Majestic Care of Lafayette

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure food was prepared and served to conserve flavor and at a safe and appetizing temperature. This deficient practice had the potential to affect 91 of 92 residents whom received meal trays.

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure a clean and comfortable environment was provided in 14 of 27 rooms and common areas reviewed for environment. (room [ROOM NUMBER], 210, 213, 124, 131, 137, 102, 103, and 114)

Inspectors wroteBased on interview and record review, the facility failed to ensure the resident's representative received notification in writing of the facility's bed hold policy and the reason for the resident's transfer and discharge to the hospital for 1 of 3 residents reviewed for hospitalization. (Resident 3)

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure showers were given according to the scheduled shower days and were accurately documented for 1 of 5 residents reviewed for activities of daily living. (Resident C)

Inspectors wroteBased on interview and record review, the facility failed to ensure medications were held and laboratory tests were obtained according to the physician's orders for 2 of 6 residents reviewed for quality of care. (Resident 28 and 77)

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure routine maintenance inspections which included following the manufacturers' recommendations and specifications for maintaining the bed rails were documented for 2 of 2 residents reviewed for bed rails. (Resident 8 and 10)

Inspectors wroteBased on interview and record review, the facility failed to ensure irregularities in the drug regimen were recognized, reported, and addressed for 2 of 5 residents reviewed for unnecessary medications. (Resident 8 and 28)

Inspectors wroteBased on interview and record review, the facility failed to ensure two step Tuberculous tests were completed following acceptable guidelines for 2 of 5 residents reviewed for infection control. (Resident 25 and 48)

Inspectors wroteBased on interview and record review, the facility failed to ensure pneumococcal vaccines were administered according to the signed consent form for 4 of 7 residents reviewed for immunizations. (Resident I, 9, 41 and 84)

Inspectors wroteBased on interview and record review, the facility failed to ensure care given to a resident was not completed by a particular staff member according to the resident's preference for 1 of 1 resident reviewed for resident rights. (Resident D)

Inspectors wroteBased on interview and record review, the facility failed to ensure staff notified the Social Service Director and the resident's physician immediately after the resident expressed suicidal thoughts for 1 of 1 resident reviewed for notification. (Resident 81)

Inspectors wroteBased on observation, interview and record review, the facility failed to administer the correct amount of oxygen as ordered by the physician for 1 of 1 resident reviewed for respiratory care. (Resident 5)

Inspectors wroteBased on record review and interview, the facility failed to ensure staff accurately documented on the narcotic count sheets, documented medication administration in the Medication Administration Record, and properly documented the disposal of medication for 1 of 2 residents reviewed for pain management. (Resident E)

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure a resident was assisted and received dental services for 1 of 1 resident reviewed for dental services. (Resident 8)

Inspectors wroteBased on observation and interview, the facility failed to ensure food was served at a safe and appetizing temperature for 1 of 1 room tray tested for temperatures. (100 hall)

Inspectors wroteBased on interview and record review, the facility failed to document mood and behaviors in the Electric Health Records (EHR) for 1 of 1 resident with suicidal thoughts. (Residents 81)

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure staff transported soiled linen down the hall correctly and staff wore PPE (personal protective equipment) into an isolation room for 3 of 3 randomly observed staff. (CNA 12, 13 and 14)

Inspectors wroteBased on interview and record review, the facility failed to ensure Covid-19 vaccines were provided when requested for 3 of 7 residents reviewed for immunizations. (Resident 65, 83 and 84)

Inspectors wroteBased on observation and interview, the facility failed to ensure incontinence products and personal items were stored appropriately, light bulbs were in working use, and trash was not on the ground for 5 of 70 rooms reviewed for environment (Rooms 112, 123, 134, 138, and 233).

Inspectors wroteBased on record review and interview, the facility failed to ensure residents were provided Activities of Daily Living (ADL) care for 4 of 4 residents reviewed for ADLs. (Residents J, K, L, and M)

Inspectors wroteBased on observation, interview and record review, the facility failed to provide continuous oxygen flow for 2 of 2 residents reviewed for continuous oxygen per physician's orders at 2 liters. (Residents B and D)

Inspectors wroteBased on record review and interview, the facility failed to ensure resident council grievances had a response for 7 of 7 months reviewed for resident council grievances. (January 2023 through July 2023)

Inspectors wrote3. During an observation and interview, on 8/09/23 at 1:58 p.m., Resident 63 was sitting in her room with the door shut. The resident indicated she enjoyed activities but the staff quit and now she stayed in her room except to go to dialysis. The resident was not reminded of the activities, and needed someone to take her. The CNAs told her they were too busy. The record for Resident 63 was reviewed on 8/14/23 at 11:53 p.m. Diagnoses included, but were not limited to, congestive heart failure, chronic pulmonary edema, dependent on renal dialysis, hypertension, cardiac pacemaker, and macular degeneration. A care plan, dated as revised on 8/9/23, indicated the resident was to be involved in group activities. The goal included to provide assistance or escort to activity functions, provide verbal reminders of time and place of activity. [...]

Inspectors wroteBased on interview and record review, the facility failed to ensure there was enough staff to address concerns identified by the resident council group for 7 of 7 resident council meetings reviewed, to provide incontinence care as identified by grievance concerns for 5 of 5 grievances reviewed, and to provide toileting needs for 2 of 2 residents reviewed for bowel and bladder. (Resident C and E)

Inspectors wroteBased on interview and record review, the facility failed to ensure incontinence care was provided and the residents were free from negative comments by staff for 2 of 2 residents reviewed for dignity. (Resident C and F)

Inspectors wroteBased on interview and record review, the facility failed to fully investigate an allegation of abuse for 2 of 5 residents reviewed for abuse. (Resident C and F)

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure a resident's care was coordinated with Hospice staff for obtaining a positioning chair and to document follow-up for a resident with left arm swelling for 2 of 2 residents reviewed for Hospice. (Resident 5 and 15)

Inspectors wrote2. The record for Resident 57 was reviewed on 08/11/23 at 9:20 a.m. Diagnoses included, but were not limited to, cerebral palsy, and left-hand contracture. A physician order, dated 7/7/23, indicated a palm protector was to be in the left hand donned upon bed and doffed upon rising. An electronic Medication Administration Record (MAR), dated July 2023, indicated there was no documentation by the staff for the placement or removal of the palm protector. An electronic MAR, dated August 2023, indicated there was no documentation by the staff for the placement or removal of the palm protector. During an interview, on 08/15/23 at 3: 39 p.m., Nurse 5 indicated she had not seen a palm protector for the resident. [...]

Inspectors wroteBased on observation, record review and interview, the facility failed to ensure a resident's oxygen was set at the physician ordered liters per minute (LPM) and the oxygen tanks were stored safely for 1 of 1 resident reviewed for oxygen. (Resident 15)

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure a resident received routine oral care and follow up dental visits for 1 of 1 resident reviewed for dental services. (Resident 14)

Inspectors wroteBased on observation and interview, the facility failed to ensure rooms were free from urine odors, free from dirty clothes on the floor and bedside tables, free from cardboard boxes on the floor and stacked on a plastic bin, personal belongings scattered in rooms, dirty clothes and a pillow on the floor for 6 of 6 rooms and failed to ensure flooring was replaced for 1 of 2 units reviewed for environment. (Rooms 105, 106, 108A, 110B, 112, 214, and the Cedarwood Unit)

Inspectors wroteBased on observation and interview, the facility failed to ensure posted staffing data had the actual worked hours per shift for 3 of 3 months reviewed for staffing. (6/4/23 through 8/9/23).