Senior Care of Marion

Inspectors wroteBased on review of the facility policy, record review and interview, the facility failed to ensure Resident (R)1 was free from verbal abuse, for 1 of 1 resident reviewed for verbal abuse. Specifically, Licensed Practical Nurse (LPN)1, used curse words directed at R1 when R1 refused to take her medications.

Inspectors wroteBased on review of facility policy, record review and interview, the facility failed to report an allegation of verbal abuse within the 2 hour reporting timeframe for an altercation between Resident (R)1 and Licensed Practical Nurse (LPN)1 for 1 of 3 residents reviewed for abuse.

Inspectors wroteBased on review of facility policy, observation and interview, the facility failed to follow Enhanced Barrier Precautions (EBP) while providing care for Resident (R)4 for 1 of 1 resident observed receiving care while on EBP. The facility further failed to follow infection control protocols and procedures during laundry services in 1 of 1 laundry rooms.

Inspectors wroteBased on review of facility policy, observation and interview, the facility failed to check the placement of a feeding tube for Resident (R)23 prior to flushing the feeding tube with 60 milliliters of water for 1 of 1 residents observed with a feeding tube. Review of the undated facility policy titled Medication Administration via Enteral Tube revealed, It is the policy of this facility to ensure the safe and effective administration of medications via enteral feeding tubes by utilizing best practice guidelines . Policy Explanation and Compliance Guidelines: . 8. Enteral tube placement must be verified prior to administering any fluids or medication. [...]

Inspectors wroteBased on review of the facility policy, record reviews and interviews, the facility failed to provide sufficient preparation and orientation to a resident to ensure safe and orderly discharge from the facility, for 1 of 3 residents. Specifically, Resident (CR)1 was transported and discharged from the facility on 01/23/24 to the local social security office. On 02/02/24 at 10:02 AM, the Administrator was notified that the failure to provide Resident (CR)1 with a safe discharge constituted Immediate Jeopardy (IJ) at F624. On 02/02/24 art 10:02 AM, the survey team provided the Administrator with a copy of the CMS Immediate Jeopardy Template and informed the facility IJ existed as of 01/23/24. The IJ was related to 42 CFR 483.15 - Admission, Transfer, and Discharge. On 02/02/24 at 3:53 PM, the facility provided an acceptable IJ Removal Plan. [...]

Inspectors wroteBased on observations, interviews and review of facility policies, the facility failed to store, prepare and serve foods under sanitary conditions in 1 of 1 main kitchen. This failure had the potential to increase the spread of foodborne illness to all residents. Findings Include: Review of the undated facility policy titled Food Storage, under the section Canned Foods, revealed, Dented or bulging cans shall be placed on damaged goods shelf and returned for credit. Review of the facility policy titled Serving Utensils dated 08/2018 revealed, Standard serving utensils will be used for serving appropriate products. Review of the undated facility policy titled Hand Washing and Glove Use, revealed, Guidelines for hand washing and glove use to promote safe and sanitary conditions throughout the department. Section 2 Handwashing Procedure: Hands must be washed prior . [...]

Inspectors wroteBased on observations, interviews, and review of facility policy, the facility failed to ensure kitchen staff maintained appropriate infection control measures for the safe handling of foods in 1 of 1 main kitchen. This failure had the potential to increase the spread of foodborne illness to all residents, due to cross contamination. Findings Include: Review of the facility policy titled Serving Utensils dated 08/2018 revealed, Standard serving utensils will be used for serving appropriate products. Review of the undated facility policy titled, Hand Washing and Glove Use, revealed, Guidelines for hand washing and glove use to promote safe and sanitary conditions throughout the department. Section 2 Handwashing Procedure: Hands must be washed prior . working with different food substances i.e. raw chicken to fresh fruit, following contact with any unsanitary surface i.e. [...]

Inspectors wroteBased on record reviews, interviews and review of the facility policy titled, Promoting/Maintaining Resident Dignity, the facility failed to ensure resident's call bells were answered timely for Resident (R)127, for 1 of 2 residents reviewed for call bells not being answered timely.

Inspectors wroteBased on record review, interviews and review of the facility weight policy, the facility failed to follow the physician orders and facility policy regarding accurate and timely recordings of weights for Resident (R)24, R26 and R7 in order to collaborate care with the residents physician and the Registered Dietitian for 3 of 3 residents reviewed for Nutrition.

Inspectors wroteBased on record reviews, interviews, and review of the facility policy titled, Notification of Changes, the facility failed to notify the attending physician and the personal representative of a significant weight loss for Resident (R)7 and R26, for 2 of 3 residents reviewed for nutrition.

Inspectors wroteBased on record reviews and interviews, the facility failed to ensure the Comprehensive Plan of Care was reviewed and revised with interventions to prevent weight loss and or decrease further weight loss for Resident #26 and Resident #7 for 2 of 3 residents reviewed for Nutrition.

Inspectors wroteBased on observations, review of medical records, interviews and review of the facility policy titled, Wound Treatment Guidelines, the facility failed to ensure a procedure was followed during wound care to prevent infection and to promote wound healing for Resident (R)7. Specifically, Licensed Practical Nurse (LPN) #1 failed to clean scissors before use, during a dressing change for R7 for 1 of 1 residents reviewed for wound care.

Inspectors wroteBased on record reviews, interviews, and review of the facility policy titled Weight Prevention, the facility failed to monitor weights and to ensure interventions were put into place to prevent further weight loss or to decrease weight loss for Resident (R)26 and R7 for 2 of 3 residents reviewed for nutrition.

Inspectors wroteBased on interviews, record reviews, review of facility policy titled, Unnecessary Drugs - Without Adequate Indication for Use, the facility failed to ensure Resident (R)179 was free from an unnecessary medication, Seroquel, an antipsychotic medication for 1 of 5 residents reviewed for Unnecessary Medications. Findings Include: Review of the undated facility policy titled, Unnecessary Drugs - Without Adequate Indication for Use revealed, It is the facility's policy that each resident's drug regimen is managed and monitored to promote or maintain the resident's highest practicable mental, physical, and psychosocial well-being . 2. The attending physician will assume leadership in medication management . taking into consideration the following elements: a. Dose b. Duration of use c. Indications and clinical need for medication. 3. [...]

Inspectors wroteBased on observations, interviews, and review of the facility policy titled, Dryer Vents/Lint Check, the facility failed to remove an excessive amount of lint built up on the wiring above the lint basket and the inside upper three sides of 1 of 1 clothes dryers