Parkway Health & Rehab LLC

Inspectors wroteBased on observation, interview, record review, and facility policy review the facility failed to follow infection prevention and control practices during medication administration and Enhanced Barrier Precautions (EBP) for two (2) of three (3) residents observed for infection control practices. (Resident #9 and Resident #81).

Inspectors wroteBased on observation, interview, record review and facility policy review, the facility failed to implement the comprehensive person-centered care plan by not maintaining Enhanced Barrier Precautions (EBP) during care for one (1) of three (3) residents reviewed for infection control practices. Resident #9.

Inspectors wroteBased on interview and record review, the facility failed to provide necessary care and services in accordance with professional standards of practice to address abdominal distention and fecal burden in a timely manner, which resulted in hospitalization for fecal impaction for one (1) of three (3) residents reviewed for hospitalization. Resident #56.

Inspectors wroteBased on observation, interviews, record review and facility policy review, the facility failed to ensure that dietary staff support and respect a resident's right to make choices about his or her meal preferences for two (2) of (18) sampled for Residents reviewed for food preferences. Resident #45 and #47.

Inspectors wroteBased on observation, staff interview, record review, and facility policy review, the facility failed to ensure dietary staff followed proper hand hygiene practices and monitor food temperatures in a manner that prevented cross-contamination for one (1) of two (2) kitchen tours. Findings Include: Review of the facility policy titled Hand and Single Use Glove Sanitation Practices with a revision date of October 2017, revealed Policy: Facility employees shall follow sanitary practices when handling food to prevent the spread of foodborne illness . Review of the facility policy titled Guidelines for Using Thermometers with a revision date of October 2017, revealed Policy: the facility shall monitor temperatures of hazardous foods to maintain quality and safety of food served using an appropriate thermometer . [...]

Inspectors wroteBased on staff interview, record review, and facility policy review, the facility failed to submit accurate staffing data into the Payroll-Based Journal (PBJ) system for one (1) of four (4) quarters reviewed.

Inspectors wroteBased on observation, resident and staff interviews, record review, and facility policy review, the facility failed to develop and/or implement care plans related to Activities of Daily Living (ADL) care for Residents #1, #34, #61 and #67, failed to develop a care plan related to Post-Traumatic Stress Disorder (PTSD) for Resident #41, and failed to develop a care plan related to activities for Resident #68. Additionally, the facility failed to implement a care plan intervention for a contracture device for Resident #12 for seven (7) of 23 resident care plans reviewed. The scope/severity of this deficiency was increased to E Pattern due to prior citation on the last Annual Recertification Survey.

Inspectors wroteBased on observation, resident and staff interviews, record review, and facility policy review, the facility failed to provide Activities of Daily Living (ADL) care for residents that require assistance for four (4) of seventy-nine (79) residents observed during the initial tour. Resident's #1, #34, #61 and #67 The scope/severity of this deficiency was increased to E - Pattern due to prior citation on the last Annual Recertification Survey.

Inspectors wroteBased on observation, staff interview, record review, and facility policy review, the facility failed to ensure a splint was applied for a resident with contractures for one (1) of 35 residents with limited range of motion (ROM) residing in the facility. Resident #12 The scope/severity of this deficiency was increased to E Pattern due to prior citation on the last Annual Recertification Survey. Findings Include: Review of the facility policy titled Resident Mobility and Range of Motion with a revision date of July 2017, revealed under, Policy Statement: 1. Residents will not experience an avoidable reduction in range of motion (ROM). 2. Residents with limited range of motion will receive treatment and services to increase and/or prevent a further decrease in ROM. 3. [...]

Inspectors wroteBased on dialysis staff and facility staff interview, record review, and facility policy review, the facility failed to promptly notify the physician of a resident change in both nutrition and hydration status for one (1) of four (4) residents reviewed for nutrition. Resident #12 Cross Reference F692 Findings Include: Review of the facility policy titled Change in a Resident's Condition or Status with a revision date of May 2017, revealed, Policy Statement: Our facility shall promptly notify the resident, his or her Attending Physician, and representative (sponsor) of changes in the resident's medical/mental condition and/or status . Record review of Resident #12's MAR revealed an order dated 1/09/25, Dialysis Fluid Restriction 1,500cc (cubic centimeters). [...]

Inspectors wroteBased on observation, staff and resident interviews, record review, and facility policy, the facility failed to ensure a resident's right to be free from physical restraints when a bed alarm pad and a wheelchair alarm pad were used that restricted the resident's movements. The alarms caused the resident to stop moving to avoid triggering the alarm sounds, demonstrating a restrictive effect for one (1) of two (2) residents reviewed for restraints. (Resident #67)

Inspectors wroteBased on dialysis staff and facility staff interview, record review, and facility policy review, the facility failed to provide nutritional and hydration care and services to meet the needs of a resident receiving both enteral feedings and dialysis for one (1) of four (4) residents reviewed for nutrition. Resident #12 Cross reference F580 Findings Include: Review of the facility policy titled Enteral Nutrition with a revision date of January 2014, revealed under, Policy Statement: adequate nutritional support through enteral feeding will be provided to residents as ordered. Additionally revealed under, 8. The Dietician will monitor residents who are receiving enteral feedings and will make appropriate recommendations for interventions to enhance tolerance and nutritional adequacy of enteral feedings . [...]

