Jackson Health Care Facility

Inspectors wroteBased on observation, interview, record reviews, and review of facility's policy, the facility failed to provide appropriate treatment, care and services to address the resident's positioning needs in accordance with professional standards of practice, comprehensive care plan and physician's orders for one (1) out of 24 sampled residents (Residents #22). Observations on 3/23/21, 3/24/21 and 3/25/21 revealed Resident #22 was not turned and repositioned per the Physician's Order and care plan. Additionally, Resident #22 did not have his/her hand towels in his/her hands per the care plan.

Inspectors wroteBased on observation, interview, record review and facility policy review, the facility failed to ensure a resident with limited Range of Motion (ROM) received appropriate treatment and services to prevent further decrease in range of motion per the comprehensive care plan and physician's orders for one (1) of 24 sampled residents (Resident #51). Observations on 3/23/21, 3/24/21, and 3/25/21 of Resident #51 revealed the resident was not wearing the ROM devices per the care plan and physician's order to prevent further decline.

Inspectors wroteBased on observation and interview, the facility failed to ensure a dietary staff member did not place the thermometer through the foil to take the temperatures of the food during the preparation of the dinner meal on 02/27/19. This affected 72 of 73 residents receiving the dinner meal from the kitchen on 02/27/19. Findings Include: On 02/27/19 at 4:33 p.m., an observation was made during the tray line. The surveyor observed six containers of food items on the tray line covered with foil. EI (Employee Identifier) #2, Dietary staff member, did not remove the foil, and took all six of the temperatures by placing the thermometer though the foil and into the food. An interview was conducted with EI #1, the Dietary Manager on 02/28/19 at 12:11 p.m. EI #1 was asked, what should be done before taking the temperatures of the food. [...]

Inspectors wroteBased on observations, interviews and a facility policy titled, Care Planning Policy and Procedure, the facility failed to ensure RI (Resident Identifier) #14's and RI #53's care plans addressing contractures (shortening and hardening of muscles, tendons or other tissue) with the use of a hand roll were followed. This deficient practice affected RI #14 and RI #53, two of 23 sampled residents whose care plans were reviewed. Findings Include: A review of a facility policy titled, Care Planning Policy and Procedure with a revised date of 2/18, revealed: Policy: The care plan is a guide for all staff on a course of action that will attain or maintain a resident's highest practicable level of well being . Procedure . 6. [...]

Inspectors wroteBased on observation, medical record review, interview and [NAME] and Perry's FUNDAMENTALS OF NURSING, the facility failed to ensure EI (Employee Identifier) #4, LPN (Licensed Practical Nurse) performed hand hygiene after removing gloves and before reaching into the medication cart during the administration of a bolus tube feeding to RI (Resident Identifier) #50. The facility also failed to ensure EI #4 did not use contaminated gloves to open a door. This affected one of one residents observed who received a bolus tube feeding. Findings Include: A review of [NAME] and Perry's FUNDAMENTALS OF NURSING, Ninth Edition, Copyright 2017, Chapter 29, Infection Prevention and Control, page 458 and 465 revealed: .Hand Hygiene. The most effective basic technique in preventing and controlling the transmission of infection is hand hygiene . [...]

Inspectors wroteBased on interviews, record reviews, and review of [NAME] and Perry's FUNDAMENTALS OF NURSING, Ninth Edition, the facility failed to accurately assess RI (Resident Identifier) #23 on the MDS (Minimum Data Set) regarding Anticoagulants (blood thinners) and RI #32 on the MDS regarding Hospice services. This affected RI #s 23 and 32, two of 19 residents whose MDS were reviewed. Findings Include: A review of [NAME] and Perry's FUNDAMENTALS OF NURSING, Ninth Edition, Copyright 2017, Chapter 16, Nursing Assessment, page 210 revealed: .As a nurse you learn to make clinical judgments from assessment data to identify a patient's level of wellness and desire for health promotion or to identify existing health problems. A comprehensive assessment leads to making accurate nursing diagnoses, allowing you to then create an appropriate plan of care for a patient. [...]

Inspectors wroteBased on record reviews, interview, and review of a facility policy titled, Care Plan Policy and Procedure, the facility failed to ensure a plan of care was developed for wander guard secure ankle bracelet use. This affected RI (Resident Identifier) #21, one of fifteen residents whose care plans were reviewed. Findings Include: A review of the facility policy titled, Care Plan Policy and Procedure, with a revision date of 07/11, revealed: Policy: The care plan is a guide for all staff on a course of action that will attain or maintain a resident's highest practicable level of well being. Procedure: 1. Nursing staff will initiate a care plan to meet the basic care needs of the resident . 6. The care plan team will develop measurable goals for the improvement, prevention, or maintenance of the resident's status. A review of the job description for the Care Plan Coordinator revealed: . [...]

Inspectors wroteBased on record reviews, interview, and a review of a facility policy titled, Care Plan Policy and Procedure, the facility failed to ensure a plan of care was revised to reflect the ADL (Activities of Daily Living) assistance required for RI (Resident Identifier) #56. This affected one of 15 residents whose care plans were reviewed. Findings Include: On 12/01/17, the State Agency received a complaint regarding RI #56 receiving a bath with the assistance of one staff member on 11/20/17, where the resident's arm was noted to be swollen. According to the complainant, there should have been two staff members assisting with the bath. A review of a facility policy titled, Care Plan Policy and Procedure, with a revision date of 07/11, revealed: Policy: The care plan is a guide for all staff on a course of action that will attain or maintain a resident's highest practicable level of well being. [...]

Inspectors wroteBased on record reviews, interview, and a review of a facility policy titled, Legal Documentation, the facility failed to ensure staff documented daily checks of a wander guard device. This affected RI (Resident Identifier) #21, one of nineteen residents whose medical records were reviewed. Findings Include: A review of a facility policy titled, LEGAL DOCUMENTATION, with a revision date of 01/17, revealed: . PURPOSE Provide an account of the resident's care and treatment, handwritten, typed or electronic. POLICY 1. Documentation in the medical record should be complete, accurate, objective, timely, and legible from all disciplines. A review of the medical record for RI #21 revealed a re-admission date of 10/22/17 with diagnoses to include Coronary Artery Disease, Heart Failure, and Delusional Disorders. [...]