Richland Care Center Inc

Inspectors wroteBased on interview and record review, the facility staff failed to develop and implement policies and procedures for the inspection, testing, and maintenance of the facility water systems to inhibit the growth of waterborne pathogens and reduce the risk of an outbreak of Legionnaire's Disease (LD). The facility census was 35. 1. Review of the Centers for Medicare and Medicaid Services (CMS) Survey and Certification (S&C) letter 17-30, dated 06/02/17 and revised on 06/09/17; showed: -The bacterium Legionella can cause a serious type of pneumonia called LD in persons at risk. Those at risk include persons who are at least [AGE] years old, smokers, or those with underlying medical conditions such as chronic lung disease or immunosuppression. [...]

Inspectors wroteBased on interview and record review, facility staff failed to prevent the commingling of four current residents (Resident #4, #22, #12, and #14) out of 15 sampled residents personal funds with the operating funds of the facility. The facility census was 35. 1. The facility did not provide a policy for accounting records. 2. Review of the facility maintained Account Receivable (AR) Aging report, dated 09/17/24, showed current residents with personal funds held in the facility operating account as follows: -Resident #4 with a credit balance of $446.00 with a start date of 01/2024; -Resident #22 with a credit balance of $988.00 with a start date of 03/2024; -Resident #12 with a credit balance of $2971.92 with a start date of 05/2024; -Resident #14 with a credit balance of $18.00 with a start date of 06/2024. [...]

Inspectors wroteBased on observation, interview and record review, the facility staff failed to ensure prepared food items were served at a safe and appetizing temperature when the facility staff failed to maintain the internal temperatures of hot food items at 120 degrees Fahrenheit (º F) or higher upon service to residents who ate in their rooms. The facility census was 35. 1. Review of the facility's Cooking Potentially Hazardous Foods Standard of Practice policy, revised on 06/13/24, showed the policy directed staff to follow state and local health department requirements and to hold prepared hot foods at 135º F. Observation on 09/17/24 from 12:05 P.M. to 12:19 P.M., showed [NAME] E prepared plates of garlic herb pork loin, creamed potatoes and peas and seasoned red cabbage, for service to the residents who ate in their rooms, from the food items held in hot holding on the steamtable. [...]

Inspectors wroteBased on interview and record review, facility staff failed to complete pre-employment screenings of the Criminal Background Check (CBC), Employee Disqualification List (EDL) verification, and Family Care Safety Registry (FCSR), for three employees (Dietary Manager (DM), CNA C, and CNA B) out of 10 employees sampled. The facility census was 35. 1. Review of the facility's policy titled Abuse Prohibition, dated 12/26/23, showed all persons hired will be checked with appropriate licensing agencies and CBC as required by Missouri law. 2. Review of the DM's personnel file showed: -Date of hire 06/07/23; -Did not contain FCSR or CBC. Review of the DM's timecard showed his/her first day worked as 06/07/23. 3. Review of CNA C's personnel file showed: -Date of hire 07/24/23; -Did not contain FCSR or CBC. Review of CNA C's timecard showed his/her first day worked as 07/24/23. 4. [...]

Inspectors wroteBased on record review and interview, facility staff failed to provide refunds of personal funds to from the facility operating account for nine residents (#294, #290, #296, #288, #295, #287, #286, #291, and #289) out of 15 sampled residents who discharged from the facility within the required 30 days. The facility census was 35. 1. The facility did not provide a policy for accounting records. Review of the facility's admission Agreement, undated, showed the facility agreed to refund the unused balance of payment when the resident discharges from the facility. 2. Review of the facility maintained Account Receivable (AR) Aging report, dated 09/17/24, showed discharged residents with personal funds held in the facility operating account as follows : -Resident #294 discharged from the facility on 12/21/23 with a credit balance of $2020.00; [...]

Inspectors wroteBased on interviews and record review, facility staff failed to report an allegation of sexual abuse towards one resident (Resident #1) to the Department of Health and Senior Services (DHSS) within the two hour required time frame. The facility census was 33. 1. Review of the facility's policy titled, Abuse Prohibition, undated, showed staff were directed to report any alleged abuse or neglect will be investigated by the administrator or their designee. Proper authorities will be notifie and the facility will report any incidents and violations to the appropriate agencies and authorities within appropraite time frames. 2. Review of Resident #1's Quarterly Minimum Data Set (MDS) a federally mandated assessment tool, dated 11/29/23, showed staff assesed the resident as: -Cognitively intact; -Active diagnoses: [...]

Inspectors wroteBased on interviews and record review, facility staff failed to investigate an allegation of rape for one resident (Resident #1). The facility census was 33. 1. Review of the facility's policy titled, Abuse Prohibition, undated, showed staff were directed any report of alleged abuse or neglect will be investigated by the administrator or their designee. 2. Review of Resident #1's Quarterly Minimum Data Set (MDS) a federally mandated assessment tool, dated 11/29/23, showed staff assesed the resident as: -Cognitively intact; -Active diagnoses: [...]

Inspectors wroteBased on observation, interview and record review, the facility staff failed to store food in a manner to prevent potential contamination and out-dated use. Facility staff failed to wear hair restraints to protect food and food-contact surfaces from potential contamination. Facility staff failed to perform hand hygiene as often as necessary to prevent cross-contamination. Facility staff also failed to ensure two of three kitchen waste containers were covered when not in actual use. The facility census was 29. 1. Review of the facility's Preventing Cross-Contamination During Storage and Preparation Standard of Practice policy, dated 07/06/22, showed the policy directed staff to train food-service employees on using the procedures in the policy and to follow state and local health department requirements. [...]

Inspectors wroteBased on observation, interview, and record review, the facility staff failed to use appropriate infection control procedures to prevent the spread of bacteria or other infectious causing contaminants when staff failed to perform appropriate perineal care when they wiped multiple times with the same area of the wipe for two residents (Residents #3 and #13), and staff failed to maintain transmission based precautions for one resident (Resident #26) in order to prevent the transmission of clostridium difficile [C-diff- a germ (bacterium) that causes diarrhea and colitis (an inflammation of the colon)] infection and failed to post guidance (e.g., posted signs at entrances) on COVID- 19 recommendation actions for visitors. The facility census was 29. 1. [...]

Inspectors wroteBased on observation and interview, facility staff failed to post the required telephone number for the Department of Health and Senior Services (DHSS) Adult Abuse and Neglect Hotline (used to report allegations of abuse and neglect) in a form and manner accessible to residents and visitors. The census was 29. 1. Review of the facility's Abuse Prohibition Policy, undated, showed information on how and to whom to report can be made will be posted at all times in various places in the facility. Observation on 5/22/23 at 2:02 P.M., showed the facility did not post the name, address, and toll free telephone number for the Adult Abuse and Neglect Hotline in an accessible location for residents, visitors or staff. [...]