Inspectors wroteBased on staff and resident interview, record review and facility policy review, the facility failed to ensure care was delivered to a resident with Post Traumatic Stress Disorder (PTSD) in a manner that would minimize triggers and the possibility of re-traumatization for one (1) of two (2) residents reviewed with PTSD. Resident # 41 Findings Include Review of the facility policy titled, Trauma Informed Care with no revision date revealed under, Purpose .To guide staff in appropriate and compassionate care specific to individuals who have experienced trauma. Record review of Resident #41's admission Record revealed the resident was re-admitted to the facility on [DATE] with medical diagnoses that included Post Traumatic Stress Disorder (PTSD) and Bipolar Disorder. Record review of Resident #41's Care Plan Detail revealed under, Focus: [...]

Inspectors wroteBased on observation, resident and staff interview, record review, and facility policy review, the facility failed to ensure medications were stored appropriately and not left in the resident's room for one (1) of 23 sampled residents.

Inspectors wroteBased on observation, resident representative and staff interviews, record review, and facility policy review, the facility failed to ensure proper catheter care and infection control practices were implemented for one (1) of four (4) residents direct care areas observed (Resident #37).

Inspectors wroteBased on staff interview, record review, and facility policy review, the facility failed to accurately complete section N of the Minimum Data Set (MDS) for a resident taking an antiplatelet medication for one (1) of 23 MDS assessments reviewed. Resident #42 Findings Include: Review of the facility policy titled Resident Assessment Instrument with a revision date of September 2010 revealed under, Policy Statement: A comprehensive assessment of a resident's needs shall be made within fourteen (14) days of the resident's admission. Additionally revealed, 4. Information derived from the comprehensive assessment helps the staff to plan care that allows the resident to reach his/her highest practical level of functioning. [...]

Inspectors wroteBased on complainant and staff interview, record review and facility policy review, the facility failed to revise a pressure risk care plan for a resident who developed a pressure ulcer for one (1) of (3) three residents care plans reviewed. (Resident #1)

Inspectors wroteBased on complainant, resident representative and staff interviews, record review, and facility policy review, the facility failed to provide necessary services to prevent new pressure ulcers from developing for one (1) of three (3) residents with wounds reviewed. (Resident #1)

Inspectors wroteBased on observation, staff interview, record review, and facility policy, the facility failed to ensure a resident's right to be free from misappropriation of property when a bottle of Morphine Sulfate was found altered in color composition and not properly accounted for on the medication administration record for (1) one of three (3) residents reviewed for misappropriation. (Resident #1)

Inspectors wroteBased on staff interview, record review, and facility policy review, the facility failed to report an allegation of narcotic diversion/misappropriation of property to the State Agency (SA) for one (1) of three (3) residents reviewed for narcotic diversion/misappropriation of property.

Inspectors wroteBased on staff interview, record review, and facility policy review, the facility failed to accurately document the administration of PRN (as needed) pain medication in the electronic medication system for one (1) of three (3) residents reviewed for narcotic administration.

Inspectors wroteBased on resident and staff interview and facility policy review, the facility failed to provide mail delivery on Saturdays for two (2) of nine (9) residents who attended the resident council meeting.

Inspectors wroteBased on observation, staff interview, resident interview, record review and facility policy review the facility failed to implement a comprehensive care plan for three (3) of thirteen (13) resident care plans reviewed. Residents #31, #29 and #17. Findings Include: Record review of the policy titled, Comprehensive Assessments and the Care Delivery Process, revised December 2016, revealed its Policy Statement Comprehensive Assessments and the Care Delivery Process. The Policy Interpretation and Implementation under number one (1) Comprehensive assessments, care planning and the care delivery process involve collecting and analyzing information, choosing, and initiating interventions, and then monitoring results and adjusting interventions. [...]

Inspectors wroteBased on observation, staff and resident interview, record review and facility policy review the facility failed to provide nail care and facial shaving for two (2) of 13 resident's reviewed for Activities of Daily Living (ADL). Resident # 29 and # 31.

Inspectors wroteBased on observation, staff interview, record review and facility policy review the facility failed to prevent a decline in the resident's range of motion (ROM) as evidenced by failing to apply the correct hand splint and knee bolster for one (1) of three (3) residents for positioning and mobility. (Resident # 17).

Inspectors wroteBased on observation, staff and resident interview, record review, and facility policy review, the facility failed to provide Oxygen (O2) in use signage on resident doorways and failed to label, store and date respiratory supplies for two (2) of five (5) resident's reviewed for respiratory care. Resident # 136 and #337.