Hunter Acres Caring Center

Inspectors wroteBased on observation, interview, and record review, the facility failed to provide a safe, clean, comfortable homelike environment. This deficient practice had the potential to affect all residents in the facility. The facility census was 87. The facility did not provide a policy on the environment. 1. Observation on 08/04/25 at 10:24 A.M., of room [ROOM NUMBER] showed: - The bathroom door with a smeared brown substance; - Dirt and debris on the floor. 2. Observation on 08/04/25 at 10:35 A.M., of room [ROOM NUMBER] showed: - A spider web in the window seal. 3. Observation on 08/05/25 at 2:55 P.M., of room [ROOM NUMBER] showed: - The bathroom flooring peeled and separated from the subfloor; - A black substance on the upper portion of all of the bathroom walls and with a musty smell. 4. Observations on 08/06/25 at 9:45 A.M., and 08/07/25 at 10:05 A.M., of room [ROOM NUMBER] showed: [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to maintain an effective pest control program to control the insect population in the facility. The facility census was 86. Review of the facility's policy titled, Pest Control, dated May 2008, showed:- This facility maintains an on-going pest control program to ensure that the building is kept free of insects and rodents;- Maintenance services assist, when appropriate and necessary, in providing pest control services. Review of the facility's Pest Control Invoices for May - August 2025 showed:- May 2025, June 2025, July 2025, and August 2025 service targeted the German roach and the house mouse;- No services targeted flies. [...]

Inspectors wroteBased on interview and record review, the facility failed to ensure the correct code status for one resident (Resident #2) out of 19 sampled residents and failed to address and receive an order for a code status for one resident (Resident #86) outside the sample. The facility census was 87. [...]

Inspectors wroteBased on interview and record review, the facility failed to attempt and ensure the physician responded to gradual dose reductions (GDRs) for medications for two residents (Residents #4 and #19) and failed to limit the use of as needed (PRN) psychotropic (medications that affect the mind, emotions, and behavior) medication orders for 14 days for one resident (Resident #19) out of five sampled residents. The facility census was 87. Review of the facility's policy titled, Medication Regimen Reviews (MRR), revised February 2025, showed: [...]

Inspectors wroteBased on interview and record review, the facility failed to follow their policy and procedure to complete Criminal Background Checks (CBC) and to check the Employee Disqualification List (EDL - a listing of individuals who have been determined to have abused, neglected, and/or misappropriated funds or property from a resident) prior to the hire date for three employees (Employees A, B, and C) out of ten sampled employees . The facility census was 86. Review of the facility's policy titled, Background Screening Investigations, dated March 2019, showed:- Background checks, reference checks, and criminal conviction checks on all potential direct access employees and contractors should be conducted. Background and criminal checks are initiated within two days of an offer of employment and completed prior to employment. [...]

Inspectors wroteBased on interview and record review, the facility failed to accurately code the Minimum Data Set (MDS - a standardized assessment tool used in nursing homes to collect comprehensive information about residents' functional capabilities and health status) for two residents (Residents #38 and #46) out of 19 sampled residents. The facility census was 87. Review of facility's policy titled, Resident Assessments, dated October 2023, showed:- Information in the MDS assessments will consistently reflect information in the progress notes, plans of care, and resident observations/interviews;- The resident assessment coordinator is responsible for ensuring the interdisciplinary team conducts timely and appropriate resident assessments;- Information in the MDS assessments will consistently reflect information in the progress notes, plans of care, and resident observations/interviews. 1. [...]

Inspectors wroteBased on interview, observation, and record review, the facility failed to establish a care plan for two residents (Resident #38 and #69) out of 19 sampled residents. The facility census was 87. Review of the facility's policy titled, Care Plans, Comprehensive Person-Centered, dated March 2022, showed: - The comprehensive, person-centered care plan describes the services that are to be furnished to attain or maintain the resident's highest practicable physical, mental, and psychosocial well-being; - Assessments of residents are ongoing and care plans are revised as information about the residents and the residents' conditions change. 1. Review of Resident #38's medical record showed: - An admission date of 11/13/19; [...]

Inspectors wroteBased on interview and record review, the facility failed to follow physician's written orders for one resident (Resident #2) out of 19 sampled residents. The facility census was 87. Review of the facility policy titled, Telephone Orders, dated February 2014, showed:- Verbal telephone order may only be received by licensed personnel;- Order must be reduced to writing by the person receiving the order and recorded in the resident's medical record;- The entry must contain the instructions from the physician, date, time, and the signature and title of the person transcribing the information.1. Review of Resident #2's medical record showed:- An admission date of 12/08/21; [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to put dietitian recommendations into place for one resident (Resident #4) out of four sampled residents that had excessive weight loss. The facility census was 87. Review of the facility policy titled, Weight Assessment and Intervention, dated March 2022, showed:- Residents are weighed upon admission and at intervals established by the interdisciplinary team;- Any confirmed weight change of five percent (%) or more since the last weight assessment will be reported to the dietitian in writing by nursing. [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to provide a safe, clean, comfortable homelike environment. This deficient practice had the potential to affect all residents in the facility. The facility census was 86. The facility did not provide a policy on the environment. 1. Observations on 08/05/24 at 10:21 A.M., and 08/08/24 at 1:05 P.M., of room [ROOM NUMBER] showed: - On 08/05/24 at 10:21 A.M., the bathroom wall to the left of the toilet with a three foot (ft.) area of scratched and/or peeled off paint. 2. Observations of the 300/400 Hall common area showed: - On 08/05/24 at 10:15 A.M., the ceiling tile and the vent near the 300 Hall covered in a brown/black substance, - On 08/05/24 at 10:17 A.M., the wall to the left of the exit door with a four ft. by one inch (in.) hole above the cove base; [...]

