Heartland Care and Rehabilitation Center

Inspectors wroteBased on observation, interview, and record review, the facility failed to provide a clean, comfortable, and homelike environment. This deficient practice had the potential to affect all residents in the facility. The facility census was 63. Review of the facility's policy titled, Maintenance Service, dated December 2009, showed: - The maintenance department is responsible for maintaining the building, grounds, and equipment in a safe and operable manner at all times; - Functions of maintenance personnel include maintaining the building in good repair and free from hazards; - The maintenance director is responsible for developing and maintaining a schedule of maintenance service to assure that the buildings, grounds, and equipment are maintained in a safe and operable manner. Observation on 09/30/25 at 11:24 A.M., of room [ROOM NUMBER] showed: - The bathroom door could not be opened. [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to maintain proper infection control practices when providing catheter (a flexible tube inserted into the bladder to drain urine) care for two residents (Residents #7 and #59) out of two sampled residents and blood sugar checks for two residents (Residents #16 and #27) out of five sampled residents. The facility census was 63. Review of the facility's policy titled, Enhanced Barrier Precautions (EBP), dated 2024, showed: - EBP refers to an infection control intervention designed to reduce transmission of multidrug-resistance organisms (MDROs) that employs targeted gown, and gloves use during high contact resident care activities; [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to follow physician's orders for four residents (Residents #5, #9, #19, and #68) out of 20 sampled residents. The facility's census was 74. The facility did not provide a policy regarding following physician's orders. 1. Review of Resident #5's medical record showed: - admitted on [DATE]; - Diagnoses of chronic obstructive pulmonary disorder (COPD - a debilitating, progressive lung disease), respiratory failure (insufficient oxygen carried to the blood), pneumonia (infection in the lungs), major depressive disorder (low mood), and heart failure (heart does not pump correctly). Review of the resident's Physician Order Sheet (POS), dated October 2024, showed an order for daily weights, contact the healthcare provider if a gain of 2 to 3 pounds a day or 5 pounds a week for heart failure (CHF), dated 09/28/24. [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure physician's orders for oxygen with the use of a bilevel positive airway pressure (BIPAP - a noninvasive ventilation device that helps people breathe by delivering pressurized air into the airways) was followed for two residents (Residents #5 and #75) out of two sampled residents. The facility census was 74. Review of the facility's policy titled, Oxygen Administration, revised October 2010, showed: - Verify that there is a physician's order for this procedure; - Review the physician's orders or facility protocol for oxygen administration; - Review the resident's care plan to assess for any special needs of the resident; - Assemble the equipment and supplies as needed. 1. Review of Resident #5's medical record showed: - admission date of 02/25/05; [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to maintain an error rate of less than five percent (%) when medications were administered. There were 28 opportunities with three errors made, for an error rate of 11% which affected one resident (Resident #8) outside the sample of four residents. The facility census was 74. Review of the facility's policy titled, Insulin Administration, dated 2001, showed: - Only appropriately licensed or certified personnel shall draw and administer insulin; - The type of insulin, dosage requirements, strength, and method of administration must be verified before administration, to assure that it corresponds with the order on the medication sheet and the physician's order; [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure drugs and biologicals were labeled in accordance with currently accepted practices. The facility also failed to ensure one resident (Resident #22) outside of the 20 sampled residents had a physician's order to keep medications at the bedside. This had the potential to affect all residents. The facility census was 74. The facility did not provide a policy regarding residents keeping at the bedside/self-administering medications. Review of the facility policy titled Medication Labeling and Storage, revised February 2023, showed: [...]

Inspectors wroteBased on interview and record review, the facility failed to maintain a system to ensure the resident trust fund account was managed in accordance with proper accounting principles by not maintaining an accurate accounting of all monies held in the resident trust fund petty cash box. This had the potential to affect all residents residing in the facility. The facility census was 74. Review of the facility policy titled, Management of Residents' Personal Funds, revised March 2021, showed: - The facility manages the personal funds of residents who request the facility to do so; - Should the facility manage the resident's funds, the facility acts as a fiduciary of the resident funds and holds, safeguards, manages and accounts for the personal funds of the resident. No service charge is levied against the resident for the management of personal funds; [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to provide a safe, clean and comfortable homelike environment. This deficient practice had the potential to affect all residents in the facility. The facility census was 76. Review of the facility policy titled, Maintenance Service, revised 2009, showed: - Maintenance service shall be provided to all areas of the building, grounds, and equipment; - The Maintenance Department is responsible for maintaining the buildings, grounds, and equipment in a safe and operable manner at all times; - The Maintenance Director is responsible for maintaining inspections of the buildings and work order requests; - Records shall be maintained in the Maintenance Director's office. Review of the facility policy titled, Resident Rights, undated, showed: - Resident has the right to a safe, clean, comfortable and homelike environment; [...]

Inspectors wroteBased on interview and record review, the facility failed to ensure a code status was accurately and consistently documented throughout the medical record for one resident (Resident #66) out of 18 sampled residents. The facility census was 76. Review of the facility policy titled, Do Not Resuscitate Order, revised [DATE], showed: - The facility will not use cardiopulmonary resuscitation (CPR) (an emergency procedure consisting of chest compressions if the heart stops beating or the person stops breathing) and related emergency measures to maintain life functions on a resident when there is a Do Not Resuscitate (DNR) (does not want cardiopulmonary resuscitation) Order in effect; - A DNR order form must be completed and signed by the attending physician and the resident or the resident's legal surrogate and placed in the front of the resident's medical record; [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to maintain an effective pest control program to control the fly population in the facility. This deficient practice had the potential to affect all residents. The facility census was 76. Review of the facility policy titled, Pest Control, revised 2008, showed: - The facility shall maintain an effective pest control program; - The facility maintains an on-going pest control program to ensure that the building is kept free of insects and rodents; - Pest control services are provided by a contract company; - Maintenance services assist, when appropriate and necessary, in providing pest control services. 1. Observation on 06/05/23 at 11:08 A.M., of the secure unit showed: - Licensed Practical Nurse (LPN) F swatted at flies with a fly swatter in the hallway and in the dining room; [...]

Inspectors wroteBased on interview and closed record review, the facility failed to ensure a discharge planning process was in place which addressed goals and needs and involved the resident and/or the resident's legal guardian and the interdisciplinary team (IDT) (a group of health care professionals from diverse fields who work in a coordinated effort toward a common goal for a resident) in developing a discharge plan for one resident (Resident #80) out of two sampled discharged residents. The facility census was 76. The facility did not provide a policy for discharge planning. 1. Review of Resident #80's closed medical record showed: - admission date of 12/01/21; [...]