Pruitthealth - Macon

Inspectors wroteBased on record review, staff interviews, and review of the facility's policy titled, Prevention of Patient Abuse, Neglect, Exploitation, Mistreatment, and Misappropriation of Property, the facility failed to ensure resident (R) (R209) was free from abuse when R200 engaged in nonconsensual sexual contact with R209 by grabbing and kissing him on the mouth out of four residents investigated for abuse. This deficient practice had the potential to place cognitively impaired residents at risk for nonconsensual sexual contact and further incidents of abuse. The facility census was 171.

Inspectors wroteBased on observations, record review, staff interviews, and review of the facility policy titled, Compliance Rounds, the facility failed to ensure a hazard-free environment for one of six residents (R) (R182)reviewed for accident hazards when six disposable razors and one hair trimmer were observed unsecured on the resident's bedside table and accessible within the resident environment. This deficient practice had the potential to place residents at risk for lacerations or other injuries from unsecured sharp objects. The facility census was 171.

Inspectors wroteBased on observations, staff interviews, record review, and review of the facility's policy titled Patients/Resident Rights, Accommodation of Needs, the facility failed to provide care in a manner that maintained or enhanced a resident's dignity for one of 50 sampled residents (R) (R73). This deficient practice had the potential to diminish R73's quality of life in an environment that promotes the maintenance or enhancement of each resident's quality of life.

Inspectors wroteBased on observations, resident and staff interviews, and review of the facility's policy titled Infection Control-Housekeeping Services, the facility failed to maintain a safe, clean, comfortable, and homelike environment in four of 97 resident rooms (Room F11, Room F13, Room F15, and Room F21). Specifically, buildup of food on a television, stained and sticky floors, and dust-covered ceilings and wall vents were observed.

Inspectors wroteBased on staff interviews and record review, the facility failed to ensure two of 20 sampled residents (R) (R112 and R10) were referred to the appropriate state-designated authority for a review for a Preadmission Screening and Resident Review (PASRR) Level II. This failure had the potential to place R112 and R10 at risk of not receiving specialized services.

Inspectors wroteBased on observations, staff interviews, record review, and review of the facility's policy titled Care Plan, the facility failed to implement the individualized care plan for one of 50 sampled residents (R) (R52) related to high fall risk. The deficient practice had the potential to place R52 at risk for safety and injuries, which could lead to hospitalization and a diminished quality of life.

Inspectors wroteBased on observations, resident and staff interviews, and record review, the facility failed to ensure services for hearing were provided for one of 50 sampled residents (R) (R106). The deficient practice had the potential to cause a decrease in R106's quality of life.

Inspectors wroteBased on observations, staff and resident interviews, and record review, the facility failed to ensure one of 50 sampled residents (R) (R127) received restorative nursing as ordered by the physician. This deficient practice had the potential to place R127 at risk for medical complications, such as decreased range of motion of her left hand.

Inspectors wroteBased on observations, staff interviews, record review, and review of the facility's policy titled Smoke Free Policy, the facility failed to ensure three of seven residents (R) (R19, R20, and R49) who smoked had complete and accurate smoking assessments. In addition, the facility failed to ensure one of seven R (R19) who smoked had a care plan related to smoking. These deficient practices had the potential to place R19, R20, and R49 at an increased risk of accident hazards related to smoking.

Inspectors wroteBased on observations, staff interviews, and record reviews, the facility failed to ensure oxygen (O2) was administered as prescribed by the physician for two of 20 residents (R) (R22 and R95) receiving O2. This deficient practice had the potential to place R22 and R95 at risk of respiratory complications and a diminished quality of life.

Inspectors wroteBased on observations, resident and staff interviews, record review, and review of the facility's policy titled Infection Prevention and Control Plan, the facility failed to ensure staff followed infection control practices during wound care for one of 18 residents (R) (R106) with pressure ulcers. In addition, the facility failed to properly store personal care supplies in one of 11 resident restrooms observed. These deficient practices had the potential to place R106 at increased risk of infection related to cross-contamination, and had the potential to increase the risk of cross-contamination to the residents residing in room A1.

Inspectors wroteBased on observations, staff interviews, and review of the facility policies titled Labeling, Dating, and Storage, Leftovers, Food Ordering, Receiving, and Storage, Dishwashing, and Pot/Pan Washing and Sanitation, the facility failed to label, date, and securely wrap opened food items; failed to remove dented cans from general can storage; failed to prevent wet nesting in staked pans to eliminate potential of bacteria growth; and failed to sanitize dishware to prevent cross-contamination. This deficient practice affected 136 of 153 residents receiving an oral diet.

