Riverbend Health and Rehabilitation Center

Inspectors wroteBased on observations and interviews, the facility failed to ensure that food and beverages were stored, distributed, and served in accordance with professional food safety standards in the main kitchen. Specifically, the facility failed to ensure:-The kitchen was kept in a sanitary manner; and,-Condiments were labeled when opened.

Inspectors wroteBased on observations, record review and interviews, the facility failed to prevent misappropriation of property for five (#79, #48, #3, #102 and #51) of five residents reviewed for misappropriation of property out of 51 sample residents. Specifically, the facility failed to prevent the theft of Resident #79, Resident #48, Resident #3, Resident #102 and Resident #51's narcotic medications.

Inspectors wroteBased on observations, record review and interviews, the facility failed to ensure the self-administration of medications was clinically appropriate for one (#65) of one resident out of 51 sample residents. Specifically, the facility failed to ensure Resident #65 was assessed for self-administration of Visine eye drops and DeepSea nasal saline.

Inspectors wroteBased on record review and interviews, the facility failed to provide evidence that a quarterly statement was provided to residents and/or resident representative to establish and maintain a system that assures a full and complete, generally accepted accounting principles, of each resident's personal funds entrusted to the facility on the resident's behalf for one (#65) of one resident reviewed for personal funds out of 51 sample residents. Specifically, the facility failed to provide Resident #65 with a copy of her personal funds statement on at least a quarterly basis.

Inspectors wroteBased on record review and interviews, the facility failed to ensure one (#65) of six residents reviewed for abuse out of 51 sample residents was kept free from abuse. Specifically, the facility failed to protect Resident #65 from verbal abuse by Resident #60.

Inspectors wroteBased on observations, record review and interviews, the facility failed to provide necessary respiratory care and services consistent with professional standards of practice and the comprehensive person-centered care plan for two (#89 and #65) of three residents reviewed for respiratory care out of 51 sample residents. Specifically, the facility failed to:-Ensure that Resident #89 received oxygen therapy in accordance with his physician's orders; and,-Ensure Resident #65's BIPAP (bilevel positive airway pressure, a non-invasive ventilator used to treat breathing difficulties) equipment was maintained in a sanitary manner in accordance with physician's orders.

Inspectors wroteBased on observations, record reviews and interviews, the facility failed to ensure proper storage of medications for one of four medication carts and two of three medication storage rooms. Specifically, the facility failed to:-Discard medications that were expired; -Label an inhaler with the date it was opened;-Discard a vial of eye drops for a resident who had been discharged ; and,-Discard undated opened medication tuberculin PPD (purified protein derivative) from a medication storage refrigerator.

Inspectors wroteBased on interviews, record review and observations, the facility failed to ensure residents consistently receive food prepared by methods that conserved nutritive value, palatable in taste, texture and temperature. Specifically, the facility failed to ensure the residents' food was palatable in taste, texture and temperature.

Inspectors wroteBased on record review and interviews, the facility failed to ensure residents were free from abuse for one (#59) of two residents reviewed for abuse out of 35 sample residents. Specifically, the facility failed to: -Protect Resident #59 from sexual abuse by Resident #62; and, -Implement interventions for Resident #62 in order to prevent the abuse from occurring again.

Inspectors wroteBased on observations, record review and interviews, the facility failed to ensure it was free of a medication error rate of five percent (%) or greater. Specifically, the medication administration observation error rate was 6.25%, or two errors out of 32 opportunities for error.

Inspectors wroteBased on observations and interviews the facility failed to maintain an infection control program designed to provide a safe, sanitary and comfortable environment to help prevent the development and transmission of disease and infection. Specifically, the facility failed to: -Ensure dispensed medications were administered in a sanitary manner; -Ensure multiple use equipment was sanitized between residents; and, -Ensure environmental service staff followed appropriate hand hygiene practices, ensure high touch areas were cleaned daily.

Inspectors wroteBased on observations and interviews the facility failed to ensure residents had the right to a safe, clean and comfortable homelike environment for 14 of 24 out of 57 resident rooms. Specifically, the facility did not facilitate the necessary housekeeping and maintenance services to maintain the resident rooms to include rooms #E01, #E08, #E10, #E12, #E16, #W101, #W104, #W105, #W106, #W113, #28, #30, #31 and #32 in a sanitary, safe and comfortable manner.

Inspectors wroteBased on observations, record review and interview, the facility failed to ensure menus were followed to meet the resident's nutritional needs. Specifically, the facility failed to have menu extension for the finger food diet, and had repetitive food items for the lacto-ovo-vegetarian (excludes meat except eggs and dairy) diet.

Inspectors wroteBased on record review and interviews, the facility failed to implement policies and procedures related to pneumococcal immunizations for four (#26, #27, #41 and #42) of five residents reviewed for immunizations out of 37 sample residents. Specifically, the facility failed to provide the pneumococcal 23-valent polysaccharide vaccine (PPSV23) to Resident #26, #27, #41 and #42.

Inspectors wroteBased on the record review, observations and interviews, the facility failed to promote and maintain resident's dignity for one (#27) of three out of 37 sample residents. Specifically, the facility failed to ensure Resident #27 was offered her breakfast.

Inspectors wroteBased on record review and interviews, the facility failed to ensure the residents' right to make choices about aspects of their lives in the facility that were significant to them for two (#28 and #37) of four out of 37 sample residents. Specifically, the facility failed to provide consistent showers for Residents #28 and #37 according to their preferences and routine shower schedules.

Inspectors wroteBased on observations, record review and interviews the facility failed to ensure the medication error rate was less than five percent for two residents (#20 and #76). Specifically, the facility had a medication error rate of 9.68 percent, which was three errors out of 31 opportunities for error.

Inspectors wroteBased on observations, interviews and record review the facility failed to ensure one (#41) of one resident reviewed for dental care out of 37 sample residents received dental services timely. Specifically the facility failed to ensure Resident #41 had a referral sent to a dentist within three days of dentures missing.