Lake City Scranton Healthcare Center

Inspectors wroteBased on interview, record review, and facility policy the facility failed to act promptly to resolve resident grievances from resident groups/family members. Grievances included but were not limited to quality of care and quality of life concerns with residents in the facility. 10 of 10 interviewed during the state agency resident council meeting; specified unresolved grievances include 2 of 10 residents.

Inspectors wroteBased on the facility policy, observations, record reviews, and interviews, the facility failed to ensure Resident 1 (R1) and R26, residents without the capacity to complete his/hers activities of daily living, received the care and services needed for bathing and grooming for 2 of 3 reviewed for activities of daily living.

Inspectors wroteBased on review of the facility policy, observation, interview, and record review, the facility failed to ensure Resident (R)74 had a right to a dignified existence in the presence of other residents/peers during a resident council meeting, 1 of 10 reviewed for dignity.

Inspectors wroteBased on observation, interview, and review of facility policy, the facility failed to ensure that appropriate hand hygiene was implemented in 1 of 1 kitchen observed. Additionally, the facility failed to ensure an effective water management program was in place to safeguard and reduce the potential growth and spread of Legionella and other pathogens in the facility water systems. The facility further failed to ensure the proper PPE (Personal Protective Equipment) was used to reposition Resident (R)42, prior to receiving wound care, for 1 of 1 resident reviewed for pressure ulcers.

Inspectors wroteBased on interviews, record review, and facility policy review, the facility failed to ensure residents were free from abuse for two of four residents (Resident (R) 66 and R11) reviewed for abuse and neglect of 29 sampled residents. This had the potential to affect resident safety at the facility.

Inspectors wroteBased on record review, interview, and policy review, the facility failed to conduct a thorough investigation for an alleged incident of resident-to-resident altercation for two of four residents reviewed out of 29 sampled residents (Resident (R) 187 and R11). This had the potential to affect resident safety at the facility.

Inspectors wroteBased on observations, interview, record review, and facility policy review, the facility failed to ensure residents who were dependent on staff for activities of daily living (ADL) assistance received services for one of one resident (Resident (R) 33) reviewed for fingernail care in a total sample of 29 residents. This failure placed residents at risk for diminished self-worth, self-esteem, feelings of embarrassment, and/or medical issues.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure the oxygen units were cleaned and sanitary for three of three residents (Resident (R) 68, R69, and R42) reviewed for respiratory care of 29 sampled residents. This failed practice has the potential to cause respiratory and other infections for residents.

Inspectors wroteBased on observations, record reviews, interviews, pharmacy labeling, manufacturer labeling, manufacturer package inserts and facility policy and procedures, the facility failed to ensure medications were properly stored and/or secured in 4 of 4 medication carts, 1 of 2 treatment carts, and 1 of 2 medication rooms. The facility further failed to ensure a medication cart on Palmetto Hall 2 was locked and medications that were in medication cups and ready to administer were secured before leaving the medication cart and going into resident rooms during one random observation.

Inspectors wroteBased on observation, interview, review of facility policy and procedure, and dietary contract the facility failed to ensure 80 of 81 residents were offered options of similar nutritive value to residents who choose not to eat food that is initially served or who request a different meal choice. Specifically, the facility failed to ensure alternative meals were not sandwiches and soups offered on a daily basis if a meal is refused.

Inspectors wroteBased on observation, interview, and review of facility policy and procedure the facility failed to ensure 1 of 1 three door refrigerator and 2 of 2 freezer temperatures were checked twice a day, a temperature log was maintained for 1 of 1 white stand alone freezer, and expired supplements were removed from the kitchen area. Specifically, the facility failed to check the temperature log sheets for the refrigerators and freezers twice a day, maintain a temperature log sheet for a freezer, and discard expired supplements.

Inspectors wroteBased on observation and interview, the facility failed to ensure proper dispose of refuse for 1 of 2 grease collection sites. Specifically, the facility failed to properly dispose of used fryer kitchen grease post accumulation and maintain a clean area around the collection site.

