Life Care Center of Westlake

Inspectors wroteBased on observations, interviews, and review of facility policy, the facility failed to ensure a clean, sanitary, and homelike environment for residents. This affected 20 residents (Residents #87, #34, #45, #56, #7, #100, #16, #88, #107, #5, #43, #405, #67, #44, #31, #66, #25, #92, #78, and #13) and had the potential to affect all 103 residents residing in the facility.

Inspectors wroteBased on observation, record review, interview, and review of the facility policy, the facility failed to ensure a medication error rate of less than 5 percent. This affected two residents (Resident #19 and Resident #30) out of five residents observed during medication administration. The facility census was 103.

Inspectors wroteBased on record review, observation, interview, and review of the American Nurses Association Code of Ethics, the facility failed to ensure Resident #7's indwelling urinary catheter drainage bag was covered to maintain privacy. This affected one resident (Resident #7) out of two residents reviewed for respect and dignity. The facility census was 103.

Inspectors wroteBased on record review and interview, the facility failed to ensure Resident #104's comprehensive care plan included a care plan with individualized interventions to manage Resident #104's behaviors. This affected one resident (Resident #104) out of three residents reviewed for behaviors. The facility census was 103.

Inspectors wroteBased on observation, interview, review of the Nursing Rights of Medication Administration, and review of the facility policy, the facility failed to ensure that nursing services were provided in accordance with professional standards of practice when one licensed practical nurse (LPN) #110 did not follow accepted nursing standards for the preparation and administration of medications for two residents (Resident #19 and Resident #30) of five residents observed for medication administration. The facility census was 103.

Inspectors wroteBased on record review, interview, and review of the facility policy, the facility failed to ensure physician orders for daily weights were updated and implemented for Resident #105, failed to ensure Resident #106's weight was obtained to ensure an accurate weight was obtained, and failed to ensure a physician order was obtained prior to the application of a wound dressing to Resident #24's wound. This affected two residents (Resident #105 and #106) of three residents reviewed for weight loss and one resident (Resident #24) out of three residents reviewed for wound care. The facility census was 103.

Inspectors wroteBased on record review and staff interviews, the facility failed to ensure staff documented bladder retraining program interventions as outlined in Resident #105's plan of care. This failure affected one resident (Resident #105) out of three residents reviewed for incontinence care. The facility census was 103.

Inspectors wroteBased on record review, interview and facility policy review, the facility failed to ensure fall interventions were in place and failed to ensure a thorough fall investigation was conducted for Resident #15. This affected one (Resident #15) of three residents reviewed for accidents. The facility census was 100.

Inspectors wroteBased on interview and record review, the facility failed to ensure accurate documentation related to behaviors in Resident #90's medical record This affected one (Resident #90) of three residents reviewed for accuracy of documentation related to behaviors. The facility census was 100.

Inspectors wroteBased on resident record review, resident interview, staff interviews, Self-Reported Incident (SRI) review, and facility policy review, the facility failed to implement policy and procedure for an allegation of verbal abuse. This affected one resident (#20) of three residents reviewed for verbal abuse. The facility census was 99.

Inspectors wroteBased on resident record review, resident interview, staff interviews, Self-Reported Incident (SRI) review, and facility policy review, the facility failed to report an allegation of verbal abuse. This affected one resident (#20) of three residents reviewed for verbal abuse. The facility census was 99.

Inspectors wroteBased on resident record review, resident interview, staff interviews, Self-Reported Incident (SRI) review, and facility policy review, the facility failed to respond appropriately to an allegation of verbal abuse. This affected one resident (#20) of three residents reviewed for verbal abuse. The facility census was 99.

Inspectors wroteBased on review of employee personnel files, staff interviews, and facility policy review, the facility failed to ensure three of five sampled staff members were certified in Cardio-Pulmonary Resuscitation (CPR). This had the potential to affect all residents residing in the facility. The facility census was 99.

Inspectors wroteBased on review of employee personnel files and staff interviews, the facility failed to ensure two of five staff members received annual performance reviews. This had the potential to affect all residents residing in the facility. The facility census was 99.

Inspectors wroteBased on observation, record review, and interview, the facility failed to administer medications according to physician orders and manufacturer instructions. This affected two residents (#16 and #21) out of three residents reviewed for medication administration. The facility census was 99.

