Nspire Healthcare Plantation

Inspectors wroteBased on observations, interviews and record reviews, the facility failed to store and prepare food in a sanitary manner in accordance with standards for food safety professional standards.

Inspectors wroteBased on observations, interviews, and record reviews, the facility failed to provide care and services in a dignified manner for 1 of 22 sampled residents reviewed during morning care observations, Resident #22; and failed to honor residents' dignity for 2 of 22 sampled residents reviewed for assistance during dining, Resident #70 and Resident #61.

Inspectors wroteBased on observations, interviews, and record reviews, the facility failed to ensure the call lights were accessible to residents while in their beds to request assistance from staff for 3 of 22 sampled residents, Resident #42, Resident #92, and Resident #104, reviewed for call lights use.

Inspectors wroteBased on observations, interviews, and record reviews, the facility failed to honor resident and family's request to be out of bed daily; and failed to ensure the provision of showers as per facility schedule and resident's request for 2 of 2 sampled residents reviewed for choices, Resident #115 and Resident #108.

Inspectors wroteBased on observations, interviews and record reviews, the facility failed to provide an environment free from restraints for 1 of 22 sampled residents, Resident #106.

Inspectors wroteBased on observation and interview, the facility failed to provide an environment which supported the residents' quality of life by failing to honor 8 of 16 sampled residents reviewed for preferences to open the dining room for meals on weekends, Residents #12, #14, #65, #20, #9, #73, #75 and #3.

Inspectors wroteBased on observations, interviews, and record review, the facility failed to appropriately use a two-person transfer via Hoyer Lift during a transfer from the resident's bed to wheelchair, placing the resident at risk for injury for 1 of 1 sampled resident reviewed for accidents, Resident #22.

Inspectors wroteBased on observations, interviews, and record reviews, the facility failed to follow their own catheter care policy to ensure residents with indwelling catheters receive appropriate care and management: to minimize pressure and tension for 1 of 2 residents reviewed, for Resident #35; and to prevent infection for 1 of 2 residents reviewed for urinary catheter care for Resident #124.

Inspectors wroteBased on observations, interviews and record reviews, the facility failed to ensure a current physician order for oxygen for 1 of 4 sampled residents, Resident #10; failed to initiate a nursing care plan for oxygen for 1 of 4 sampled residents reviewed for respiratory care, Resident #10; and failed to ensure oxygen tubing, nasal cannula and mask were dated for 2 of 4 sampled residents, Resident #10 and Resident #35.

Inspectors wroteBased on interview, record review, and observation, the facility failed to appropriately identify Post Traumatic Stress Disorder (PTSD) behavior triggers and implement a person-centered care plan for PTSD with behavior triggers for 2 of 2 sampled residents reviewed for behaviors, Residents #96 and #95.

Inspectors wroteBased on observation, interview, and record review, it was determined the medication error rate was 8 percent. Two (2) medication errors were identified while observing a total of 25 opportunities, affecting Resident #119.

Inspectors wroteBased on observations, interview and record review, the facility's Quality Assurance and Performance Improvement Activities (QAPI) failed to demonstrate that effective plans of actions were implemented to correct identified quality deficiencies in the problem area as evidenced by repeated deficiencies in F812 food procurement, store, prepare and serve. These repeated deficient practices have the potential to affect all 110 residents residing in the facility at the time of this survey.

Inspectors wroteBased on observations, interviews, and record reviews, the facility failed to perform appropriate hand hygiene during medication administrations for 2 of 6 residents, for Residents #79 and 18, and failed to properly disinfect blood pressure (BP) cuff during medication administration for 3 of 6 residents for medication administration observations, for Residents # 119, 110 and 37.

Inspectors wroteBased on observations, interviews and record review, the facility failed to prepare and serve food in a sanitary manner in accordance with professional standards for food safety.

Inspectors wroteBased on observation, records review, and interviews, the facility failed to ensure it timely answered call lights in response to residents' needs for 3 of 24 sampled resident, Residents #13, #38, and #55.

Inspectors wroteBased on observations, interviews, and record review, the facility failed to follow the physicians' orders for wound treatment and failed to provide wound care in a timely manner for 1 of 2 sampled residents, reviewed for wound care, Resident #18.

Inspectors wroteBased on review of policy and procedure, record review, observation and interview, the facility failed to administer the correct type of Aspirin medication, as per physician's order for 1 of 5 sampled residents observed during a Medication Administration Observation, Resident #94.

