Regency Omak

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure hand hygiene was performed when indicated during the lunch meal service. The facility further failed to ensure the microwave and ice machine were clean and dishwasher temperatures were maintained at the appropriate temperatures. These failures placed residents at risk for food-borne illnesses and food served from unsanitary conditions.

Inspectors wroteBased on observation, interview, and record review, the facility failed to monitor a resident's neurological status (an evaluation completed on a person's alertness, muscle strength, coordination, ability to feel and reflexes) after multiple unwitnessed falls occurred for 1 of 1 sampled residents (Resident 34) reviewed for falls. This failure placed the residents at risk for falls.

Inspectors wroteBased on interview and record review, the facility failed to implement care planned interventions related to monitoring during a viral infection for 2 of 3 residents (1 and 2) whose care plans were reviewed. This failure put the residents at risk for worsening of their condition and unmet care needs.

Inspectors wroteBased on interview and record review, the facility failed to ensure 3 of 5 sampled residents (Resident 2, 26, and 14), reviewed for unnecessary medications, were informed of the potential risks associated with the use of psychotropic medications (medications that can affect the mind, emotions, and behaviors). This failure placed the residents and/or their representative at risk of not being fully informed of the potential risks and benefits of taking the medications.

Inspectors wroteBased on interview and record review, the facility failed to identify what information was conveyed to the hospital at the time of transfer for 1 of 2 sampled residents (Resident 34) reviewed for hospitalizations. This failure placed the resident at risk for a disruptive and ineffective transition from the facility to the hospital setting.

Inspectors wroteBased on interview and record review, the facility failed to ensure it completed a notice of bed hold for 1 of 2 (Resident 34) sampled residents reviewed for hospitalization. This failure placed the resident and/or their representative at risk for a lack of knowledge regarding their right to hold their bed while in the hospital.

Inspectors wroteBased on interview and record review, the facility failed to ensure 1 of 5 sampled residents (Resident 26), reviewed for Pre-admission Screening and Resident Review (PASARR) [an assessment completed prior to admission into a skilled nursing facility to determine whether a resident with a diagnosis of a serious mental illness needed specialized mental health services] was completed accurately and if indicated, a referral for additional screening had been made.

Inspectors wroteBased on interview and record review, the facility failed to ensure an adequate indication for the use of an antidepressant for 1 of 5 sampled residents (Resident 14) reviewed for unnecessary medications. This failure placed the resident at risk to receive unnecessary medications and/or experience adverse side effects.

Inspectors wroteBased on observation, interview, and record review, the facility failed to destroy a deceased resident's controlled medication timely, in accordance with currently accepted professional standards, in 1 of 1 medication storage rooms. Additionally, the facility failed to ensure that controlled medications were stored in a permanently affixed, locked storage compartment in the medication refrigerator. These failures placed the facility at risk for potential diversion or misappropriation of controlled medications.

Inspectors wroteBased on interview and record review, the facility failed to ensure vaccine consents, medication reviews, and advance directives records were complete and accurate for 3 of the 19 sampled residents (2, 14, 20 and 26) whose records were reviewed. Failure to ensure clinical records were complete and accurate, placed residents at risk of not having their needs met.

Inspectors wroteBased on interview and record review the facility failed to develop and implement a system to evaluate agency/contracted staff competencies in skills and techniques to ensure staff provided necessary care and respond to each resident's individualized needs for 1 of 4 sampled staff (Staff I), reviewed for nursing services. This failure resulted in ineffective communication with Resident 1 that made them feel uncomfortable, placed residents at risk of unmet care needs and diminished quality of life.

Inspectors wroteBased on interview and record review, the facility failed to honor a resident's right to refuse care for 1 of 3 residents (1) investigated for abuse. two staff members insisted that a resident have a shower, despite their initial refusal. This failure placed the resident at risk for feelings of disrespect and decreased self-worth.

Inspectors wroteBased on interview and record review, the facility failed to ensure allegations of potential abuse were reported immediately to the State Survey Agency as required, for 1 of 3 sampled residents (Resident 1). This failure placed the resident at risk for abuse.

Inspectors wroteBased on interview and record review, the facility failed to complete a thorough investigation into allegations of abuse in a timely manner, for 1 of 3 sampled residents (Resident 1). Failure to recognize allegations as possible abuse and failure to immediately investigate allegations, placed the resident at risk for diminished quality of life, and continued possible abuse.

Inspectors wroteBased on observation, interview, and record review, the facility failed to implement interventions, consistently monitor pressure ulcers, and notify appropriate disciplines once pressure ulcers were identified for 3 of 3 sampled residents (Residents 3, 7, and 29), reviewed for pressure ulcer care. Actual harm occurred for Resident 3, when facility staff did not have preventive protective boots(cushioned devices placed on the feet to protect against pressure) implemented timely, the resident lost a significant amount of weight, developed an additional pressure injury, and the Registered Dietician (RD) was not notified of the resident's wounds. This failure placed the other residents at risk of harm from further deterioration of their skin conditions, and a decreased quality of life.

Inspectors wrote<Resident 17> Per the 03/02/2023 quarterly assessment, Resident 17 admitted to the facility with obstructive sleep apnea (a problem in which your breathing pauses during sleep), hypoxemia (a low level of oxygen in the blood), shortness of breath, and a disorder of diaphragm (the thin muscle below the lungs and heart), and required oxygen due to those conditions. Review of the physician orders showed on 12/18/2020, the resident had been prescribed oxygen to be used continuously due to the diagnoses listed. The respiratory care plan showed the licensed nursing staff were instructed on 09/23/2019 to change the oxygen tubing weekly. There was no direction on cleaning the concentrator, or a physician's order to do so. On 05/23/2023 at 9:25 AM, Resident 17 was observed wearing oxygen with a date on the tubing of 05/16/2023. [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to refer a resident for behavioral health services when needed for 1 of 1 sampled residents (Resident 12), reviewed for mood and behavior. This failure placed the resident at risk for worsening depression and a decreased quality of life.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure expired medications were disposed of timely, in accordance with currently accepted professional standards, in 1 of 1 medication storage rooms. The facility further failed to ensure narcotics were locked in a permanently affixed narcotic container. These failures placed residents at risk for receiving compromised or ineffective medication, and placed the facility at risk for potential diversion or misappropriation of narcotic medications.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure two of three sampled residents (Residents 29, 191), reviewed for use and care of a urinary catheter (a flexible tube inserted into the bladder to drain urine into a drainage bag), received appropriate care and services to minimize the risk of associated urinary infections. In addition, the facility failed to ensure hand hygiene and glove changes were performed when indicated in the kitchen by one of three kitchen staff (Staff I), observed during tray line service. These failures placed the residents at risk for infection.