Panola County Nursing & Rehabilitation

Inspectors wroteBased on observation, interview, and record review, the facility failed to maintain an effective pest control program to keep the facility free of water bugs for one (1) common area hallway near secure unit, and for one (room [ROOM NUMBER]) of 5 rooms reviewed for pests. The facility failed to maintain an effective pest free from water bugs for Resident #36 and a dead water bug located in one common hall located near the secured These failures placed residents at risk for the potential spread of infection, cross-contamination, food-borne illness, and decreased quality of life.

Inspectors wroteBased on interview, and record review, the facility failed to coordinate assessments with the pre-admission screening and resident review (PASRR) program to include all residents with newly evident or possible serious mental disorder for 1 of 7 residents (Resident #28) reviewed for the PASRR program. The facility failed to ensure Resident #28 was referred for a PASRR (Level II) evaluation when she admitted to the facility on [DATE] with a possible serious mental disorder. This failure could place residents at risk for a diminished quality of life and not receiving necessary care and services in accordance with individually assessed needs.

Inspectors wroteBased on observation, interview, and record review, the facility failed to develop and implement a comprehensive person-centered care plan to meet each resident's medical, nursing, mental and psychosocial needs for 2 of 16 residents reviewed for care plans. (Resident #8, Resident #43)1. The facility failed to ensure Resident #8's care plan had interventions to be used for the use of a self-releasing seat belt, on his motorized wheelchair. 2. The facility failed to implement the comprehensive person-centered care plan for Resident #43's low air loss mattress on the correct settings for her current weight. These failures could place residents at risk of not having individual needs met, a decreased quality of life, and cause residents not to receive needed services.

Inspectors wroteBased on interview and record review, the facility failed to ensure each resident's person-centered comprehensive care plan was reviewed and revised by the interdisciplinary team after each assessment for 1 of 16 residents (Resident #6), reviewed for care plans. The facility failed to revise and update Resident #6's care plan after she was coded on the annual MDS assessment dated [DATE] for use of a diuretic and an antiplatelet. This failure could affect residents by placing them at risk of not receiving appropriate interventions to meet their current needs.

Inspectors wroteBased on observations, interview, and record review the facility failed to ensure a resident who was unable to carry out activities of daily living receives the necessary services to maintain good nutrition for 1 of 5 residents (Resident #50) reviewed for ADLs. The facility did not ensure Resident #50 received set-up assistance during the lunch meal on 08/11/25. This failure could place residents at risk of decreased quality of life, weight loss, and injury related to choking.

Inspectors wroteBased on observation, interview, and record review, the facility failed to provide an ongoing program of activities in accordance with the comprehensive assessment to meet the interests and the physical, mental, and psychosocial well-being for 2 of 16 residents reviewed for activities. (Resident's #30 and #50) The facility failed to ensure Resident #30, and Resident #50 were offered to participate in activities on 08/11/25 and 08/12/25. This failure could place residents at risk for not having activities to meet their interests or needs and a decline in their physical, mental, and psychosocial well-being.

Inspectors wroteBased on observations, interviews, and record review the facility failed to ensure each resident received adequate supervision and assistance devices to prevent accidents for 1 of 6 residents (Resident #49) reviewed for accidents and hazards. The facility failed to ensure Resident #49's fall mat was utilized while he was in his bed on 08/11/25 and 08/12/25. This failure could place residents at risk of injury or harm and a decreased quality of care related to falls.

Inspectors wroteBased on observation, interview, and record review the facility failed to ensure that residents who needed respiratory care were provided with such care, consistent with professional standards of practices for 1 of 5 residents (Resident #31) reviewed for respiratory care. The facility failed to ensure Resident # 31's internal filter (the air passes through a series of filters that remove impurities, ensuring that the oxygen delivered to the patient is of high quality) in the oxygen concentrator (take air from your surroundings, extract oxygen and filter it into purified oxygen for you to breathe) was free of white/yellow, fuzzy particles. This failure could place residents at risk for respiratory infections.

Inspectors wroteBased on observations, interviews, and record review, the facility failed to ensure that residents who are trauma survivors receive culturally competent, trauma-informed care in accordance with professional standards of practice and accounting for residents' experiences and preferences in order to eliminate or mitigate triggers that may cause re-traumatization of the resident for 1 of 1 resident (Resident #6) reviewed for trauma-informed care. The facility failed to ensure Resident #6 had a care plan to address past trauma with a PTSD diagnosis. Resident #6 completed a brief trauma assessment on [DATE] which indicated a positive trauma screen. This failure could place residents at an increased risk for psychological distress due to re-traumatization.

