Parkwood Health Care Facility

Inspectors wroteBased on observations, interviews, and a facility policy title Cleaning Dishes/Dish Machine: the facility failed to ensure sanitary conditions were maintained in the dishwashing area to prevent cross contamination. Specifically, staff were observed working on both the soiled (dirty) side and the clean side of the dish room without changing gloves between tasks. This practice had the potential to affect 71 of 71 residents who received meals from the kitchen. Findings Include: A facility policy titled, Cleaning Dishes/Dish Machine dated 2023 revealed: . Procedure: Staff will follow these procedures for washing dishes: . 2. The person loading dirty dishes will not handle the clean dishes unless they change into a clean apron and wash their hands thoroughly before moving from dirty to clean dishes. [...]

Inspectors wroteBased on observation, interviews, and the facility's policy titled Housekeeping the facility failed to ensure a safe, clean, and comfortable environment for three of 21 residents reviewed. Specifically Resident Identifier (RI) #3's, RI #41's, and RI #51's rooms had scrapes and holes in the drywall and cracks in the ceiling. Additionally, RI #3's and RI #41's room had brown stains observed on the ceiling, and the window blinds in RI #41's room were not functioning properly. These conditions had the potential to negatively impact residents' comfort and overall homelike environment. Findings Include:An undated policy titled Housekeeping documented: . Housekeeping is one of the most important environmental services since it plays a major role in providing a healthy, comfortable environment. [...]

Inspectors wroteBased on interviews, resident's medical records, review of Facility Reported Incidents (FRIs) received by the State Agency, the facility's investigative files, the facility's policies titled ABUSE POLICY and Behavior Management Program Policy and Procedures the facility failed to protect the residents' right to be free from physical abuse perpetrated by other residents. Specifically:1. On 06/08/2024 the facility failed to protect Resident Identifier (RI) #39's right to be free from physical abuse perpetrated by RI #78. On 06/08/2024 Registered Nurse (RN) #9 witnessed RI #78 slap RI #39 on the head. RI #78 had a history of aggressive behaviors, which included verbal and physical aggression. The facility failed to provide adequate supervision and interventions for RI #78 to prevent other residents from being abused. [...]

Inspectors wroteBased on interview, medical record review and a facility policy titled, Care Planning Policy and Procedure, the facility failed to develop a comprehensive care plan to address Resident Identifier (RI) #53 use of PRN (as needed) oxygen. Record review indicated the resident received oxygen as needed however, there was no care plan in place to address the use of PRN oxygen, including indications, monitoring or staff interventions. This failure had the potential to result in inconsistent implementation of care and unmet respiratory needs. This deficient practice affect RI #53 one of one resident sampled for respiratory care. Findings Include: A policy titled Care Planning Policy and Procedure with a revised date of October 2022 documented: Policy: The care plan is a guide for all staff on a course of action that will attain or maintain a resident's highest practicable level of well-being. [...]

Inspectors wroteBased on observation, interview, resident record review and review of a facility document titled F550 Resident Rights, the facility failed to ensure Resident Identifier (RI) #112 and RI #9 were not left in the hall for 25 minutes, lined up parallel to the wall, in their wheel chairs, wrapped in sheets, while waiting for showers near the front entrance of the facility. This affected two of 23 sampled residents.

Inspectors wroteBased on observation, interview, record review and review of facility policies titled Incontinent Care and Catheter Care Using Disposable Wipes and Hand Hygiene Policy and Procedure, the facility failed to ensure a Certified Nursing Assistant (CNA) washed her hands between glove changes during perineal care and prior to the application of a moisture barrier and a clean brief to Resident Identifier (RI) #46, a resident who required staff assistance with both toileting and personal hygiene. This affected one of one resident observed for incontinence care.

Inspectors wroteBased on observation, interviews, review of the facility policy related to the cleaning of food carts, and recommendations from the manufacturers of the Auto-Chlor dish machine, the facility failed to ensure: 1) staff sanitized a cart used for transporting resident trays after use; and 2) resident dishes/trays were consistently washed at recommended water temperatures. This had the potential to affect all 70 residents for whom meals were prepared and served at the time of this survey.

Inspectors wroteBased on interviews, record reviews and a review of the Resident Handbook, the facility failed to ensure resident personal funds/petty cash was available after business hours and on the weekends. This affected three of eleven residents, Resident Identifier (RI) #24, #26 and #39, who attended resident council/group meeting. Findings Include: A review of the Resident Handbook revealed the following: . You should anticipate your cash needs for weekends and withdraw funds accordingly on Friday before the business office closes . RI #24 was admitted to the facility on [DATE]. RI #26 was admitted to the facility on [DATE]. RI # 39 was admitted to the facility on [DATE]. On 10/24/18 at 11:00 AM, during the group meeting, residents were asked if funds were available on evenings and weekends. [...]

