Lawrence Presbyterian Manor

Inspectors wroteThe facility had a census of 37 residents. The sample included 12 residents. Based on observation, record review, and interview, the facility failed to store, distribute, and serve food by professional standards for food service safety in the facility's kitchen, kitchenette, and one of two dining rooms.

Inspectors wroteThe facility had a census of 37 residents. The sample included 12 residents. Based on observation, record review, and interview, the facility failed to ensure a sanitary and comfortable environment to help prevent the development and transmission of communicable diseases and infections when staff failed to follow Enhanced Barrier Precautions (EBP-infection control interventions designed to reduce transmission of resistant organisms, which employ targeted gown and glove use during high contact care)when providing care for Resident (R) 5 and R6. Staff also failed to cover a cart with the resident's linen when transporting it down the hall.

Inspectors wroteThe facility had a census of 37 residents. The sample included 12 residents. Based on observation, interview, and record review, the facility failed to utilize an antibiotic stewardship program that included tracking, monitoring, and attempts to decrease the use of unnecessary antibiotics (a class of medications used to treat infections).

Inspectors wroteThe facility had a census of 37 residents. The sample included 12 residents. Based on observation, interview, and record review the facility failed to resolve recurring issues reported by the Resident Council.

Inspectors wroteThe facility identified a census of 37 residents. The sample included 12 residents with one resident reviewed for activities of daily living (ADL). Based on observation, record review, and interview, the facility failed to ensure staff assisted Resident (R) 25 with grooming and shaving and further failed to ensure R25's clothing was clean, and without dried food stains. Findings Included: - R25's Electronic Medical Record (EMR) from the Diagnosis tab documented diagnoses of Alzheimer's disease (progressive mental deterioration characterized by confusion and memory failure), major depressive disorder (major mood disorder that causes persistent feelings of sadness), hypertension (elevated blood pressure), lack of coordination, and need assistance with person care. [...]

Inspectors wroteThe facility had a census of 37 residents. Based on observation, record review, and interview, the facility staff failed to measure food portions for two of three residents who received ground meat diets, Resident (R) 33 and R28.

Inspectors wroteThe facility identified a census of 35 residents. The sample included 12 residents and five Certified Nurse Aides (CNAs) reviewed for performance evaluations and the associated in-service training. Based on record review and interview, the facility failed to ensure two of the five CNA staff reviewed had the required yearly performance evaluations completed. This placed the residents at risk for inadequate care.

Inspectors wroteThe facility identified a census of 35 residents. The sample included 12 residents with one resident reviewed for treatment and services to prevent pressure ulcers (localized injury to the skin and underlying tissue usually over a bony prominence, because of pressure, or pressure in combination with shear and friction). Based on observation, record review, and interviews, the facility failed to ensure Resident (R) 2's low air loss mattress was set at the appropriate setting for R2's weight, who was prone to pressure-related injury. This placed R2 at increased risk for the development of pressure ulcers and the development of new pressure ulcers.

Inspectors wroteThe facility identified a census of 35 residents. The sample included 12 residents with one resident reviewed for respiratory care. Based on observation, record review, and interviews, the facility failed to ensure Resident (R) 27's continuous positive airway pressure (CPAP- ventilation device that blows a gentle stream of air into the nose to keep the airway open during sleep) mask was stored in a sanitary manner to decrease exposure and contamination. This deficient practice placed R27 at an increased risk of developing respiratory infection.

Inspectors wroteThe facility had a census of 35 residents. The sample included 12 residents with five reviewed for unnecessary medications. Based on observation, record review, and interview, the facility failed to ensure nonpharmacological interventions were attempted and documented prior to administration of an antipsychotic (class of medications used to treat a mental disorder characterized by a gross impairment testing) medication for Resident (R) 2, who had a diagnosis of dementia (a progressive mental disorder characterized by failing memory, confusion). This placed the resident at risk for unnecessary psychotropic (alters perception, mood, consciousness, cognition, or behavior) medications and related complications.

Inspectors wroteThe facility identified a census of 35 residents. The sample included 12 residents with one resident reviewed for hospice. Based on observation, record review, and interviews, the facility failed to ensure a communication process was implemented, which included how the communication would be documented between the facility and the hospice provider. This deficient practice created a risk for missed or delayed services and impaired care for Resident (R)32.

Inspectors wroteThe facility identified a census of 35 residents. The sample included 12 residents with five residents reviewed for pneumococcal (a disease that refers to a range of illnesses that affect various parts of the body and are caused by infection) vaccinations. Based on record review and interviews, the facility failed to obtain a signed consent or declination for pneumococcal vaccination Prevnar 20 (PCV20) for Resident (R) 2, R25, and R86. This deficient practice placed the residents at risk of acquiring, spreading, and experiencing complications from pneumococcal disease.

Inspectors wroteThe facility identified a census of 35 residents. Based on observation, record review, and interviews, the facility failed to retain the daily posted nursing staffing data for the 18 months as required.

Inspectors wroteThe facility had a census of 36 residents. The sample included 12 residents with one reviewed for abuse. Based on observation, interview, and record review the facility failed to implement protective measures for the resident immediately after an allegation of abuse. This deficient practice placed Resident (R) 11 at risk for impaired safety and psychosocial wellbeing.

Inspectors wroteThe facility had a census of 36 residents. The sample included 12 residents. Based on observation, interview, and record review the facility failed to ensure staff possessed the skills and knowledge necessary to perform and record an immediate physical assessment of Resident (R) 11 after an allegation of rape. This deficient practice placed R11 at risk for unidentified injury and delayed treatment decisions.