Medilodge of Alpena

Inspectors wroteThis citation pertains to intake # 2712549. Based on interview and record review the facility failed to provide bed mobility in a safe manner for one Resident (Resident #2) out of three residents reviewed for accidents, hazards, and supervision.

Inspectors wroteBased on interview and record review, the facility failed to provide written bed hold notifications to residents and/or responsible parties for eight Residents (#2, #7, #9, #10, #11, #27, #59, & #87) of nine residents reviewed for hospitalizations.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure safe storage of medications and labeling for three of three medication carts reviewed for medication storage.

Inspectors wroteBased on observation, interview, and record review the facility failed to supply appropriate devices to ensure resident safety while smoking for one Resident (#104) of one resident reviewed for safe smoking.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure a medication error rate less than 5 percent, with 3 errors identified, out of 25 medication administration opportunities observed. This deficient practice resulted in a medication error rate of 11.54 percent, and the potential for the administration of non-therapeutic doses of medication, and preparation of medication not according to manufacturer's instructions.

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure current infection control practices were maintained for two Residents (#10 & #126) of 24 residents reviewed for infection control practices related to medication administration and reusable oxygen tubing.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure quality of care was provided for two Residents (R8, and R9) of nine residents reviewed for quality of care by failing to: 1. provide diabetic foot care and 2. perform proper assessments and charting for new admissions.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure medications were dispensed and destroyed per standards of practice and per facility policy for two Residents (#1 and #4) of nine residents reviewed for pharmacy services.

Inspectors wroteThis citation pertains to intake: MI00149326. Based on interview and record review, the facility failed to ensure radiology exams were obtained as ordered for one Resident (#7) of 9 residents reviewed for radiology services.

Inspectors wroteBased on interview and record review, the facility failed to recognize a change in condition for one Resident (R70) out of 23 residents reviewed for quality of care. This deficient practice resulted in hospitalization and death.

Inspectors wroteBased on observation, interview, and record review the facility failed to prevent the development of pressure wound for two Residents (R33 & R70) out of three residents reviewed for pressure ulcer care. This deficient practice resulted in deterioration of pressure wound, sepsis, and hospitalization, requiring wound debridement for R70.

Inspectors wroteBased on observation, interview, and record review the facility failed to provide food in a manner that was a palatable (preferable) temperature for 19 of 23 residents interviewed. This deficient practice resulted in frustration with meals and the potential for weight loss and inadequate nutrition.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure a medication administration error rate of less than five percent, with three errors identified out of 25 opportunities, affecting one Resident (R10) of four residents observed for medication administration, resulting in a medication error rate of 8.00 percent.

Inspectors wroteBased on observation, interview, and record review, the facility failed to: 1.) Remove expired IV (intravenous) medications and supplies. 2.) Remove expired needles and syringes. 3.) Remove expired wound vac tubing. 4.) Remove expired respiratory suctioning and nebulizer supplies. from medication storage rooms; 5.) Remove expired healthcare disinfectant wipes. 6.) Maintain a clean medication cart free of loose pills. 7.) Properly date multi-use inhalers when opened for two of two medications, and two of three medication carts reviewed for medication storage. This deficient practice had the potential for expired IV medications/supplies to be utilized/administered, missed medication doses, medication misappropriation, reduced efficacy of healthcare disinfectant used for cleaning multi-use medical supplies, and had the potential to affect the entire resident population.

Inspectors wroteBased on observation, interview and record review, the facility failed to store, prepare, distribute, and serve food in accordance with professional standards for food service safety as evidenced by: 1. Failing to ensure two staff persons washed their hands after being potentially contaminated. 2. Failing to ensure the ventilation system in the kitchen and dish washing rooms was properly balanced to exhaust the steam being generated by the high temperature dish machine. 3. Failing to ensure beverage containers being used by employees were stored in a manner which could not contaminate food contact surfaces. These deficient practices have the potential to result in food borne illness among any and all 109 residents of the facility.

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure meal menus were reviewed and approved by the facility dietitian or other qualified nutrition professional to ensure the menus and production recipes were followed to ensure nutritional requirements of the residents were met. This deficient practice had the potential to result in malnutrition to nutritionally at-risk residents.

Inspectors wroteBased on observation, interview, and record review, the facility failed to provide food preference accommodations based on the preferences of six Residents (R26 and five confidential residents) of ten residents reviewed for food preferences. This deficient practice resulted in food dissatisfaction, decreased food consumption and potential weight loss when food preferences were not provided as requested.

Inspectors wroteBased on observation, interview, and record review, the facility failed to check for peg tube residual and properly clean a glucometer according to accepted nursing standards of practice, for two Residents (#9 and #39) reviewed for professional standards of practice. This deficient practice resulted in the potential for adverse effects related to tube feeding administration and the spread of blood borne pathogens.

Inspectors wroteBased on interview and record review, the facility failed to ensure follow up was performed for a laboratory urine culture and sensitivity for one Resident (#58) of 20 residents reviewed for quality of care. This deficient practice resulted in the delay of treatment, potential for worsening of infection and lack of monitoring for a urinary tract infection.

Inspectors wroteBased on observation, interview, and record review, the facility failed to provide oxygen services per standards of practice and per physician orders for one Resident (#67) of one resident reviewed for oxygen services. This deficient practice resulted in the potential for the development of respiratory complications, including infections.

Inspectors wroteBased on observation, interview, and record review, the facility failed to provide dining adaptive equipment for two Residents (R4 and R46) of three residents reviewed for dining assistive devices. This deficient practice resulted in increased difficulty with food consumption and decreased independence with eating, as well as the potential for decreased food/fluid intake and risk for weight loss.