The Springs Magnolia

Inspectors wroteBased on observations, interviews, record review, facility document review, facility policy review, it was determined that the facility failed to provide the appropriate treatment with enteral nutrition for one (Resident #11) of one resident reviewed for Medication Administration through a Percutaneous feeding tube (PEG). Based on observations, record review, interviews, and facility policy review, the facility failed to provide the appropriate services and treatment to prevent complications for one (Resident #11) of one resident reviewed for medication administration through a percutaneous endoscopic gastrostomy (PEG) tube.

Inspectors wroteBased on observation, record review, interviews, and facility policy review, it was determined the facility did not ensure incontinence care was provided in a manner that promoted cleanliness, prevented odor, and/or infections for one (Resident #1) of one resident, observed for incontinence care technique and hygiene care.

Inspectors wroteBased on observation, interview, record review, and facility policy review, it was determined the facility did not ensure proper hand hygiene and infection control procedures were used while incontinence care was being provided to one (Resident #1) of one resident observed for incontinence care technique and hygiene care.

Inspectors wroteBased on observation, record review, and interview, the facility failed to ensure 2 (Residents #23 and #49) did not have medications stored at the bedside.

Inspectors wroteBased on observation, record review and interview, the facility failed to ensure canned goods were dent free and cleaning supplies were not setting on the puree prep table while food was being prepared.

Inspectors wroteBased on observations, interviews, and facility policy review, the facility failed to notify the proper state authority when they became aware of a new diagnosis of mental illness for 1 (Resident #53) sampled Resident.

Inspectors wroteBased on observation, interviews, and facility policy review, the facility failed to ensure the treatment cart used to store medication was locked when unattended by staff.

Inspectors wroteBased on observation, record review and interview, the facility failed to ensure staff provided proper hand hygiene while providing incontinent care to 1 (Resident #61) to prevent the risk of cross contamination.

Inspectors wroteBased on observation, interview and record review, the facility failed to follow a Resident ' s care plan concerning transfer, resulting in a fall for one (Resident (R) #1) of three (R #1, #2 and #3) sampled residents.

Inspectors wroteBased on interview and record review, the facility failed to ensure receipts were filed for charges imposed by the facility for 6 (Residents #1, #5, #6, #7, #8 and #9) of 6 case mix residents.

Inspectors wroteBased on an interview and record review, the facility failed to thoroughly investigate for misappropriation of funds for 6 (Residents #1, #5, #6, #7, #8 and #9) of 6 case mix residents after the facility's Business Office Manager was identified as stealing funds from resident accounts.

Inspectors wroteBased on observation and interview, the facility failed to ensure food items stored in the refrigerator were covered and dated, dietary staff washed their hands when contaminated to decrease the potential for food borne illness for residents receiving food from 1 of 1 kitchen, 2 of 2 ice machine were maintained in a clean and sanitary condition and dietary staff washed their hands before handling clean equipment or food items to prevent potential food borne illness for residents who received meals from 1 of 1 kitchen. The failed practices had the potential to affect 71 residents who received meals from the kitchen (total census: 72) as documented on a list provided by the Dietary Supervisor on 06/06/23 at 8:00 AM.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure water was accessible and provided based on physician orders for 1 (Resident #10) of 2 (#10 and #63) sampled residents. This failed practice had the potential to affect 2 residents who are on Therapeutic Orders for hydration according to a list provided by the Administrator on 06/08/23 at 9:14 AM.

Inspectors wroteBased on observation, record review, and interview, the facility failed to ensure posting of cautionary and safety signs for resident rooms indicating the use of oxygen in the facility for 2 (Residents #3 and #33) of 4 (#3, #33, #38 and #60) sampled residents who use oxygen, as documented on lists provided by the Director of Nursing (DON) on 06/07/23 at 3:26 PM.

Inspectors wroteBased on observation and interview, the facility failed to ensure the narcotics that had been discontinued were properly stored and locked in a permanently affixed compartment prior to being sent back to the state for destruction. The failed practice has the potential to affect all ambulatory residents in the facility. a. On 06/08/23 the Surveyor asked the Director of Nursing (DON), Where do you store the discontinued narcotics before returning them to the State? She reached under her desk and pulled a paste board box out and handed it to the Surveyor. Inside the box was a bottle of clear liquid labeled Hydrocodone 7.5mg/325mg (milligrams) with a resident's name on it. There were 5 ounces of liquid in the bottle. The Surveyor asked, Do you have a cabinet, safe or file cabinet to store the narcotics in before they are sent in? The DON stated, No. [...]

Inspectors wroteBased on observation, record review, and interview, the facility failed to ensure meals were prepared and served according to the planned written menu to meet the nutritional needs of the residents for 1 of 1 meal observed. This failed practice had the potential to affect 12 residents who received mechanical soft diets, and 6 residents who received pureed diets from the kitchen according to a list provided by the Dietary Supervisor on 06/06/23.

Inspectors wroteBased on observation and interview, the facility failed to ensure the pureed food items were blended to a smooth, lump free consistency to minimize the risk of choking or other complications for residents who required pureed diets for 1 of 1 meal observed. The failed practice had the potential to affect 6 residents who received pureed diets as documented on the list provided by the Food Service Supervisor on 06/06/23.

Inspectors wroteBased on observation, record review, and interview, the facility failed to ensure that the call light system on the 200 Hall was functioning properly for 1 resident (Resident #54) of 3 (#6, #54 and #62) sampled residents who were able to use a call light indicated by a list provided by the Administrator on 06/08/23 at 9:14 AM. This failed practice had the potential to affect 14 residents who reside in 200 Hall.

Inspectors wroteBased on record review and interview, the facility failed to ensure advanced directive information was accurately documented in the medical record to ensure the resident's wishes would be carried out in the event of cardiopulmonary arrest for 1 resident (Resident #30) of 3 (#30, #31 and #224) sampled residents that were admitted in the last 3 months and had signed a document stating Do Not Resuscitate (DNR). This failed practice had the potential to affect all 6 residents in the facility as documented on list provided by Director of Nursing (DON) on [DATE] at 3:26 PM.