Life Care Center of Raynham

Inspectors wroteBased on observation and interview, the facility failed to follow professional standards of practice for food safety and sanitation to prevent the potential spread of foodborne illness to residents who are at high risk. Specifically, the facility failed to: 1. Ensure food items were properly dated and stored in the main kitchen and kitchenettes; and 2. Ensure two of three ice machines were maintained in a clean and sanitary condition.

Inspectors wroteBased on record review, observation, and staff interview, the facility failed to ensure that for four Residents (#28, #88, #78, and #143), of a total sample of 29 residents, infection control measures were implemented in order to prevent the potential development and spread of disease. Specifically, the facility failed: 1. For Residents #28 and #88, to ensure respiratory equipment was maintained in a clean and sanitary manner to decrease the risk of potential contamination and infection; 2. For Resident #78, to remove feces from hands prior to providing meals; and 3. For Resident #143, to ensure Contact Precaution measures were followed in a manner to prevent the potential spread of infection for a Resident with non-recurrent Clostridium difficile, a germ that causes diarrhea and colitis (an inflammation of the colon) and can be life-threatening.

Inspectors wroteBased on interview and record review, the facility failed to develop and implement an individualized, person-centered care plan to meet the physical, psychosocial, and functional needs for one Resident (#73), out of 29 sampled residents. Specifically, the facility failed to ensure a comprehensive care plan was developed for the use of an anticoagulant medication.

Inspectors wroteBased on observation, interview, and record review, the facility failed to meet professional standards of practice for two Residents (#5 and #35), out of a sample of 29 residents. Specifically, the facility failed: 1. For Resident #5, to ensure a physician's order was in place for the use of compression stockings for bilateral lower extremity edema, swelling caused due to excess fluid accumulation in the body tissues; and 2. For Resident #35, to ensure a physician's order was in place for the use of an air mattress for pain.

Inspectors wroteBased on observations, interviews, and records reviewed, for one Resident (#14), out of five residents with pressure ulcers investigated and 29 total sampled residents, the facility failed to ensure Resident #14 received necessary treatment and services, consistent with professional standards of practice to promote healing and prevent infection. Specifically, the facility failed to ensure the pressure ulcer was assessed by the Wound team as soon as it was identified, resulting in a delay in treatment, and to conduct daily assessments of the Resident's wound to monitor changes in the wound status between 5/21/24 and 5/30/24.

Inspectors wroteBased on observation, record review, and staff interview, the facility failed to ensure that appropriate care and services were implemented to prevent the development of urinary tract infections (UTI) for one Resident (#58), of a total sample of 29 residents.

Inspectors wroteBased on interview and record review, the facility failed to act upon recommendations made by the Consultant Pharmacist during the monthly Medication Regimen Reviews (MRR) for one Resident (#14), out of a total sample of 29 residents. Specifically, the facility failed to act on the Consultant Pharmacist's recommendation to consider an antidepressant medication dose reduction.

Inspectors wroteBased on observation and staff interview, the facility failed to ensure that accident hazards were minimized for the residents on the [NAME] Unit, where staff failed to ensure that medications were secure, attended to, and not accessible to residents.

Inspectors wroteBased on observation, interview, and policy review, the facility failed to ensure all drugs and biologicals were securely stored within locked compartments with only authorized personal having access to the keys, and labeled in accordance with currently accepted professional principles, which included the appropriate cautionary instructions, and expiration date when applicable. Specifically, the facility failed to: 1. Ensure medications were stored under proper temperature controls in two of the two medication storage rooms observed. 2. Ensure staff labeled the open-date on multi-dose vials of biologicals with shortened dates of expiration once accessed, in one of the two medication storage rooms observed. 3. Ensure all drugs were properly contained in packaging with appropriate labeling in three of the four medication carts observed. 4. [...]

Inspectors wroteBased on interview, document review, and policy review, the facility failed to maintain an infection control and prevention program to help prevent the potential transmission of a communicable disease. Specifically, the facility failed to: 1. Implement outbreak testing for staff in accordance with their policy, state and national standards when the facility was experiencing an outbreak of COVID-19 infections; 2. Ensure all medication carts were maintained in a clean, sanitary manner, to reduce the risk of contamination of stored medications in three of the four medication carts observed; 3. Ensure for a. Resident #2's Oxygen and b. Resident #53's Oxygen equipment was maintained in a sanitary manner, to help decrease the risk of contamination and infection; and, 4. [...]

Inspectors wroteBased on document review, and interview, the facility failed to fully implement their antibiotic stewardship program which included antibiotic use protocols and monitoring antibiotic use in line with the facility antibiotic stewardship program. Specifically, the facility failed to maintain a complete and thorough tracking system and follow the McGeer's criteria for usage of antibiotics.

Inspectors wroteBased on observation, record review, and staff interview, the facility failed to ensure that for two sampled Residents (#41 and #64) with indwelling urinary catheters, out of a total sample of 28 residents, that the Residents' dignity was maintained. Specifically, the facility failed: 1. For Resident #41, to consistently place the Resident's urinary catheter continuous drainage (CD) bag in a privacy bag. 2. For Resident #64, to ensure that the Resident's CD bag was consistently placed in a privacy bag.

Inspectors wroteBased on record review, policy review, and staff interview, the facility failed to ensure the resident representative was fully informed in advance and given information necessary to make health care decisions on behalf of the resident for one Resident (#34) out of a total sample of 28.

Inspectors wroteBased on observation, record review, policy review, and interview, the facility failed to develop and implement a baseline care plan within forty-eight hours of admission that included instructions necessary to provide individualized care, for two Residents (#513 and #461) that use oxygen, out of a total sample of 28 residents.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure one Resident (#139), out of a total sample of 28 residents, received care and treatment in accordance with professional standards. Specifically, the facility failed to consistently implement orders from the physician to apply Geri sleeves (provides protection to skin on the arms) to the Resident's bilateral upper extremities.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure staff provided appropriate care and services for one Resident (#139) with a Gastrostomy tube (G-tube: a tube that is placed directly into the stomach through an abdominal incision for administration of nutrition, fluids, and medications), out of 28 sampled residents. Specifically, the facility failed to: a. ensure staff labeled the enteral formula container and water flush bag with the Resident's name, date and time hung, the administration rate, duration, and initials of the staff member hanging them. b. [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure the proper care and treatment of a midline catheter (long, thin, flexible tube that is inserted into a large vein in the upper arm to administer medication into the bloodstream) device in accordance with professional standards of practice and facility policy/protocol for one Resident (#64), out of a total sample of 28 Residents. Specifically, the facility failed to: a. ensure staff labeled and changed the midline catheter's transparent dressing as needed when visibly soiled; b. ensure staff properly monitored the Resident's upper arm circumference measurement to rule out potential adverse events; and c. [...]

Inspectors wroteBased on policy review, record review and interview, the facility failed to ensure psychotropic medications in use by Resident #34 were necessary to treat targeted behaviors or a diagnosis, out of a total sample of 28 residents.