Inspectors wroteBased on interview and record review, the facility failed to ensure staff provided the necessary care and services in accordance with professional standards of practice by failing to notify the physician immediately of one resident's (Resident #22) significant change in status and by failing to provide emergency treatment in a timely manner for one resident (Resident #58) out of two sampled residents. The facility's census was 86. Review of facility policy titled, Change in a Resident's Condition or Status, dated February 2021, showed: - The nurse will notify the resident's attending physician or physician on call when there has been a significant change in the resident's physical/emotional/mental condition, a need to alter the resident's medical treatment significantly, and/or a need to transfer the resident to a hospital/treatment center; [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to timely and effectively address significant weight loss for one resident (Resident #58) out of 20 sampled residents. The facility's census was 86. Review of the facility's policy titled, Weight Assessment and Intervention, revised March 2022, showed: - Any weight change of 5% of more since the last weight assessment is retaken the next day for confirmation. If the weight is verified, nursing will notify the dietician; - Unless notified of significant weight change, the dietician will review the unit weight record monthly to follow individual weight trends over time.; - The threshold for significant unplanned and undesired weight loss will be based on the following criteria [where percentage of body weight loss=(usual weight - actual weight)/(usual weight) x 100]: For one month - 5% weight loss is significant; [...]

Inspectors wroteBased on observation, interview and record review, the facility failed to maintain a medication error rate of less than five percent (%). There were 36 opportunities with two errors made, resulting in an error rate of 5.56% for two residents (Resident #12 and #30) out of five sampled residents. The facility's census was 86. Review of the facility's policy titled, Administering Medications, dated April 2019, showed: - Medications are administered in accordance with prescriber orders, including any required time frame; - Medications are administered within one hour of their prescribed time, unless otherwise specified (for example, before and after meal orders). 1. Review of Resident #12's Physician Order Sheet (POS), dated August 2024, showed: [...]

Inspectors wroteBased on interview and record review, the facility failed to provide adequate supervision for one resident (Resident #1), who had impaired memory, poor judgement and insight, and was assessed as an elopement risk. On 11/04/23, during a supervised smoke break, the supervising staff person left the resident alone and the resident left the facility grounds. The resident was found in a city approximately 30 miles away. The facility census was 87. The Administration was notified on 11/07/23 of a Past Non-Compliance citation Immediate Jeopardy (IJ) which began on 11/4/23. Upon discovery, the facility staff conducted an investigation, implemented facility protocols, and in-serviced staff on protective oversight. The IJ was corrected on 11/04/23. Review of the facility's policy titled, Smoking Policy- Residents, dated August 2022, showed: [...]

Inspectors wroteBased on interview and record review, the facility failed to ensure code status (the type of treatment a person would or would not receive if their heart or breathing were to stop) was consistent throughout the medical record for one resident (Resident #49) out of 18 sampled residents. The facility's census was 84. Record review of the facility's Advance Directives policy, revised [DATE], showed: - The resdient has the right to formulate an advance directive, including the right to accept or refuse medical or surgical treatment. Advance directives are honored in accordance with state law and facility policy; - The facility defines the following in accordance with current OBRA definitions and guidelines: [...]

Inspectors wroteBased on interview and record review, the facility failed to issue a Centers for Medicare and Medicaid Services (CMS) Skilled Nursing Facility Advance Beneficiary Notice (SNF ABN: Medicare requires SNFs to issue a SNFABN to beneficiaries prior to providing care that Medicare usually covers, but may not pay for because the care is not medically reasonable and necessary or considered custodial) Form 10055 for two residents (Resident #17 and #186) out of three sampled residents who remained in the facility when benefits were not exhausted. The facility's census was 84. 1. Record review of Resident #17's CMS Notice of Medicare Non-Coverage (NOMNC: Medicare requires SNFs to issue a NOMNC to beneficiaries no later than two days before covered services end) Form 10123 and SNF ABN forms showed: [...]

