Prairie Acres

Inspectors wroteNumber of residents sampled: Number of residents cited: Based on observations, interviews, and record review, the facility failed to ensure residents were treated in a respectful manner that maintained or enhanced each resident's dignity for 1 (Resident #21) of 16 residents reviewed for dignity. The facility failed to ensure CNA C did not incite a verbal altercation with facility staff in the presence of Resident #21. This failure could place residents who require assistance from nursing staff at risk of feeling disrespected.

Inspectors wroteNumber of residents sampled: Number of residents cited: Based on interviews, 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 included measurable objectives and timeframes to meet a resident's medical, nursing, mental, and psychosocial needs that were identified in the comprehensive assessment for 1 of 8 residents (Resident #5) reviewed for care plans. Resident #5 did not have a care plan for Cognitive Loss/Dementia, Communication, Urinary Incontinence, Pressure Ulcers, and did not include her diagnosis of Alzheimer's Disease with late onset. This failure could place residents at risk of not receiving the care required to meet their individualized needs.

Inspectors wroteBased on observation, interview, and record review, the facility failed to store, prepare, distribute, and serve food in accordance with professional standards for food service safety in 1 of 1 kitchen reviewed for dietary services, in that: The facility failed on 07/29/2025 to properly wash hands during food preparation. This failure could place residents at risk for food contamination and foodborne illness.

Inspectors wroteBased on observations, interviews, and record reviews the facility failed to ensure each resident receives adequate supervision and assistance devices to prevent accidents for 1 (Resident 35) of 12 residents reviewed for accidents. On 05/20/24 the facility failed to provide adequate supervision and assistance devices for Resident #35 and he had an unwitnessed fall which resulted in a broken left hip. This failure could place residents at risk of injury or harm. Findings Included: Record review of Resident #35's admission record dated 05/30/24 revealed an [AGE] year-old male originally admitted to the facility 03/29/23 with a most recent admission date of 05/29/24. [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to store, prepare, distribute, and serve food in accordance with the professional standards for food service safety for 1 of 1 kitchen reviewed for kitchen sanitation. 1. The facility failed to ensure freezer items were properly stored, labeled, and dated. 2. The facility failed to ensure walk-in refrigerator items were stored, labeled, and dated. 3. The facility failed to ensure pantry foods were properly stored, labeled, and dated. These failures could place residents who ate food served by the kitchen at risk of food-borne illness.

Inspectors wroteBased on observation, interview, and record review, the facility failed to 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 (LVN C, CNA E, NA G, and CNA F) of 5 staff members in that: -LVN C did not don PPE to administer medication via PEG tube to Resident #91 -LVN C did not perform hand hygiene or change gloves in between dirty and clean portions of wound care for Resident #5. -CNA E did not perform hand hygiene before, during, or after incontinent care of Resident #24. -NA G did not perform hand hygiene before, during, or after incontinent care of Resident #24. -CNA F did not perform hand hygiene in between assisting Resident #17 and Resident #21 with eating at lunch time meal. [...]

Inspectors wroteBased on interviews and record review, the facility failed to implement written policies and procedures that prohibit and prevent abuse, neglect, and exploitation of residents for 1 (CNA I) of 12 staff reviewed for abuse policies. The facility did not implement the training /orientation of CNA I related to abuse, neglect, and exploitation per facility policy. This failure could place residents in the facility at risk of Abuse, Neglect, or Exploitation.

Inspectors wroteBased on observations, interviews, and record reviews the facility failed to develop and implement a comprehensive person-centered care plan for 1 (Resident #35) of 12 residents reviewed for care plans. The facility failed to implement Resident #35's care plan for a chair alarm in his w/c and 1:1 monitoring, and he had an unwitnessed fall which resulted in a broken left hip. This failure could place residents at risk of injury due to falls. Findings Included: Record review of Resident #35's admission record dated 05/30/24 revealed an [AGE] year-old male originally admitted to the facility 03/29/23 with a most recent admission date of 05/29/24. [...]

Inspectors wroteBased on observation, interview, and record review the facility failed to ensure a resident who is fed by enteral means receives the appropriate treatment and services to prevent complications of enteral feeding including but not limited to aspiration pneumonia, diarrhea, vomiting, dehydration, metabolic abnormalities, and nasal-pharyngeal ulcers for 1 (Resident #91) of 1 residents reviewed for tube feeding. The facility failed to check for PEG tube placement before administering medication (Cephalexin) via the tube for Resident #91. This failure could place resident at risk of aspiration, bleeding, or perforation, pneumonia, and even death. Findings Included: [...]

