Resident #'s 51 and for an unsampled resident) of 3 residents reviewed for dressing changes. Specifically, for Resident #50, the facility did not ensure standard precautions were maintained during a dressing change, and for an unsampled resident. This was evidenced by: Resident #50: The resident was admitted to the facility with diagnoses of Type 2 diabetes mellitus, vascular dementia with behavioral disturbance and radiculopathy, lumbar region. [...]

Inspectors wroteBased on observation and staff interview during the recertification survey, the facility did not provide effective housekeeping and maintenance services. Specifically, floors were not clean and in good repair on 2 of 3 resident units. This is evidenced as follows. The floors were spot checked on 02/20/2020 at 1:30 PM. The floors next to walls, in corners, and at the base of door frames were soiled with dirt and a brown build-up in resident rooms E-5, E-8, E-11, E-15, E-22, E-23, W-26, W-27, W-29, W-42, W-43, W-44, and the corridors on the East and [NAME] resident units. Floor and wall tiles in the East A and East B shower rooms were cracked and missing grout. The Director of Maintenance stated in an interview on 02/20/2020 at 2:25 PM, that he will clean the floors in the resident rooms and hallways, and he will replace the tiles in the shower rooms. 483.10(i)(2)

Inspectors wroteBased on observation, record review and interviews during a recertification survey the facility did not ensure person-centered comprehensive care plans (CCP's) were developed and implemented that included measurable objectives and timeframe's to meet the residents needs for 4 (Resident #'s 17, 19, 66, 92) of 23 residents reviewed. Specifically, for Resident #'s 17 and 66, the facility did not ensure their CCP's were resident-centered, for Resident #19, did not ensure a CCP for a respiratory infection was developed and for Resident #92, did not ensure a CCP for the use of psychotropic medication was developed and implemented after a recent hospitalization. This is evidenced by: [...]

Inspectors wroteBased on observation, interview and record review during a recertification survey and abbreviated survey, (Case #NY00241438), the facility did not ensure each resident's drug regime was free from unnecessary drugs for 2 (Resident #'s 213 and 92) of 7 residents reviewed. Specifically, for Resident #213, the facility did not ensure the resident who was receiving pain medication on an as needed bases, was consistently monitored for adverse consequences of the pain medication per plan of care and evaluated for the effectiveness of the pain medication. Additionally, the doseage of the pain medication was increased without adequate monitoring and evaluating the prn doesage, and for Resident #92, the facility did not consistently ensure that a post prn pain scale was obtained and documented. This was evidenced by: [...]

Inspectors wroteBased on observation and staff interview during the recertification survey the facility did not store, prepare, distribute and serve food in accordance with professional standards for food service safety. Food packages shall be in good condition and shall protect the integrity of the contents so food is not exposed to adulteration or potential contaminants, a minimum chlorine residual of 50 parts per million (ppm) must be maintained in the dish machine rinse cycle, handwashing sinks must be maintained in working order, and non-food surfaces must be kept clean. Specifically, cans of food were dented, the dish machine sanitizing solution concentration was not maintained, a handwash sink was clogged, and the gaskets on the reach-in refrigerator and the walls in the walk-in cooler were not clean. This is evidenced as follows. The main kitchen was inspected on 02/18/2020 at 8:45 AM. [...]