Medilodge of Livingston

Inspectors wroteThis citation pertains to intake #3004757. Based on interview and record review, the facility failed to ensure accurate skin assessments and initiate treatments for skin impairments for one resident (R805) of two residents reviewed for skin impairments, resulting in unidentified and untreated wounds.

Inspectors wroteBased on observation, interview and record review, the facility failed to maintain sanitary conditions in the kitchen and pantry in accordance with professional standards for food service safety. This deficient practice had the potential to affect all residents that consume food from the facility.

Inspectors wroteThis citation pertains to Intake 2670486. Based on observation, interview and record review the facility failed to provide proper hand hygiene procedure during medication administration for two (R112, R09) of four residents reviewed for medication administration.

Inspectors wroteBased on interview and record review, the facility failed to promote the resident's right to be treated with dignity and respect for one (R96) reviewed for dignity, resulting in facility staff searching a resident's personal possessions without giving the resident the opportunity to decline.

Inspectors wroteBased on interview and record review, the facility failed to ensure prompt efforts to resolve a complaint/grievance regarding the disposal of fresh purchased personal food items for one resident (R29) of one reviewed for grievances.

Inspectors wroteBased on observation, interview, and record review, the facility failed to meet professional standards of quality for medication administration for two (R114, R09) of four residents reviewed for the medication administration task.

Inspectors wroteBased on observation, interview and record review, the facility failed to conduct a Safe Smoking Assessment of one resident (R96) of one reviewed for smoking.

Inspectors wroteBased on observation and interview the facility failed to ensure accurate accounting for an administered controlled medication (refers to drugs that are regulated due to their potential for abuse and dependance) for one resident (R09) of one reviewed for controlled medication administration.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure the results of the most recent recertification survey were readily accessible to residents, their family members, and their legal representatives and failed to post a notice of availability of survey reports for the past three years. This has the potential to affect all residents who reside in the facility.

Inspectors wroteThis citation pertains to intake 2647121Based on interview and record review, the facility failed to provide behavioral health services for one resident (R901) of three residents reviewed for Changes in condition.

Inspectors wroteThis citation pertains to Intake #2584966Based on observation, interview and record review the facility failed to ensure residents received scheduled showers for one (R801) out of one resident reviewed for ADL (activities of daily living) care.

Inspectors wroteThis citation pertains to Complaint #2588818. Based on interview and record review, the facility failed to perform respiratory assessments upon admission and before and after breathing treatment administration for one (R802) of one resident reviewed for a change in condition.

Inspectors wroteThis citation pertains to intake MI00149991 and MI00150073. Based on interview, and record review, the facility failed to assess the integrity of a mechanical transfer sling for one resident (R901) reviewed of three for accidents resulting in an avoidable fall requiring emergent transfer to a higher level of care and surgery for fractures sustained to the left and right lower extremities and pain.

Inspectors wroteBased on interview and record review, the facility failed to consistently ensure physician approved recommendations from the pharmacist were implemented for three (R4, R10, R19, R77) of four residents reviewed for medication regimen reviews.

Inspectors wroteBased on observation and interview, the facility failed to ensure appropriate medication storage and labeling in two of three carts reviewed for medication storage and labeling.

Inspectors wroteBased on observation, interview, and record review the facility failed to ensure nursing staff maintained professional standards, and practices for one (R239) resident of four reviewed for medication administration.

Inspectors wroteBased on observation, interview and record review, the facility failed to revise/implement effective interventions to prevent reoccurring falls for one resident (R22) of one residents reviewed for accidents/hazards/supervision.

Inspectors wroteBased on observation, interview and record review, the facility failed to follow the Physician's order for enteral nutrition for one resident (R78) of one residents reviewed for tube feeding.

Inspectors wroteBased on observation, interview and record review the facility failed to ensure sufficient staffing was provided for two residents (R10) was well as two anonymous residents who participated in the group meeting, out of a total census of 90 resulting in the potential for unmet care needs.

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure non-pharmacological interventions were attempted prior to PRN (as needed) psychotropic mediation administration for one resident (R22) of six residents reviewed for unnecessary psychotropic medications.

Inspectors wroteBased on observation, interview, and record review, the facility failed to provide proper hand washing facilities during a hot water outage, resulting in the potential for food contamination from employee hands and the increased risk of foodborne illness, affecting all residents who consume food from the kitchen.

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure resident care equipment and flooring were maintained in a sanitary manner for two (R75, R15) of five residents whose room environment was observed, resulting in unsanitary conditions, a non-homelike environment, and increased risk for harborage of bacteria.

Inspectors wroteBased on observation, interview, and record review, the facility failed to maintain an effective pest control program to prevent pests, harborage conditions, and clean pest droppings, resulting in pest droppings in five resident rooms (room #'s 201, 203, 208, 214, and 404).

Inspectors wroteThis citation pertains to Intake #MI00140111 Based on observation, interview and record review the facility failed to contact the resident's responsible party following a fall for one (R22) of two residents reviewed for falls/notification of change.

Inspectors wroteBased on observation, interview, and record review the facility failed to ensure an allegation of abuse was immediately reported to the State Agency (SA) for one (R61) of one resident reviewed for abuse.

Inspectors wroteBased on observation, interview and record review the facility failed to ensure effective interventions to reduce pressure and promote the healing of pressure ulcers were in place for one resident (R34) of four residents reviewed for pressure ulcers.

Inspectors wroteThis citation pertains to intake: MI00136011. Based on interview and record review the facility failed to timely implement and consistently monitor and care for a PEG (percutaneous endoscopic gastrostomy) tube sites for two (R's 239 & 61) of four residents reviewed for tube feeding.

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure routine maintenance and cleaning of an AVAP (Average Volume Assured Pressure Support - a non-invasive ventilator) in accordance with professional standards and manufacturer's recommendations for one (R2) of one resident reviewed for respiratory care.