Haskell Care Center

Inspectors wroteBased on observation and interview, the facility failed to ensure posted staffing information contained projected and actual staffing hours worked. The administrator identified 35 residents who resided in the facility.

Inspectors wroteBased on record review and interview, the facility failed to report an allegation of abuse for one (#10) of two sampled residents reviewed for abuse. The administrator identified seven allegations of abuse within the last six months.

Inspectors wroteBased on record review and interview, the facility failed to ensure discharge and entry resident assessments were completed for one (#7) of six sampled residents whose resident assessments were reviewed. The administrator identified 35 residents who resided in the facility.

Inspectors wroteBased on record review and interview, the facility failed to ensure a resident assessment was accurate for one (#7) of six sampled residents whose resident assessments were reviewed. The administrator identified 35 residents who resided in the facility.

Inspectors wroteBased on observation, record review, and interview, the facility failed to: a. ensure a level II PASARR was care planned for one (#7); and b. make a referral to the OHCA after a new serious mental illness diagnosis for one (#9) of two sampled residents whose PASARRs were reviewed. The administrator identified 35 residents who resided in the facility.

Inspectors wroteBased on record review and interview, the facility failed to ensure a resident was competent to self administer medication and report medication errors to the physician for one (#7) of six sampled residents whose medications were reviewed. The administrator identified 35 residents who resided in the facility.

Inspectors wroteBased on observation, record review, and interview, the facility failed to ensure oxygen tubing and humidifier bottles were changed and labeled monthly for one (#5) of two sampled residents whose oxygen tubing/humidifier bottles were observed. The administrator identified 35 residents who resided in the facility

Inspectors wroteBased on record review and interview, the facility failed to implement their abuse policy for one (#10) of twelve sampled residents reviewed for abuse and one (CNA#1) of five sampled employees whose background checks were reviewed. The administrator identified 35 residents who resided in the facility.

Inspectors wroteBased on record review and interview, the facility failed to thoroughly investigate an allegation of abuse for one (#10) of two sampled residents reviewed for abuse. The administrator identified seven allegations of abuse within the last six months.

Inspectors wroteBased on record review, observation, and interview, the facility failed to provide adequate supervision and assistance to help prevent falls for two (#1 and #5) of three residents reviewed for falls. Res #1 had four falls in two months, they suffered a hematoma to back of head and abrasion to elbow with one fall and had a fracture to their orbital facial bones on the last fall. The facility failed to: a) Implement interventions and/or appropriate interventions to prevent falls for the residents after each fall occurrence. b) Monitor and/or update the residents' plan of care for appropriate fall interventions. c) Ensure staff were aware of additional care needs for the residents. The administrator identified 16 residents had fallen in the last six months.

Inspectors wroteBased on observation, record review, and interview, the facility failed to develop a wound care plan for one (#24) resident of three residents reviewed for pressure ulcers.

Inspectors wroteBased on observation, record review, and interview, the facility failed to ensure residents' care plans were reviewed and revised for two (#18 and #25) of 12 residents whose care plans were reviewed. The facility failed to update the residents' care plans: a. with new interventions in response to psychotropic drugs for resident #18, and b. with new interventions in response to weight loss for resident #25. The Resident Census and Conditions of Residents documented 34 residents resided in the facility.

Inspectors wroteBased on observation and interview, the facility failed to ensure daily staffing information containing all of the required components was posted and retained for the required amount of time.

Inspectors wroteBased on observation and interview, the facility failed to provide a hand washing sink in the kitchen with soap and water separate from the sink used for food preparation. The Resident Census and Conditions of Residents, dated 08/07/23, documented 34 residents resided in the facility. On 08/07/23 at 9:28 a.m., an initial tour of the kitchen was conducted. The following observations were made: a. a sink utilized for hand hygiene was in a separate room with pots and pans laying in and around the sink, b. an OUT OF ORDER sign was hanging above the sink, c. no soap was available to wash hands before food preparations, and d. no paper towels were available to dry hands before food preparations. On 08/07/23 at 9:28 a.m., [NAME] #1 stated they used the same sink to wash their hands as they used to prepare food for the residents. [...]

