Randolph County Nursing Home

Inspectors wroteBased on observation, record review, interview, and facility policy review, the facility failed to ensure expired food items and leftovers food items were promptly removed/discarded on or before the expiration or use by date and dietary staff washed their hands between dirty and clean tasks and before handling clean equipment for 1 of 1 meal observed.

Inspectors wroteBased on observation, record review and interview, the facility failed to ensure foods stored in the freezer, refrigerator and dry storage area were covered, sealed and dated to minimize the potential for food borne illness for residents who received meals from 1 of 1 kitchen; expired dessert with dairy products and food items were promptly removed / discarded on or before the expiration or use by date to prevent the growth of bacteria; dietary staff washed their hands between dirty and clean tasks and before handling clean equipment or contamination and hot food items were maintained at above 135 degrees Fahrenheit on the steam table while awaiting service to prevent potential food borne illness for residents who received meals from 1 of 1 kitchen. [...]

Inspectors wroteBased on observation and interview, the facility failed to ensure 19 residents ' personal information was kept confidential.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure a physician's order was followed for 1 (Resident #111) Resident of 6 (Residents #1, #5, #11, #62, #106, #111) sample mixed residents on the 200 halls.

Inspectors wroteBased on observations, interview and record review, the facility failed to ensure medication was not left unattended at the bedside; and topical ointments and mouthwash was stored properly for 2 f 2 Resident ' s #1 and #111. The failed practice had the potential to affect 7 ambulatory residents.

Inspectors wroteBased on observation and interview, the facility failed to ensure a CPAP (Continuous Positive Airway Pressure) storage bag was changed weekly for 1 of 1 (Resident #119) sampled residents, and the facility failed to ensure oxygen tubing was dated for 1 (Resident #5) of 2 Residents (Resident #5 & #88) requiring oxygen on the 200 Hall.

Inspectors wroteBased on observation and interview the facility failed to ensure daily staffing schedules were posted in a public location.

Inspectors wroteBased on observation, interview and policy review, the facility failed to store controlled medications were not stored properly in a permanently affixed box in 2 (100, and 300 Halls) of 4 Medication Storage Rooms in the facility.

Inspectors wroteBased on observation, record review and interview, the facility failed to ensure meals were prepared and served according to the planned written menu to meet the nutritional needs of the residents for 1 of 1 meal observed. This failed practice had the potential to affect 8 residents who received pureed meals from 1 of 1 kitchen.

Inspectors wroteBased on observation and interview, the facility failed to ensure pureed food items were blended to a smooth, lump-free consistency to minimize the risk of choking or other complications for residents who required pureed diets for 2 of 2 meals observed. This failed practice had the potential to affect 8 residents who received pureed diets.

Inspectors wroteBased on observation, interview, and record review the facility failed to ensure staff had on appropriate Personal Protection Equipment (PPE) for 1 of 1 (Resident #62) sampled residents that were on enhanced barrier precautions on the 200 hall.

Inspectors wroteBased on observation and interview the facility failed to ensure 1 (Resident #16) of 6 (Resident #16, #18, #84, #101, #119, and #126) sampled residents who receive a meal tray from the kitchen on the 100 hall was not served food on a paper towel.

Inspectors wroteBased on interviews, and record review, the facility failed to ensure resident concerns from the Resident Council Meeting were acted upon promptly for 1 of 1 (Resident #3) sampled residents. This failed practice had the potential to affect 129 residents that reside in the facility.

Inspectors wroteBased on interview and record review, the facility failed to ensure the responsible party/family member was notified of changes in condition after new orders were obtained for 3 (Resident #1, Resident #2, and Resident #3) of 3 sample mix residents. This failed practice had the potential to affect 129 residents who reside in the facility. A. Review of the Order Summary Reports showed the following: 1. A physician order for Resident #1 with a start date of 06/07/2023 to administer Lamictal 25 mg (milligram) by mouth at bedtime and no documentation of the responsible party notification. 2. A physician order for Resident #2 with a start date of 09/09/2023 to administer Seroquel 12.5 mg by mouth in the morning and no documentation of the responsible party notification. 3. [...]

Inspectors wroteBased on observation and interview, the facility failed to ensure that staff washed their hands before handling clean equipment or food items to prevent the potential for cross contamination, expired food items and spoiled foods were promptly removed and discarded on or before the expiration or use by dates and failed to ensure leftover food items were used by the use-by date to prevent potential food borne illness for residents who received meal trays from 1 of 1 kitchen; failed to ensure opened food items in a rubber container were covered to maintain freshness and prevent potential cross contamination. These failed practices had the potential to affect 128 residents who received meals from the kitchen (total census: 129) according to the list provided by the Dietary Supervisor dated 10/11/2022.

Inspectors wroteBased on observation, record review and interview, the facility failed to ensure meals were served at temperatures that were acceptable to the residents to improve palatability and encourage good nutritional intake during 1 of 1 meal observed. This failed practice had the potential to affect 35 residents who received meal trays in their rooms on the 100 Hall, 32 residents who received meal trays in their room on the 200 Hall, 36 residents who received their meal trays in their rooms on the 300 Hall and 28 residents who received their meal trays in their rooms on the 400 Hall as documented on a list provided by Dietary Supervisor on 10/11/2022.