Vivo Healthcare Fort Pierce

Inspectors wroteBased on record review and interview, the facility failed to complete baseline care plans in the required time frame for 1 of 9 sampled residents reviewed, Resident #93.

Inspectors wroteBased on observations and interviews, the facility failed to ensure daily staffing was accurate and current for 2 of 6 days.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure a safe, clean, and homelike environment for 6 of 11 rooms observed as evidenced by discolored floors, molding and walls, stained/dirty privacy curtains, peeling wallpaper, damaged drywall, and a damaged/dirty electrical outlet cover in occupied and unoccupied rooms. The census at the time of survey was 72. The bed capacity was 79.

Inspectors wroteBased on observation and interview, the facility failed to ensure timely housekeeping and maintenance in 2 of 4 (100 and 300) resident hallways, affecting Resident #224, #42, #23, and #66; and failed to maintain ceiling vents and common area walls on all four resident units and in the central common area.

Inspectors wroteBased on observation and interview, the facility failed to ensure a clean and sanitary kitchen and failed to maintain food that was not past it's use-by or expired date. This could potentially affect 72 of 75 residents who consume an oral diet.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure the call bell was within reach for 1 of 1 sampled resident, Resident #42, who was capable to use the call bell and needed assistance.

Inspectors wroteBased on policy review, observation, interviews, and record review, the facility failed to ensure timely fingernail care for 2 of 5 sampled residents, Residents #6 and #61, reviewed for activities of daily living (ADLs) care.

Inspectors wroteBased on policy review, observation, interview, and record review, the facility failed to ensure wound dressing changes were completed per physician order for 1 of 2 sampled residents, Resident #61, reviewed for wound care.

Inspectors wroteBased on observation, interview and record review, the facility failed to effectively communicate the resident's complaint of pain, failed to evaluate the effectiveness of pain interventions, and failed to appropriately treat pain for 1 of 5 sampled residents, Resident #42, reviewed for pain management.

Inspectors wroteBased on policy review, interview, and record review, the facility failed to ensure adequate monitoring of side effects and behaviors for residents receiving psychotropic medications, for 1 of 5 sampled residents reviewed for unnecessary meds, Resident #16.

Inspectors wroteBased on observation, interview, record review, and policy review, the facility failed to use appropriate hand hygiene practices and personal protective equipment (PPE) when providing incontinence and wound care for 2 of 3 sampled residents observed for direct care, Residents #65 and #61.

Inspectors wroteBased on observation, interview and record review the facility failed to ensure documented evidence of showers as per schedule and preference for 2 of 4 residents (Resident #2 and Resident #6).

Inspectors wroteBased on resident interviews, Resident Council meeting minutes, record reviews, and staff interviews, the facility failed to act upon Resident Council grievances in a timely manner regarding voiced resident concerns about direct care staff as consistently stated in each Resident Council Meeting Minutes reviewed from May 2023 to October 2023.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure Minimum Data Set (MDS) assessment accuracy related to Activities of Daily Living (ADLs), indwelling urinary catheter use, medications, and hospitalizations for 4 of 16 sampled residents (Resident #19, #28, 39, and #61).

Inspectors wroteBased on record review and interview, the facility failed to ensure completion of a Level 2 PASARR (Preadmission Screening and Resident Review) for 1 of 2 sampled residents. Resident #9 had a documented Level 1 PASARR dated 04/17/23, and a supplemental review on 11/02/23 that revealed the necessity for a Level 2, which was not completed.

Inspectors wroteBased on record review and interview, the facility failed to ensure Level 1 PASARR (Preadmission Screening and Record Review) screening was completed for 1 of 2 sampled residents prior to or upon admission (Resident #19).

Inspectors wroteBased on observation, interview, and record review, the facility failed to update the comprehensive care plans and or ensure resident representative participation in the care needs for 3 of 16 sampled residents, after changes in condition were identified. Resident #23 had a decline in eating ability with facility failure to update the care plan. Resident #28 required two person assistance for transferred that was not reflected in the current care plan. Resident #39 had a decline in eating ability and the facility failed to update the care plan. The resident representative for Resident #39 had requested a consult for upper dentures and was not informed of the findings of the dentist.

Inspectors wroteBased on observation, interview, and record review, the facility failed to provide wound care, and accurately document the provision of dressing changes, as per physician order for 2 of 3 sampled residents with wounds (Residents #19 and #28).

Inspectors wroteBased on policy, observation, interview, and record review, the facility failed to ensure proper peri-care for 1 of 1 sampled resident who had a urinary tract infection (UTI), (Resident #4).

Inspectors wroteBased on record review, interview, and policy review, the facility failed to ensure accurate documentation related to Medication Administration Records (MARs), physician consults, and orders for 3 of 16 sampled residents. The record for Resident #39 lacked the provided dental consult, an order for Hospice services, and contained multiple blank areas in the MAR. The records for Residents #52 and #53 contained numerous blank areas in the MARs.

Inspectors wroteBased on record review and interview the facility failed to document review and revision of the care plan with the required Interdisciplinary Team (IDT) for 3 of 18 residents in the final sample (Resident#18, #32, #39), and failed to document required IDT involvement in the care planning process for 9 of 18 residents in the final sample (Residents #32, #8, #39, #44, #61, #48, #17, #15, #7).

Inspectors wroteBased on Facility Policy, record review, interview, and observation the facility failed to document ongoing coordination of care with Hospice for 6 of 6 resident reviewed for Hospice (Resident #21, #67, #19, #68, #69 and #38).

Inspectors wroteBased on facility policy, observation, interview and record review, the facility failed to determine a resident was approved and safe to self-administer inhaler medications. This failure affected 1 of 1 residents reviewed for medication self-administration (#42). An inhaler is a medical device used for delivering medicines into the lungs through the work of a person's breathing.

Inspectors wroteBased on record review and interview, the facility failed to provide Notice of Medicare Non-Coverage (NOMNC) and Skilled Nursing Facility Advance Beneficiary Notice (SNFABN) in a timely manner in order for residents and or resident's representatives to file an appeal, and failed to provide and inform the residents of their financial responsibilities after being discharged from Medicare for 3 of 3 residents reviewed for Beneficiary Protection Notification (Residents #224, 225 and 226).

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure the facility was secure to prevent a resident with a risk of elopement from eloping the facility for 1 of 1 resident reviewed for accidents (Resident #54).

Inspectors wroteBased on record and interview the facility failed to ensure accurate documentation of medication administration between the controlled substance record and the medication administration records (MARs) for 3 of 4 residents reviewed during the medication storage process (Residents #15, #59 and #68).