Jonesboro Center for Nursing and Healing LLC

Inspectors wroteBased on interview, record review, and review of the facility policy titled, Advance Beneficiary Notices, the facility failed to provide Skilled Nursing Facility Advanced Beneficiary Notice of Non-coverage (SNF ABN) as required for three of three sampled residents (Resident (R) 160, R76, and R103) reviewed for beneficiary notices out of a sample of 50 residents. This failure had the potential to lead to financial burdens for residents, as they may have to pay out-of-pocket for care that is typically covered by Medicare.

Inspectors wroteBased on observation, interview, document review, and policy review, the facility failed to ensure tuna salad sandwiches were served at the proper temperature. This deficient practice had the potential to cause food born illnesses affect 115 out of 119 residents.

Inspectors wroteBased on observation, interview, record review, and review of the facility policy titled, Promoting/ Maintaining Resident Dignity, the facility failed to ensure staff dressed residents in daily clothing for one of one (Resident (R) 30) reviewed for dignity. This failure had the potential to cause embarrassment for the resident and failed to respect the resident's autonomy to maintain their personal identity.

Inspectors wroteBased on record review, staff interview, and review of the facility policy titled, MDS3.0 Completion, the facility failed to complete a Significant Change in Status Assessment (SCSA) Minimum Data Set (MDS) within the required timeframe when a resident experienced multiple areas of functional decline for one of five residents (Resident (R) 57) reviewed for resident assessments. This failure placed R57 at risk for further decline if care plan revisions and interventions addressing the resident's change in condition were delayed.

Inspectors wroteBased on record reviews, staff interviews, and review of the facility policy titled, MDS3.0 Completion, the facility failed to transmit Minimum Data Set (MDS) assessments within the federally required timeframe for two of five residents (Resident (R) 4 and R144) reviewed for Resident Assessments. This failure had the potential to affect the accuracy and timeliness of federally required resident assessments.

Inspectors wroteBased on interview, record review, and review of the facility policy titled, the facility failed to ensure accurate assessments were completed for four of 50 sample residents (Resident (R) 33, R117, R67 and R96) by failing to capture services the residents were receiving. This failure has the potential to prevent residents from receiving a needed service.

Inspectors wroteBased on record review, interview, and facility policy titled, Resident Assessment-Coordination with PASARR Program, the facility failed to ensure a Preadmission Screening and Resident Review (PASARR) Level II assessment was completed for one resident (Resident (R) 94) reviewed for PASARR, who has a diagnosis of bipolar disorder and requires specialized services. This failure had the potential of placing R94 at risk for inappropriate care and lack of specialized services.

Inspectors wroteBased on record review, interview and review of the policy titled, Activities of Daily Living, the facility failed to ensure good hygiene was maintained for three residents (Residents (R) 1, R7, and R156) out of nine reviewed for activities of daily living (ADL) in the sample of 50 residents. This failure has the potential for the residents to develop skin infections, have poor hygiene and a general decline in health.

Inspectors wroteBased on observation, record review, and interviews, the facility failed to ensure two residents (Resident (R) 33 and R12) of two residents reviewed for activities out of a sample of 50 residents received an ongoing activities program to support their choice of activities. This failure had the potential for the residents' physical, mental, and psychosocial well-being to worsen and potentially develop a general decline in health.

Inspectors wroteBased on observations, interviews, record review, and policy review, the facility failed to ensure one resident (Resident (R) 33) reviewed for skin concerns out of a total sample of 50 residents received the proper care and monitoring to prevent an axilla rash under the left arm from worsening. This failure had the potential for R33's skin to worsen, cause pain, and potentially develop a general decline in health.

Inspectors wroteBased on observation, record review, and interviews, the facility failed to ensure two of two resident (Resident (R) 33 and R83) reviewed for range of motion (ROM) out of a sample of 50 residents received restorative services to ensure ROM did not worsen in the upper and lower extremities, splint devices were in place, and failed to ensure staff were educated on placement of splint devices. This failure had the potential for the resident's ROM to worsen, cause pain, skin break down and potentially develop a general decline in health.

