Linn Community Nursing Home

Inspectors wroteThe facility had a census of 41 residents. Based on observation, record review, and interview, the facility failed to store, prepare, distribute, and serve food by professional standards for food service safety in one kitchen and two kitchenettes.

Inspectors wroteThe facility had a census of 41 residents. Based on observation, interview, and record review, the facility failed to develop a Facility Assessment to include the nursing resources necessary to care for the residents during the day-to-day operations, which has the potential to affect all residents in the facility.

Inspectors wroteThe facility had a census of 41 residents. The sample included 12 residents with one reviewed for hospice services. Based on observation, record review, and interview, the facility failed to ensure Resident (R)9's care plan, who admitted to hospice on 02/10/26, included a plan of care and a description of the services provided, which included contact information, visit frequency, medications, and medical equipment.

Inspectors wroteThe facility had a census of 41 residents. The sample included 12 residents. Based on observation, record review, and interview, the facility failed to ensure a sanitary environment, to help prevent the potential development and transmission of communicable diseases and infections. when staff failed to change gloves when going from a dirty to clean area during incontinence care for Resident (R)15.

Inspectors wroteThe facility had a census of 37 residents. The sample included two residents. Based on observation, record review, and interview, the facility failed to report Resident (R) 1's request to not be pushed by Maintenance Staff U as witnessed by staff to the State Agency (SA) as required. This placed R1 at risk for ongoing abuse and mistreatment.

Inspectors wroteThe facility had a census of 37 residents. Based on observation, record review, and interview, the facility failed to fully investigate an allegation of abuse for Resident (R) 1. This placed the resident at risk for ongoing abuse.

Inspectors wroteThe facility had a census of 38 residents. The sample included 12 residents, with four reviewed for accidents. Based on observation, record review, and interview the facility failed to ensure an environment free from accident hazards for cognitively impaired Resident (R) 35. On 05/23/24 at approximately 10:07 AM, Dietary Staff (DS) BB let R35 out the exit door by the main dining room, which led to the patio. DS BB then returned to dietary tasks without ensuring additional supervision for R35. The patio area contained a gate that was unlocked and R35 exited the patio area through the unlocked gate. At approximately 10:39 AM, Maintenance Staff U saw R35 on a bench by the front door reading a newspaper and when he went out the door, R35 walked back inside the facility. [...]

Inspectors wroteThe facility had a census of 38 residents. The sample included 12 residents. Based on observation, interview, and record review the facility failed to store foods and ensure proper dishwashing in a manner to prevent food-borne illness. This placed the residents at risk for foodborne illness.

Inspectors wroteThe facility had a census of 38 residents. Based on interviews and record review, the facility failed to implement a water management program for Legionella disease (Legionella is a bacterium spread through mist, such as from air-conditioning units for large buildings. Adults over the age of 50 and people with weak immune systems, chronic lung disease, or heavy tobacco use are most at risk of developing pneumonia caused by Legionella). This placed the residents in the facility at risk for infectious disease.

Inspectors wroteThe facility had a census of 38 residents. The sample included 12 residents with five reviewed for unnecessary medications. Based on observation, record review, and interview, the facility failed to ensure the Consultant Pharmacist (CP) identified and reported an unapproved indication for use, the lack of target behaviors and side effect monitoring, and lack of patient-specific rationale describing why a gradual dose reduction (GDR) was contraindicated for the use of psychotropic (alters mood or thoughts) medications for Resident (R) 6, R13, R22, and R21. This placed the residents at risk for unnecessary medication side effects.

Inspectors wroteThe facility had a census of 38 residents. The sample included 12 residents with five reviewed for unnecessary medications. Based on observation, record review, and interview, the facility failed to ensure Resident (R) 6, R13, R22, and R21 had approved indications and adequate monitoring for the use of psychotropic (alters mood or thought) medications. This placed the residents at risk of receiving unnecessary psychotropic medications.

Inspectors wroteThe facility had a census of 38 residents. Based on the interview and record review, the facility failed to offer pneumococcal (type of bacterial infection) immunizations for four of the six residents sampled for immunizations: Residents (R) 13, R25, R12, and R24. This placed the residents at risk for complications related to pneumococcal pneumonia.

Inspectors wroteThe facility had a census of 38 residents. The sample included 12 residents. Based on observation, record review, and interview, the facility failed to provide Resident (R) 17 or his representative with written information regarding the facility bed hold policy when R17 transferred to the hospital. This placed the resident at risk of not being permitted to return and resume residence in the nursing facility.

Inspectors wroteThe facility had a census of 38 residents. The sample included 12 residents with one reviewed for discharge. Based on record review, and interview, the facility failed to complete a discharge summary for Resident (R) 39, which included a recapitulation (a concise summary of the resident's stay and course of treatment in the facility) summary of the resident's stay in the facility. This placed the resident at risk of unidentified and unmet care needs.

Inspectors wroteThe facility had a census of 38 residents. The sample included 12 residents. Based on observation, record review, and interview the facility failed to assess Resident (R) 22 for trauma-informed care needs to eliminate or mitigate triggers that may cause re-traumatization of the resident. This placed R22 at risk for impaired quality of life.

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 distribute and serve food in accordance with professional standards for food service safety for the 37 residents who resided in the facility and received their food from the facility kitchen, when the facility failed to ensure clean and sanitary food prep and storage areas, and failed to wear hairnets in the two kitchenettes, while dishing up food for the residents meals. This placed the 37 residents at risk for foodborne illness.

Inspectors wroteThe facility had a census of 37 residents. The sample included 12 residents with no COVID-19 ((an acute respiratory illness capable of producing severe respiratory complications including death) positive residents identified. Based on observation, record review and interview the facility failed to identify high community transmission rates for COVID-19 and failed to ensure facility staff wore masks to protect COVID-19 transmission for the 37 residents residing in the facility.

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 exercise safe needle (sharp) practice after Resident (R) 3 received an intramuscular injection (an injection in a muscle). This placed R3 and others in the affected area at risk for accidental needle sticks.

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 treat Resident (R) 3 with respect and dignity by not providing privacy during an intramuscular (IM-an injection in a muscle) injection. This placed the resident at risk for an undignified life.

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 identify, assess and respond to alteration in Resident (R) 13's skin condition. This placed the resident at risk for delay in intervention to prevent further injury and unidentified care needs.