Inspectors wroteBased on observation, interview and record review, the facility failed to provide pharmaceutical services including procedures that assure the accurate administering of all drugs and biologicals, to meet the needs of 2 of 16 residents (Resident #31 and Resident #26) reviewed for pharmacy services. The facility failed to ensure Resident #31's Claritin (Loratadine) order had a dosage for administration. The facility failed to ensure RN B documented the medication order change for Resident #26's Folic Acid 400 MCG to 1000MCG on 8/12/25, which resulted in RN B documenting administration of the wrong medication dosage on the MAR. These failures could place residents at risk for inaccurate drug administration.

Inspectors wroteBased on observations, interviews and record review, the facility failed to act upon the recommendations of the pharmacist report of irregularities and to ensure the attending physician documented in the resident's medical record that the identified irregularity has been reviewed and what, if any, action has been taken to address it in response to the pharmacist report for 1 of 5 residents (Resident #35) reviewed for (MRR) Medication Regimen Review. The facility failed to ensure Resident #35's Medication Regimen Review dated 4/30/25, had a specific duration for the extended duration beyond 14 days of PRN Ativan (Lorazepam). This failure could place residents at risk from maintaining their highest practicable level of physical, mental, and psychosocial well-being, and could place them at risk for adverse consequences related to medication therapy.

Inspectors wroteBased on observation, interview, and record review, the facility failed to maintain an infection prevention and control program designed to provide a safe and sanitary environment and to help prevent the development and transmission of communicable diseases and infections for 1 (Resident #8) of 16 residents reviewed for infection control. The facility failed to ensure LVN C did not place Resident #8 feeding tubing, in his bed during g-tube medication administration on 8/12/25. This failure could place a resident at risk for an infection.

Inspectors wroteBased on observation, interview, and record review, the facility failed to provide a safe, clean, comfortable, and homelike environment for 5 of 17 residents reviewed for environment. (Residents #9, #35, #36, #16, and #7) The facility failed to ensure Resident #35 and Resident #36 had a clean room free from dust and dead roaches. The facility failed to repair Resident #9 ceiling tiles in room with water spots, due to water damage. The facility failed to ensure Resident #16's room was free of roaches. The facility failed to ensure Resident #7's room was free of water bugs. The facility failed to repair the ceiling in hall by the dining area. The facility had a trash can catching rainwater. These failures could place residents at risk of an unsafe or uncomfortable environment and a decrease in quality of life and self-worth.

Inspectors wroteBased on observation, interview, and record review, the facility failed to develop and implement a comprehensive person-centered care plan to meet each resident's medical, nursing, mental and psychosocial needs for 3 of 17 residents reviewed for care plans. (Resident #28, Resident #47, Resident #50) 1. The facility failed to provide Resident #28 with scheduled smoke breaks. Resident #28's care plan indicated he wished to smoke. 2. The facility failed to develop a care plan for Resident #47's ADL dependence, dietary needs, vision impairment, bowel/bladder status, and diagnoses of anemia (is when you have low levels of healthy red blood cells to carry oxygen throughout your body), constipation, insomnia, and gastroesophageal reflux disease (is a condition in which stomach acid repeatedly flows back up into the tube connecting the mouth and stomach, called the esophagus). 3. [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to provide an ongoing program of activities in accordance with the comprehensive assessment to meet the interests and the physical, mental, and psychosocial well-being for 1 of 1 memory care unit reviewed for activities. The facility failed to provide meaningful activities for dementia (impaired ability to remember, think, or make decisions that interferes with doing everyday activities) residents on the memory care unit. This failure could place residents at risk for not having activities to meet their interests or needs and a decline in their physical, mental, and psychosocial well-being.

Inspectors wroteBased on observation, interview, and record review, the facility has failed to ensure that the resident environment remains as free of accident hazards as possible and provide supervision to prevent avoidable accidents for 3 of 16 residents (Resident #30, Resident #31, Resident #50) and 3 of 5 staff (CNA A, CNA H, DON) reviewed for transfer and supervision. The facility failed to ensure CNA A did not leave the secure unit unsupervised on 06/04/24 which resulted in Resident #30 ambulating without her wheelchair and with no supervision. The facility failed to ensure CNA H performed a safe 1 person transfer which resulted in Resident #31 obtaining a skin tear to his forearm on 05/28/24. The facility failed to ensure CNA H did not transfer Resident #50 without another staff assistance on 04/07/24. During one person transfer, Resident #50 obtained a skin tear during transfer. [...]