Inspectors wroteBased on observation, interview, record review, and facility policy review, the facility failed to ensure respiratory supplies were dated and stored in a sanitary manner in accordance with professional standards for one of two residents (Residents (R)117) reviewed for respiratory care. This failure had the potential to affect infection control and had the potential to spread infection in the facility.

Inspectors wroteBased on record review, interview, and a review of the facility policy titled Hospice Services Facility Agreement, the facility failed to ensure comprehensive fall assessments were completed after a fall, and implement appropriate, individualized fall interventions, placing residents at risk for falls and fall-related injuries for one of five (Resident (R) 68) residents reviewed for falls and also failed to ensure the medical record was complete and accurate for two of three hospice residents (R14 and R36) out of the total sample of 50 residents. This failure placed residents at risk for unmet care needs.

Inspectors wroteBased on staff interviews, record review, the facility failed to provide bed hold information, in writing, at the time of transfer or within 24 hours, for one of 40 sampled residents (R) (R16). This failure had the potential to contribute to possible denial of re-admission and loss of the resident's home following a hospitalization for residents transferred to the hospital.

Inspectors wroteBased on observations, resident and staff interviews, record review, and review of the facility policy titled, Comprehensive Person-Centered Care Plans, the facility failed to implement a care plan for oxygen (O2) therapy for one of 10 residents (R) (R53) receiving O2 therapy. The deficient practice had the potential for R53's needs to go unmet.

Inspectors wroteBased on observations, record review, resident and staff interviews, and review of the facility's policies titled, Admission/readmission Orders and Oxygen (O2) Therapy, the facility failed to transcribe and to have physician orders for catheter care for one of one resident (R) (R93) reviewed with an indwelling catheter; and failed to follow physician orders to administer O2 to one of 10 R's (R53) receiving O2 therapy. The deficient practice had the potential to cause risk of complications, urinary tract infections (UTI) and other catheter-related harm to R93, and low O2 levels to R53.

Inspectors wroteBased on observations, interviews, record review, and review of the policies titled Self-Administration Protocol and Medication Administration: General Guidelines, the facility failed to assess one of four residents (R) (R80) for the ability to self-administer medications prior to leaving medications at the bedside.

Inspectors wroteBased on observations, interviews, and review of facility documentation, the facility failed to maintain a clean, homelike environment as evidenced by dirty packaged terminal air conditioner (PTAC) filters and grills, detached PTAC cover, missing PTAC ventilation slats, a non-functioning bathroom emergency call light, a missing dresser drawer handle, a broken closet door handle, and detached baseboards which were observed on three of three units.

Inspectors wroteBased on observations, staff interviews, record review, and review of policy and procedures titled Comprehensive Person-Centered Care Plans the facility failed to implement a care plan for one of three residents (R) (R30) observed during wound care.

Inspectors wroteBased on observations, interviews, and record review, the facility failed provide daily oral care for two of three sampled residents (R) (R51 and R175).

Inspectors wroteBased on observations, staff interviews, record review, and review of policy and procedures titled Pain Evaluation/Management the facility failed to provide pain management for one of three residents (R) (R30) observed receiving wound care.

Inspectors wroteBased on observations, staff interviews, record review, and review of policy and procedures titled Handwashing, Pressure Ulcer/Injury and Skin Conditions Guide for Wound Evaluation Documentation and Treatment Technique Competency Audit, the facility failed to ensure hand hygiene was completed between glove changes and between removing old dressings and application of clean dressing during wound care for two of three resident (R) (R50 and R15) reviewed for wound care.

Inspectors wroteBased on observation and interview, the facility failed to maintain an emergency bathroom resident call light as evidenced by a malfunctioning emergency call light in one of 24 sampled bathrooms rooms (room [ROOM NUMBER]).