Lake Andes Senior Living

Inspectors wroteBased on observation, interview, and record review, the provider failed to ensure kitchen equipment surfaces were clean and food was stored under clean and sanitary conditions in one of one freezer.

Inspectors wroteBased on record review, interview, and policy review, provider failed to ensure smoking evaluations were completed quarterly for one of seven sampled resident (12) who continued to smoke at the facility.

Inspectors wroteBased on observation and interview, the provider failed to ensure infection control practices were followed by allowing one of one sampled resident's (5) oxygen tubing to sit on the floor.

Inspectors wroteBased on review of the provider's South Dakota Department of Health (SD DOH) facility reported incident (FRI), interviews, observation, and record review, the provider failed to keep one of one resident (1) safe from elopement.

Inspectors wroteBased on interview and record review the provider failed to ensure care and services according to accepted standards of clinical practice regarding blood sugar monitoring, interventions, and notification to the resident's physician for four of seven diabetic residents (3, 20, 22, and 38) that experienced blood sugar levels outside of the normal range. Interventions and timely follow-up to those blood sugars was not consistently identified in their records.

Inspectors wroteBased on observation, interview, record review, and policy review the provider failed to ensure the management COVID-19 cases with 12 of 12 sampled residents (5, 6, 8, 10, 19, 20, 29, 31, 32, 33, 38, and 89) implement appropriate precautions, and prevent further transmission of the disease, including ensuring staff demonstrated the proper use of personal protective equipment (PPE) (e.g. N95 face masks and gowns), and proper hand hygiene between residents to prevent the spread of COVID-19 infection.

Inspectors wroteBased on observation, interview, and record review, the provider failed to ensure a clean and homelike environment was maintained for all 39 residents who resided at the facility.

Inspectors wroteBased on interview, staff schedule review, and payroll record review, the provider failed to ensure a registered nurse (RN) was scheduled for eight consecutive hours for two of four weekends in May 2023.

Inspectors wroteBased on observation, interview, and policy review, the provider failed to ensure food items for resident consumption were appropriately labeled and stored in a safe and sanitary manner for the following: *Three of five freezers that contained food items that were not labeled or dated. *One of one resident refrigerator that contained food items that were not labeled, dated, or discarded by the use-by date. 1. Observation on 8/27/24 at 8:15 a.m. of the lower-level food storage area revealed: *A freezer labeled Freezer 1 contained two bags of fruit that were opened and not labeled or dated. *A freezer labeled Freezer 2 contained: -One bag of waffles that was open and not dated. -One bag of French Toast that was opened and not dated. -Three bags of frozen omelets that were not labeled or dated. -Garlic bread that was open and not dated. [...]

Inspectors wroteBased on observation, interview, record review, policy review, and job description review the provider failed to ensure the facility was operated and administered by executive director (ED) A and director of nursing (DON) B, in a manner that ensured the safety and overall well-being of all 39 residents in the facility. Those areas included: *Maintaining an effective infection control program that included following appropriate infection control procedures for the prevention and management of COVID-19 infections which included: -The implementation of appropriate precautions, including enhanced barrier precautions. -Ensuring staff demonstrated the proper use of personal protective equipment. -Hand hygiene after caring for infected residents. [...]

Inspectors wroteBased on interview and policy review, the provider failed to implement an effective quality assurance process improvement (QAPI) program that focused on identifying and improving systemic problems.

Inspectors wroteBased on employee file review the provider failed to ensure that seven of seven sampled employees (B, C, J, P, Q, X, and Y) had been educated on the quality assurance and performance improvement process of the facility.

Inspectors wroteBased on observation, interview, and policy review, the provider failed to ensure dignity was maintained for two of three sampled residents (19 and 34) who had urinary catheter drainage bags that were not covered.

Inspectors wroteBased on record review and interview, the provider failed to ensure the proper Medicare notices were completed and provided timely for three of three sampled residents (12, 38, and 39) prior to their discharge from Medicare Part A skilled services.

Inspectors wroteBased on observation, interview, and policy review the provider failed to ensure privacy had been maintained for four of four sampled residents (35, 36, 38, and 139) who had adjoining rooms with a shared bathroom.

Inspectors wroteBased on observation, interview, record review, and policy review the provider failed to ensure the care plans for two of two sampled residents (19 and 139) reflected their current needs: *Resident 139's care plan did not include fall and elopement interventions. *Resident 19's care plan did not include enhanced barrier precautions (EBP) (use of gown and gloves while providing contact care) due to his open wounds and his indwelling catheter.

Inspectors wroteBased on observation, interview, record review, and policy review the provider failed to ensure care plans were revised to reflect the current care needs of two of two sampled residents (22 and 38) related to: *Resident 22 who had a central venous catheter (CVC) he used for dialysis treatments. *Resident 38 who checked her blood sugars and self-administered insulin.

Inspectors wroteBased on record review, interview, and policy review the provider failed to ensure complete and accurate documentation had been entered in the resident records for four of twenty (20, 22, 34, and 38) sampled residents.

Inspectors wroteBased on record review, and interview, the provider failed to ensure one of one sampled resident (11) had documentation of a power of attorney for healthcare that would have allowed information to be released to the resident's friend.

Inspectors wroteBased on record review, interview, observation and policy review, the provider failed to ensure: *One of one sampled resident (11) had been re-weighed after a nine-pound weight loss within 13 days. *One of one sampled resident (38) had been accurately assessed for self-administration of medication.

Inspectors wroteBased on record review, interview, and policy review the provider had failed to ensure one of one sampled resident (139) had as needed (PRN) lorazepam (antianxiety medication) order renewed for use beyond 14 days.