Mt Vernon Nursing

Inspectors wroteBased on observation, interview, and record review, the facility failed to keep food safe from potential contamination at all times when staff failed to ensure glasses were fully air dried before stored/used. The facility census was 43. Review of the facility policy, Dish and Utensil Handling, revised January, 2016, showed the following: -All silverware, dishes, and glasses shall be handled to ensure sanitary conditions and infection control; -Dishes, cups, and glasses will be air-dried prior to storing; -Flatware is to be washed twice and air-dried. Review of the 1999 Food Code, issued by the Food and Drug Administration, showed the following information: -After cleaning and sanitizing, equipment and utensils shall be air-dried or used after adequate draining before contact with food. -Items must be allowed to drain and to air-dry before being stacked or stored. [...]

Inspectors wroteBased on record review and interview, the facility failed to notify the resident and/or the resident's representative in writing of a transfer to the hospital for three residents (Residents #20, #40 and #36) of three sampled residents. The facility census was 43. Review of the facility form titled Resident Transfer Form to ER (emergency room), dated December 2015, showed the following to be completed by facility staff: -Date of transfer to the ER; -Resident name, date of birth ; -Next of kin or health care power of attorney name and telephone number and whether notified; -Resident's diagnosis, functional status; -Reason for transfer to ER. Review of the facility form titled Notice of Transfer/Discharge Missouri, undated, showed the following to be completed by facility staff: -Resident name, facility name, Administrator, and phone number; [...]

Inspectors wroteBased on record review and interview, the facility failed to notify the resident and/or the resident's representative in writing of the bed hold policy for a transfer to the hospital for three residents (Residents #20, #40 and #36) of three sampled residents. The facility census was 43. Review of the facility policy titled, Bed Hold Policy and Agreement Form, dated February 2014, showed the following: -Purpose to establish policy and procedure for facility to notify the resident/responsible party of the bed hold policy and agreement to pay charges for bed hold; -The bed hold agreement is to be obtained for each occurrence, hospital or therapeutic home leave; -When hospital or therapeutic home leave is reported on the midnight census, the business office will notify the resident/responsible party to sign the bed hold agreement; [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure each resident was provided access to drinks at palatable temperature when staff stored drinks on the Special Care Unit at room temperatures. The facility census was 43. Review showed the facility did not provide a policy related to drink storage/temperatures. 1. Observations on 10/07/24, starting at 12:03 P.M., showed the following: -Open (about half-full), 46 ounce (oz.) bottle of orange juice sitting on counter in the secure care unit (SCU) dining room. The exterior of the bottle felt the same as room temperature (approximately 72 degrees Fahrenheit (F)); -Open (about half-full), 46 oz. bottle of apple juice; -Large serving pitcher labeled as Kool-aid. Observation on 10/08/24, at 9:44 A.M., showed the Kool-aid, apple juice, and orange juice out on the counter of the SCU. [...]

Inspectors wroteBased on interview and record review, facility staff failed to maintain a complete infection control program when staff failed to ensure the required two step tuberculosis (TB-a communicable disease that affects the lungs characterized by fever, cough, and difficulty breathing) screening test was administered timely and correctly documented for three staff members (Business Office Manager (BOM), Certified Medication Technician (CMT) I, and Activity Director) of ten sampled staff. The facility census was 43. Review of the facility policy tilted, Infection Prevention and Control Manual, Employee Health, dated 2019, showed the following information: -Employee was defined as employees, consultants, contractors, volunteers, caregivers who provide care to the residents on behalf of the facility, and nurse or nurse aide students working in the facility; [...]

