Seacoast Nursing and Rehabilitation Center

Inspectors wroteBased on observations, record reviews and interviews, the facility failed to prevent a decline in range of motion leading to the development of a contracture for one Resident (#46) out of a total sample of 26 residents.

Inspectors wroteBased on observations, record reviews and interviews, the facility failed to ensure that one Resident (#96) was free from significant medication errors out of a total sample of 26 residents. Specifically, the facility failed to ensure medications were not administered when the Resident #96's blood pressure was not within the parameters prescribed by the physician.

Inspectors wroteBased on observation, interviews, and records reviewed the facility failed to establish and maintain an infection prevention and control program designed to provide a safe, sanitary and comfortable environment and to help prevent the development and transmission of communicable diseases and infections. Specifically, 1.) The facility failed to disinfect shared resident medical equipment and adhere to infection control guidelines during medication pass. 2.) For one Resident (#26) out of a total sample of 26 residents, the facility failed to implement Enhanced Barrier Precautions (EBP). Findings Include: Review of the facility policy titled 'Resident Care and Treatment- Diagnostic Testing Glucose Testing with Glucometer (Assure Platinum)', dated as revised September 2024, indicated: 14. Clean Assure Platinum according to manufacturer's guidelines. Meter shuts down after two minutes. [...]

Inspectors wroteBased on record reviews and interviews, the facility failed to ensure one Resident (#69) was free from unnecessary psychotropic medications by ensuring a reassessment of an as needed (PRN) dose of trazodone after 14 days, out of a total sample of 26 residents.

Inspectors wroteBased on observations, interviews, and record review, the facility to ensure that services provided met professional standards for one Resident (#43), out of 26 total sampled residents. Specifically, the facility failed to obtain and implement a physician's order for Resident #43's skin tear for approximately three days.

Inspectors wroteBased on observation, record review and interview, the facility failed to identify and address a significant weight loss for one Resident (#14) out of a total of 26 sampled residents.

Inspectors wroteBased on observation and interview the facility failed to store all drugs and biologicals in accordance with currently accepted professional principles on one of three units. Specifically, the facility failed to secure drugs and biologicals on one of three units during a medication pass when medication was left unattended at the nurse's station.

Inspectors wroteBased on observation, interviews, and record review, the facility failed to ensure that staff accommodated food preferences for one Resident (#65), out of a total sample of 26 residents. Specifically, the facility failed to honor Resident #65's preferences and served the Resident foods he/she disliked, including eggs, white bread, toast, and broccoli.

Inspectors wroteBased on record review and interview, the facility failed to document urinary output as ordered for one Resident (#93) out of a total sample of 26 residents.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure that one Resident (#9) did not self-administer medications out of a total sample of 23 residents. Specifically, Resident #9 was not assessed to be able to safely self administer medication, and was observed self administering medication.

Inspectors wroteBased on record reviews, observations and interviews, the facility failed to ensure resident centered care plans were implemented for two Residents (#36 and #59) out of a total sample of 23 residents. Specifically, 1. For Resident #36, the facility failed to implement thigh high TED hose (compression stockings) as ordered by the Physician. 2. For Resident #59, the facility failed to implement pressure relieving boots, as ordered by the Physician.

Inspectors wroteBased on observations, record review, policy review and interviews, the facility failed to provide assistance with Activities of Daily Living (ADLs), for one Resident (#59) out of a total sample of 23 residents. Specifically, the facility failed to provide assistance with meals as per the plan of care for Resident #59.

Inspectors wroteBased on observation, record review and interview the facility failed to ensure it was free from a medication error rate of greater than 5 percent. Three out of the four nurses observed made 6 errors in 32 opportunities resulting in a medication error rate of 18.75%. These errors impacted 3 Residents (#33, #69 and #316) out of 4 residents observed.

Inspectors wroteBased on observation, policy review, and interviews the facility 1) failed to ensure medications were stored in a safe manner and 2) failed ensure outdated needles were not stored and made available for use in 2 out of 2 medications rooms.

Inspectors wroteBased on observation, policy review and interviews the facility failed to ensure a call light was placed within reach of the resident for 1 Resident (#313), out of a total sample of 26 residents.

Inspectors wroteBased on observation, record review and interview the facility failed to ensure for one Resident (#54), out of a total sample of 26 residents that the medical plan of care was implemented for the use of a night guard.

Inspectors wroteBased on record review and interview the facility failed to ensure professional standards of practice for 1 discharged Resident (#112) out of three discharged records reviewed. Specifically, the facility failed to obtain a physician or nurse practitioner order for the RN (Registered Nurse) to provide the pronouncement of death.

Inspectors wroteBased on observations, record reviews and interviews, the facility failed to provide needed assist with Activities of Daily Living (ADLs) to 1 Resident (#13) out of a total sample of 26 Residents.

Inspectors wroteBased on record review and interview the facility failed to ensure for one Resident (#16) that professional standards of care were implemented out of a total sample of 26 residents. Specifically, the facility failed to 1. complete weekly skin assessments, in accordance with the medical plan of care, 2. failed to follow the physician's order related to documenting on a pressure injury, and 3. failed to complete weekly assessments of the identified pressure ulcer.

Inspectors wroteBased on record review and interview the facility failed to ensure professional standards of care for respiratory treatment for one Resident (#64) out of a total sample of 26 residents. Specifically, the facility failed to develop and implement a care plan for nebulizer equipment and failed to change the nebulizer mask and tubing timely.

Inspectors wroteBased on record review and interview the facility failed to ensure laboratory results were obtained and the results were reported to the medical provider for 1 Resident (#73) out of a total sample of 26 residents.