Little River Nursing & Rehab

Inspectors wroteBased on record review, observation, and interviews, the facility failed to ensure the Comprehensive Care Plan contained the necessary information to fully provide and coordinate care and services for a resident with a stage 3 pressure ulcer for 1 (Resident #39) of 1 sampled resident reviewed for pressure ulcers.

Inspectors wroteBased on record review, interview, and facility policy review, the facility failed to ensure (1) gradual dose reductions (GDR) were attempted for psychotropic (anti-anxiety) medications in the absence of a physician's documented evaluation of the specific risks versus benefits of continuing the as needed (PRN) medication past 14 days, (2) to ensure a documented explanation as to why a dose reduction attempt would be contraindicated, (3) and a duration for continuation, in order to ascertain the smallest effective dose and minimize the potential for adverse drug effects for 1 sampled (Resident # 25) of 5 resident sampled for unnecessary medications.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure foods stored in the freezer, refrigerator and dry storage area were covered, sealed, and dated to minimize the potential for food borne illness for residents who received meals from 1 of 1 kitchen; expired food items were promptly removed/discarded on or before the expiration or use by date to prevent the growth of bacteria; failed to ensure food items were dated; ensure leftover food items were used properly to maintain food quality; dietary staff washed their hands before handling clean equipment or food items to prevent the potential for cross contamination; [...]

Inspectors wroteBased on record review and interview, the facility failed to ensure a resident or residents' representative was provided in writing the notice of discharge including the contact number for the Office of Long Term Care (OLTC) as required for 2 (Resident # 30, #183). This failed practice had the potential to affect 2 sampled residents that received a 30-day notice of intent to discharge in the last 120 days.

Inspectors wroteBased on observation, record review, and interview, the facility failed to ensure that dryer lint in the laundry room was regularly removed to prevent an excessive build-up that could contribute to the potential for fire hazards for 1 of 1 onsite laundry. This failed practice had the potential to affect all 77 residents that have linens or clothing cleaned in the facility laundry.

Inspectors wroteBased on observation, record review, and interview, the facility failed to ensure there was a physician's order for oxygen for 2 (Resident #16 and #58) sampled residents, failed to ensure an oxygen in use sign was on the residents door for 1(Resident #68) sampled residents, and failed to ensure that humidifier bottles, tubing, and masks were dated and stored correctly for 2 (Resident #16 and #34) sampled residents to reduce the potential for respiratory complications. This failed practice had the potential to affect 16 residents that were receiving oxygen therapy.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure meals were prepared and served according to the planned written menu and facility quantified recipe for super calorie meals to meet the nutritional needs of the residents for 1 of 1 meal observed. This failed practice had the potential to affect 3 residents who received meals from 1 of 1 kitchen.

Inspectors wroteBased on observation and interview, the facility failed to ensure pureed food items were blended to a smooth, lump-free consistency to minimize the risk of choking or other complications for residents who required pureed diets for 1 of 1 meal observed. This failed practice had the potential to affect 6 residents who received pureed diets.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure resident laundry was covered when transported in the hall to resident rooms to prevent clothing from coming into contact of staff uniforms, and to prevent cross contamination. This failed practice affected 1 (Resident #29) of 5 sampled (Residents #18, #34, #51, #58, #68) residents and had the potential to affect 16 residents residing on 200 Hall; the facility failed to ensure that medical equipment used in isolation rooms were appropriately disinfected to prevent the spread of germs and to prevent cross contamination that affects all 77 residents living in the facility; the facility failed to ensure that staff use proper hand hygiene while providing incontinence care to Resident #71.

Inspectors wroteBased on record review and interview, the facility failed to accurately complete the assessment of 1 (Resident #23) of 4 sampled Residents with mental illness to ensure the residents received any care and therapy that could have been recommended and deemed essential for their highest practicable functioning. This failed practice had the potential to affect 8 Residents in residing in the facility with mental illnesses.

Inspectors wroteBased on record review and interviews, the facility failed to coordinate assessments with the Pre-admission Screening and Resident Review (PASARR) program by incorporating the recommendations from the PASARR Level II determination and evaluation report into the Resident' s assessment, care planning, and transitions of care for 1 (Resident #23) of 4 sampled Residents with mental illness. This failed practice had the potential to affect 8 Residents residing in the facility with diagnoses of mental illness.

Inspectors wroteBased on observations, record reviews, and interview, the facility failed to ensure that a toothbrush was stored in a manner that prevented the spread of infection for 1 (Resident #71) of 3 sampled Residents dependent on staff for oral care. The failed practice had the potential to affect 8 Residents on 400 Hall dependent on staff to provide oral care.

Inspectors wroteBased on observations, interviews, and record review, the facility failed to ensure proper incontinence care was provided to 1 (Resident #71) of 3 sampled residents (Residents #23, #71, and #28) dependent on staff for incontinence care on 400 Hall. This failed practice had the potential to affect 18 Residents dependents on staff for incontinence care.