Inspectors wroteBased on record review, staff interviews, and review of facility policy titled Care Plans, the facility failed to develop or implement a care plan for seven of 37 sampled residents (R) (R81, R17, R9, R130, R133, R64, and R26).

Inspectors wroteBased on observation, resident and staff interviews, record review, and review of the facility policy titled Self-Administration of Medications by Patients/Residents, the facility failed to ensure one resident (R) (R48) reviewed for self-administration of medications did not have medications stored at the bedside. This deficient practice had the potential to allow R48 to administer the medications in an unsafe manner. The sample size was 37 residents.

Inspectors wroteBased on record review, resident responsible party interview, staff interviews, review of the facility policy titled Reporting Patient Abuse, Neglect, Exploitation, Mistreatment, and Misappropriation of Property, and review of the website titled Agency of Healthcare Research and Quality (AHRQ), the facility failed to notify the physician and family of an allegation of abuse for one resident (R) (R9). The sample size was 37 residents.

Inspectors wrote2. Initial observation tour on D Unit on 1/12/2024 at 9:18 am of Room D-3 revealed a 30 cubic centimeter (cc) syringe on the floor next to a trash can that had no liner. The trash can was observed with trash stuck in the bottom of the can along with a brown liquid substance. There was dried formula observed on a tube feeding pump and pole. A dried formula was observed on the left bed rail. Observation revealed the floor was dirty with trash. The nightstand had flaky particles and stains next to a suction machine with the suction tubing hanging from the left side of the nightstand. The floor on the right side of Bed B had a fall mat partially rolled up with trash on top of it. Observations from 1/12/2024 through 1/14/2024 revealed all environmental concerns listed above remained unchanged. [...]

Inspectors wroteBased on record review, staff interviews, and review of facility policy titled Care Plans, the facility failed to develop a baseline care plan regarding dementia and hospice care for one resident (R) (R206) of 13 newly admitted residents in the past 30 days.

Inspectors wroteBased on observations, resident interviews, staff interviews, and record review, the facility failed to provide Activities of Daily Living (ADL) care related to showers and shaving for four of 38 sampled residents (R) dependent on staff for ADL care, (R17, R18, R58, and R123.) This failure had the potential to negatively impact R17, R18, R58, and R123's quality of life.

Inspectors wroteBased on observations, staff interviews, record review, and review of the policy titled Restorative Nursing Program, the facility failed to ensure Occupational Therapy recommendations were implemented for two of 17 residents (R) (R56 and R127). This deficient practice had the potential to cause a negative outcome to the resident's physical, mental and psychosocial health, or well-being. The sample size was 37 residents.

Inspectors wroteBased on observations, staff interviews, record review, and review of the facility's policy titled Medication Administration: Enteral Tubes, the facility failed to provide enteral nutrition and hydration according to current physician orders for one of twenty-one residents (R) (R64) receiving tube feeding via a gastrostomy tube (G-tube) (a tube placed into a patient's stomach through the abdominal wall to provide a means of feeding when oral intake is not adequate). The sample size was 37 residents.

Inspectors wroteBased on observations, resident and staff interviews, record reviews, and a review of the facility policy titled Oxygen Administration, the facility failed to ensure that oxygen therapy was administered as ordered by the Physician for one resident (R) (R48) receiving oxygen. The sample was 37 residents.

Inspectors wroteBased on observations, interviews, record review, and review of the facility policy titled State Minimum Staffing for Healthcare Center, the facility failed to ensure sufficient staffing to meet residents' needs on one of seven units (F Unit). The census was 153 residents.

Inspectors wroteBased on staff interviews, record review, and review of the facility policy titled Monitoring of Antipsychotics, the facility failed to ensure one of five residents (R) (R26) reviewed for unnecessary medications received medications as ordered. Specifically, the facility failed to decrease the dose of aripiprazole (an antipsychotic medication) for R26 as ordered by the Nurse Practitioner (NP).

Inspectors wroteBased on observation, staff interviews, and record review, the facility failed to provide routine dental services for one of 37 sampled residents (R) (R17). This failure had the potential to negatively impact R17's quality of life.

Inspectors wroteBased on observation, staff interview, and review of the facility recipe titled Puree Oven Baked Chicken, the facility failed to ensure dietary staff followed recipes for preparing pureed foods to avoid compromising the nutritive value, flavor, or appearance. This affected eight of 136 residents receiving an oral diet.

Inspectors wroteBased on observation, staff and resident interviews, record review, review of the facility policy titled Nutritional Screening and Assessments/Food Preferences, and review of the facility document titled Position Description: Job Title: Dietary Manager, the facility failed to honor food preferences for one resident (R) (R84) of 67 residents with food likes, dislikes, and preferences.