Smp Health - Maryhill

Inspectors wroteBased on observation, record review, review of facility policy, and staff interview, the facility failed to provide adequate supervision and assistive devices necessary to ensure safety for 2 of 4 sampled residents (Resident #2 and #9) observed during transfers and ambulation. Failure to utilize gait belts and the required staff assistance placed the residents at risk for accidents and/or injury.

Inspectors wroteBased on observation, record review, review of facility policy, and staff interview, the facility failed to follow standards of infection control and prevention for 3 of 4 sampled residents (Resident #2, #27, and #28) observed during cares. Failure to practice infection control standards during personal cares has the potential to spread infection throughout the facility.

Inspectors wroteBased on observation, review of facility policy, review of manufacturer's instructions, and staff interview, the facility failed to sanitize surfaces in 1 of 1 facility dining room. Failure to ensure the concentration of quaternary (quat) sanitizing solution is within manufacturer's guidelines may result in an incorrect solution concentration, inadequate sanitization of dining room surfaces, and places residents at risk for foodborne illness.

Inspectors wroteBased on record review and staff interview, the facility failed to comply with the North Dakota Administrative Code (NDAC), Chapter 33-43-01-20 Medication assistant I and II initial registration and renewal for 1 of 1 staff member (#4) administering medications to residents as a medication assistant (MA). Failure to ensure qualified staff administered medication increases the risk for adverse consequences.

Inspectors wroteBased on observation, review of facility policy, record review, and staff interview, the facility failed to ensure the competency of nursing staff for 1 of 1 nursing staff (#7) observed during insulin administration (#143) . Failure to provide a meal or juice with in 5-10 minutes after administering short acting insulin, administering insulin to a nonarousable resident, and failure to notify a nurse of a resident's altered status may result in harm to facility residents. During the standard survey, the team determined an Immediate Jeopardy (IJ) situation existed on 10/03/23 at 2:00 p.m. The IJ resulted from a medication aide administering short acting insulin to a resident not alert enough to consume food thus, putting the resident at risk for a reaction from low blood sugar. [...]

Inspectors wroteBased on observation, record review, review of facility policy, and resident, family, and staff interviews, the facility failed to assess, develop, and implement interventions to promote dignity for 1 of 1 sampled resident (Resident #3) with concerns regarding toileting/incontinence. Failure to determine appropriate toileting methods caused Resident #3 embarrassment and/or psychosocial harm.

Inspectors wroteBased on record review, review of facility policy, and staff interview, the facility failed to notify the resident's physician of a change in condition for 1 of 1 sampled resident (Resident #3) who experienced a change in bowel status. Failure to notify the physician of these changes may have prevented the physician from altering the treatment/care provided to the resident.

Inspectors wroteBased on record review, review of facility policy, and staff interview, the facility failed to review and revise comprehensive care plans to reflect the residents' current status for 3 of 15 sampled residents (Resident #9, #12, and #35). Failure to review and revise the care plan limited staffs' ability to communicate needs and ensure continuity of care.

Inspectors wroteBased on observation, review of facility policy, review of professional reference, and staff interview, the facility failed to follow professional standards of practice regarding medication administration and monitoring blood sugars for 1 of 2 sampled residents (Resident #143) and 1 supplemental resident (Resident #8) observed during medication pass. Failure to ensure the resident eats within 5-10 minutes of receiving a rapid acting insulin and failure to monitor blood sugars per physician orders may result in a hypoglycemic reaction (low blood sugar), diabetic coma and/death and failure to ensure residents receive the correct medications may result in serious adverse health effects.

Inspectors wroteBased on observation, review of facility policy, and staff interview, the facility failed to provide adequate supervision and assistive devices necessary to prevent accidents for 2 of 6 sampled residents (Resident #12 and #143) observed during a gait belt transfers. Failure to use a gait belt during transfers placed the residents at risk of accidents and injury.

Inspectors wroteBased on observation, record review, and resident, family, and staff interviews, the facility failed to provide appropriate services and assistance to maintain bowel/bladder continence for 1 of 6 sampled residents (Resident #3) observed during toileting/incontinence care. Failure to provide toileting assistance may result in unnecessary incontinence, a loss of dignity, and avoidable skin issues.

Inspectors wroteBased on observation, record review, review of facility policy, and staff interviews, the facility failed to provide respiratory care consistent with professional standards of practice for 2 of 4 sampled residents (Resident #23 and #143) receiving oxygen by nasal cannula. Failure to administer oxygen according to the physician's order may result in complications and compromise the residents' respiratory status.

Inspectors wroteBased on observation, review of facility policy, and staff interview, the facility failed to follow standards of infection control for 2 of 6 sampled residents (Resident #3 and #18) observed during personal cares. Failure to practice infection control standards related to hand hygiene has the potential to spread infection throughout the facility.

Inspectors wroteBased on observation and staff interview, the facility failed to post complete and accurate daily staff information for 3 of 4 days of survey (October 02-04, 2023). Failure to post accurate staffing data does not allow residents and visitors knowledge of the number of licensed and unlicensed staff on duty each shift.