Inspectors wroteBased on observations, interviews, and record reviews, the facility failed to have sufficient nursing staff to provide nursing and related services to assure resident safety and attain or maintain the highest practicable physical, mental, and psychosocial wellbeing of each resident, as determined by resident assessments and individual plans of care and considering the number, acuity and diagnoses of the facility's resident population for 3 (Resident #50,#32, and #31) of 16 residents residing on the secured unit. The facility failed to have sufficient staff available to provide resident care and supervision to prevent falls with injury on the secured unit for 3 of 3 months reviewed for staffing (March 2024-May2024). This failure could put residents at risk of not receiving necessary care and supervision to maintain their highest practicable physical, mental, and psychosocial wellbeing. [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to establish and maintain an infection prevention and control program designed to provide a safe, sanitary, and comfortable environment, and to help prevent the development and transmission of communicable diseases and infections for 4 of 14 residents (#35, #36, #3 and #6) reviewed for infection control practices. 1. The Facility failed to ensure Resident #35 and #36 had wash basins stored properly with names and in bags. 2. The facility failed to ensure wipes with feces were properly discarded and were left on Resident #3 and #6's bedroom floor. These failures could place residents at risk of exposure to communicable diseases, cross-contamination, and infections.

Inspectors wroteBased on interview and record review, the facility failed to implement an antibiotic stewardship program that included antibiotic use protocols for 6 of 6 months (January 2024 through June 2024) reviewed for Infection Control Tracking and Trending. -The facility did not implement the antibiotic orders protocol in their Antibiotic Stewardship policy. -The facility had missing information on the Tracking and Trending Logs as to the outcome of the antibiotic use (if the infections were resolved or not). -The facility did not implement the 72-hour Antibiotic Time Out protocol in their Antibiotic Stewardship program. These failures could place residents with infections at risk for unnecessary antibiotic use and increased infections that are resistant to antibiotics.

Inspectors wroteBased on observation, interview, and record review, the facility failed to promote care for residents in a manner and in an environment that maintained or enhanced each resident's dignity and respect in full recognition of his or her individuality for 2 of 17 residents reviewed for dignity. (Resident #31, Resident #49) The facility to ensure CNA H did not push Resident #31 backwards in his wheelchair from his room to the dining room. The facility failed to ensure LVN D did not stand up while assisting Resident #49 with his lunch meal. These failures placed residents at risk for diminished quality of life, loss of dignity and self-worth.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure the right to be free from any physical restraints imposed for purposes of convenience and not required to treat medical symptoms for 1 of 16 residents reviewed for restraint use (Resident #30). The facility failed to ensure Resident #30 was free from physical restraints in the form of CNA A locking her wheelchair which did not allow her to move freely around the secured unit. This failure could place residents at risk for a decreased quality of life, a decline in physical functioning and injury.

Inspectors wroteBased on interview and record review, the facility failed to develop and implement a baseline care plan for each resident that includes the instructions needed to provide effective and person-centered care of the resident that meet professional standards of quality care within 48 hours of a resident's admission including the minimum healthcare information necessary to properly care for 2 of 7 residents reviewed for new admissions. (Resident #110 and Resident #111) The facility failed to develop a baseline care plan within 48 hours of admission for Residents #110 and #111. This failure could place residents at risk of not receiving care and services to meet their needs.

Inspectors wroteBased on interview and record review, the facility failed to ensure each resident's person-centered comprehensive care plan was reviewed and revised by the interdisciplinary team after each assessment for 1 of 17 residents (Residents #50), reviewed for care plans. The facility failed to revise and update Resident #50's comprehensive care plan to reflect change in diet order from regular to pureed. The facility failed to revise and update Resident #50's comprehensive care plan to reflect swallowing disorder of coughing or choking during meals or when swallowing medications. The facility failed to ensure Resident #50's care plan for ADL dependence was updated to reflect a change from substantial-maximal assist to dependent assist with transfer per the MDS. [...]

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure that respiratory care was provided consistent with professional standards of practice for 1 of 4 residents reviewed for respiratory care. (Resident #39) The facility failed to ensure Resident #39's nebulizer mask (provide vaporized medicine into the airway) was stored in a bag after use. The facility failed to ensure Resident #39's nebulizer mask was labeled and dated. These failures could place residents at risk of respiratory infections.

Inspectors wroteBased on observation and interview, the facility failed to post the daily nurse staffing information with the current date, resident census, and numbers of staff actual hours worked at the beginning of each shift for 3 of 3 days reviewed, in a place readily accessible to residents and visitors, in that: The facility failed to update and post the daily nurse staffing information (current date, resident census, and numbers of staff actual hours worked) on 06/03/2024,06/04/2024, and 06/05/2024. This failure could affect residents, their families, and facility visitors by placing them at risk of not having access to information regarding the numbers of staff caring for the residents each shift and facility census.

