Valley Vista Care Center of St. Maries

Inspectors wroteBased on record review, interview, and policy review, the facility failed to ensure two of two residents and their resident representatives (Resident (R) 8, and R52) reviewed for emergent hospital transfer out of a total sample of 18 residents were provided with a written bed hold policy and transfer notice. This failure had the potential to affect the resident and their resident representative (RR) by not having the knowledge of how to appeal the transfer, if desired, and had the potential to contribute to the possible denial of re-admission and loss of the resident's home following a hospitalization for residents transferred to the hospital.

Inspectors wroteBased on observation, interview, record review, and facility policy, the facility failed to provide assistance with showering for two of three residents (Resident (R) 45 and R16) reviewed for activities of daily living (ADLs) out of a total sample of 18. This failure increased the potential for R45 and R16 to have unmet hygiene needs.

Inspectors wroteBased on observation, staff interviews, and policy review, the facility failed to discard expired medications stored in one medication room storage refrigerator of one medication room. This deficient practice resulted in outdated medications remaining available for use.

Inspectors wroteBased on policy review, record review, review of the State Survey Agency's Long-Term Care Reporting Portal, and staff interview, it was determined the facility failed to ensure residents' rights were protected to be free from abuse and neglect. This was true for 6 of 16 residents (Residents #5, #24, #36, #299, #300, and #349) reviewed for abuse and neglect. This failure placed all residents at risk of ongoing abuse and neglect, and potential physical and psychosocial harm.

Inspectors wroteBased on policy review, record review, review of the State Survey Agency's Long-Term Care Reporting Portal, and staff interview, it was determined the facility failed to ensure allegations of abuse were thoroughly investigated. This was true for 6 of 16 residents (#36, #298, #300, #348, #349, and #350) reviewed for abuse. This failure created the potential for residents to be subjected to ongoing abuse without detection and protective measures implanted by the facility.

Inspectors wroteBased on observation, record review, and staff interview, the facility failed to ensure resident-centered care and treatment were provided timely and bowel care administered per physician orders in accordance with professional standards of practice. This was true for 2 of 23 Residents (#25 and #352) whose records were reviewed. These failures caused harm to Resident #352 when there was a delay in treatment and subsequent decline in her health and put Resident #25 at risk of adverse effects when she did not receive bowel care as ordered.

Inspectors wroteBased on facility document review and staff interview, it was determined the facility failed to ensure they employed an RN as the full-time DNS. The failure to have a full-time RN/DNS placed residents at risk of inadequate care and supervision of their medical status for a census of 44 residents.

Inspectors wroteBased on observation, policy review, and staff interview, it was determined the facility failed to ensure food items were dated and labeled and hygiene practices followed. This failure had the potential to affect 44 of 44 residents residing in the facility who consumed food prepared by the facility at risk of adverse health outcomes, including food-born illnesses.

Inspectors wroteBased on interview and document review, it was determined the facility's administration failed to ensure a full-time DNS was on staff. This failure had the potential to affect the care of the 44 residents in the facility and the assistance and care needed to attain or maintain the highest practicable physical, mental, and psychosocial well-being.

Inspectors wroteBased on staff interview and document review, it was determined the facility failed to report accurate Payroll Based Journal (PBJ) information for the facility as required for a census of 44 residents.

Inspectors wroteBased on record review, policy review, and staff interview, it was determined the facility failed to ensure employees were trained on abuse. This was true for 43 of 79 employees whose records were reviewed for abuse training. This failure had the potential to place all residents in the facility for unidentified or continued abuse if an employee was unable to identify and report abuse.

Inspectors wroteBased on review of the State Agency's Long Term Care Reporting Portal, record review, incident reports, and staff interview, it was determined the facility failed to ensure allegations of resident abuse were reported to the State Survey Agency within 2 to 24 hours. This affected 2 of 5 residents (#7 and #8) who were reviewed for abuse, and for additional unidentified residents referenced in 2 incident reports. This failure created the potential for residents to be subjected to ongoing abuse without detection and protective measures implemented by the facility.

Inspectors wroteBased on record review and staff interview, it was determined the facility failed to ensure a resident's representative and physician were immediately notified when the resident had a significant change in condition. This was true for 1 of 1 resident (Resident #352) reviewed for notification of change in condition. This deficient practice placed Resident #352 at risk for lack of advocacy and support from their representative, and deterioration of her health status.

Inspectors wroteBased on record review, policy review, and resident staff interview, it was determined the facility failed to ensure a Level I Preadmission Screening and Resident Review (PASRR) was completed when the resident had a clinical diagnosis of Post-Traumatic Stress Disorder (PTSD). This was true for 1 of 1 resident (Resident #16) whose PASRR record was reviewed. This deficient practice had the potential to cause harm if residents' specialized services for mental health needs were not provided due to a lack of updated screening.

Inspectors wroteBased on observation, record review, policy review and resident and staff interview, it was determined the facility failed to ensure residents' care plans were revised to reflect current needs and interventions. This was true for 1 of 23 residents (Resident # 26) whose care plans were reviewed. This deficiency placed residents at risk of adverse outcomes if care and services were not provided due to care plans not being revised as residents ' needs changed.

Inspectors wroteBased on resident and staff interview, record review, and facility policy review, it was determined the facility failed to assess, monitor, and identify potential triggers for 1 of 1 resident (Resident #16) reviewed for trauma-informed care. This failure created the potential for .

Inspectors wroteBased on policy review, observation, and staff interview, it was determined the facility failed to ensure infection control and prevention practices were maintained to provide a safe and sanitary environment when providing wound care. This was true for 1 of 1 resident (Resident #2) observed during wound care. This failure put Resident #2 at risk for infection due to cross contamination and potential exposure to bacteria and other pathogens.