Reliable Health & Rehab at Lakewood

Inspectors wroteBased on observations, staff interviews, and review of the facility's policy titled, Infection Prevention and Control Program, the facility failed to prevent cross-contamination of dirty laundry from clean laundry. This deficient practice had the potential to cause the spread of infection throughout the facility. The census was 94.

Inspectors wroteBased on observations, record review, staff interviews, and review of the facility's policies titled, Self-Administration of Medications, and Bedside Medication Storage, the facility failed to ensure they had a physician's order for medication stored at the bedside and the residents had been assessed for the ability to safely self-administer medications for one of two residents (R) (R92) reviewed for self-administration of medications. This deficient practice had the potential to cause adverse reactions if unsecured medications were accessed or ingested.

Inspectors wroteBased on observations, staff interviews, and review of the facility's policy titled, Maintenance Service, the facility failed to ensure that it was maintained in a safe, clean and comfortable home-like environment including stained and damaged ceiling tiles in one resident bedroom (room [ROOM NUMBER]A), near the facility nurses' station, in the glass day room, and in the middle of the east hall.

Inspectors wroteBased on record review, staff interviews and review facility policy titled, Abuse Policy, the facility failed to protect one resident (R) (R113) from sexual abuse perpetrated by another resident (R12) out of 4 residents reviewed for abuse. This deficient practice had the potential to result in harm and emotional distress.

Inspectors wroteBased on observations, staff and resident family interviews, record review, and a review of the facility policy titled, Comprehensive Care Plan, the facility failed to develop and implement a comprehensive care plan for two of eight sampled residents (R44 and R3). The deficient practice placed R44 and R3 at risk for unmet care and services.

Inspectors wroteBased on record review, staff interviews, and review of the facility's policy titled, Comprehensive Care Plan, the facility failed to revise the comprehensive care plan for one of 33 sampled residents (R) (R92) to reflect interventions implemented. This deficient practice had the potential to result in staff being unaware of current interventions, placing R92 and other residents at risk of not receiving the care and services needed.

Inspectors wroteBased on observations, record review, staff interviews, and review of the facility's policy titled, Smoking Policy, the facility failed to ensure the environment remained free from accident hazards for one of two residents (R) (R92) reviewed for accident hazards. Findings Include:Review of the facility's policy titled, Smoking Policy, revised May 2017, revealed under Policy: The facility will ensure that the safety of the residents is protected by close supervision of residents who smoke. This will include completion of a smoking assessment, supervised smoking schedule, daily searches for tobacco products, matches, and lighters on non-compliant smokers, and weekly searches of compliant smokers. These searches will be documented. The policy further stated under Procedure: 1. [...]

Inspectors wroteBased on observations, staff interviews, record review, and review of the facility policy titled, Catheter Management Catheter Care, the facility failed to ensure proper indwelling catheter care, securing of the catheter tubing and proper use of personal protective equipment (PPE) for one of 33 sampled residents (R) (R3). The deficient practice created the potential for R3 to experience tears of the meatus, urethral trauma, and urinary tract infection (UTI).

Inspectors wroteBased on observations, staff interviews, and review of the facility's policy titled, Medication Storage in the Facility, the facility failed to securely lock the Treatment Cart. This deficient practice had the potential to create a hazardous condition in which any resident could access the treatment cart and come into contact with topical creams that could be toxic if ingested. The census was 94.

Inspectors wroteBased on staff interviews, record review, and review of the Long-Term Care (LTC) Resident Assessment Instrument (RAI) 3.0 Manual, the facility failed to ensure the Minimum Data Set (MDS) accurately reflected the resident's status for three (3) of three (3) sampled residents (Resident (R) #24, R#25, and R#74) reviewed for hospice care. The MDS Assessments for the sampled residents did not reflect the residents had terminal illnesses.

Inspectors wroteBased on observations, staff interviews, record review, and review of facility policy, the facility failed to ensure the Preadmission Screening and Resident Review (PASRR) was accurate for one (resident (R) #61 of seven residents reviewed. Specifically, the facility failed to ensure the PASRR was completed accurately upon admission.

Inspectors wroteBased on observations, staff interviews, record review, and facility policy review, the facility failed to carry out activities of daily living (ADL) for a dependent resident for one (1) (Resident (R) #9) of 30 sampled residents reviewed. Specifically, the facility failed to provide nail care to a dependent resident.

Inspectors wroteBased on observations, staff interviews, record review, and facility policy review, the facility failed to ensure the resident did not experience a reduction in motion for one of one resident (R#9) reviewed. Specifically, the facility failed to assess and provide services to prevent contractures.

Inspectors wroteBased on observations, staff interviews, and review of the facility policies titled, Sanitation-Store Rooms/Freezer/Refrigerator and Dating and Labeling, the facility failed to ensure food was properly stored, prepared, distributed, and served in accordance with professional standards for food service safety as required for 89 census residents who received meals from the facility kitchen. These failures had the potential to lead to food-borne illness among all facility residents.

Inspectors wroteBased on record review, resident representative and staff interviews, and review of the facility policy titled, Abuse, Neglect, Exploitation and Misappropriation Prevention Program, the facility failed to protect the resident's right to be free from physical abuse by a staff member for one of 18 sampled residents (R) (R28) reviewed for abuse. Specifically, Certified Nursing Assistant (CNA) CNA 1 was seen pulling R28 down the hallway by her legs, yelling to stay out of other resident's rooms.

Inspectors wroteBased on observations, staff interviews, record review, and review of the facility policy titled, Wound Management program for Pressure Ulcers, the facility failed to follow the doctor's order for one of six residents (R) (R 66) reviewed for pressure ulcers out of a sample of 18 residents. Specifically, the facility failed to consistently apply boots to the heels of R66 to relieve pressure to a stage three pressure ulcer.

Inspectors wroteBased on record review, staff interviews, and review of the facility policy titled, Documentation-Behavior Monitoring, the facility failed to ensure behavioral and side effect monitoring for antipsychotic and psychiatric medications for two of five residents (R) (R42 and R81) reviewed for unnecessary medications. The deficient practice had the potential for residents to erroneously receive medications for unidentified behaviors and suffer side effects from such medications that were not monitored.