Inspectors wroteBased on interview and record review, the facility failed to ensure each residents' drug regimen was free from unnecessary psychotropic drugs (without adequate behavior monitoring) for 1 (Resident # 47) of 5 residents whose medications were reviewed in that: 1. The facility failed to ensure Resident #47 had an appropriate diagnosis for his prescribed Seroquel (Quetiapine; is an antipsychotic medication that treats several kinds of mental health conditions including schizophrenia (is a serious mental illness that affects how a person thinks, feels, and behaves) and bipolar disorder (is a mental illness that causes unusual shifts in a person's mood, energy, activity levels, and concentration)) 2. The facility failed to ensure Resident #47 had behavior monitoring (monitor activities and mood) for his prescribed Seroquel. 3. [...]

Inspectors wroteBased on observations, interviews, and record reviews the facility failed to provide special eating equipment and utensils for residents who need them and appropriate assistance to ensure that the resident can use the assistive devices when consuming meals for 1 (Resident #19) of 3 residents reviewed for special eating equipment and assistance when consuming meals, in that: The failed to assess and provide Resident #19 with an assistive device to helps prevent food from accidently being pushed off the plate while eating during meal service to minimize food spillage. This failure could place residents at risk for harm by weight loss, diminished independence, and self-esteem.

Inspectors wroteBased on observation, interview, and record review, the facility failed to maintain and ensure safe and sanitary storage of residents' food items for 1 of 12 resident personal refrigerators reviewed for food safety (Resident #26). The facility failed to ensure the refrigerator for Resident #26 did not contain a decomposing banana, watermelon, and expired meat. This failure could place resident at risk for food borne illnesses.

Inspectors wroteBased on observation, interviews and record review, the facility failed to ensure residents had the right to a clean, comfortable, and homelike environment, which included but not limited to receiving treatment and supports for daily living safety, for 4 of 14 residents (Resident #29, Resident #28, Resident #33, and Resident #4) reviewed for a homelike environment. 1. The facility failed to ensure water damaged ceiling tiles above Resident #29's bed were replaced. 2. The facility failed to keep Resident #28 and Resident #33's Geri chairs (are large, padded chairs with wheeled bases, and are designed to assist seniors with limited mobility) clean. 3. The facility failed to keep Resident #4's feeding pump and pole clean. These failures could place residents at risk for diminished quality of life due to the lack of a well-kept environment.

Inspectors wroteBased on interview and record review, the facility failed to ensure an accurate MDS assessment was completed for 4 of 14 residents reviewed for MDS accuracy. (Resident #13, Resident #16, Resident #7, and Resident #204) 1. The facility failed to accurately document Resident #13's and Resident #16's antidepressant usage. 2. The facility failed to accurately document Resident # 7's PASRR status. 3. The facility failed to accurately document Resident #204's fall history on the MDS. These failures could place residents at risk for not receiving needed care and services.

Inspectors wroteBased on observations, interview, and record review, the facility failed to develop and implement a comprehensive person-centered care plan for each resident, consistent with the resident rights, that includes measurable objectives and timeframes to meet a resident's medical, nursing, mental and psychosocial needs that are identified in the comprehensive assessment for 4 of 6 residents (Resident #4, Resident #19, Resident #33, Resident #42) reviewed for comprehensive person-centered care plans related to limited range of motion or contractures. The facility failed to care plan Resident #19's and Resident #33's limited range of motion. The facility failed to develop interventions for Resident #4 to address contractures and limited range of motion. The facility failed to implement an intervention to document meal consumption for Resident #19 and Resident #42. [...]

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure a resident with limited range of motion receives appropriate treatment and services to increase range of motion and/or to prevent further decrease in range of motion for 3 of 6 residents (Resident #4, Resident #19, Resident #33) reviewed for range of motion and mobility, in that: Resident #4 who had functional limitation in range of motion (interfered with daily functions or placed residents at risk for injury) to unilateral upper extremity and bilateral lower extremities was not provided treatment and services to prevent further decrease in range of motion. Resident #19 who had functional limitation in range of motion to bilateral upper extremities was not provided treatment and services to prevent further decrease in range of motion. [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to provide the necessary services to maintain personal hygiene for residents who are unable to carry out activities of daily living receives the for 2 of 16 residents reviewed for ADLs (Residents #10, Resident #33). The facility did not clean or trim Resident #10's fingernails. The facility failed to ensure Resident #33 did not have facial hair and received schedule shower/bed baths. These failures could place residents who required assistance from staff for ADLs at risk of not receiving care and services to meet their needs which could result in poor care, risk for skin breakdown, feelings of poor self-esteem, lack of dignity and health.

Inspectors wroteBased on interview and record review, the facility failed to ensure, based on the comprehensive assessment of a resident, residents who had not used psychotropic drugs were not given these drugs unless the medication was necessary to treat a specific condition as diagnosed and documented in the clinical record for 1 of 5 residents (Resident #204) reviewed for psychotropic medications. The facility failed to ensure Resident #204 had an appropriate diagnosis for usage of Olanzapine (antipsychotic). This failure could place residents at risk of being over-medicated or experience undesirable side effects.