M.m. Ewing Continuing Care Center

Inspectors wroteBased on observations, interviews and record review conducted during the Recertification Survey from 7/17/23 to 7/21/23, it was determined that for one (Resident #8) of three residents reviewed for communication and sensory deficits, the facility did not ensure that each resident was treated with respect and dignity and care for each resident in a manner that promotes enhancement of their quality of life. Specifically, staff did not identify themselves as requested and per Resident #8's comprehensive care plan (CCP) and did not provide clear communication when providing care to the resident who has communication and sensory deficits. This is evidenced by the following: Resident #8 had diagnoses including legal blindness, acquired absence of the left eye, and hemiplegia (paralysis) of the left upper and lower extremities. [...]

Inspectors wroteBased on observations, interviews and record review conducted during the Recertification Survey from 7/17/23 to 7/21/23, it was determined that for one (Resident #16) of three residents reviewed for choices, the facility did not ensure the resident's right to retain and use personal possessions as space permits unless to do so would infringe upon the rights or health and safety of other residents. Specifically, Resident #16 was not given permission to purchase a small personal item to keep in their room without a valid reason. This is evidenced by the following: The undated facility policy Residents Rights and Grievance Policy documented that residents have the right to have and use personal possession such as furniture, clothing, and electronics. [...]

Inspectors wroteBased on observations, interviews, and record reviews conducted during a Recertification Survey from 7/17/23 to 7/21/23, it was determined that for one (Resident #271) of one resident reviewed for edema (swelling due to excess fluid in the body's tissues, usually occurring in the lower extremities), the facility did not provide services, as outlined by the resident's person-centered comprehensive care plan (CCP) and physician orders, that met professional standards of quality. Specifically, Resident #271 was observed without TED stockings (compressions stockings used for edema and to prevent blood clots in the lower extremities) as ordered by the physician. Additionally, staff documented that the TED stockings were applied to the resident when they were not. This is evidenced by the following: [...]

Inspectors wroteBased on observations, interviews and record reviews conducted during a Recertification Survey, completed on 11/16/21, it was determined that for one (Resident #115) of five residents reviewed for unnecessary medications and one (Resident #19) of three residents reviewed for indwelling (Foley) catheter, the facility did not develop and implement a plan of care for each resident that included measurable goals and objectives to address the residents' medical, physical, mental, and psychosocial needs. [...]

Inspectors wroteBased on observations, interviews and record review conducted during a Recertification Survey, completed on 11/16/21, it was determined that for one (Resident #326) of one resident reviewed, the facility did not ensure that proper fluid intake was monitored and provided to maintain proper hydration and health. Specifically, physician orders for a fluid restriction were not consistently monitored or documented to ensure compliance. This was evidenced by the following: Resident #326 had diagnoses that included hyponatremia (low sodium level), traumatic amputation below the knee and clostridium difficile (an infection in the intestinal tract). [...]

Inspectors wroteBased on interviews and record reviews conducted during the Recertification Survey, it was determined that for 13 (Residents #123, #129, #30, #52, #73, #59, #35, #45, #77, #167, #106, #118, and #78) of 20 residents reviewed for Baseline Care Plans, the facility did not develop a care plan that included the minimum required health care information within 48 hours of admission and/or provide the resident and/or resident representative with a written summary of the resident's Baseline Care Plan in a language and conveyed in a manner that the resident or representative can understand. This is evidenced by, but not limited to, the following: [...]

Inspectors wroteBased on observations, interviews, and record reviews conducted during the Recertification Survey, it was determined that for one (Resident #143) of three residents reviewed for accidents, the facility did not ensure the implementation of each resident's care plan. Specifically, the resident was not wearing geri sleeves at the time of the 3/18/19 incident, and staff did not instruct the resident to tuck in his arms while going through the doorway. This is evidenced by the following Resident #143 was admitted to the facility on [DATE] and had diagnoses including a traumatic brain injury, rightsided hemiparesis (weakness), and a history of skin tears. [...]

Inspectors wroteBased on observations, interviews, and record reviews conducted during the Recertification Survey and complaint investigation (#NY00227931), it was determined that for one (Resident #30) of five residents reviewed for Activities of Daily Living, the facility did not provide the necessary care and services to maintain personal hygiene. The issue involved the lack of incontinence care in a timely manner. This is evidenced by the following: Resident #30 was admitted to the facility on [DATE] and has diagnoses including Alzheimer's dementia, weight loss, and dysphagia (difficulty swallowing). The Minimum Data Set, Assessment, dated 4/17/19, revealed that the resident had severely impaired cognition, was frequently incontinent of bladder and bowel, and required the extensive assist of one staff for transfers and toileting. [...]

Inspectors wroteBased on observations, interviews, and record reviews conducted during the Recertification Survey, it was determined that for one (Resident #78) of five residents reviewed for unnecessary medications, the facility did not ensure that each resident's drug regimen was free of unnecessary psychotropic medications. The issues involved the lack of consistent non-pharmacological interventions prior to multiple doses of an anti-anxiety medication, and the lack of a medical evaluation prior to renewing the psychotropic medication every 14 days. This is evidenced by the following: Resident #78 was admitted to the facility on [DATE] with diagnosis including, but not limited to, heart failure, diabetes, depression, and morbid obesity. [...]