Pruitthealth - Marietta

Inspectors wroteBased on observations and staff interviews, and review of the facility policy titled, Disposal of Medications, the facility failed to ensure expired medications were removed from active medication storage areas and unavailable for use in one of two medication rooms (first floor medication room) reviewed. This deficient practice had the potential to affect 51 residents receiving medications on the unit.

Inspectors wroteBased on observations, record review, and resident and staff interviews, the facility failed to ensure oxygen equipment was safely maintained and monitored for two of nine residents (R) (R70 and R83) reviewed for oxygen use. Specifically, the facility failed to remove an oxygen tank from a resident room that was unsecure and unattended (R70) and failed to date respiratory supplies and to keep an oxygen concentrator filter free of debris (R83). The deficient practices had the potential to create accident hazards, improper oxygen administration, and impaired oxygen delivery.

Inspectors wroteBased on observations and staff interviews, the facility failed to ensure appropriate hand hygiene practices were performed during wound care treatment for one of six residents (R) (R6) with pressure ulcers. This deficient practice had the potential to increase the risk of transmission of infection.

Inspectors wroteBased on staff interviews, record reviews, and review of the facility policy titled Care Plans, the facility failed to develop a care plan for one resident (R)(R715) of 49 sampled related to amount of assistance needed to provide care during a transfer. Actual harm occured on 11/5/2024 when R715 was hit on the head by the mechanical lift swing when Certified Nursing Assistant (CNA) KK attempted a transfer alone. This resulted in bruising to the left eye of R715.

Inspectors wroteBased on observations, staff and resident interviews, record review, and review of the facility's policy titled, Occurrence Reduction Plan, the facility failed to provide adequate staff to prevent injuries while using a mechanical lift for one of 49 sampled residents (R) (R715). Actual harm occured on 11/5/2024 when R715 was hit on the head by the mechanical lift swing when Certified Nursing Assistant (CNA) KK attempted a transfer alone. This resulted in bruising to the left eye of R715.

Inspectors wroteBased on observations, resident interviews, and staff interviews, the facility failed to maintain a safe, functional, sanitary, and comfortable environment as evidenced by wedged items in privacy curtain and dust build up in PTAC in room [ROOM NUMBER], a loose PTAC unit in room [ROOM NUMBER], peeling trim near the second floor shower room, substances on the floor/tile in the A-Hall shower room, black and black/brown substances in the ceiling of kitchen dish washing room and dry storage area. This deficient practice had the potential to jeopardize the health and safety of all 106 residents in the facility in three resident rooms, two of four shower rooms, and the kitchen.

Inspectors wroteBased on observations, staff interviews, record review, and review of the facility policy titled, Medication Administration: General Guidelines, the facility failed to adhere to accepted standards of quality care by crushing medications that cannot be opened or crushed in one out of seven residents observed during a medication pass, and not measuring the correct dosage of Diclofenac ointment (nonsteroidal anti-inflammatory drug (NSAID) used to reduce pain and inflammation) in one out of seven residents (R) (R12) who have diclofenac ointment ordered. This deficient practice could result in serious adverse effects, including an increased risk of medication side effects or reduced efficacy due to improper administration techniques.

Inspectors wroteBased on observations, resident and staff interviews, and review of facility policy titled Transmission Based Isolation Precautions, the facility failed to maintain sanitary conditions for two of 50 sampled residents (R)(R23 and R3). Specifically, oxygen equipment (nasal cannula) was hung over the humidifier and touched the floor when not in use for R23 and the facility failed to use appropriate Personal Protection Equipment (PPE) for a resident R3 on Enhanced Barrier Precautions (EBP) of 50 sampled residents. This deficient practice could risk equipment contamination, increasing the likelihood of infections and health complications.

Inspectors wroteBased on observations, record review, interviews, and review of the facility's policy, it was determined that the facility failed to ensure bed/side rails had been assessed for the risk of entrapment and only used bed/side rails after trying other alternatives for three of three residents (R) (R#15, R#46, and R#249). The facility also failed to obtain informed consent for the use of bed/side rails for two of three residents (R#15 and R#46) reviewed for bed/side rail use.

Inspectors wroteBased on observations, interviews, record review, and document review, it was determined the facility failed to have sufficient nursing staff to provide care for two of nine (R) (R#12 and R#293) reviewed for activities of daily living and one of four residents (R#56) who required daily wound care.

Inspectors wroteBased on observation, document review, and interviews, the facility failed to prohibit the Director of Nursing (DON) from serving as a charge nurse for eight of 18 days reviewed when the facility's census was greater than 60 residents and there was no staffing waiver in effect.

Inspectors wroteBased on observations, interviews, record review, and document review, the facility failed to accommodate the needs of three of 48 sampled residents (R) (R#3, R#21, and R#52) related to providing a functional shower bed for use on the second floor of the facility, resulting in the residents failing to receive showers as preferred.

Inspectors wroteBased on record review, interviews and review of the facility's policy, the facility failed to prevent abuse for one of three sampled residents (R) (R#193) related to sexual abuse.

Inspectors wroteBased on record reviews, interviews, facility document review, and review of the facility's policy, it was determined that the facility failed to report allegations of abuse for two of three residents (R) (R#31 and R#193) reviewed for abuse. Specifically, the facility failed to: -Ensure staff reported an incident of sexual abuse that occurred to R#193 in a timely manner; and -Ensure staff reported an allegation of sexual abuse that occurred to R#31 to the Administrator so an appropriate investigation could occur.

Inspectors wroteBased on record review, facility policy review, and interviews, it was determined that the facility failed to ensure the Preadmission Screening and Resident Review (PASARR) was accurate upon admission for one of two residents (R) (R#34) reviewed for PASARR.

Inspectors wroteBased on record review, interviews, and review of the facility's policy, it was determined that the facility failed to ensure one of five residents (R) (R#15) reviewed for unnecessary medications received blood sugar monitoring and medications as ordered by the physician.

Inspectors wroteBased on observations, interviews, and facility document review, it was determined the facility failed to provide wound care per physician's orders for one of three residents (R) (R#56) reviewed for pressure ulcers.

Inspectors wroteBased on observations, record review, interviews, and review of the facility's policy, it was determined that the facility failed to ensure two of 31 residents (R) (R#249 and R#15) reviewed had accurately documented medical records. Specifically, the facility failed to accurately document the correct amount of warfarin (an anticoagulant) administered to R#249 and failed to accurately document the amount of water flush being administered to R#15.