Timberidge Nursing and Rehabilitation Center

Inspectors wroteBased on observation, interview and record review, the facility failed to store, prepare, distribute, and serve food under sanitary conditions in the facility's only kitchen observed for kitchen sanitation. [...]

Inspectors wroteBased on interview and record review, the facility failed to ensure an encoded, accurate, and complete MDS assessment was electronically transmitted to the CMS System within 14 days after completion for 1 of 4 residents (Resident #22) reviewed for encoding/transmitting assessments. The facility failed to transmit a death record assessment for Resident #22 within 14 days of completion. This failure could place residents at risk of not having records completed and submitted in a timely manner as required.

Inspectors wroteBased on observations, interviews, and record review, the facility failed to provide the necessary services to maintain personal hygiene for 1 of 12 residents reviewed for ADLs (Residents #1.) The facility did not apply moisturizer on the cracked and dry lips of Resident #1. This failure could place residents who required assistance from staff for ADLs at risk of not receiving care and services to meet their needs which could result in poor care, risk for skin breakdown, feelings of poor self-esteem, lack of dignity, and health.

Inspectors wroteBased on observations, interviews, and record review, the facility failed to establish and maintain an infection prevention and control program designed to provide a safe, sanitary, and comfortable environment, and to help prevent the development and transmission of communicable diseases and infections for 2 of 4 (Resident's #6 and #38) reviewed for infection control. 1. CNA B did not change her gloves when going from dirty to clean after performing incontinent care. CNA B did not sanitize or wash her hands after performing incontinent care when she applied Resident #6's clean brief. 2. LVN A did not change her gloves when going from dirty to clean when providing indwelling urinary catheter care. LVN A did not sanitize or wash her hands after performing Resident #38's indwelling urinary catheter care when she changed her gloves. [...]

Inspectors wroteBased on observation, interviews and record review, 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 for kitchen sanitation in that: 1. Hairnets were not worn or were worn unproperly. 2. Food was not labeled or dated. 3. Expired food was not thrown away. These deficient practices could place residents who received meals from the main kitchen at risk for food borne illness.

Inspectors wroteBased on observation, interview, and record review, the facility failed to provide the necessary services to maintain personal hygiene for 2 of 15 residents reviewed for ADLs (Residents #27 and Resident #1) The facility did not shave Resident #27's facial hair. The facility did not trim Resident #1's long nails. This failure could place residents who required assistance from staff for ADLs at risk of not receiving care and services to meet their needs which could result in poor care, risk for skin breakdown, feelings of poor self-esteem, lack of dignity and health.

Inspectors wroteBased on observation, interview, and record review the facility failed to ensure that residents maintained acceptable parameters of nutritional status, such as usual body weight or desirable body weight range and electrolyte balance, unless the resident's clinical condition demonstrates that this is not possible or resident preferences indicate otherwise when the facility failed to implement significant interventions for three (Residents #16, #28, and #39) of nineteen residents reviewed for significant weight loss. There were residents with significant weight variances (both for weight loss and weight gains) that were not identified until after surveyor intervention. This system failure allowed significant weight loss and weight gains to go undetected and untreated. 1. [...]

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure that respiratory care was provided consistent with professional standards of practice for 1 of 15 residents reviewed for respiratory care. (Resident #205). The facility failed to ensure Resident #205 received continuous oxygen per physician's orders. These failures could place residents at an increased risk of respiratory complications.

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 and to help prevent the development and transmission of communicable diseases and infections for 2 of 15 residents (Residents #26 and Resident #35) reviewed for infection control practices. CNA O failed to remove her dirty gloves and perform hand hygiene (general term referring to any action of hand cleansing) before touching multiple clean items in the Resident's environment during incontinent care for Resident #26. CNA P failed to remove her dirty gloves and perform hand hygiene before touching clean items in the Resident's environment during incontinent care for Resident #35. These failures could place residents at risk for cross contamination and infections.

Inspectors wroteBased on observation, interview, and record review, the facility failed to follow established policy regarding smoking areas, and smoking safety for 1 of 1 smoking area reviewed. The facility failed to keep trash out of the red metal trash cans designated for cigarette butts in the smoking area and failed to implement their smoking safety policy. This failure could place residents who smoke at risk of physical harm and lead to an unsafe smoking environment. The Findings Included: Record review of List of smokers undated revealed there were 2 residents listed as smokers. During an observation on 05/23/23 at 09:45 AM revealed in the smoking area 2 red metal trashcans with automatic closing lids. Observed in the trashcan on the right side of the smoking area red trashcan #1 was filled to the top with multiple empty cigarette packs, napkins, straws, chip bags and soda cans. [...]