Inspectors wroteBased on interview and record review, the facility failed to complete a comprehensive Minimum Data Set (MDS-a federally mandated assessment tool) within the required time frames for three residents (Resident #15, #31, and #65) out of 18 sampled residents. The facility's census was 84. Record review of the facility's MDS Completion and Submission Timeframes, revised March 2017, showed: - Our facility will conduct and submit resident assessments in accordance with current federal and state submission timeframes; - The Assessment Coordinator or designee is responsible for ensuring that resident assessments are submitted in accordance with current federal and state guidelines; - Timeframes for completion and submission of assessments is based on the current requirements published in the Resident Assessment Instrument (RAI) Manual. Record review of the RAI Manual showed: [...]

Inspectors wroteBased on interview and record review, the facility failed to complete a quarterly Minimum Data Set (MDS-, a federally mandated assessment) within the required timeframe for eight residents (Resident #2, #14, #19, #39, #41, #48, #56, and #62) out of 18 sampled residents and three residents (Resident #27, #40, and #54) outside the sample. The facility's census was 84. Record review of the facility's MDS Completion and Submission Timeframes , Revised March 2017, showed: - Our facility will conduct and submit resident assessments in accordance with current federal and state submission timeframes; - The Assessment Coordinator or designee is responsible for ensuring that resident assessments are submitted in accordance with current federal and state guidelines; [...]

Inspectors wroteBased on interview and record review, the facility failed to document a complete and accurate Minimum Data Set (MDS- a federally mandated assessment) for four residents (Resident #4, #39, #49, and #56) out of 18 sampled residents. The facility's census was 84. 1. Record review of Resident #4's Physician Order Sheet (POS), dated April 2023, showed: - An order, dated 2/21/23, for Plavix (medication which helps prevent blood platelets from sticking together) 75 milligram (mg) by mouth daily. Record review of the resident's significant change MDS, dated [DATE], showed: - The resident received anticoagulant (a blood thinner which can reduce coagulation of blood, prolonging the clotting time) medication; - The resident's MDS did not reflect an accurate assessment of the medication. 2. Record review of Resident #39's POS, dated April 2023, showed: [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to implement care plans with specific interventions to meet individual needs for three residents (Resident #38, #48, and #49) out of 18 sampled residents. The facility's census was 84. Record review of the facility's care plan titled, Care Plans, Comprehensive Person Centered, revised March 2022, showed: - The interdisciplinary team (IDT), in conjunction with the resident and his/her family or legal representative, develops and implements a comprehensive, person-centered care plan for each resident; - The comprehensive, person-centered care plan is developed within seven days of the completion of the required MDS assessment and no more than 21 days past admission; [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to implement procedures to ensure medications were accurately administered, documented, disposed of and reconciled for two residents (Resident #42 and #63) outside of the 18 sampled residents. The facility's census was 84. Record review of the facility's Controlled Substances policy, revised April 2019, showed: - The facility complies with all laws, regulations, and other requirements related to handling, storage, disposal, and documentation of controlled medications; - Only authorized licensed nursing and or pharmacy personnel shall have access to controlled drugs maintained on premises; - Access to controlled medications remains locked at all times and access is recorded; - Controlled substances are reconciled upon receipt, administration, disposition, and at the end of each shift; [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure vials of Levemir insulin (medication to control high blood sugar with diabetes) and Aplisol (a solution used during a tuberculosis test) were dated when opened, and failed to ensure the integrity of medications when they were stored near sticky liquids. This had the potential to affect all residents, including one resident (Resident #18) outside of the 18 sampled residents. The facility's census was 84. Record review of the facility's Storage of Medications policy, revised November 2020, showed: - The facility stores all drugs and biologicals in a safe, secure, and orderly manner; - The nursing staff is responsible for maintaining medication storage and preparation areas in a clean, safe, and sanitary manner; [...]

Inspectors wroteBased on observation, interview and record review, the facility failed to utilize proper technique during incontinent care for one resident (Resident #38) out of 18 sampled residents when staff touched the resident's linens and call light with soiled gloves after providing pericare. Staff did not change gloves, perform hand hygiene after performing pericare and gathered trash, opened the resident's door without removing gloves or washing hands and exited the resident's room. During wound care, staff failed to perform appropriate hand hygiene and glove changes, disinfect bandage scissors before placing them on a barrier, discard or leave unused treatment supplies in the resident's room and clean overbed table after utilizing it for wound care for one resident (Resident #49) out of 18 sampled residents. [...]

Inspectors wroteBased on interview and record review, the facility failed to maintain the surety bond (a purchased bond for security of residents' personal funds) amount for at least one and one half times the average monthly balance of the residents' personal funds for the last 12 consecutive months from May 2022 through April 2023. The facility's census was 84. Record review on 5/4/2023 of the residents' personal funds account for the last 12 consecutive months from May 2022 through April 2023 showed: - The facility's approved bond amount equaled $168,000.00; - The average monthly balance for the residents' personal funds equaled $139,154.54; - An average monthly balance of $139,154.54 rounded to the nearest thousand equaled $139,000.00, at one and one half times will equal the required bond amount of at least $208,500.00. [...]