Madison Co Nh

Inspectors wroteBased on interview, record review and facility policy review, the facility failed to ensure the resident's right to be free from abuse for one (1) of (20) sampled residents. Resident # 53Findings include:Record review of facility policy; Abuse Policy and Procedure , revision date April 2021 revealed, Residents have the right to be free from abuse. Policy interpretation and implementation: The resident abuse, neglect and exploitation prevention program consist of facility wide commitment and resource allocation to support the following objectives: 1. Protect residents from abuse. by anyone including but not necessarily limited to: a. facility staff . Record review of the facility investigation dated 4/21/26 revealed on 4/17/26 CNA # 1, Certified Nurse Aide (CNA), reported to Licensed Practical Nurse (LPN) # 4, that Resident #1 had a bruised left eye. [...]

Inspectors wroteBased on observation, interview, facility policy review and record review, the facility failed to ensure staff followed infection prevention and control practices to prevent the spread of infection during resident care for two (2) of five (5) care observations. Resident #2 and Resident #82Findings Include: Record review of the facility policy Policy for Handwashing undated, revealed, Objective: To prevent and to control the spread of infectious disease.1. Appropriate 15 second hand washing with antimicrobial soap and water must be performed under the following conditions: a. when hands are visibly dirty or soiled with blood or other body fluids; b. after contact with blood, body fluids, secretions, mucous membranes or non-intact skin; c. after handling items potentially contaminated with blood, body fluids, or secretions; d. before eating; e. after using a restroom .3. [...]

Inspectors wroteBased on observation, interview, record review, and facility policy review, the facility failed to ensure other alternatives were implemented prior to the installation of bed rails and failed to assess and monitor the use of bed rails as a restraint and ensure they were medically necessary and the least restrictive intervention for one (1) of five (5) resident reviewed for restraints. Resident #42Findings Include: [...]

Inspectors wroteBased on staff interviews, record review, and facility policy review, the facility failed to ensure a resident was free from a significant medication error resulting in harm for one (1) of (6) six residents reviewed for narcotic medication administration (Resident #2).

Inspectors wroteBased on staff interview, record review, and facility policy review the facility failed to ensure a resident was free from abuse and misappropriation of resident property when a resident was found to have 36 oxycodone pain pills missing from the narcotic box for (1) one of (6) six residents narcotics reviewed. (Resident #1)

Inspectors wroteBased on observation, staff interview and facility policy review the facility failed to ensure a resident's dignity as evidenced by allowing the resident to sit in a public area with a private body part exposed for one (1) of 21 residents sampled.

Inspectors wroteBased on observation, staff interview, record review, and facility policy review, the facility failed to implement a comprehensive person-centered care plan for a resident requiring grooming and personal hygiene and failed to develop a care plan for splint/mobility devices for three (3) of 21 care plans reviewed. Resident #20, Resident #44 and Resident #68 Findings Include: Review of the facility policy titled, Care Plans-Comprehensive with no revision date revealed under the Policy Statement .A comprehensive care plan that includes measurable objectives and timetables to meet the resident's medical, nursing, mental and psychological needs shall be developed for each resident. Resident #20 Review of Resident #20's Care Plan revealed, ADLS (activities of daily living): Requires assistance with ADLS related to impaired functional ability/right sided hemiplegia, and cognitive impairment. [...]

Inspectors wroteBased on observations, staff interview, record review, and facility policy review, the facility failed to provide assistance with activities of daily living (ADLs) for a resident dependent on staff for shaving and changing visibly soiled clothing for two (2) of 21 sampled residents. Resident #20 and Resident #44 Findings Include: Review of the facility policy titled Activities of Daily Living undated, revealed, Policy Statement: Residents who are unable to carry out activities of daily living independently will receive the services necessary to maintain good nutrition, grooming and personal and oral hygiene . Resident #20 An observation on 7/8/2024 at 11:44 AM, revealed Resident #20 lying in bed, non-communicative with grayish-black facial hair observed above the upper lip, under the lower lip, and to her chin, measuring approximately 1/4 (one-fourth) inch in length. [...]

Inspectors wroteBased on observation, staff interview, record review and facility policy review, the facility failed to provide services to assure a resident maintained the level of range of motion (ROM) for one (1) of three (3) residents positioning and mobility.

Inspectors wroteBased on observations, staff interviews, record review and facility policy review, the facility failed to prevent the possibility of infection as evidenced by failing to cleanse and properly store a Percutaneous Endoscopic Gastrostomy (PEG) tube syringe for (1) one of (5) five resident care observations.

Inspectors wroteBased on observation, staff/resident interview, record review and facility policy review the facility failed to provide a safe, clean environment for three (3) of the eighteen residents sampled. Resident Resident #25, Resident# 49 and Resident #65.

Inspectors wroteBased on observation, staff and resident representative interview, record review and facility policy review the facility failed to ensure residents were free from physical restraints for three (3) of eighteen residents on sample. Resident #25, #31, and #72.

Inspectors wroteBased on staff interviews and record review the facility failed to accurately code the Minimum Data Set (MDS) for one (1) of eighteen residents sampled.

Inspectors wroteBased on staff interview, record review and facility policy review the facility failed to develop a comprehensive care plan for physical restraints for one (1) of eighteen residents sampled.