Inspectors wroteBased on observations, interviews, and record review, the facility failed to ensure accurate records related to dressing change for 1 of 2 sampled residents reviewed for wound care, Resident #18; and failed to ensure complete and adequate documentation for 1 of 1 sampled resident reviewed as deceased in the facility, Resident #99.

Inspectors wroteBased on observations, interviews, and record review, the facility failed to follow Enhanced Barrier Precautions (EBP) during medication administration for 1 of 11 sampled residents reviewed for EBP, Resident #53; failed to ensure Personal Protective Equipment (PPE) gowns were available on the 2nd floor for 8 of 11 residents who were on EBP; failed to have appropriate signage posted to indicate precautions for 1 of 11 sampled residents reviewed for EBP, Resident #53; failed to properly utilize hand hygiene and discard a used lancet after Blood Glucose check during medication administration observation for 1 of 1 sampled resident, Resident #3; and failed to ensure a sanitary environment during perineal care for 1 of 1 sampled resident reviewed for Urinary Tract Infection (UTI), Resident #56. The census at the time of the survey was 90 residents.

Inspectors wroteBased on record review and interview, the facility failed to follow-up on monitoring residents with a change in condition for 1 of 2 sampled residents reviewed for death in the facility, Resident #1.

Inspectors wroteBased on observation, interview and record review, the facility failed to prepare, store and serve food in a sanitary manner and in accordance with professional standards.

Inspectors wroteBased on observations, interviews, and record review the facility failed to secure 3 of 6 medication carts, failed to secure 1 treatment cart, and failed to secure meds at the bedside for 1 of 19 sampled residents (Resident #143)

Inspectors wroteBased on observations, interviews, and record review the facility failed to assist residents during meals in a dignified manner for 2 of 4 residents observed for dignity (Residents #82 and #66) and the facility failed to provide privacy for 1 of 4 residents observed for dignity (Resident #90).

Inspectors wroteBased on observations, interviews, and record reviews, the facility failed to provide residents with preferences for being out of bed for 1 of 1 residents reviewed for Preferences (Resident #47).

Inspectors wroteBased on record reviews and interviews, the facility failed to act on request for Level II Pre-admission Screening and Resident Review (PASARR) for a resident determined to have 'Serious Mental Illness' for 1 of 3 residents reviewed for PASARR (Resident #11). The facility failed to have a PASARR screening completed upon admission for 2 of 3 residents reviewed for PASARR (Resident #38 and 25).

Inspectors wroteBased on observation, interview and record review, the facility failed to provide showers based on shower schedule and resident preferences for Resident 2 of 4 residents reviewed for Activities of Daily Living (ADLs) (Residents #7 and 32). The facility failed to ensure proper nail care for 1 of 4 residents reviewed for ADL Care (Resident #90).

Inspectors wroteBased on observations, interviews, and record reviews, the facility failed to provide adequate podiatry care for 2 of 2 residents reviewed for Podiatry Care, (Residents #34 and 90).

Inspectors wroteBased on observations, interviews and record reviews, the facility failed to provide appropriate device in the form of a smoking apron to prevent injury and skin damage to 1 of 1 resident reviewed for smoking (Resident #11).

Inspectors wroteBased on record review, observations and interviews, the facility failed to follow the facility's Urinary Catheter Care policy, and failed to ensure the staff followed hand hygiene practices consistent with accepted standards of practice during foley/peri-care provided to 1 of 1 resident sampled for urinary catheter care review (Resident #3).

Inspectors wroteBased on record review, observations and interviews, the facility failed to monitor the resident's weight as evidenced by six (6) pounds weight loss in 12 days for 1 of 1 resident sampled for nutrition review (Resident #143).

Inspectors wroteBased on observations, interviews, and record reviews, the facility failed to ensure tube feeding tubing was changed in a timely manner and failed to ensure tube feeding was administered per physician orders for 4 of 4 residents reviewed for Tube Feeding (Resident #47, 67, 20, and 40).

Inspectors wroteBased on observations, interviews, and record review the facility failed to administer scheduled medications in a timely manner for 1 resident reviewed for pain management (Resident #60) and for 1 resident reviewed for insulin (Resident #3). Medications are administered within (60 minutes) of scheduled time. Unless otherwise specified by the prescriber, routine medications are administered according to the established medication administration schedule for the facility.

Inspectors wroteBased on observations and interviews, the facility failed to ensure accurate posting of nursing staffing at 2 of 2 nursing stations on 06/19/23 and 06/20/23.