Inspectors wroteBased on record review and interview, the facility failed to reevaluate for preadmission screening and resident review (PASRR) level 1 after a change in diagnosis for two (#10 and #32) of four residents reviewed for PASRR services. The Census and Conditions of Residents form documented 40 residents lived in the facility.

Inspectors wroteBased on record review, observation, and interviews, the facility failed to ensure an open wound and edema were assessed for one (#89) of three sampled residents reviewed for skin issues. The ''Resident Census and Conditions of Residents'' report documented 40 residents resided at he facility.

Inspectors wroteBased on record review, observation, and interview, the facility failed to provide restorative services to help prevent further decline in range of motion for two (#22 and #25) of two residents sampled for limited range of motion. The ''Resident Census and Conditions of Residents'' report documented three residents with contractures.

Inspectors wroteBased on record review, observation, and interview, the facility failed to: a. Evaluate the resident for the risk of falls. b. Determine the root causes of falls. c. Ensure interventions were relevant and implemented consistently. d. Implement new interventions to reduce risks, and e. Evaluate the effectiveness of interventions for one (#28) of three sampled residents reviewed for accident hazards The ''Resident Census and Conditions of Residents report documented 40 residents resided in the facility.

Inspectors wroteBased on record review, observation, and interview, the facility failed to assess the need and risk of using bed rails for two (#17 and #90) of two sampled residents reviewed for bed rail usage. The Census and Conditions of Residents form documented 40 residents lived in the facility.

Inspectors wrote3. Res #2 had a physician order, dated 04/01/20, which documented to administer carvedilol 12.5 mg twice a day for chronic systolic heart failure. A physician order, dated 12/08/20, documented to monitor and document blood pressure twice daily. The order documented the therapeutic range was more than 90/60 and less than 160/90. The order documented to notify the physician if out of range. As of 04/13/22, the April 2022 MAR, documented two blood pressures for the month. No other blood pressure documentation was provided. Based on record review and interview, the facility failed to ensure residents' drug regimen was free from unnecessary medication for four (#2, 7, 26, and #32) of five sampled residents who were reviewed for unnecessary medication. [...]

Inspectors wrote3. Resident #2 had diagnoses which included diabetes mellitus, hyperlipidemia, congestive heart failure, and cerebral infarction. A physician order, dated 08/05/20, documented to obtain a CBC and CMP lab test every six months in August and February. A physician order, dated 08/05/20, documented to obtain a HgA1c lab test every three months in August, November, February, and May. On 04/14/22 at 12:11 p.m., the corporate nurse stated she could not find where the facility obtained the CBC, CMP, and HgA1c in February as ordered. Based on record review, observation, and interview, the facility failed to ensure physician ordered lab services were obtained for four (#2, 7, 26, and #32) of five residents sampled reviewed for unnecessary medications. The Census and Conditions of Residents form documented 40 residents lived in the facility.

Inspectors wroteBased on record review and interview, the facility failed to ensure an allegation of abuse was reported to OSDH within two hours after the allegation was made for one (#89) of two residents sampled for abuse. The ''Resident Census and Conditions of Residents report documented 40 residents resided at the facility.

Inspectors wroteBased on record review, observation, and interviews, the facility failed to conduct pressure ulcer assessments at least weekly for one (#89) of three sampled residents reviewed for pressure ulcers. The ''Resident Census and Conditions of Residents'' report documented two residents had pressure ulcers.

Inspectors wroteBased on record review and interview, the facility failed to ensure the physician responded to a pharmacy recommendation for one (#32) of five sampled residents whose medications where reviewed. The Census and Conditions of Residents form documented 40 residents lived in the facility.

Inspectors wroteBased on record review and interview, the facility failed to ensure residents were free from unnecessary psychotropic medications for one (#7) of five residents reviewed for unnecessary medications. The Census and Conditions of Residents form documented 31 residents received psychotropic medications.

Inspectors wroteBased on record review, observation, and interview the facility failed to have an adequate call system in place for one (#32) of 16 residents who were reviewed for adequate call system. The Census and Conditions of Residents form documented 40 residents lived in the facility.