Larksfield Place

Inspectors wroteThe facility reported a census of 74 residents. Based on observation, record review, and interview, the facility failed to prepare and serve food under sanitary conditions, to the residents of the facility appropriately to prevent the potential for food borne bacteria, by failing to ensure the ice machine had an appropriate drainage air gap from the tubing to the floor drain, as required.

Inspectors wroteThe facility reported a census of 74 residents with 20 residents sampled for review, including one resident reviewed for hospitalization. Based on observation, interview, and record review, the facility failed to complete an accurate Minimum Data Set (MDS) for one Resident (R)70, regarding discharge to an acute hospital.

Inspectors wroteThe facility identified a census of 74 residents with 20 residents sampled, including two residents reviewed for positioning. Based on observation, interview, and record review, the facility failed to ensure proper wheelchair positioning for one Resident (R)5.

Inspectors wroteThe facility reported a census of 74 residents with 20 residents sampled, including nine residents reviewed for accidents. Based on observation, interview, and record review, the facility failed to ensure one Resident (R)3's toilet safety rail was secure and R 29, related to failure to ensure the resident was safe in the use of his lift chair.

Inspectors wroteThe facility reported a census of 74 residents with 20 residents selected for review, which included two residents reviewed for urinary catheters (a flexible tube inserted through the urethra [the external opening of the urinary tract] and into the bladder). Based on observation, interview, and record review, the facility failed ensure consistent monitoring of one Resident (R)58's penile erosion (a split in the urethra) caused by pressure of a urinary catheter.

Inspectors wroteThe facility reported a census of 74 residents with 20 residents selected for review, which included six residents reviewed for unnecessary medications. Based on observation, interview, and record review, the facility failed to ensure staff followed physician orders for medication for one Resident (R)52 who received a lower dose a chemotherapy (medication used to treat cancer) than ordered by the physician.

Inspectors wroteThe facility reported a census of 74 residents with 20 residents sampled, including five residents reviewed for indwelling urinary catheter (a thin, hollow tube that is inserted into the bladder through the urethra to drain and collect urine). Based on observation, interview and record review, the facility failed to provide appropriate catheter care for two Residents (R)47, and R58 with indwelling urinary catheters, in a clean and sanitary manner.

Inspectors wroteThe facility had a census of 59 residents. The facility had a large main kitchen and a satellite kitchen for the long term/skilled branch of the facility. Based on observation, interview, and record review the facility failed to ensure the light fixtures above the food preparation areas in the main facility kitchen were cleaned and the storage shelving without rust. This deficient practice placed residents at risk for food borne illness.

Inspectors wroteThe facility had a census of 59 residents. The sample included 15 residents. Based on record review and interview, the facility failed to provide two sampled residents, Resident (R)7 and R37 (or their representative) the completed Skilled Nursing Facility Advanced Beneficiary Notices (ABN) form 10055, (CMS) Centers for Medicare and Medicare Services. This placed the residents at risk for uniformed decisions regarding skilled services.

Inspectors wroteThe facility reported a census of 65 residents, with one main kitchen. Based on observation and interview the facility failed to store foods in a safe and sanitary manner by the failure of staff to date and reseal opened food items, and failure to discard expired food items.

Inspectors wroteThe facility census was 65 with 16 residents sampled. Based on observation, interview, and record review, the facility failed to verify Resident (R) 10, R157, R48, and R155's Advance Directives (a legal document in which a person specified what actions should be taken for their health), and the facility provided conflicting information regarding the residents code status (decision whether or not to withhold medical intervention in the event the resident's heart stops) to the staff responsible for R10, R157, R48 and R155's care.

Inspectors wroteThe facility reported a census of 65 residents with 16 sampled including three for Activities of Daily Living (ADL). Based on observation, interview, and record review the facility failed to provide ADL assistance to include bathing services to maintain good grooming for Resident (R) 155, who required extensive assistance of two staff with bathing. Findings Included: - Review of R155's Electronic Health Record (EHR) documented the following diagnoses dated 04/20/21: macular degeneration (progressive deterioration of the retina), osteoarthritis (degenerative changes to one or many joints characterized by swelling and pain), and fractures of the right tibia (bone of the lower leg) and fibula (one of the two bones of the lower leg). Review of R155's admission Minimum Data Set (MDS) dated [DATE] documented a Brief Interview for Mental Status (BIMS) of 15, indicating intact cognition. [...]

Inspectors wroteThe facility reported a census of 65 residents, with 16 sampled and four for falls. Based on interviews, observations, and record review, the facility failed to adequately ensure R38's fall interventions were in place to prevent future falls and failed to implement new interventions related to two falls with noted lack of appropriate footwear on R38.