North Valley Hospital

Inspectors wroteBased on interview and record review, the facility failed to ensure an anti-inflammatory medication (medication that reduces inflammation and pain), taken in conjunction with an anticoagulant (blood thinning) medication, was administered according to medical provider orders for 1 of 3 Residents (Resident 1). This failure resulted in the medication being administered in excess which may have contributed to bruising and placed the resident at risk for additional bleeding and worsening of their overall condition.

Inspectors wroteBased on observation and interview, the facility failed to follow food code regulations to prevent the potential of foodborne illness by not correctly performing hand hygiene when indicated during the lunch meal service for 2 of 2 dietary staff (Staff D and E). This failure placed residents at risk for food-borne illnesses.

Inspectors wroteBased on interview and record review, the facility failed to ensure pharmacy recommendations were followed up on for 1 of 5 sampled residents (Resident 3), reviewed for unnecessary medication. This failure placed the resident at risk for experiencing adverse side effects from receiving medication at a higher dose, and for being on a medication for a longer duration than medically necessary.

Inspectors wroteBasedonobservation interview andrecordreview thefacilityfailedtostorefoodinaccordancewithprofessionalstandardsforfoodservicesafety Failuretoensureexpiredfoodswerediscardedfor3 of3 refrigerators 1 of1 drystorageareas openeddateswereplacedonfooditemsintherefrigeratorandfreezerandperformedhandhygienewhenindicated Thefacilityfurtherfailedtoconsistentlymonitorrefrigeratoranddishwashertemperatures Thesefailuresplacedresidentsatriskforfoodborneillnesses

Inspectors wroteBased on observation and interview the facility failed to ensure damaged paint and drywall was repaired timely after a water leak in 1 of 3 halls, reviewed for environment. In addition, the facility failed to ensure hazardous chemicals were secured in 1 shower room. This failure placed residents at risk of potentially avoidable accidents, lack of dignity and diminished quality of life.

Inspectors wroteBased on interview and record review the facility failed to ensure Level I Preadmission Screening and Resident Review (PASRR, an assessment to ensure individuals with serious mental illness or intellectual/developmental disabilities were not inappropriately placed in nursing homes for long term care) was accurately completed for 1 of 6 sampled residents (Resident 6), reviewed for PASRR. In addition, the facility failed to routinely ensure residents with a positive Level I PASRR were referred for Level II PASRR evaluations, as required for 2 of 6 sampled residents (Resident 6 and 31). This failure placed the residents at risk for not receiving the care and services appropriate for their needs.

Inspectors wroteBased on observation and interview the facility failed to ensure standard precautions were maintained and hand hygiene was performed when indicated during 2 of 2 medication pass observations. This failure placed residents at risk of contracting communicable diseases and diminished quality of life.

Inspectors wroteBased on observation, interview, and record review the facility failed to ensure the Minimum Data Set (MDS, assessment tool) accurately reflected the status of 1 of 11 sampled residents (Resident 31), reviewed for resident assessment. This failure placed residents at risk of inaccurate monitoring of resident status over time, unmet care needs, and diminished quality of life.

Inspectors wroteBased on observation, interview and record review, the facility failed to determine a resident had a significant change in their physical condition for 1 of 11 sampled residents (Resident 27) reviewed for comprehensive assessments. This failure placed the resident at risk for unidentified care needs and a lack of revisions to their plan of care.

Inspectors wroteBased on observation, interview, and record review the facility failed to develop and implement a comprehensive person-centered care plan that included dentation status and needs for 1 of 11 sampled residents (Resident 31), reviewed for care planning. This failure placed residents at risk of unmet care needs and diminished quality of life.

Inspectors wroteBased on observation, interview, and record review, the facility failed to consistently provide grooming for 1 of 2 sampled residents (Resident 30), reviewed for activities of daily living. This failure placed the resident at risk for not being groomed according to their preferences, and a diminished quality of life.

Inspectors wroteBased on interview and record review the facility failed to ensure residents administered psychotropic (drugs that alter brain function and could cause changes in mood, behavior, awareness, thoughts, or feelings) medications were adequately monitored and had indications for medication use documented in their medical record for 1 of 5 sampled residents (Resident 18), reviewed for unnecessary medications. This failure placed the residents at risk for receiving unnecessary medication and a diminished quality of life.

Inspectors wroteBased on observation, interview, and record review the facility failed to assist the resident in obtaining routine dental care as required for 1 of 1 sampled residents (Resident 31), reviewed for dental services. This failure placed residents at risk of unmet dental care needs and diminished quality of life.

Inspectors wroteBased on observation and interview, the facility failed to maintain kitchen equipment in a safe and clean operating condition for 1 of 1 stove hoods when reviewed. This failure placed staff at risk of injury, residents at risk of consuming contaminated food products and a diminished quality of life.

Inspectors wroteBased on interview and record review, the facility failed to develop comprehensive, person-centered care plans for 3 of 14 sampled residents (Residents 31, 5 and 2), reviewed for care planning. Failure to establish care plans that addressed care needs for the management of diabetes mellitus, (a chronic, metabolic disease that results due to the body not being able to break down sugar (glucose) for the body's cells to use for energy), blood thinning medications, and hydration placed residents at risk for unmet care needs and worsening of medical conditions.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure 2 of 2 residents (Resident 5, 8), reviewed for use and care of a urinary catheter (a flexible tube that passes through the urethra and into the bladder to drain urine), received appropriate care and services to maintain dignity. These failures placed the residents at risk for diminished quality of life.

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure a resident that had significant weight loss was reassessed and their weights monitored for 1 of 3 sampled residents (Resident 11) reviewed. Also, the provider was not notified of Reisdent 11's weight loss. This failure placed residents at risk for further undesired weight loss, and a decline in their health.

Inspectors wroteBased on observation, interview and record review, the facility failed to develop goals and interventions to manage a resident's chronic pain or implement existing pain interventions for 1 of 1 sampled residents (Resident 24) reviewed. This failure placed residents at risk for unmet comfort needs and decreased quality of life.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure 1 of 1 sampled residents (Resident 5), reviewed for use and care of a supra pubic urinary catheter (a surgically created connection between the urinary bladder and the skin used to drain urine from the bladder in individuals with obstruction of normal urinary flow), received appropriate care and services to minimize the risk of associated urinary infections. These failures placed the residents at risk for infection.

Inspectors wroteBased on interview and record review, the facility failed to ensure in-service training for 1 of 6 nursing assistants (Staff L) included dementia management, as required. These failures placed residents with dementia at risk for receiving care from inadequately trained staff.