Legacy Nursing and Rehabilitation of Tallulah

Inspectors wroteBased on record review and interviews the facility failed to ensure competent nursing staff provided nursing and related services to attain or maintain the highest practical physical, mental and psychosocial well-being of each resident by failing to administer insulin as ordered for 1 (#56) of 5 residents whose medication regimens were reviewed.

Inspectors wroteBased on record review and interview, the facility failed to ensure residents that had an order for psychotropic medication as needed were not subjected to chemical restraints for 1 (#2) of 5 residents reviewed for unnecessary medications. The facility failed to ensure a prn order for a psychotropic medication was limited to 14 days for Resident #2.

Inspectors wroteBased on record review and interview, the facility failed to ensure the pharmacist identified irregularities related to adequate monitoring of a prescribed medication for 1 (#14) of 5 residents reviewed for unnecessary medications.

Inspectors wroteBased on record review and interview, the facility failed to ensure each resident's drug regimen was free from unnecessary drugs by failing to obtain a Vitamin D level as ordered for 1 (#14) of 5 residents reviewed for unnecessary medications.

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure it did not have a medication error rate of greater than 5% by having a medication error rate of 7%.

Inspectors wroteBased on record review and interview, the facility failed to report an injury of unknown origin with serious bodily injury to the State Survey Agency in accordance with State law for 1 (#1) of 4 sampled residents.

Inspectors wroteBased on observations, record reviews, and interviews the facility failed to immediately inform the responsible party of tests results for 1 (#1) of 3 (#1, #2, and #3) residents reviewed for notification of change. The facility failed to ensure that resident #1's responsible party was notified of the resident's x-ray results, in a timely manner.

Inspectors wroteBased on observation, interview, and record review the facility failed to accurately assess safety devices for effectiveness and elimination for 1 (#58) of 1 (#58) residents reviewed for restraints.

Inspectors wroteBased on record review and interview, the facility failed to ensure it provided an ongoing program to support the residents in their choice of activities for 1 (#26) of 1 (#26) residents reviewed for activities. The facility failed to provide adequate activities for resident #26 who had a diagnosis of blindness.

Inspectors wroteBased on observations, record reviews and interviews, the facility failed to: 1) ensure residents had a physician's order for bed rails, 2) obtain informed consent from the resident or resident's representative for bed rail use, and 3) assess residents for the risk of entrapment from bed rails prior to the installation of bed rails for 4 (#23, #30, #34, and #60) of 4 (#23, #30, #34, and #60) residents reviewed for bed rails.

Inspectors wroteBased on record reviews and interviews, the facility failed to ensure each resident's medication regimen was free from unnecessary medications by failing to monitor for bleeding for a resident who received anticoagulant medication for 1 (#15) of 1 (#15) residents reviewed for anticoagulants.

Inspectors wroteBased on observations and interviews, the facility failed to store, prepare, and serve food in accordance with professional standards for food service safety by, 1) storing clean pots on a shelf with old food particles, 2) having a buildup of an unknown black substance on the inside of the ice machine and a buildup of dust on the filters of the ice machine, 3) foods items being stored in the freezer that were open and exposed to air, and 4) storing flats of bottled water directly on the storage room floor. According to the Diet Type Report, there was a total of 84 residents who currently received a meal tray from the kitchen.

Inspectors wroteBased on observations and interviews, the facility failed to maintain a sanitary environment to help prevent the development and transmission of communicable diseases and infections by, failing to ensure employees did not store their personal belongings in the kitchen food preparation and storage room. According to the Diet Type Report, there was a total of 84 residents who currently received a meal tray from the kitchen.

Inspectors wroteBased on observations and interviews, the facility failed to maintain all mechanical equipment in safe operating condition by having a buildup of metal shavings on the can opener and a grease buildup inside of the deep fryer. According to the Diet Type Report, there were a total of 84 residents who currently received a meal tray from the kitchen.

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure each resident received services within a reasonable accommodations of their needs for 1 (#144) of 1 (#144) residents reviewed for accommodation of needs. The facility failed to ensure resident #144 was supplied with a call light that he could activate.

Inspectors wroteBased on record review and interview, the provider failed to ensure an incident involving an elopement was reported to the State Survey Agency for 1 (#294) of 1 sampled resident reviewed for elopement.

Inspectors wroteBased on observations, record reviews and interviews, the facility failed to ensure each resident received adequate supervision to prevent elopement for 1 (#294) of 1 sampled resident reviewed for elopement.

Inspectors wroteBased on record reviews and interviews, the facility failed to ensure that each resident's drug regimen was free from unnecessary drugs for 2 (#1, #5) of 5 (#1, #2, #3, #4, and #5) sampled residents reviewed for unnecessary medications. The facility failed to ensure the nurses' followed an insulin sliding scale as ordered (#1) and blood pressure parameters as ordered (#1, #5).

Inspectors wroteBased on observations, record reviews, and interviews, the facility failed to ensure a resident who is unable to carry out activities of daily living receives the necessary services to maintain good personal hygiene for 1 (#1) of 5 (#1, #2, #3, #4, and #5) residents reviewed for activities of daily living by, failing to ensure resident #1's feet were kept cleaned and his face was groomed.

Inspectors wroteBased on observation, interview and record review the facility failed to ensure residents received treatment and care in accordance with professional standards of practice and the comprehensive person-centered care plan. The facility failed practice was evidenced by 1) not turning or repositioning dependent residents every 2 hours for 1 (#50) of 2 (#50, #28) residents investigated for position/mobility and 2) not administering medication as ordered by the physician for 1 (#345) of 2 (#345, #69) residents investigated for respiratory care.

Inspectors wroteBased on observation, record review and interview the facility failed to maintain acceptable parameters of nutritional status for 1 (#1) of 7 (#1, #11, #32, #33, #39, #72, #81) residents reviewed for nutritional intake.

Inspectors wroteBased on observation and interview the facility failed to serve food that was palatable to taste and attractive.

Inspectors wroteBased on review of the QAA (Quality Assessment and Assurance) manual and interview, the facility failed to have documented evidence of having QAA meetings at least quarterly. Review of the Long-Term Care Facility Application for Medicare and Medicaid report revealed the facility had a census of 97.

Inspectors wroteBased on observation and interview the facility failed to store, prepare, distribute and serve food in accordance with professional standards for food service safety. The facility failed to ensure 1) the prep table next to the fryer and the top of the fryer was clean and free from heavy grease build up; 2) the stove and small standup oven were free of spills and splatters, and 3) the flour scoop was stored properly and not in direct contact with the top of the flour bin; 4) the floor of the dry pantry was clean and dry by having a grease spill; 5) the inside of the ice machine contained black substance on the walls; 6) grease and carbon build up on muffin pans and cookie sheets; 7) food in the standup refrigerator was properly labeled and contained personal staff drink; 8) food in the walk in refrigerator was not stored properly by having bacon stored over raw cabbage; [...]