Inspectors wroteBased on medical record review, staff interview and facility policy review, the facility failed to monitor Resident #97 for injuries after a fall. This affected one resident (#97) of three resident injuries reviewed. The facility census was 94. Findings Include: Resident #97 was admitted to the facility on [DATE] with diagnoses including dementia, depression, insomnia, drug induced subacute dyskinesia, mixed hyperlipidemia, urinary incontinence, and constipation. Review of the Minimum Data Set (MDS) assessment, dated 12/08/24, revealed Resident #97 had severe cognitive impairment. Review of the progress notes, dated 12/05/24, revealed Resident #97 was found with her knees on the ground, legs out of her bed, and head/torso still lying on her bed. Staff documented that there was discoloration to Resident #97's knees and a small area to her right elbow. [...]

Inspectors wroteBased on medical record review, review of a facility investigation, review of email documents, review of self-reported incidents (SRIs), and review of a facility policy, the facility failed to ensure residents were free from misappropriation. This affected one (#75) of four residents reviewed for misappropriation. The facility census was 95. Findings Include: Review of Resident #75's medical record revealed an admission date of 03/08/24. Diagnoses included chronic obstructive pulmonary disease (COPD), pneumonia and epilepsy. Review of the most recent Minimum Data Set (MDS) 3.0 assessment dated [DATE] revealed Resident #75 was cognitively intact and required one-person physical assistance for his activities of daily living. Further review of the medical record revealed Resident #75 was discharged to a nursing facility closer to his family on 07/15/24. [...]

Inspectors wroteBased on record review, staff interview, and facility policy review the facility failed to ensure an allegation of staff to resident abuse was reported to the state agency as required. This affected one resident (#80) of three residents reviewed for abuse. The facility census was 102. Findings Include: Resident #80 was admitted to the facility on [DATE] with diagnoses including anoxic brain damage, dementia with other behavioral disturbance, generalized anxiety disorder, and chronic obstructive pulmonary disease. Review of the most recent Minimum Data Set (MDS) 3.0 assessment dated [DATE] revealed Resident #80 had moderately impaired cognition and was independent for ambulation. Interview on 02/29/24 at 10:00 A.M. with Human Resources Director (HR) #204 revealed that there was an incident this past weekend that involved Resident #80 and a dietary staff member. [...]

Inspectors wroteBased on record review and interviews the facility failed to ensure physician orders were followed to hold Resident #100's tube feed in preparation for a dentist appointment. This affected one resident (Resident #100) of three reviewed for quality of care.

Inspectors wroteBased on interview and record review, the facility failed to ensure Resident #29 received adequate foot care to regularly trim toenails. This affected one resident (Resident #29) out of three residents reviewed for foot care.

Inspectors wroteBased on record review and interviews the facility failed to ensure Resident #100's medical record accurately reflected NPO (nothing by mouth) status. This affected one of three residents reviewed (Resident #29 and Resident #95). The census was 95.

Inspectors wroteBased on observation and staff interview the facility failed to ensure food was labeled and dated properly and was stored in a clean and sanitary manner to prevent contamination and food borne illness. This had the potential to affect 95 of 96 residents who received meals from the kitchen. The facility identified one resident (#8) who received nothing by mouth (NPO).

Inspectors wroteBased on observation and staff interview, the facility failed to maintain its garbage disposal area in a clean and sanitary condition. This had the potential to affect 95 of 96 residents who received meals from the kitchen. The facility identified one resident (#8) who received nothing by mouth (NPO).

Inspectors wroteBased on observation, review of the facility insulin storage parameters, and interview, the facility failed to ensure insulin containers were labeled with opening dates to ensure they were not used beyond their recommended expiration. This affected four of four residents with insulin stored on the 200-hall medication cart (Resident's #34, #97, #9, and #30). The facility census was 96.

Inspectors wroteBased on record review and staff interview, the facility failed to ensure all required notices of potential financial obligation were provided to residents prior to the discontinuation of skilled services while using their Medicare Part A benefit. This affected three residents (#38, #69, and #98) of three residents reviewed for appropriate beneficiary notices.

Inspectors wroteBased on record review and staff interview the facility failed to ensure a valid level one pre-admission screen and resident review (PASRR) was completed prior to Resident #26's admission to the facility from a community setting. This affected one resident (#26) of three residents reviewed for PASRR. The facility census was 96.

Inspectors wroteBased on record review and interview, the facility failed to provide care and services to diagnose and treat a suspected urinary tract infection (UTI) in a timely manner for Resident #43. This affected one resident (#43) of one resident reviewed for UTIs. The facility census was 96.

Inspectors wroteBased on record review and interview, the facility failed to ensure Resident #5's elopement events were submitted as self-reported incidents to the Ohio Department of Health incident tracking website. This affected one (Resident #5) of three residents reviewed for elopement. The total census was 99.

