Hansford Manor

Inspectors wroteBased on observation, interview, and record review, the facility failed to store, prepare, distribute, and serve food in accordance with the professional standards for food service safety for 1 of 1 kitchen reviewed for kitchen sanitation. 1. The facility failed to ensure food items were properly stored, labeled, and dated.2. The facility failed to the kitchen was free of expired foods. These failures could place residents who ate food served by the kitchen at risk of food-borne illness.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure all residents had the right to formulate an advanced directive for 1 (Resident #25) of 24 residents reviewed for advanced directives. Resident #25 had a DNR in her record that was missing the date of when Resident #25 signed the DNR. This failure could place residents a risk for not receiving healthcare as per their or their legal representatives wishes.

Inspectors wroteBased on observation, interview and record review, the facility failed to implement a comprehensive care plan for each resident that includes measurable objectives and timeframes to meet a resident's medical, nursing, and mental and psychosocial needs that are identified in the comprehensive assessment and describes the services that are to be furnished to attain or maintain the resident's highest practicable physical, mental, and psychosocial well-being for 1 (Resident #1) of 15 Residents reviewed for comprehensive care plans. -The facility failed to include a care plan for Resident #1's wounds. This failure could result in resident not being able to attain or maintain their highest practicable physical, mental, and psychosocial well-being.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure residents who need respiratory care were provided such care consistent with professional standards of practice for 1 (Resident #12) of 15 residents reviewed for respiratory care. -Resident #12 was not receiving oxygen at the correct dose. This failure could place residents at risk for respiratory compromise and associated complications such as shortness of breath, confusion, respiratory failure, infection, and exacerbation of their condition.

Inspectors wroteBased on observation, interview, and record review; the facility failed to ensure a medication was labeled and stored in accordance with currently accepted professional principles for 1 of 2 medication carts reviewed for medication storage. The Hall 2 medication cart had a inulin pen that had been used that was not marked with the date of when it was opened/accessed or when it should expire. This failure could result in ineffective treatment resulting in exacerbation of resident's disease processes.

Inspectors wroteBased on interview and record review, the facility failed to complete an assessment that accurately reflected the resident's status for 1 of 14 residents (Resident #4) reviewed for accuracy of MDS assessments. The facility failed to complete an accurate assessment for Resident #4, the assessment indicated she received insulin and did not. This failure could affect residents by placing them at risk for not receiving adequate care and services.

Inspectors wroteBased on observation, interview, and record review the facility failed to develop and implement a comprehensive person-centered care plan for each resident, consistent with resident rights that includes measurable objectives and timeframes to meet a resident's medical, nursing, and mental and psychosocial needs that are identified in the comprehensive assessment and describes the services that are to be furnished to attain or maintain the resident's highest practicable physical, mental, and psychosocial well-being for 2 (Resident #28 and Resident #101) of 14 residents reviewed for care plans. The facility failed to include bed rail use in the care plans of Resident #28 and Resident #101. These failures could place residents at risk of harm due to incorrect care and/or lack of monitoring. Findings Included: 1. [...]

Inspectors wroteBased on observation, interview, and record review the facility failed to attempt to use appropriate alternatives prior to installing a side or bed rail for 2 (Resident #4 and Resident #101) of 14 residents reviewed for bed rails. The facility placed bed rails on the beds of Resident #4 and Resident #101 on the day the residents were admitted without attempting other interventions. These failures could place residents at risk of entrapment or injury due to bed rails.

Inspectors wroteBased on observation, interview, and record review the facility failed to ensure the resident environment remained as free of accident hazards as is possible for 14 of 49 residents (Resident #7 and the 13 residents residing on the north end of hall 1) reviewed for accident hazards. 1. Resident #7 was allowed to keep his cigarettes and lighter with him. 2. Three 200 mg tablets of Amiodarone were found on the floor of the north end of hall 1. These failures could place residents at risk of injury.

Inspectors wroteBased on observation, interview, and record review, the facility failed to 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 2 residents (Resident #3 and #40) and 1 of *(Nutrition Aide-(NA D) observed for infection control practices. NA D failed to use proper hand hygiene techniques when providing feeding assistance between Resident #3 and Resident #40. This failure may place resident at an increased risk for transmissible diseases.