Heritage Manor of Opelousas

Inspectors wroteBased on observations, interviews, and record reviews, the facility failed to implement a comprehensive person-centered care plan for 2 (#1, #3) of 3 (#1, #2, #3) total sampled residents. This was evidenced by failing to:1.ensure physician orders to monitor a surgical incision for signs and symptoms of infection were implemented for Resident #1;2.apply palm protectors for Resident #3; and3.monitor and document the response to pain medication for Resident #3.

Inspectors wroteBased on record review, observation, and interview, the facility failed to ensure a resident who was unable to carry out Activities of Daily Living (ADLs) received the necessary services to maintain good personal hygiene and grooming for 2 (Resident#1, Resident#3) of 3 residents reviewed for ADLs. The facility failed to:1. provide personal hygiene for Resident #1, and2. Provide personal hygiene and nail care for Resident #3

Inspectors wroteBased on record reviews and interviews, the facility failed to maintain accurate medical records in accordance with accepted professional standards and practices by failing to ensure staff accurately documented baths for 1 (Resident #1) of 3 (#1, #2, #3) residents sampled for Activities of Daily Living (ADL) care.

Inspectors wroteBased on record review, observation, and interview, the facility failed to ensure a resident who was unable to carry out Activities of Daily Living (ADLs) received the necessary services to maintain good grooming and personal hygiene for 1 (#78) out 2 (#1 and #78) resident investigated for ADLs.

Inspectors wroteBased on record review and interview, the facility failed to ensure that the resident's physician timely addressed the resident's RP (Representative) and/or resident's request for pain medication for 1 (#78) of 1 resident out of final sample of 38 residents.

Inspectors wroteBased on observation, interviews, and record review, the facility failed to store and process linens to prevent the spread of infection as evidenced by failing to ensure clean items were not stored in the soiled linen area of the laundry department.

Inspectors wroteBased on record review and interview, the facility failed to follow the resident's plan of care for 1 (Resident #1) of 3 (#1, #2, #3) sampled residents.

Inspectors wroteBased on interview, observations, and record reviews, the facility failed to ensure a cognitively impaired resident received adequate supervision during facility transportation which resulted in the resident falling from a wheelchair and sustaining a severe head injury for 1 (#2) of 3 (#2, #3, #R5) sampled residents with impaired cognition investigated for safe transportation via wheelchair. The deficient practice resulted in an Immediate Jeopardy for Resident #2 on 10/08/2024 at 10:00 a.m., when S2D (Driver) left Resident #2 unattended in her wheelchair on a sidewalk outside of an eye doctor's office while S2D moved the transportation van. Resident #2, who was cognitively impaired, fell from her wheelchair during this time, striking her head against the concrete pavement. Resident #2 was transferred to a local hospital (Hospital A) for evaluation on 10/08/2024 at 12:01 p.m. [...]

Inspectors wroteBased on observation, interview and record review, the facility failed to maintain an effective infection control program in order to prevent the transmission of communicable diseases and infections as evidenced by failing to ensure: 1. a previously used insulin multi-dose pen that is designed for single patient use, was not used to administer insulin to another resident. 2. proper cleaning of glucometer between use 3. staff wore proper Personal Protective Equipment (PPE) for Enhanced Barrier Precautions (EBP) while performing high contact resident care activity. 4. proper use and storage of PPE for used on residents in contact isolation. This deficient practice resulted in an Immediate Jeopardy (IJ) on 08/27/2024 at 11:17 a.m. [...]

Inspectors wroteBased on observation and interview, the facility failed to properly store drugs as evidenced by loose pills found in the bottom of medication cart drawers for 3 (Cart A, Cart B, and Cart C) of 3 medication carts checked for safe and secure storage.

Inspectors wroteBased on record review and interviews, the facility failed to provide individual financial record to the resident through quarterly statements and/or upon request for 1 (#5) of 1 (#5) residents investigated for personal funds. The deficiency had the potential to affect a census of 107.

Inspectors wroteBased on observations and interview, the facility failed to ensure the cleanliness of a wheelchair for 1 (#33) out of 2 (#33 and #105) residents investigated for a safe, clean, comfortable and homelike environment, out of a total sample size of 39 residents.

Inspectors wroteBased on record review and interview, the facility failed to ensure that a MDS (Minimum Data Set) assessment was completed and submitted to CMS (Center for Medicare And Medicaid Services) in a timely manner, after a resident was discharged for 1 (#82) of 1 (#82) resident investigated for Resident Assessment out of a final sample of 39 residents. The deficient practice had the potential to affect 107 residents.

Inspectors wroteBased on record review and interview, the facility failed to ensure the resident's Minimum Data Set (MDS) was completed accurately for 1 (#56) out of 39 sampled residents.

Inspectors wroteBased on record reviews, interviews and observations, the facility failed to develop and/or implement a resident centered comprehensive plan of care for 3 (#36, #76 and #105) out of 39 sampled residents as evidenced by failing to: 1. implement Resident #36's plan of care to apply bilateral heel protectors while in bed; 2 develop a plan of care for Resident #76 that addressed his significant weight loss; and 3. develop a plan of care to address Resident #105's Urinary Catheter and her diagnosis of Urinary Tract Infection.

Inspectors wroteBased on record review and interview, the facility failed to facilitate the resident's and if applicable, the resident representatives' participation in the care planning process for 1 (#5) of 2 (#5, and #76) residents investigated for care planning out of a total sample of 39 residents.

Inspectors wroteBased on observation, record review and interviews the facility failed to provide oral care for 1 (#64) of 4 (#44, #56, #64, #91) residents reviewed for ADL's (Activities of Daily Living) from a sample of 39 Residents.

