The Woodleigh of Baton Rouge

Inspectors wroteBased on interview and record review, the facility failed to ensure an allegation of abuse was reported to the State Agency, within two hours for 1 (#R1) of 5 (#1, #2, #3, #4, and #R1) residents investigated for abuse.

Inspectors wroteBased on observations, interviews and record review, the facility failed to ensure a resident's call light was within reach for 1 (#34) of 34 residents reviewed during the initial pool.

Inspectors wroteBased on record reviews and interviews, the facility failed to ensure all medical records regarding the resident's code status reflected the resident's wishes for 2 (#67 and #78) of 34 residents reviewed in the initial screening for advance directives. This deficient practice had the potential to affect 103 that resided in the facility.

Inspectors wroteBased on observations, interviews, and record reviews, the facility failed to ensure services were provided by the facility to meet quality professional standards. The facility failed to ensure medications were stored safely and were kept locked by leaving medication at the bedside for 1 (#341) of 33 residents observed during the initial screening of residents upon facility entrance.

Inspectors wroteBased on observations, interviews, and record review, the facility failed to provide necessary care and services for the provision of respiratory care in accordance with professional standards. The facility failed to ensure oxygen tubing was properly labeled for 1 (#342) of 5 (#65, #77, #84, #341, and #342) residents reviewed for oxygen therapy.

Inspectors wroteBased on observations, interviews, and record review, the facility failed to ensure medications were stored and labeled properly in accordance with current accepted professional principles. The facility failed to ensure: 1. An expired medication was not available for use for Resident #54 in 1 (Cart B) of 2 carts (Cart A and Cart B) reviewed; and 2. An opened medication was labeled with an open date and not available for use in 1 (Cart B) of 2 carts (Cart A and Cart B) reviewed.

Inspectors wroteBased on observations and interviews, the facility failed to ensure garbage and waste were properly contained in the outdoor trash dumpster.

Inspectors wroteBased on observations, interviews and record review, the facility failed to maintain an infection prevention and control program designed to provide a safe and sanitary environment to help prevent the development and transmission of infection. The facility failed to ensure S12LPN wore proper Personal Protective Equipment (PPE) while providing urinary catheter care for 1 (#67) of 2 (#13 and #67) residents with indwelling medical devices.

Inspectors wroteBased on observations, interviews and record reviews, the facility failed to ensure the resident assessments accurately reflected the resident's status. The facility failed to ensure staff accurately coded the assistance required for eating for 1(#1) of 4 (#1, #2, #3, and #4) sampled residents.

Inspectors wroteBased on interviews, and record review, the facility failed to ensure that a resident that was frequently incontinent was provided services to restore as much normal bowel function as possible for 1 (#1) of 4 (#1, #2, #3 and #4) residents reviewed for Bladder and Bowel Incontinence.

Inspectors wroteBased on record review and interviews, the facility failed to ensure Activities of Daily Living (ADL) care was accurately documented for 1 (#1) of 4 (#1, #2, #3 and #4) Residents reviewed for ADL care.

Inspectors wroteBased on interviews and record reviews, the facility failed to ensure each nurse aide was competent when transferring a resident with the slide board for 1 (#29) of 3 (#29, #61, and #69 ) residents reviewed for falls. This deficient practice resulted in an actual harm for Resident #29, beginning on 04/02/2024 at 4:30 p.m. when S16CNA inappropriately used the slide board during a transfer, which resulted in Resident #29 falling to the floor. On the morning of 04/03/2024, Resident #29 refused care due to severe pain when she moved. On 04/03/2024 at 12:12 p.m., Resident #29 had X-rays in the facility that revealed a Left Femur Fracture. Resident #29 was transferred to the emergency room and found to have a Left Distal Femur Fracture and a Right Displaced fracture that required surgical interventions. Review of the Facility's November 2023 Training Materials revealed the following, in part: [...]

Inspectors wroteBased on interviews and record review, the facility failed to ensure all licensed nursing and certified nursing assistant staff had documented new hire and annual competency demonstrations for all skills related to their expected roles for 5 out of 5 personnel files reviewed. This had the potential to affect all 89 residents residing in the facility.

Inspectors wroteBased on interviews and record reviews, the facility failed to ensure resident MDS assessments accurately reflected the resident's status for 2 of 2 (#13 and #18) residents reviewed for PASRR by failing to correctly code the residents PASRR evaluations.

Inspectors wroteBased on observation and interview, the facility failed to ensure nurse staffing data, including resident census, and total number and actual hours worked for licensed and unlicensed nursing staff, was posted in a prominent location readily accessible to residents and visitors. This deficient practice had the potential to affect any of the 90 residents residing in the facility.

Inspectors wroteBased on interviews and record review, the facility failed to ensure PRN orders for psychotropic medications were limited to 14 days and indicated the duration for 4 (#17, #35, #58, and #69) of 5 (#17, #35, #58, #64, and #69) residents reviewed .

Inspectors wroteBased on record review and interviews, the facility failed to make prompt efforts to resolve grievances for 1 (#3) of 2 (#3 and #29) residents reviewed for grievances. The facility failed to ensure a grievance was promptly investigated when Resident #3 reported a missing blanket and clothing to staff.

Inspectors wroteBased on record review, observations and interviews, the facility failed to ensure services were provided by the facility to meet quality professional standards. The facility failed to ensure medications were administered safely and timely by leaving the medications at the bedside for 1 (#64) of 24 residents observed during the initial screening of residents upon facility entrance.

Inspectors wroteBased on observations, interviews, and record review, the facility failed to ensure a resident who was unable to carry out ADLs received the necessary services to maintain good grooming and personal hygiene for 1 (#13) of 2 (#13, and #23) residents reviewed for ADL's. The facility failed to trim fingernails for Resident #13.

Inspectors wroteBased on observations, interviews, and record review, the facility failed to ensure a resident was offered a therapeutic diet when the health care provider ordered a nutritional supplement for 1 (#3) of 5 (#3, #35, #44, #64 and #79) residents reviewed for nutritional status.

Inspectors wroteBased on interviews and record review, the facility failed to implement a comprehensive person-centered care plan for 1 (#88) of 28 residents reviewed in the final sample. The facility failed to provide a psychiatric consult.

Inspectors wroteBased on interviews and record review, the facility failed to ensure residents received treatment and care in accordance with professional standards by failing to ensure documentation was accurate and complete for 2(#58 and #88) of 28 resident reviewed in the final sample.

Inspectors wroteBased on observations, interviews, and record review, the facility failed to ensure a resident who was unable to carry out ADLs received the necessary services to maintain good grooming and personal hygiene for 2 (#54 and #57) of 5 (#4, #12, #47, #54, and #57) residents reviewed for ADL's. The facility failed to comb and shampoo hair for Resident's (#54 and #57).

Inspectors wroteBased on interviews and record review, the facility failed to ensure residents who required dialysis received such services, consistent with professional standards, by failing to maintain on-going communication with the dialysis facility for 1 (#58) of 4 (#33, #46, #58, and #390) residents reviewed for dialysis.

Inspectors wroteBased on interviews and record review, the facility failed to maintain resident's dignity for 1(#72) of 28 residents reviewed during the initial pool process.

Inspectors wroteBased on observations, record review, and interviews, the facility failed to maintain an infection control program designed to provide a safe, sanitary environment, and to help prevent the development and transmission of disease and infection by 1 (S13CNA) of 2 (S10CNA and S13CNA) staff members failing to perform hand hygiene during dining service.