Inspectors wroteBased on observation, interview, and record review the facility failed to ensure a resident who needs respiratory care, is provided such care, consistent with professional standards of practice, the comprehensive person-centered care plan, and the residents' goals and preferences for 1 (Resident #34) of 12 residents reviewed for respiratory care. Resident #34 had physician's orders for oxygen via nasal cannula at 2-3 lpm and was receiving oxygen at 5 lpm. This failure could place residents at risk for hypercapnia (too much carbon dioxide in the blood), pulmonary oxygen toxicity (damage to the lung lining tissues and air sacs), hypoxemia (low levels of oxygen in the blood, decreasing the oxygen supply to vital organs), and shortness of breath. Findings Included: [...]

Inspectors wroteBased on observation, the interview and record review, the facility failed to ensure residents were free of any significant medication errors for one of 1 (Resident #20) 12 residents reviewed for medication administration. -LVN C was attempting to administer Resident #20's expired insulin. Resident #20's insulin did not have an open date on the vial; therefore it could not be determined if insulin was expired. This failure could place residents who receive insulin medications at an increased risk for complications such as increased blood glucose levels, change in cognition, and an exacerbation of symptoms and disease process.

Inspectors wroteBased on observation, interview, and record review, it was determined the facility failed to ensure drugs and biologicals were stored in locked compartments and labeled in accordance with currently accepted professional principles and include the appropriate accessory and cautionary instructions, and the expiration date when applicable for 2 of 2 (Halls Emerald and [NAME], and Halls Topaz and Sapphire) medication carts and 1 of 1 medication room, and 1 of 1 treatment cart reviewed for medication storage. -1 insulin medications were found in Hall Emerald and [NAME] medication cart with no date of when medication vial was opened. -Medication refrigerator in medication room was logged at 30 degrees 4 out of the last 28 days. -LVN C left treatment cart unlocked and unattended. [...]

Inspectors wroteBased on interview and record review the facility failed to provide training to their staff that at a minimum educates staff on activities that constitute abuse, neglect, exploitation, and misappropriation of resident property and procedures for reporting incidents of abuse, neglect, exploitation, or the misappropriation of resident property and dementia management for 2 (CNA I and CNA J) of 12 employees reviewed for staff training. The facility failed to train CNA I on what constitutes abuse, neglect, exploitation, misappropriation of resident property and how to report the above. The facility failed to train CNA I on dementia management. The faciltiy failed to train CNA J on dementia management. These failures could place residents at risk of injury or harm due to being cared for by untrained staff.

Inspectors wroteBased on observation, interview and record review, the facility failed to implement a comprehensive care plan for each resident that includes measurable objectives and timeframes to meet a resident's medical, nursing, mental, and psychosocial needs that are identified in the comprehensive assessment and describes the services that are to be furnished to attain or maintain the resident's highest practicable physical, mental, and psychosocial well-being for 1 (Resident #27) of 13 Residents reviewed for comprehensive care plans. -The facility failed to include care plans for Resident #27's catheter. This failure could affect all residents in the facility receiving care per comprehensive person-centered care plans resulting in resident not being able to attain or maintain their highest practicable physical, mental, and psychosocial well-being.

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure that residents who needed respiratory care, including tracheostomy care and tracheal suctioning, were provided such care, consistent with professional standards of practice, the comprehensive person-centered care plan, the residents' goals, and preferences for one (Resident #147) of 13 residents assessed for respiratory care. Resident #147 was wearing/receiving oxygen but did not have an order for oxygen. This failure could place residents requiring oxygen at risk for receiving the wrong amount of oxygen, which could lead to shortness of breath, hypoxemia (below normal levels of oxygen in blood), or oxygen toxicity (condition resulting from the harmful effects of breathing molecular oxygen at increased partial pressures).

Inspectors wroteBased on observation, interview, and record review, the facility failed to 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 1 (CNA A) of 4 staff observed for resident care. -CNA A failed to perform hand hygiene or glove changes during incontinent care. This deficient practice has the potential to affect all residents in the facility by exposing them to care that could lead to the spread of viral infections, secondary infections, tissue breakdown, communicable diseases, and feelings of isolation related to poor hygiene.