Inspectors wroteBased on observation, record review, and interview, the facility failed to provide care per standards of practice when staff failed complete blood glucose monitoring by finger stick without a physician order to do so for one resident (Resident #25) when the Freestyle glucose monitor (continuous glucose monitoring device) was not available. The facility census was 43. Review showed the facility did not provide a policy related to physician orders. Review of the FreeStyle Libre Sensor prescribing information, dated 2021, showed the following information: -The FreeStyle Libre 14 day Flash Glucose Monitoring System is a continuous glucose monitoring (CGM) device indicated for the management of diabetes in persons age [AGE] and older; -It is designed to replace blood glucose testing for diabetes treatment decisions; [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure each resident's personal privacy was protected when a staff member (Certified Nurse Aide (CNA) A) posted a video to social media for public view that included one resident (Resident #1), of four sampled residents, without the resident or resident's responsible party's permission. The facility census was 45. On 08/19/24, the Administrator was notified by facility staff of the Past Non-Compliance that occurred on 08/19/24. The Administrator and Director of Nursing immediately began an investigation that included review the videos and interviews with residents and staff. The facility began inservice education with all staff on 08/19/24 regarding phone use and protecting resident privacy. The noncompliance was corrected on 08/20/24. [...]

Inspectors wroteBased on interview and record review, facility staff failed to provide basic life support, including cardio-pulmonary resuscitation (CPR - an emergency procedure that is performed when a person's heartbeat or breathing has stopped) for one full code resident (Resident #47) when staff found the resident without a pulse or respirations. A sample of 17 residents was selected for review. The facility census was 43. The Administrator was notified on [DATE], at 3:00 P.M., of the Immediate Jeopardy (IJ) Past Non-Compliance which occurred on [DATE]. On [DATE], the Administrator became aware of the deficient practice to not administer CPR to a resident who wished to receive it. On [DATE], the staff member was counseled and the facility inserviced the staff on the cardio-pulmonary resuscitation policy and procedures. The IJ was corrected on [DATE]. [...]

Inspectors wroteBased on interview, observation, and record review, the facility failed to keep food safe from potential contamination when dishes were stacked wet instead of air dried, potentially trapping water to promote bacteria growth. This deficient practice had the potential to affect all residents. The facility census was 43 . Review of the Food and Drug Administration (FDA) 2013 Food Code showed the following information: -After cleaning and sanitizing, equipment and utensils shall be air-dried or used after adequate draining before contact with food; -Items must be allowed to drain and to air-dry before being stacked or stored. Stacking wet items such as pans prevents them from drying and may allow an environment where microorganisms can begin to grow. Review of the facility's policy titled, Dish and Utensil Handling, undated, showed the following information: [...]

Inspectors wroteBased on interview, observation, and record review, the facility failed to have a process in place to ensure the facility staff knew how much water needed to be kept on-hand in case of emergency and where the emergency water was located. This deficient practice had the potential to affect all residents. The facility census was 43. Record review of the facility's Emergency Water Supply List, dated 11/09/18, showed phone numbers for local county/public contacts. The policy did not specify the amount of water that needed to be kept on-hand in case of emergency. Record review of the provider contract for water, dated 03/02/23, showed the following: -In the event of a disaster requiring an alternate water supply the provider provide emergency water; -The provider would deliver 3 cases of 1 gallon drinking water, or 24 bottles of water; [...]

Inspectors wroteBased on interview and record review, the facility failed to ensure all medication regimens were free from unnecessary medications when the facility failed to provide adequate indications for usage and failed to have an appropriate diagnosis for use of an antipsychotic medication (Haldol) for one resident (Resident #29). A sample of five residents was reviewed in a facility with a census of 43. Review of the facility policy titled, Psychotropic Medication Use, dated 09/2022, showed the following: -Residents will only receive psychotropic medications when necessary to treat specific conditions for which they are indicated and effective; -Prior to starting psychotropic medications, informed consent will be obtained from resident/representative per state guidelines; [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to provide wound care in a manner to promote healing and prevent potential infection when staff failed to perform hand hygiene appropriately during wound care of one resident's (Resident #35) pressure ulcer (injuries to the skin and underlying tissue primarily caused by pressure on the skin). One resident was sampled in a facility with a census of 43. Record review of the facility policy titled, Infection Prevention and Control Manual, dated 2019, showed the following: -Appropriate hand hygiene is essential in preventing transmission of infectious agents; -Hand hygiene continues to be the primary means of preventing the transmission of infections; -The policy did not address when staff should perform hand hygiene. [...]