Inspectors wroteBased on observation, interview, record review and a review of the facility's policies titled, ENTERAL TUBE ADMINISTRATION and MEDICATION ADMINISTRATION - GENERAL GUIDELINES, the facility failed to ensure licensed staff provided privacy to Resident Identifier (RI) #167, during an observation of medication administration via (by) G (Gastrostomy) Tube (GT). This affected one of one sampled resident observed for medications administered via GT. Findings Include: A review of the facility's policy titled, ENTERAL TUBE ADMINISTRATION dated 01/12, revealed the following: . Procedures 1. Explain the procedure and screen the resident for privacy . A review of the facility's policy titled, MEDICATION ADMINISTRATION - GENERAL GUIDELINES dated 01/12, revealed the following: . Procedures . 18. Provide privacy for resident . [...]

Inspectors wroteBased on observation, interview, record review, review of a Walmart receipt and a review of the facility's policy titled, ABUSE POLICY, the facility failed to ensure RI #62's 32 inch LED (Light Emitting Diodes) television (TV) was mounted in his/her room after purchase with RI #62's funds on 9/18/18. This affected one of one sampled resident whose purchases were reviewed. Findings Include: A review of the facility's policy titled, ABUSE POLICY dated November 2016, revealed the following: . Misappropriation of Resident's Property - Misappropriation of resident property is the deliberate misplacement, exploitation or wrongful, temporary or permanent use of resident's belongings, property . without the resident's consent. Acts that constitute the misappropriation of resident property include, but are not limited to, the theft or attempted theft of a resident's . personal property, . [...]

Inspectors wroteBased on observation, interview and record review the facility failed to ensure licensed staff did not leave Resident Identifier (RI) #167's medications unattended and out of licensed staff's line of sight. This affected one of eight residents observed during medication administration. Findings Include: RI #167 was admitted on [DATE] with diagnoses to include Encounter for Attention to Gastrostomy and End Stage Renal Disease. On 10/24/18 at 9:00 AM, Employee Identifier (EI) #4, Registered Nurse (RN) was observed preparing the following medications for administration to RI #167 via GT. 1. Multivitamin one per GT QD (every day) 2. Ascorbic Acid 500 mg (milligram) one per GT QD 3. Metoprolol Tartrate 25 mg give 1/4 tablet (6.25 mg) one per GT BID (twice a day) EI #4 entered RI #167's room. RI #167's roommate was seated in the wheelchair and the therapist was at the resident's bedside. [...]

Inspectors wroteBased on observations, interviews, record reviews, and a review of the facility's policy titled, Glove Use and Policy and Procedure for Aseptic Technique With Dressing Changes, the facility failed to ensure licensed staff washed their hands after removing unclean gloves and before applying clean gloves during an observation of medication administration and wound care. This affected Resident Identifier (RI) #167, who was one of eight residents observed during medication administration and one of three residents observed during wound care. Findings Include: A review of the facility's policy titled, Glove Use with a revised date of 6/17, revealed the following: . PROCEDURE: . 9. Hand hygiene is necessary prior to donning (putting on) and after gloves are removed. [...]

Inspectors wroteBased on interviews and a review of the facility's Resident Handbook, the facility failed to ensure resident's received mail on Saturdays and received mail unopened. This affected eleven of eleven residents who attended the Resident Council meeting on 10/24/18, who said they did not receive mail on Saturday and three of eleven residents who received mail that had been opened. This deficient practice had the potential to affect all residents in the facility who receive mail. Findings Include: A review of the facility's Resident Handbook revealed the following: .11. Mail. You have the right to privacy in written communications, including the right to . promptly receive mail that is unopened . [...]

Inspectors wroteBased on observation and interviews, the facility failed to ensure a notice was posted to indicate the availability of the most recent survey results. This deficient practice had the potential to affect all 72 residents who currently reside in the facility, as well as visitors and other individuals who visit the facility. Findings Include: On 10/23/18 at 10:30 AM, the survey results were observed in a plastic binder outside of and adjacent to Employee Identifier (EI) #8's, Administrator, office which was located in the front lobby. There was a label on the binder that documented the following: The last 3 annual ADPH (Alabama Department of Public Health) survey results. There were no postings or signs observed in the facility as to the location of the survey results. [...]