Inspectors wroteBased on observations, interviews, and record reviews, the facility failed to provide respiratory care consistent with professional standards of practice for 2 ( Resident #31 and #54) of 3 (Resident #31, Resident #54 and Resident #359) investigated for respiratory care by failing to properly store: 1. Resident #31's nebulizer mask, and 2. Resident #54's BiPAP (Bilevel Positive Airway Pressure) mask

Inspectors wroteBased on interviews, and record review, the facility failed to ensure that pain management was provided to residents who require such services, consistent with professional standards of practice and the comprehensive person-centered care plan for 1 (#64) of 3 (#11, #64, and #69) residents sampled for pain. The facility failed to ensure Resident #64 who displayed verbal pain received the ordered interventions to alleviate pain.

Inspectors wroteBased on observation, record reviews, and interviews, the facility failed to ensure nursing staff demonstrated competencies and skill sets to provide nursing and related services to assure resident safety and attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident for 2 (# 61, #78) residents out of 39 sampled residents. The facility failed to ensure staff demonstrated competency for: 1. safe injection practices when S27LPN used Resident #61's used multi-dose insulin pen designed for single patient use to administer insulin to Resident #6; and 2. correct application of Resident #78's bed bolsters by CNAs (certified nursing assistants). The facility had a census of 107 residents.

Inspectors wroteBased on observation, record reviews, and interviews, the facility failed to ensure that recipes were followed for residents who received pureed diets, by failing to follow a recipe for steamed rice. This deficiencies had the potential to effect 8 residents receiving a pureed diet.

Inspectors wroteBased on record review and interview, the facility failed to coordinate care as evidenced by failing to obtain pertinent information from the contracted hospice agency for 1 (#99) out of 2 (#99, #46) residents investigated for hospice.

Inspectors wroteBased on observation, record review and interview, the facility failed to ensure the staff followed the policy and procedures to prevent accidents for 1 (#1) out of 3 (#1, #2, #3) sampled residents.

Inspectors wroteBased on record review and interview, the facility failed to ensure that the nursing staff failed to immediately notify the Administrator of an injury of unknown origin for 1 (Resident #1) of 3 (Resident #1, Resident #2 and Resident #3) sampled residents investigated. This deficient practice had the potential to effect a census of 109.

Inspectors wroteBased on interview and record review, the facility failed to ensure that pain management was provided to residents who require such services, consistent with professional standards of practice and the comprehensive person-centered care plan as evidenced by failing to administer pain medication to a resident who displayed nonverbal indicators of pain for 1 resident (#2) out of 3 (#1, #2, #3) sampled residents.

Inspectors wroteBased on observations, record reviews and interviews, the facility failed to ensure nursing staff demonstrated competencies to provide care as ordered for 4 residents (#12, #33, #61 and #68) out of a final sample of 44 residents. This deficient practice was evidenced when: 1. S10LPN (Licensed Practical Nurse) failed to administer scheduled morning medications as ordered for Resident #12 2. S8TX (Treatment Nurse) failed to accurately document Resident #33's wound assessment and physician's ordered wound care to the right lower leg. 3. Nursing staff failed to discontinue Resident #61's order for pneumatic compression devices after the resident's family member removed the devices from the facility because the devices were painful for Resident #61. Nursing staff continued to document that the pneumatic compression devices were applied at night despite there being no device to apply. 4. [...]

Inspectors wroteBased on interview and record review, the facility failed to ensure each resident's plan of care and clinical record reflected their advance directives for 2 (#52, #78) residents out of 2 (#52, #78) residents investigated for advance directives.

Inspectors wroteBased on observations, record review, and interviews, the facility failed to maintain a homelike environment by failing to ensure the air conditioner (AC) cover for the AC unit was intact for 1 (#2) of 7 (#2, #7, #64, #75, #77, #80 and #83) residents investigated for environment.

Inspectors wroteBased on record reviews and interviews, the facility to accurately code the Resident's Minimum Data Set(MDS) Assessments to reflect the status of a state Level II PASRR for 3 (#3,#64, #95) out of 4 (#3,#62, #64, #95) residents reviewed for PASARR (Preadmission Screening and Resident Review); and, Resident #101's discharge disposition status out of 44 sampled residents.

Inspectors wroteBased on interview and record review, the facility failed to incorporate the recommendations from the PASARR (Preadmission Screening and Resident Review) Level II determination and the PASARR evaluation report into a resident's assessment, care planning, and transitions of care for 1 (#62) of 4 (#3, #62, #64, #95 ) residents reviewed for PASARR out of a total of 44 sampled residents.

Inspectors wroteBased on record review and interview, the facility failed to complete a baseline care plan within 48 hours of admission for 1 (#102) out of 44 sampled residents.

Inspectors wroteBased on record review and interview the facility failed to weigh a resident weekly as per plan of care for 1 (#64) of 4 (#38, #64, #65, #78) reviewed for nutrition. This deficient practice had the potential to affect a census of 98 residents.

Inspectors wroteBased on interviews and record reviews, the facility failed to ensure staff implemented interventions to prevent or reduce the risk of accidents for 1 resident ( #33) of 3 residents (#1, #12 and #33) investigated for accidents out of a final sample of 44 residents.

Inspectors wroteBased on observation, record review and interview, the facility failed to ensure that a resident who required hemodialysis receive such services consistent with professional standards of practice by not assessing the dialysis resident's shunt site for bruit and thrill for 1(#78) out of 1(#78) sampled residents for dialysis.

Inspectors wroteBased on record review and interviews, the facility failed to electronically submit accurate payroll information for direct care staffing as required.