Inspectors wroteBased on observation, record review and interview, the facility failed to prevent two elopement events by Resident #5. This affected one (Resident #5) of three residents reviewed for elopement. The total census was 99.

Inspectors wroteBased on observation and interview the facility failed to ensure staff washed/sanitized their hands appropriately during medication administration for Resident #20 and failed to don appropriate personal protective equipment and handle laundry appropriately during wound care for Resident #68. This affected one out of three residents observed for medication administration and one out of two residents observed for wound care (#20 and #68). The facility census was 105.

Inspectors wroteBased on observation, record review and interview the facility failed to maintain the kitchen in clean and sanitary conditions and ensure handwashing was performed during food preparation to prevent potential contamination and/or food borne illness. This had the potential to affect all 113 residents residing in the facility with the exception of Resident #41 who received nothing by mouth.

Inspectors wroteBased observation, record review and interview the facility failed to ensure privacy was provided for Resident #99 during a physical assessment. This affected one resident (#99) of 38 residents residing on the 600 Hall with the exception of Resident #41 who does not eat in the dining room.

Inspectors wroteBased on interview and record review the facility failed to timely reach a resolution to resident concerns regarding call lights. This affected 18 residents, Resident #102, Resident #49, Resident #35, Resident #254, Resident #98, Resident #94, Resident #48, Resident #86, Resident #79, Resident #60, Resident #10, Resident #87, Resident #16, Resident #18, Resident #92, Resident #50, Resident #42, Resident #80, of 18 residents that attended the resident group meeting .It had the potential to affect previous meeting attendee with concerns not resolved. The facility census was 105.

Inspectors wroteBased on interview and record review, the facility failed to notify the Long-Term Care Ombudsman of Resident #43 transfer to the hospital within 30 days of hospitalization. This affected one (Resident #43) of one residents reviewed for hospitalization, with the potential to affect nine (Resident # 16, Resident #17, Resident #73, Resident #102, Resident #9, Resident #42, Resident #77, Resident #89, and Resident #104) of ten residents that were transferred to the hospital from [DATE] through December 2018. The facility census was 105.

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure tuberculin vials were dated. This affected two out of three vials of tuberculin solution in one of two medication rooms and had the potential to affect any of the seven residents (#97, #153, #253, #254, #303, #304 and #305) who were admitted in the facility for the past 30 days and use insulin. The facility census was 102.

Inspectors wroteBased on observation, record review and interview, the facility failed to ensure the kitchen was maintained in a clean and sanitary manner, that milk was stored to prevent contamination and food products were dated when opened. This had the potential to affect 103 out of 105 residents who ate meals in the facility's kitchen.

Inspectors wroteBased on Interview, observation and record review the facility failed ensure proper handwashing procedures during Medication Administration. This affected one resident (Resident #9) of three Residents (Resident #9, #39 and #98) observed for medication administration and had the potential to effect 15 Residents (Resident #1, #8, #9, #15, #43, #56, #58, #72, #74, #76, #85, #87,#91, #101, #305) who receive medication administered by a nurse in the 200 hallway. The facility also failed to ensure proper disinfection of the glucometer devise. This affected one resident (Resident # 63) who received accuchecks, blood sugar reading, and had the potential to effect six Resident (Resident #53, #73, #89, #95, #99 and #253) who ordered accuchecks. The facility census was 105. Finding Include: 1. [...]

Inspectors wroteBased on observation, interview and record review the facility failed to revise Resident # 73 and Resident #24 Care Plan. This affected two residents (Resident #73 and #24) of 21 residents reviewed for Care Plans. The facility census was 105. Finding Include: 1. Record review revealed Resident #73 was admitted on [DATE]. Diagnosis included diabetes, bilateral below the knee amputee, major depressive disorder, muscle weakness and hypertension. Quarterly Minimum Data Set 3.0 (MDS) assessment, dated 11/18/18, documented Resident #73 was cognitively intact, needed extensive assist with bed mobility and toilet use and required total dependence with transfers, was frequent incontinent of urine and always incontinent of stool. Review of Physician order dated 11/18/18 documented to use a Hoyer lift, an assisted device used to lift patients, for all transfers. Observation on 01/15/16 at 8:32 A.M. [...]

Inspectors wroteBased on interview and record review the facility failed to accurately document Resident #48 blood sugars in the Medication Administration Record. This affected one Resident (#48) of 21 Residents reviewed for medications. The facility census was 105.