Life Care Center of Las Vegas

Inspectors wroteBased on interview, record review, and document review, the facility failed to protect residents from ongoing and repeated sexual and/or physical contact by a cognitively impaired resident with a history of continued repeated behaviors for 1 of 6 sampled residents (Resident 2) and 3 of 3 unsampled residents (Resident 7, 8, and 9). The deficient practice placed the residents at risk for continued nonconsensual physical contact and potential psychosocial distress.

Inspectors wroteBased on interview, record review, and document review, the facility failed to reassess, revise, or reevaluate the effectiveness of care plan interventions, despite continued sexual and/or physical behaviors for 1 of 6 sampled residents (Resident 1). The deficient practice had potential to result in ineffective management of continued sexual and physical intrusive behaviors.

Inspectors wroteBased on interview, record review, and document review, the facility failed to implement, and accurately complete physician ordered behavior monitoring for agitation, sexual behavior, interventions, and outcomes for 1 of 6 sampled residents (Resident 1). The deficient practice had the potential to result in failure to identify, monitor, and manage continued sexual and physical behaviors.

Inspectors wroteBased on observation, interview, record review and document review, the facility failed to ensure a care plan intervention to provide one-on-one (1:1) feeding assistance for a resident who was assessed to be at risk for malnutrition was implemented for 1 of 40 sampled residents (Resident 19). The deficient practice had the potential to place the resident at an increased risk for malnutrition.

Inspectors wroteBased on observation, interview, record review and document review, the facility failed to ensure physician orders were followed to provide one-on-one (1:1) feeding assistance for a resident assessed to be at risk for malnutrition for 1 of 40 sampled residents (Resident 19). The deficient practice had the potential to place the resident at an increased risk for malnutrition.

Inspectors wroteBased on observation, interview, record review, document review, the facility failed to ensure information gathered by hospice staff related to the resident's hospice recertification reflected the improving nutritional status for a resident with a primary hospice diagnosis of protein-calorie malnutrition for 1 of 40 sampled residents (Resident 177). The deficient practice had the potential to deprive the resident of a higher level of medical care outside hospice services.

Inspectors wroteBased on observation, interview, and document review, the facility failed to ensure stored foods were stored properly and ice machines were properly cleaned for 3 of 5 ice makers in the facility. This deficient practice posed a potential risk to safety and health standards which could lead to contamination and place residents at risk of foodborne illness.

Inspectors wroteBased on clinical record review, document review and interview, the facility failed to ensure residents were provided information about the right to formulate an advanced directive for 2 of 31 sampled residents (Resident #74 and Resident #5). The deficient practice has the potential to deprive residents of their right for self-determination. Findings Include: Resident #74 (R74) R74 was admitted to the facility on [DATE], with diagnoses including Guillain-Barre Syndrome, multiple sclerosis, systemic lupus erythematosus, and unspecified dementia. R74's social services progress note dated 07/29/2024 documented the resident was alert and oriented times three and scored a 15/15 on the Brief Interview for Mental Status (BIMS) exam, meaning the resident is cognitively intact. The note also states the resident can make their own decisions. [...]

Inspectors wroteBased on interview, record review and document review, the facility failed to ensure the appropriate state mental health authority was notified promptly following a change in condition for 1 of 31 sampled residents (Resident #81). The deficient practice had the potential to deprive the resident of concern and other residents of necessary behavioral health services.

Inspectors wroteBased on interviews, record review, and document review, the facility failed to ensure a care plan was revised after a resident elopement for 1 of 31 sampled residents (Resident 167). The deficient practice placed the resident at risk for inappropriate care, supervision, and accidents.

Inspectors wroteBased on interview and document review, the facility failed to ensure employee records contained evidence of current Nevada Automated Background System (NABS) clearance per Nevada Revised Statutes (NRS) 449.124, for 4 of 19 employee records reviewed (Employees 4, 5, 6 and 7). The deficient practice had the potential to allow unqualified employees to provide care for residents.

Inspectors wroteBased on interview, record review, and document review, the facility failed to ensure the resident who had functional impairments was evaluated and appropriately discharged for 1 of 4 sampled residents (Resident 1). This failure could potentially lead to medical complications or adverse events which could result in hospitalization, prolonged illness, or even death.

Inspectors wroteBased on interviews, record review, and document review, the facility failed to ensure a care plan was revised after a resident-to-resident incident for 1 of 4 sampled residents (Resident 3). The deficient practice had the potential to place the resident at risk for inappropriate care, supervision, and accidents.

Inspectors wroteBased on observation, interview, record review, and document review the facility failed to ensure a resident with mitten restraints was assessed for the use of restraints and the physician order contained parameters for release of the restraint for 1 of 35 sampled residents (Resident 139). The deficient practice had the potential to cause physical and psychosocial harm to the resident.