Inspectors wroteBased on interview, record review and review of facility policy and procedure the facility failed to ensure Activities of Daily Living (ADL) care was documented for 3 of 3 Residents (R)1, 14, and 56). Specifically, the facility failed to ensure daily ADL care for bathing was documented.

Inspectors wroteBased on observation, record review, staff interview, and review of the facility policy, the facility failed to maintain the resident's dignity by ensuring (Resident (R) 24's) catheter bag was covered for one of one sampled residents. Specifically, R24's catheter bag was uncovered on multiple observations throughout the survey (March 21-24, 2022). This failure had the potential to affect the residents right for privacy.

Inspectors wroteBased on observations, record reviews and interviews the facility failed to assure that a decision-making capacity form and/or power of attorney was recorded for 1 of 2 residents reviewed for advanced directives (Resident (R) 29). This failure had the potential to affect the resident's right to make healthcare decisions

Inspectors wroteBased on record reviews, interviews, and review of the facility policy titled, Fall Management, the facility failed to ensure interventions were put into place and the care plan for Resident #71 (R71) was revised with the interventions to reduce falls and or to prevent falls for 1 of 1 residents reviewed for falls with a major injury. No other residents in the facility obtained a fall with a major injury.

Inspectors wroteBased on observation, record review, interviews, and review of the facility policy, the facility failed to provide necessary care and services to prevent constipation and gastro-internal discomfort to resident (R)42 diagnosed with abnormalities of gait and mobility, chronic pain, muscle wasting, and atrophy and who is on scheduled opioid medications for one of one sampled resident reviewed for constipation. The facility's failure put the resident at risk for fecal impaction. Additionally, the facility failed to ensure Hospice services were rendered in accordance to the R1's hospice contract for one of one resident reviewed for Hospice.

Inspectors wroteBased on record review, observations, interview, and review of the facility policy titled, Wound Care Policies and Procedures, Performing a Dressing Change, the facility failed to ensure a procedure was followed during wound care for Resident (R)50 to promote healing and to prevent infection for 1 of 2 residents reviewed for Pressure Ulcers. Specifically, Licensed Practical Nurse (LPN)10 failed to clean the scissors, that were removed from her pocket, to cut Calcium Alginate to be placed in a wound bed.

Inspectors wroteBased on record reviews, interviews and the policy title, Fall Management, the facility failed to ensure that interventions were in place to prevent or decrease falls for Resident (R) 71 for 1 of 1 residents reviewed for falls with a major injury. No other residents in the facility obtained a fall with a major injury Fndings include: The facility admitted R71 with diagnoses including, but not limited to Abnormality of Gait and Mobility, Lack of Coordination, Difficulty Walking, Attention and Concentration Deficit, Muscle Wasting, Dementia and Chronic Pain. Review on 3/22/22 at 9:31 AM of the medical record for R71 revealed a fall on 3/7/22. At the time of the fall on 3/7/22, R71 had no signs or symptoms of injury. On 3/10/22, R71 was complaining of pain, it was reported to the physician and an X-ray of the left hip was obtained. [...]

Inspectors wroteBased on interview, record review, and review of facility contract, the facility failed to ensure ongoing communication and collaboration with the dialysis facility regarding dialysis care and services for one Resident (R) 56 of 1 resident reviewed for dialysis. Specifically, the facility failed to ensure communication sheets between the facility and the dialysis facility were acquired, reviewed, and maintained in R56's medical chart.

Inspectors wroteBased on observations, interviews, review of maintenance logs, and review of the facility policy titled, Maintenance/Housekeeping Policies and Procedures, Equipment and Utilities Management Program, for clothes dryers, the facility failed to ensure an excessive amount of lint was removed from over the wiring and on all three sides of the lint compartment in 3 of 3 clothes dryers.