Talladega Healthcare Center, Inc

Inspectors wroteBased on observations, interviews and review of facility policies, titled Sanitation: Food Handling, Nourishment Room Refrigerators and Personal Cleanliness and Standards for Sanitation, the facility failed to ensure: 1. food in the kitchen cooler/freezer was labeled with an open and use by date; 2. kitchen in staff wore head coverings This had the potential to affect 184 of 184 residents who received meals from the kitchen.

Inspectors wroteBased on interview, record review and a review of the, Centers for Medicare & Medicaid Services Long- Term Care Facility Resident Assessment Instrument 3.0 User's Manual, the facility failed to ensure RI (Resident Identifier)'s #2 and #3's discharge MDS (Minimum Data Set) assessment was transmitted to CMS within 14 days of the discharge date . This deficient practice affected two out 35 sampled residents whose MDS's were reviewed. Findings Include: A review of the Centers for Medicare & Medicaid Services Long-Term Care Facility Resident Assessment Instrument 3.0 User's Manual, dated October 2019 revealed: '' .09. Discharge Assessment-Return Not Anticipated .Must be submitted within 14 days after the MDS completed date . RI #2 was admitted to the facility on [DATE] and discharged on 10/08/21. A review of RI #2's MDS's revealed: .10/08/21 (D) Close . [...]

Inspectors wroteBased on observation, interviews and review of a facility policy, titled Food Storage, the facility failed to ensure expired canned goods were removed from the dry storage area. This had the potential to affect 168 residents receiving meals from the kitchen. Findings Include: 1. A review of a facility policy undated titled Food Storage revealed .11. All expired food and food products should be discarded . 12. Left over foods are labeled and dated. These are used within 72 hours. On 7/29/19 at 3:44 p.m., during the initial kitchen tour, the dry storage area was observed as having nine cans of chicken noodle soup 50 ounce(oz) size all with an expiration date [DATE]. A pan labeled dressing, with a used by date 7/24/19, was also observed in the freezer/cooler. On 8/01/19 at 9:30 a.m., the surveyor conducted an interview with Employee Identifier (EI) #4, Dietary Manager. [...]

Inspectors wroteBased upon observation, interviews and review of a facility policy titled, Respiratory Therapy Equipment, the facility failed to ensure that a resident's mask for breathing treatments was contained in a plastic bag. This affected Resident Identifier (RI) # 118, one of four sampled residents receiving breathing treatments. Findings Include: A review of a facility policy titled, Respiratory Therapy Equipment with no date, revealed: . Medication Nebulizers/Continuous Aerosol: . 7. Store circuit in plastic bag, marked with date and resident's name, between uses . RI # 118 was admitted to the facility on [DATE] with a diagnosis of chronic obstructive pulmonary disease. A physician order for RI #118, dated 8/22/18, revealed the order for Iprat-Albut 0.5-3(2.5) milligram (mg) /3 milliliters (mls) give 3 mls per nebulization every 6 hours. [...]

Inspectors wroteBased on observation, interviews, record review and review of a facility document titled The Medication Pass, the facility failed to ensure a nurse did not administer the wrong dose of Metformin to Resident Identifier (RI) #85. This affected one out of 27 medication opportunities observed.

Inspectors wroteBased on observations, interviews and a facility's policy titled, General Procedures for Medication Administration the facility failed to ensure: 1. another licensed staff did not leave medication out, unattended and out of the licensed staff view and 2. another licensed staff member did not leave the medication cart unlocked, unattended and out of the licensed staff member's view. These deficient practices affected two of the five nurses observed during medication pass.

Inspectors wroteBased on observation, interview and review of a facility policy titled Hand Hygiene, the facility failed to ensure a Certified Nursing Assistant (CNA) did not remove her gloves during peri-care, wash her hands and use paper towels to dry hands. This deficient practice affected Resident Identifier (RI) #25, one of one resident observed for pericare. Finding Include: A facility policy titled Hand Hygiene dated November 28th, 2017 revealed, Appropriate hand hygiene must be performed under the following conditions: .15 After removing personal protective equipment. RI #25 was admitted to the facility on [DATE] and readmitted on [DATE]. Diagnoses included, but not limited to, Chronic Obstructive Pulmonary Disease, Urinary Tract Infection, and Chronic Pain. On 7/31/19 at 9:14 a.m., peri-care was observed with Employee Identifier (EI) #3, Certified Nursing Assistant (CNA). [...]

Inspectors wroteBased on observations, interviews, record review, and a review of the facility's policy titled, . ADMINISTRATION OF MEDICATION VIA NASOGASTRIC OR GASTROSTOMY TUBE . the facility failed to ensure Resident Identifier (RI) #183's enteral feeding was infusing at 60 ml/hr as ordered by the physician. This affected one of three sampled residents observed for tube feeding. Findings Include: A review of the facility's policy titled, . ADMINISTRATION OF MEDICATION VIA NASOGASTRIC OR GASTROSTOMY TUBE POLICY: Medications are administered appropriately and safely when the resident has a Nasogastric tube or Gastrostomy tube. Medication is administered, as ordered by a physician, . A review of RI #183's medical record showed a physician's order written on 5/26/18 revealed: GLUCERNIA 1.5 DIET. GIVE GLUCERNIA 1.5 at 60 ML/HR X22 HR PER FEEDING TUBE. [...]

Inspectors wroteBased on observations, interviews, medical record review, and a review of [NAME] AND PERRY's, FUNDAMENTALS OF NURSING the facility failed to ensure a licensed nurse washed her hands and changed her gloves after cleaning one wound and before cleaning the second wound, and further failed to use a separate cotton tipped applicator to apply gel to each wound while performing wound care on Resident Identifier (RI) #187. This affected one of two sampled residents observed for wound care. Findings Include: A review of [NAME] and Perry's, FUNDAMENTALS OF NURSING, NINTH EDITION, PAGE 459, TABLE 29-6 revealed: Centers for Disease Control and Prevention Isolation Guidelines Standard Precautions . [...]