Sterling Nursing and Rehab

Inspectors wroteBased on observation, interview, and record review, the facility failed to maintain an infection prevention and control program designed to provide a safe, sanitary and comfortable environment to help prevent the development and transmission of communicable diseases and infections for 1 of 2 residents (Resident #2) reviewed for infection control, 26 of 26 cans of foam hand sanitizer reviewed for expiration dates and 2 of 2 bottles of gel hand sanitizer reviewed for expiration dates. CNA A failed to change her gloves after they became contaminated during incontinent care while assisting Resident #2. The facility failed to prevent the use of expired alcohol-based hand sanitizer (foam and gel). These failures could place residents at risk for cross contamination and the spread of infection.

Inspectors wroteBased on observation and interview, the facility failed to maintain all mechanical, electrical, and patient care equipment in safe operating condition for 1 of 1 kitchen reviewed for physical environment. The facility failed to ensure the dishwasher met manufacturer's recommendation of 120 degrees Fahrenheit for the wash and sanitize cycle. This failure could place residents at risk of foodborne illnesses and residents and staff.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure that a resident who needs respiratory care was provided such care, consistent with professional standards of practice for 2 (Resident #9 and Resident #12) of 6 residents observed for oxygen management. The facility failed to ensure oxygen in use signage was on Resident #9's and Resident #12's doorway. This failure could place residents at risk of hazards such as explosions which could lead to physical harm.

Inspectors wroteBased on observation, interviews, and record reviews, the facility failed to ensure food was prepared in a form designed to meet individual needs for two of five residents (Residents #5 and #11) reviewed for food meeting residents' needs, in that: Resident #5 did not receive a puree diet (a diet consistency of highly blended food) as recommended by the physician. Resident #11 did not receive a puree diet as recommended by the physician. This deficient practice could place residents at risk of choking, poor intake, and/or weight loss.

Inspectors wroteBased on observations, interviews, and record reviews the facility failed to store, prepare, distribute, and serve food in accordance with professional standards for food service safety for 1 of 1 kitchen reviewed. The facility failed to use pasteurized eggs for fried eggs for the residents. The facility failed to ensure temperatures of the mechanically altered diets were checked for safe holding temperatures. The facility failed to take out sweet potatoes in the dry storage when they were beginning to show signs of rot. The facility failed to keep the freezer clean, the freezer floor had food particles and debris. The facility failed to store dishes in a manner to prevent contamination, dishes were stored face-up. Facility staff failed to wear effective hair restraints. [...]

Inspectors wroteBased on interviews and record review, the facility failed to develop and implement a comprehensive, person-centered care plan for each resident that included measurable objectives and time frames to meet, attain, and/or maintain the resident's highest practicable physical, mental, and psychosocial well-being for 2 of 12 residents (Resident #22 and #6) reviewed for care plans. 1. The facility failed to have a care plan in place to accurately address Resident #6's oxygen use. 2. The facility failed to have a care plan in place to accurately address Resident #22's ¼ side rail use. This failure could affect residents by placing them at risk of not receiving individualized care and services to meet their needs.

Inspectors wroteBased on observations, interviews, and record review, the facility failed to maintain an infection prevention and control program designed to provide a safe, sanitary, and comfortable environment to help prevent the development and transmission of communicable diseases and infections for 3 (Resident #1, #12 and #28) of 4 residents reviewed for infection control practices. LVN A failed clean and sanitize the glucometer (portable device that measure blood glucose levels) with the appropriate sanitizing wipes while checking Resident #1 and Resident #12's blood sugar. RN D failed to wash or sanitize her hands in between glove changes during wound care for Resident #28. This failure could affect the residents by placing them at risk for the spread of infection.

Inspectors wroteBased on observations, interviews, and record review the facility failed to attempt to use appropriate alternatives prior to installing a side or bed rail, assess the resident for risk of entrapment from bed rails prior to installation, and review the risks and benefits of bed rails with the resident or resident representative and obtain informed consent prior to installation for 1 of 4 (Resident #22) residents reviewed for bed rails. Resident #22 had two quarter-rail bed rails on her bed with no documentation of resident consent, physician orders, and no care plan prior to installation. This failure could place residents at risk of injury, hinder residents from getting out of bed, and/or cause a decline in resident's ability to engage in activities of daily living.

Inspectors wroteBased on observation, interview, and record review the facility failed to ensure adequate supervision and assistance devices was provided for 2 of 4 residents reviewed for transfers and accidents (Resident #20 and #23). The facility failed to ensure that Resident #23 had foot pedals on her wheelchair after demonstration she was unable to hold her feet up resulting in a possible fracture/ sprain. CNA C, NA G, and CNA H transferred Resident # 20 and Resident #23 by hooking their arms under the resident's armpits . This deficient practice has the potential to affect residents in the building who required extensive assistance which could result in residents having pain, falls or injuries including lacerations and fractures.

Inspectors wroteBased on observation, interview and record review, the facility failed to store, prepare, distribute and serve food in accordance with professional standards in the facility's only kitchen. The facility failed to ensure the dishwasher machine dispensed the correct amount of chlorine sanitizer. This failure could place residents who receive food prepared in the facility kitchen at increased risk of exposure to food-borne illnesses.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure the 3 of 6 nurse aides were able to demonstrate competency in skills and techniques necessary to care for residents' needs as identified through residents' assessments, and described in the care plan for two of four residents (Resident #20 and Resident #23) reviewed for transfers, in that: CNA H and NA G hooked their arms under Resident #20 while transferring the resident. CNA C hooked her arms under Resident #23's arms while transferring the resident. This failure could affect residents who required assistance with transfers by placing them at risk for discomfort, pain and or injury.

Inspectors wroteBased on observation, interview and record review the facility failed to maintain an infection control program designed to prevent the development and transmission of infections for 5 of 7 (Residents #2, #7, #9, #18, and #21) reviewed for infection control. The facility failed to ensure: Resident #7, #9, #18, and #21's small volume nebulizer (SVN) masks were bagged when not in use. LVN B washed her hands prior to putting gloves on and changing them once they were used to provide care for Resident #2. Resident #7, #9, #18, and #21 oxygen tubing was bagged when not in use. These failures could place resident's risk for cross contamination and the spread of infection.

Inspectors wroteBased on observation, interview and record review the facility failed to ensure resident rooms were designed or equipped to assure full visual privacy for each resident, in that three rooms did not provide full visual privacy . Resident #8 had a track for privacy curtains, but no privacy curtains in place. Residents #6 and #29 had a privacy curtain between beds, but the curtains at the foot of the beds did not go all the way across. Residents # 12 and #24 had a privacy curtain between beds, but no privacy curtain at the foot of the beds. This failure could affect residents by placing them at risk for loss of privacy and dignity.