Huntington Healthcare Center

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure the right measuring device and the right ingredients were used in preparing the Consistent Carbohydrate Diet (CCHO, meal plan designed to manage blood sugar, especially for diabetes) and the low sodium (salt) food. This deficient practice had the potential to affect all the residents receiving CCHO and low sodium diets. This had the potential to result in elevated blood sugar levels for diabetic residents and fluid overload (clinical condition where excess fluid builds up in the body), edema (swelling), heart failure (chronic condition where heart muscle becomes weak or stiff to pump blood efficiently to meet the body's needs for oxygen), for residents with kidney diseases.

Inspectors wroteBased on interview and record review, the facility failed to ensure dental services were scheduled so that one of three sampled residents (Residents 1), was seen by a dentist (a health care professional who specializes in teeth, gums, and mouth). This deficient practice had the potential to result in the worsening condition of the resident's teeth, leading to tooth infection, to suffer toothache, affecting the resident's inability to eat.

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure the food was palatable (tasty) for one of three sampled residents (Residents 1). This deficient practice had the potential for resident's poor meal intake and weight loss.

Inspectors wroteBased on observation, interview and record review, the facility failed to provide a therapeutic diet (meal plan prescribed by a healthcare professional [physician or dietitian] that modifies a regular diet to manage a specific medical condition, treat an illness, or improve overall health) as ordered by the physician for one of three sample residents (Resident 1). This deficient practice resulted in high blood sugar readings for Resident 1 and had the potential to cause complications such as diabetic coma (life-threatening, state of unconsciousness caused by extreme blood sugar levels).

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure safe and sanitary food storage and preparation practices in the kitchen. This deficient practice had the potential to result in harmful bacterial growth and cross-contamination (transfer of harmful bacteria from one place to another) that could lead to foodborne illness (a disease caused by consuming food or drinks that are contaminated by germs or chemicals) in 94 of 94 residents who received food from the kitchen.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure a resident's personal inventory list was completed when staff did not obtain the resident's signature and did not document a valid reason for the missing signature for one of six sampled residents (Resident 3). This resulted in an incomplete inventory record and had the potential to affect the facility's ability to account for Resident 3's belongings.

Inspectors wroteBased on observation, interview, and record review, the facility failed to complete accurate Minimum Data Set (MDS) assessments for four of 21 sampled residents (Residents 91, 61, 70 and 20) when failing to: 1. Ensure an accurate assessment of Resident 91's hearing and vision impairments.2. Ensure an accurate assessment of Resident 61 and 70's oral/dental status.3. Ensure an accurate assessment of Resident 20's hearing impairment. This failure had the potential to delay the development or the revision of care plan interventions for communication and sensory deficits for Resident 91 and 20, and dental status for Residents 61 and 70.

Inspectors wroteBased on observation, interview, and record review, the facility failed to develop an individualized resident centered care plan for six of 18 sampled residents (Resident 91, Resident 20, Resident 42, Resident 55, Resident 61, and Resident 70) when: 1. Staff failed to develop a care plan addressing Residents 91 and 20's hearing impairment.2. Staff failed to develop a care plan addressing Resident 42 and 55's diagnosis of dementia (a progressive state of decline in mental abilities). 3. Staff failed to develop a care plan addressing Resident 61 and 70's missing natural teeth. These deficient practices had the potential for Residents 91, 20, 42, 55, 61, and 70 to not receive required appropriate care.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure good grooming and personal hygiene for two of six sampled residents (Resident 61 and Resident 5) by failing to provide routine fingernail and toenail care. This failure had the potential to result in a negative impact on Residents 61 and 5's quality of life and self-esteem and had the potential for the development of infections.

Inspectors wroteBased on interview and record review, the facility failed to maintain complete and accurate clinical records for one of five sampled resident (Resident 72) after a change in condition. This failure resulted in incomplete and missing documentation regarding Resident 72's clinical status and had the potential to affect the resident's continuity of care.

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure the surgical face mask (a loose-fitting, disposable device that creates a physical barrier between the mouth and nose of the wearer and potential contaminants in the immediate environment) of one of 4 staffs, was worn correctly while in a resident-care area, as indicated in the facility's policy and procedure (P&P) titled, Personal Protective Equipment-Using Face Masks. This failure had the potential to increase the spread of Coronavirus Disease 2019 ([COVID-19] highly contagious viral infection) virus to other residents, staff, and visitors in the facility, resulting in respiratory infections, hospitalizations and death.

Inspectors wroteBased on interview and record review, the facility failed to revise the fall care plan for one of nineteen sampled residents (Resident 64), following Resident 64's fall with subsequent injury on 6/20/2024. This deficient practice increased the potential for staff to be unaware of the interventions required to prevent Resident 64 from suffering additional avoidable falls and potential subsequent injuries.

