Greeley County Hospital Ltcu

Inspectors wroteThe facility had a census of 15 residents. Based on observation, interview, and record review, the facility failed to use appropriate barriers while sorting soiled laundry.

Inspectors wroteThe facility had a census of 15 residents. Based on observation, interview, and record review, the facility failed to offer a pneumococcal (type of bacterial infection) PVC20 immunization for Residents (R) 6, R12, and R10 per the guidance from the Centers for Disease Control and Prevention (CDC).

Inspectors wroteThe facility had a census of 15 residents. The sample included eight residents, with five reviewed for unnecessary medications. Based on observation, interview, and record review, the facility failed to ensure an appropriate indication, or a documented physician rationale which included the unsuccessful attempts for nonpharmacological symptom management and risk versus benefits for the continued use for Resident (R) 12's antipsychotic (a medication used to treat any major mental disorder characterized by a gross impairment testing).

Inspectors wroteThe facility had a census of 15 residents. The sample included eight residents, including one resident reviewed for accidents. Based on observation, interview, and record review, the staff failed ensure fall interventions were implemented to prevent a fall which resulted in transport to a local hospital and subsequent hip fracture and hematoma (collection of blood trapped in the tissues of the skin or in an organ, resulting from trauma) for Resident (R) 12.

Inspectors wroteThe facility had a census of 15 residents. The sample included eight residents. Based on observation, interview, and record review, the facility failed to ensure the Consultant Pharmacist (CP) identified the lack of specific parameters for Resident (R) 1's use of as-needed (PRN) opioid (a class of drug used to reduce moderate to severe pain) and diuretic (a medication to promote the formation and excretion of urine) use and R12's unapproved diagnosis for the use of an antipsychotic (a class of medications used to treat major mental conditions that cause a break from reality).

Inspectors wroteThe facility had a census of 15 residents. The sample included eight residents. Based on observation, interview, and record review, the facility failed to obtain parameters for as needed (PRN) medication related to opioid (a class of drug used to reduce moderate to severe pain) and diuretic (a medication to promote the formation and excretion of urine) use.

Inspectors wroteThe facility had a census of 16 residents. The sample included nine residents with two reviewed for accidents. Based on observation, record review, and interview the facility failed to ensure an environment free from accidents for Resident (R)3, when staff served her a hot beverage in the wrong cup. R3 spilled the hot beverage on her abdomen, which caused a second-degree burn (potentially painful burn that affects the first and second layer of the skin) and placed the resident at risk for increased pain.

Inspectors wroteThe facility had a census of 16 residents. Based on record review and interview, the facility failed to submit complete and accurate staffing information through Payroll Based Journal (PBJ) as required. This deficient practice placed the residents at risk for unidentified and ongoing inadequate nurse staffing.

Inspectors wroteThe facility had a census of 16 residents. The sample included nine residents with two reviewed for skin issues. Based on observation, interview, and record review the facility failed to perform weekly skin assessments and follow-up documentation of non-pressure related skin issues found for Resident (R) 9, placing R9 at risk for further skin issues.

Inspectors wroteThe facility had a census of 16 residents. The sample included nine residents. Based on observation, interview, and record review the facility failed to label and date one vial of insulin (a hormone that lowers the level of glucose in the blood) for Resident (R) 15, placing R15 at risk of receiving expired or ineffective insulin.

Inspectors wroteThe facility had a census of 18 residents. The sample included eight residents. Based on observation, record review and interview the facility failed to promote an environment free of hazards for Resident (R)8 who smoked cigarettes but was not assessed for safe smoking practices by the facility. This placed the resident at risk for avoidable injuries and fire related hazards

Inspectors wroteThe facility identified a census of 16 residents. Based on record review, observation, and interview, the facility failed to provide sufficient nurse staffing with the appropriate competencies and skill sets to assure residents safety and attain or maintain the highest practicable physical, mental, and psychosocial wellbeing for Resident (R)1 which resulted in R1 falling and breaking her left hip. On 07/26/23 at 02:15 AM, Certified Medication Aide (CMA) R sat at the nurse's station and heard someone yelling. CMA R went down the hallway and found R1 in her room by her bed. R1 stated, I fell, and I can't get up and R1 stated she was trying to reach her call light, which was noted to be at the end of her bed. CMA R called the hospital to get one of the nurses to come help with R1's assessments and neurological checks. R1 told the hospital nurse her left hip hurt. [...]

Inspectors wroteThe facility had a census of 16 residents. The sample included eight residents. Based on observation, record review, and interview, the facility failed to promote care in a manner to maintain and enhance dignity and respect when staff administered nasal spray to Resident (R)2 in the dining room with other residents in full view of the procedure. This placed the resident at risk for an undignified experience.

Inspectors wroteThe facility had a census of 16 residents. The sample included eight residents with one reviewed for hospitalization. Based on observation, interview, and record review the facility failed to inform Resident (R) 11 of the facility's bed hold policy when she was transferred to the hospital. This deficient practice placed R11 at risk to make uninformed decisions regarding her care.

Inspectors wroteThe facility had a census of 16 residents. The sample included eight residents with one reviewed for vision. Based on observation, interview, and record review the facility failed to ensure availability of eye drops as prescribed by the physician for Resident (R) 14. This deficient practice placed R14 at risk for eye discomfort or further reduction in vision.

Inspectors wroteThe facility had a census of 16 residents. The sample included eight residents, with five reviewed for unnecessary medications. Based on observation, record review, and interview, the facility's failed to ensure the Consultant Pharmacist identified and reported an inappropriate indication for the use of an antipsychotic medication (class of medications used to treat any major mental disorder characterized by a gross impairment in reality testing and other mental emotional conditions) for one of five sampled residents, Resident (R)13 and failed to notify the director of nursing of missing administration of prescribed eye drops for R14. This placed the residents at risk for unnecessary medications and related side effects.

Inspectors wroteThe facility had a census of 16 residents. The sample included eight residents, with five reviewed for unnecessary medications. Based on observation, record review, and interview, the facilty failed to provide an acceptable indication, or a documented physician rationale which included the multiple unsuccessful attempts for nonpharmacological symptom management and risk versus benefits for Resident (R) 13 who received an antipsychotic (class of medications used to treat psychosis (any major mental disorder characterized by a gross impairment in reality testing) and other mental emotional conditions) medication. This placed the resident at risk for unnecessary antipsychotic medication and related side effects.

Inspectors wroteThe facility had a census of 16 residents. The sample included eight residents. Based on observation, record review and interview, the facility failed to correctly prepare a pureed diet for Resident (R)3 and R5 This placed the residents at risk for inadequate nutrition.

Inspectors wroteThe facility had a census of 16 residents. The sample included eight residents. Based on observation, interview, and record review the facility failed to provide mail delivery for residents on Saturdays.