Highland Manor of Mesquite Rehabilitation LLC

Inspectors wroteBased on interviews, record review, and facility policy review, the facility failed to ensure four of five residents reviewed (Resident (R) 1, R12, R20, and R79) were provided with written information or education regarding advance directives and the right to formulate an advance directive to ensure their desired level of medical care was known in the event they were unable to direct care on their own. This failure had the potential to affect the ability of cognitively intact residents to direct their care.

Inspectors wroteBased on observations, interviews, record review, and facility policy review, the facility failed to ensure oxygen concentrator filters were free of dust and heavy buildup of lint for three of four sampled residents (Residents (R) 62, R5, and R79) out of a total sample of 24 residents. This failure had the potential for the residents to have an increased chance of unnecessary respiratory treatments and/or infection.

Inspectors wroteBased on observation, interview, and facility policy review, the facility failed to ensure that laundry staff were aware of what Personal Protective Equipment (PPE) was available for staff to use while sorting dirty laundry. This deficient practice had the potential to spread infectious organisms throughout the facility of 90 residents.

Inspectors wroteBased on observation, interview, record review and document review, the facility failed to ensure consents for psychotropic medications were not obtained from a resident who was assessed to have severely impaired cognition for 1 of 18 sampled residents (Resident 36). The deficient practice potentially deprived the resident and the resident's representative the right to be informed of the medications' purpose, risks, benefits and potential side effects.

Inspectors wroteBased on observation, interview, record review and document review, the facility failed to ensure a resident who was observed taking own medications was assessed for capability to self-administer medications for 1 of 18 sampled residents (Resident 54). The deficient practice had the potential to compromise the resident's safety and negatively impact overall well-being.

Inspectors wroteBased on observation, interview, record review and document review, the facility failed to ensure a nurse did not document medications as having been administered without direct observation of the resident's consumption of the medications for 1 of 18 sampled residents (Resident 54). The deficient practice had the potential to compromise the resident's safety and inaccurately document care provided to the resident.

Inspectors wroteBased on interview, record review and document review, the facility failed to ensure a resident's blood pressure and heart rate were obtained and parameters were followed in accordance with physician's order for an anti-hypertensive medication for 1 of 18 sampled residents (Resident 36). The deficient practice resulted in unnecessary medications.

Inspectors wroteBased on observation, interview and document review, the facility failed to ensure the medication storage room was free from expired medications. The deficient practice placed residents at risk for receiving expired medications.

Inspectors wroteBased on observation, interview, and document review, the facility failed to ensure stored foods were stored in accordance with facility standards for food service safety and sanitization test strips to measure correct sanitizing levels were not expired. These deficient practices posed a potential risk to safety and health standards which could lead to contamination and place residents at risk of foodborne illness.

Inspectors wroteBased on observation, interview, record review, and policy review, the facility failed to have menu spreadsheets for the weekly menus that included portion sizes and regular and therapeutic diets for all residents and three of eight residents R16, R29, and R34) who were reviewed for menus. This deficient practice affected all residents who received meals prepared in the facility's only kitchen.

Inspectors wroteBased on observation, interview and policy review, the facility failed to use proper procedures for handwashing, cooling leftovers, and dating leftovers. This deficient practice had the potential to affect all residents who received meals prepared in the facility's kitchen.

Inspectors wroteBased on interview, record review and review of facility policy, the facility failed to ensure six residents (Residents (R) R40, R60, R5, R57, R19, and R130) were free from verbal and/or physical abuse. Specifically, the facility failed to ensure R40 and R60 were free from verbal abuse by an agency staff member, and R5, R57, R19 and R130 were free from resident-to resident physical abuse. These failures placed residents at risk for diminished quality of life.

Inspectors wroteBased on record review, interviews and facility policy review, the facility failed to ensure 1 of 5 Certified Nursing Assistant's (CNA3) background check was completed prior to hire, out of 10 employee files reviewed. This failure had the potential to negatively impact all residents.

Inspectors wroteBased on interview and record review, and review of the facility policy, the facility failed to thoroughly investigate an allegation of staff to resident verbal abuse for two (Residents (R)40, R60) of 10 residents reviewed for abuse. This failure placed the residents at risk of increased mental health issues, and a diminished quality of life.

Inspectors wroteBased on interview and record review, the facility failed to ensure the Food Service Supervisor had completed a course in food safety and management for 1 of 1 Food Service Managers (FSM) for the facility's only kitchen. This deficient practice had the potential to affect all residents who received meals prepared in the facility's kitchen.