Lakes of Monclova Health Campus the

Inspectors wroteBased on observation, staff interview, medical record review, and policy review, the facility failed to ensure residents were treated with dignity. This affected one (Resident #3) of five residents observed during dining. The facility census was 59.

Inspectors wroteBased on observation, staff and resident interview, medical record review, and policy review, the facility failed to properly store medications. This affected one (#64) of one residents observed for medication storage in residents' rooms. The facility census was 59.

Inspectors wroteBased on observation, medical record review, review of a diet guide, and staff interview, the facility failed to follow instructions for the preparation and serving of residents receiving pureed textured food to ensure accurate portion sizes. This had the potential to affect three (#3, #17, and #29) of three residents receiving pureed diets. The facility census was 59.

Inspectors wroteBased on observation, medical record review, and staff interview, the facility failed to ensure food was fed to residents in a sanitary manner. This affected one (#3) of one residents observed receiving meal assistance. The facility identified three (#3, #10, and #17) residents who received meal assistance. The facility census was 59.

Inspectors wroteBased on medical record review, staff interview and policy review, the facility failed to ensure the medical record was complete and accurate when addressing elevated blood sugars. This affected one (#13) of three discharged medical records reviewed for accuracy. The facility census was 54.

Inspectors wroteBased on observation, resident interview, staff interview, medical record review and review of facility policy, the facility failed to ensure residents were provided with scheduled bathing. This affected three residents (#20, #35, and #52) of five residents observed for activities of daily living. The facility census was 58.

Inspectors wroteBased on observation, staff interview, review of the medical record, and review of facility policy, the facility failed to ensure there were appropriate receptacles placed inside of the doorway to resident rooms to doff (remove) personal protective equipment (PPE) into. This affected two residents (#7 and #20) who were in Enhanced Barrier Precaution (EBP) isolation of five residents reviewed for isolation. The facility identified 11 residents (#1, #3, #5, #6, #7, #10, #16, #20, #24, #35, #52) residents in EBP isolation. The facility census was 58.

Inspectors wroteBased on record review of staff schedules, review of posted staffing, and staff interview, the facility failed to use the services of a registered nurse (RN) for at least eight consecutive hours a day, seven days a week as required. This had the potential to affect all 56 residents residing in the facility. The census was 56.

Inspectors wroteBased on observation, staff interview, review of resident diet list, and review of the menu spreadsheet, the facility failed to provide adequate portions of protein and mashed potatoes to residents on a mechanical soft diet. This had the potential to affect all 10 residents on a mechanical soft diet (#10, #16, #19, #20, #27, #30, #44, #262, #309, and #310). Additionally, the facility failed to provide adequate portions of protein and vegetables to residents on a pureed diet. This affected all four residents on a pureed diet (#4, #18, #37, and #40). The facility census was 56.

Inspectors wroteTHE FOLLOWING DEFICIENCY REPRESENTS AN INCIDENT OF PAST NONCOMPLIANCE THAT WAS SUBSEQUENTLY CORRECTED PRIOR TO THIS SURVEY. Based on medical record review, review of medication administration records, review of staffing assignments, and review of Certified Registered Medication Aide (CRMA) licenses, the facility failed to ensure licensed staff were administering medications. This affected 21 residents (#8, #9, #12, #13, #15, #18, #19, #22, #23, #24, #27, #28, #31, #32, #24, #36, #37, #40, #42, #45, and #108) of 24 residents reviewed for medication administration. The facility census was 56.

Inspectors wroteBased on observation, staff interview, record review, and review of the policy, the facility failed to ensure personal protective equipment (PPE) was worn by staff while performing care for a resident in contact precautions. This affected one (#307) of one resident reviewed for transmission based precautions and had the potential to affect all residents on the 100-hall (#20, #30, #39, #41, #47, #311, #312, #313, and #314). Additionally, the facility failed to ensure Enhanced Barrier Precaution (EBP) signage was posted appropriately for residents. This affected one (#26) of four residents reviewed for EBP. The facility census was 56.

Inspectors wroteBased on medical record review, resident interview, staff interviews, and policy review, the facility failed to ensure a resident was provided with showers per their preference. This affected one (#48) of one resident reviewed for choices. The census was 56.

Inspectors wroteBased on medical record review and staff interviews, the facility failed to timely obtain laboratory test as ordered by the physician. This affected one (#25) of two residents reviewed for hospitalization. The facility census was 56.

Inspectors wroteBased on medical record review, interview of nephrology clinic staff, review of fax confirmation, and staff interviews, the facility failed to timely notify the nephrologist of abnormal laboratory test as ordered by the primary care physician. This affected one (#25) of two residents reviewed for hospitalization. The facility census was 56.

Inspectors wroteBased on observation, review of resident council minutes, resident and staff interviews, the facility failed to ensure residents were served meals on nondisposable dishes, glasses/cups and silverware, to promote a homelike environment. This had the potential to effect 51 of the 52 residents in the facility. Resident #11 received nothing by mouth. The facility census was 52.

Inspectors wroteBased on resident record review, observation, and staff interview; the facility failed to ensure fall interventions were in place in accordance with the plan of care. This affected one (#37) of three resident's reviewed for falls. The census was 52.

Inspectors wroteBased on medical record review, resident and staff interviews, the facility failed to ensure a resident was seen by a physician as required. This affected one (#38) of three residents reviewed for physician visits. The facility census was 52.

Inspectors wroteBased on observation and staff interview; the facility failed to ensure a resident's environment was free from electrical wires being exposed. This affected one (#33) of 24 residents observed for the environment. The census was 52.