Natchez Rehabilitation and Healthcare Center

Inspectors wroteBased on observations, interviews and record reviews the facility failed to identify and provide needed resident-centered care for a resident who is unable to carry out Activities of Daily Living (ADL) to maintain good personal hygiene for one (1) of three (3) sampled residents, Resident #1.

Inspectors wroteBased on observation, interview, record review, and facility policy review the facility failed to reasonably accommodate the food preference communication needs of two (2) of (18) residents reviewed for choice and preferences (Resident #27 and Resident #45).

Inspectors wroteBased on observation, interview, record review, and facility policy review the facility failed to ensure oxygen (O2) therapy was safely and effectively administered and monitored reviewed as evidenced by, failure to post oxygen signage outside the resident's room to indicate oxygen in use, and the nasal cannula was not worn as ordered for one (1) of three (3) residents reviewed for oxygen therapy. (Resident # 48)

Inspectors wroteBased on observation, facility policy review, record review and interviews, the facility failed to ensure a cognitively impaired resident received adequate supervision to prevent elopement when Resident #1 was left unattended and unsupervised in the facility van at a local gas station. Resident #1 exited the facility van and was unsupervised by facility staff for (40) minutes until the resident was observed by a community member 0.8 miles from the gas station where the resident had exited the van and was walking along the sidewalk. This was 1.3 miles from the facility. Resident #1 was returned to the facility. This was for one (1) of four (4) sampled residents dependent on the facility for transportation. Resident #1. [...]

Inspectors wroteBased on interviews and record review of the Certification and Survey Provider Enhanced Reports (Casper) reporting data review, the provider failed to ensure their Payroll Based Journal (PBJ), (information on the staffing hours for the appropriate care of the residents) had been corrected before submitting to the Center for Medicare and Medicaid Services (CMS) for the first Quarter of the 2024 Fiscal Year (October 1, 2023-December 31, 2023). Findings Include: Review of the provider's [NAME] reporting data revealed the facility triggered excessively low weekend staffing for the first quarter of the 2024 fiscal year. Record review of facility policy titled, Staffing Policy, revised October 2017 revealed,Policy Statement: [...]

Inspectors wroteBased on observation, staff and resident interviews, record reviews, and facility policy reviews, the facility failed to provide an ongoing weekend activity program to support residents in their choice of activities for two (2) of seventeen (17) sampled residents. Resident #18 and Resident #47. Findings Include: A review of the facility policy titled, Activity Program, dated 2001 revealed, Policy Statement: An ongoing program of activities is designed to meet the needs of each resident .Policy Interpretation and Implementation . 6. Individualized and group activities are provided that- a. Reflect the schedule, choices, and rights of the residents; b. Are offered at hours convenient to the residents, including evenings, holidays, and weekends; c. Reflect the cultural and religious interests of the residents . [...]

Inspectors wroteBased on observation, interview, record review, and facility policy review the facility ailed to implement the comprehensive care plan related to oral hygiene and positioning for one (1) of 15 sampled Residents. Resident #35 Findings Include: Review of the facility policy titled, Care Plans, Comprehensive Person-Centered, revealed A comprehensive, person centered care plan that includes measurable objectives and timetables to meet the resident's physical, psychosocial and functional needs is developed and implemented for each resident. The facility failed to develop a care plan for hand rolls for a resident with bilateral upper extrememity and hand contractures. Review of the resident's care plan revealed no care plan for hand rolls. Observation on 05/21/23 at 02:54 PM revealed contractures of bilateral upper extremities. The resident's fingers and hand were bent in toward the wrist. [...]

Inspectors wroteBased on observation, interview, record review, and facility policy review, the facility failed to provide mouth care for a dependent resident for one (1) of 15 sampled residents. Findings Include: Review of the facility's policy titled, Activities of Daily Living (ADL), Supporting, revised March 2018, revealed, 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. Observation on 05/21/23 at 02:49 PM revealed Resident #35 had mouth odor present. Teeth and mouth were not clean as evidenced by the resident's mouth had build up of white sticky substance. Observation also revealed approximate 0.5 inch of hair growth on chin. Interview with Resident #35 on 05/21/23 at 02:49 PM revealed she was interviewable by nodding and shaking head to yes and no questions. [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to provide positioning hand rolls for a dependent resident with contractures for one (1) of 15 residents sampled. Findings Include: Observation on 05/21/23 at 02:54 PM revealed contractures of bilateral upper extremities. The resident's fingers and hand were bent in toward the wrist. Nails were short and not pushing into the hand of the resident. No open areas noted. No hand rolls in hands. Resident nods when asked if she would like to use a hand roll for the contractures in bilateral upper extremities (BUE). Observation with Resident #35, Director of Nurses, and Charge Nurse on 05/22/23 at 01:57 PM revealed Resident was observed with contractures bilaterally. The DON and Charge nurse stated the resident does not want roles placed in hands for positioning. [...]

Inspectors wroteResident #42 Respiratory Care Based on observation, record review, and staff and resident interview, the facility failed to provide respiratory care consistent with professional standards of practice as evidence by a resident receiving oxygen therapy with no physician's order, monitoring or plan of care for one (1) of 15 sampled residents. Resident #43 Findings Include: An observation and interview on 05/22/23 at 03:20 PM revealed Resident #43 lying in bed with bilateral nasal cannula in nares, oxygen concentrator on administered at 2.5 Liters(L). Resident #43 noticed my observation of concentrator setting and commented the setting should be on 1.5L. A record review of Resident # 42's most recent quarterly Minimum Data Set (MDS) with an Assessment Reference Date of 04/23/2023 revealed in Section O regarding O2 use, the resident was marked as not receiving O2 therapy. [...]

Inspectors wroteFACILITY Kitchen Based on observation, interview, and facility policy review, the facility failed to ensure supplemental nutritional shakes were thawed in a manner to prevent potential foodborne illness. This deficient practice had potential to affect four (4) of 4 residents who received nutritional shake supplements of 52 residents in the facility. Findings Include: A review of the Facility's Policy titled Food: Preparation states the cook(s) will thaw frozen items using one of the following methods: thawing in the refrigerator, in a drip-proof container, and in a manner that prevents cross-contamination; thawing the item in a microwave oven then transferring immediately to conventional cooking equipment; completely submerging the item under cold water (at a temp of 70 degrees Fahrenheit) or below that is running fast enough to agitate and float off loose ice particles; [...]