Inspectors wroteBased on interview and record review the facility failed to: 1. Account for one dose of Controlled Substances (also known as Controlled Drug and Controlled Medications [CS, CD, CM]- medications which have a potential for abuse and may also lead to physical or psychological dependence) for Residents 23, in one of two inspected medication carts (Medication Cart 1.) 2. Include the verifying signatures of either the Director of Nursing (DON) or a Registered Nurse (RN) along with the Licensed Vocational Nurse (LVN) on the Controlled Drug accountability logs for six of six sampled records awaiting disposal (removal, destroying) in the DON's office. 3. Include the witness signatures and quantity on the Medication Disposition log for 16 non-CMs disposed on 10/14/2024. [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure safe and sanitary food preparation practices for 89 of 89 residents when: 1. The dietary staff failed to perform hand hygiene and change gloves when leaving and returning to the tray line to prepare food. 2. The dietary staff failed to wear a N-95 mask (a disposable face mask that covers the user's nose and mouth which offers protection from small solid or liquid droplets found in the air) appropriately while preparing food on the tray line. These deficient practices had the potential to result in harmful bacteria growth and cross contamination (transfer of harmful bacteria from one place to another) that could lead to foodborne illnesses in all residents who received food from the kitchen.

Inspectors wroteBased on interview and record review, the facility failed to notify the responsible party (RP) of a change in condition for one of 19 sampled residents (Resident 79), in the RP's preferred language of Korean (language spoken in the country of Korea). This deficient practice delayed Resident 79's RP's ability to be informed and aware of Resident 79's plan of care, including changes in Resident 79's condition, hospitalizations, and readmissions.

Inspectors wroteBased on interview and record review, the facility failed to develop care plans for three of three sampled residents (Resident 72, 37, and 74) addressing the following: a. The hearing difficulties for Resident 72. b. The discomfort of dentures for Resident 37. c. The usage of dentures for Resident 74. These deficient practices placed Resident 72 at risk of an inability to be aware of the care being provided due to staff being unaware of Resident 72's hearing difficulty and need for staff to speak loudly or speak close to hear. These deficient practices also had the potential to delay necessary care, increase the risk of undesired weight loss, and increase the risk of pressure ulcer (localized, pressure-related damage to the skin and/or underlying tissue usually over a bony prominence) development for Residents 37 and 74.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure one of six sampled residents (Resident 31) received appropriate treatment by applying a wrist hand finger orthosis ([WHFO] a device that provides support and help with joint stiffness and contractures [a condition of shortening and hardening of muscles, or other tissue, often leading to deformity and rigidity of joint]), and an elbow splint (a flexible device used to protect and immobilize a body part) as ordered by the physician. This deficient practice placed Resident 31 at increased risk of further decline to the right elbow and wrist contracture.

Inspectors wroteBased on observation, interview, and record review, the facility failed to identify fire hazard risks for one of six sampled residents (Resident 23) by not knowing Resident 23 kept a lighter and cigarettes at the bedside. This deficient practice had a potential to increase the risk for injury for Resident 23.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure one of 19 sampled residents (Resident 64) received a meal tray as prescribed by the physician. This deficient practice created the potential for Resident 64 to suffer from repeat weight loss and malnutrition resulting from not receiving his prescribed and expected number of calories and nutritive value.

Inspectors wroteBased on observation, interview, and record review, the facility failed to store and discard (remove, destroy) one expired insulin (short-acting regular human insulin) Novolin R (type of insulin injection device) vial for Resident 53 from use, in accordance with facility and manufacturer requirements, in one of one inspected medication room (Medication Room Nursing Station 2.) This deficient practice increased the risk that Resident 53 could have received medication that had become ineffective or toxic due to improper storage, possibly leading to health complications.

Inspectors wroteBased on observation, interview, and record review, the facility failed to honor the food choices and offer alternative menu options for one of six sampled residents (Resident 15). This deficient practice had the potential to impact Resident 15's nutritional status, quality of life and result in food dissatisfaction leading to insufficient food intake.

Inspectors wroteBased on interview and record review, the facility failed to manage pain for one of three sampled residents (Resident 1) by failing to ensure Resident 1's pain medication was available and administered for severe pain as ordered by the physician and according to the resident's care plan. This deficient practice resulted a delay in treatment and unrelieved pain for Resident 1.

Inspectors wroteBased on observation, interview and record review, the facility failed maintain the toilet in safe condition for 1 of 3 residents' toilets, (Resident 1). This deficient practice placed the resident at risk for falls and injuries. Findings During a review of Resident 1's admission, the admission record indicated Resident 1 was admitted to the facility on [DATE], with diagnoses that included type 2 diabetes (high blood sugar), hypertension (high blood pressure), and low back pain. During a review of Resident 1's history and physical (H&P) dated 11/9/2023, the H&P indicated Resident 1 had the capacity to understand and make medical decisions. [...]

Inspectors wroteBased on interview and record review, the facility failed to: 1. Ensure the Advance Directives (a written statement of a person's wishes regarding medical treatment) of two of 12 sampled residents' (Residents 86 and 88), were completed by the residents and/or their responsible parties. This deficient practice violated the residents' and/or the responsible parties' right to be fully informed of the option to formulate their advance directives and had the potential to cause conflict with the residents' wishes regarding health care. 2. [...]

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure: 1. Expired mustard packets in the dry storage room was discarded after its expiration date. 2. Dietary aide performed hand hygiene after removing gloves during the tray line (preparation of food), touching menu book and returning to tray line to continue preparing meal trays. These deficient practices had the potential to cause food-borne illnesses.

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure the two dryers were free of lints, and to maintain a log to record maintenance for lint removal and water temperature. These failures places the facility at high risk for fire when the dryer was not maintained in a safe manner and the potential to increase the risk of spreading bacteria when resident clothes and linens are not washed with the right water temperature.