The Springs of Greers Ferry

Inspectors wroteBased on observation, interview, and facility policy review, the facility failed to ensure kitchen ceiling tiles were cleaned to provide a sanitary environment for food preparation; and the ice machine on the 400 Hall was maintained in a clean and sanitary condition to prevent food and beverage contamination in 1 of 1 kitchen; expired food items were promptly removed/discarded on or before the expiration or use by date to prevent the growth of bacteria; leftover food items were used in a manner to maintain food quality; 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. These failed practices had the potential to affect 82 residents who received meals from the kitchen (total census:82), as documented on a list provided by the Dietary Manager on 8/12/2024.

Inspectors wroteBased on observation, record review, and interview the facility failed to ensure dignity was maintained during lunch service in the dining room as evidenced by staff members not sitting with residents to help them with lunch for two sampled residents, (Resident #45 and Resident #70).

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 8 residents who received regular diets from 1 of 1 kitchen according to a list provided by the Dietary Manager on 8/12/24.

Inspectors wroteBased on observation, and interview, the facility failed to ensure pureed food items were blended to a smooth, lump free consistency to minimize the risk of choking or other complications for those residents who required pureed diets for 2 of 2 meals observed. The failed practice had the potential to affect 8 residents who received pureed diets.

Inspectors wroteBased on record review, observations, and interviews, the facility failed to ensure infection control measures, including hand hygiene were implemented during tracheostomy care for 1 (Resident #9) of 1 sampled resident to prevent potential infection and or the spread of infections.

Inspectors wroteBased on observation, record review, and interview, the facility failed to ensure the menu card was followed to accommodate one (Resident #61) sampled resident.

Inspectors wroteBased on observation, record review, and interview, the facility failed to ensure foods stored in the freezer and refrigerator were covered, sealed and dated to minimize the potential for food borne illness for residents who received meals from 1 of 1 kitchen; and expired food items were promptly removed from stock to prevent potential food borne illness for residents who received meals from 1 of 1 kitchen; dietary staff washed their hands and changed gloves before handling food items to prevent the potential for cross contamination for residents who received meals from 1 of 1 kitchen. These failed practices had the potential to affect 67 residents who received meals from the Kitchen (Total Census: 67), according to the list provided by the Dietary Supervisor on 07/04/23 a PM.

Inspectors wroteBased on observation, record review, and interview, the facility failed to ensure facial hair was removed regularly to maintain good grooming for 1 (Resident #63) of 20 (Residents #1, #6, #7, #10, #11, #25, #30, #31, #33, #39, #40, #47, #49, #55, #59, #60, #63, #64, #66 and #67) sampled residents who were dependent on staff for shaving and failed to ensure fingernails were regularly trimmed when needed to maintain good grooming for 2 (Residents #11 and #63) of 30 (Residents #1, #6, #7, #10, #11, #12, #18, #22, #25, #26, #30, #31, #32, #33, #36, #38, #39, #40, #47, #49, #55, #58, #59, #60, #61, #63, #64, #66, #67 and #321) sampled residents who were dependent on staff for nail care.

Inspectors wroteBased on observation and interview, the facility failed to ensure 2 of 2 clothes dryers remained free of lint build-up to decrease the potential for fire and loss of laundry services for 1 of 1 laundry room. This failed practice had the potential to affect all 67 residents due to the potential for the interruption of laundry services and the potential for fire due to the proximity of the laundry room according to the Resident Census and Conditions of Residents form dated 07/03/23.

Inspectors wroteBased on observation, record review and interview, the facility failed to ensure sufficient qualified nursing staff were available at all times to provide nursing and related services to meet the residents' needs safely. This failed practice had the potential to affect 67 residents who resided in the facility according to the Census and Conditions of Residents provided by the Administrator on 07/03/23.

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 4 residents who received pureed diets and 12 residents who received mechanical soft diets (total census: 67) according to a list provided by the Dietary Supervisor on 07/03/23.

Inspectors wroteBased on record review and interview, the facility failed to develop and implement procedures to ensure the resident's medical record included documentation the resident either received the pneumococcal and influenza vaccine(s) or did not receive the vaccine(s) due to medical contraindications, previous vaccination, or refusal for 2 (Residents #64 and #67) of 5 (Residents #1, #36, #64, #66 and #67) sampled residents.

Inspectors wroteBased on observation, record review, and interview, the facility failed to ensure an indwelling urinary catheter drainage bag was concealed in a privacy bag when visible from open door to room and when in common areas to promote dignity and maintain privacy for 1 (Resident # 63) of 5 (Residents #11, #25, #36, #55, and #63) sampled residents who had an indwelling urinary catheter. This failed practice had the potential to affect 6 residents who had indwelling urinary catheters as documented on list provided by the Director of Nursing (DON) on 07/04/23 at 2:40 PM.

Inspectors wroteBased on record review and interview, the facility failed to develop and implement a Chronic Viral Hepatitis C plan of care for 1 (Resident #47) of 2 (Residents #18 and #47) sampled residents who had a diagnosis of Chronic Viral Hepatitis C as documented on a list provided by the Administrator on 07/05/23 at 3:40 PM.