Inspectors wroteBased on interview and document the facility failed to refer a resident for a Pre-admission Screening and Resident Review (PASRR) level II evaluation for 1 of 35 sampled residents (Resident 101). The deficient practice had the potential to deprive a resident of appropriate behavioral health services. Findings Include: Resident 101 (R101) was admitted on [DATE] with diagnoses including bipolar disorder, and pressure ulcer of the right plantar foot distal site. A review of the Nevada PASRR level I identification determination dated 06/30/2020 documented no mental illness, no intellectual disability, dementia, or related condition. The resident was appropriate for nursing facility placement. A review of the medical record revealed a diagnosis of bipolar disorder with an onset of 09/05/2022. [...]

Inspectors wroteBased on observation, interview, record review and document review, the facility failed to ensure person centered comprehensive care plans were developed for 3 of 35 sampled residents (Resident 330, 96 and 107), The deficient practice had a potential for staff not to provide a personalized care for residents.

Inspectors wroteBased on observation, interview, record review, and document review, the facility failed to ensure a shower or bed bath was provided at least twice a week for 1 of 35 sampled residents (Resident 26). The deficient practice had the potential to pose the risk of compromised hygiene and potential adverse effects on the resident's skin or skin breakdown.

Inspectors wroteBased on observation, interview, record review and document review the facility failed to 1) implement interventions for edema for 1 of 35 sampled residents (Resident 96); 2) ensure a resident received follow-up oncology services for a lesion on the left arm as recommended for 1 of 35 residents (Resident 103). The deficient practice had the potential to affect a resident's overall health, treatment, and care.

Inspectors wroteBased on observation, interview, record review and document review, the facility failed to ensure resident was assessed and interventions were put into place for hand contractures for 1 of 35 sampled residents (Resident 107). The deficient practice failed to implement interventions needed to avoid progression of a resident's contractures.

Inspectors wroteBased on observation, interview, record review and document review, the facility failed to ensure staff had training and a physician's order for a urinary collection device utilized within the facility for 1 of 35 sampled residents (Resident 330), The deficient practice had a potential for staff not to be aware and properly care for a resident with a specialized medical device.

Inspectors wroteBased on observation, interview, record review and document review, the facility failed to ensure intravenous (IV) accesses were changed according to physician's order and IV dressings, tubing and bags were labeled for 2 of 35 sampled residents (resident 46 and 88), and two unsampled Residents (resident 106 and 329). The deficient practice failed to implement infection control practices for residents' IV accesses.

Inspectors wroteBased on observation, interview, record review and document review, the facility failed to ensure Oxygen (O2) was administered as ordered for 2 of 35 sampled residents (Residents 16 and 22). The deficient practice could potentially lead to inadequate oxygen administration.

Inspectors wroteBased on observation, interview, record review and document review, the facility failed to ensure the medications were available and administered timely during the medication pass for 1 of 35 sampled residents (R216). The deficient practice could have led to a significant risk to the residents' health and well-being due to potential delays or missed doses of essential medications.

Inspectors wroteBased on interview, record review, and document review the facility failed to ensure pharmacist recommendations for monitoring of targeted behaviors for a resident taking psychotropic medication was completed for 1 of 35 of sampled residents (Resident 84). The deficient practice could potentially result in the unnecessary use of the medication or lack an appropriate assessment for monitoring the medication dosage and effectiveness for a resident.

Inspectors wroteBased on observation, interview, record review, and document review, the facility failed to ensure their medication error rate was not five percent (%) or greater when three errors were identified with 25 opportunities observed, resulting in an error rate of 12%. Failure to reduce the medication error rate to less than 5% could lead to an adverse drug reaction which can cause harm or injury to the resident.

Inspectors wroteBased on observation, interview and document review, the facility failed to ensure a multidose vial was discarded past the used by date. The deficient practice had the potential of an unviable medication to be administered to a resident or a staff member.

Inspectors wroteBased on observation, interview, and document review, the facility failed to ensure 1) two food items past the use by date were discarded, 2) a food item in one of four nourishment rooms was labeled and dated, and 3) two kitchen sink drains and a hood vent were maintained. The deficient practice had the potential to serve food to residents at an increased risk of food-borne illness and cause the potential contamination of clean and sanitized ware.

Inspectors wroteBased on observation, interview, record review, and document review, the facility failed to ensure documentation was accurate in the Medication Administration Record (MAR) when Oxygen (O2) was not administered for 1 of 35 sampled residents (Resident 16) and Oxygen tubing was not changed as scheduled for 1 of 35 sampled residents (Resident 22). The deficient practice had the potential to compromise the health and well-being of residents, leading to inadequate oxygen therapy.

Inspectors wroteBased on observation, interview, and document review the facility failed to ensure 1.) an employee wore an N95 respirator when entering a resident's room who was positive for COVID-19 and 2.) an employee properly wore an N95 respirator while providing services for COVID-19 positive residents on droplet-based precautions. The deficient practice had the potential to place other staff and residents at risk for contracting COVID-19.