Vivo Healthcare Wauchula

Inspectors wroteBased on observation and interview, it was determined that the facility failed to store, prepare, distribute and serve food, in accordance with professional standards for food service safety.

Inspectors wroteBased on observations, interviews and record review, the facility failed to ensure residents were treated in a dignified manner when entering the resident's room and during medication administration for 2 of 5 residents observed for medication pass administration (Residents #38 and #165).

Inspectors wroteBased on observations, interviews and record review, the facility failed to assess the safety of smoking for 1 of 1 resident reviewed for smoking (Resident #37).

Inspectors wroteBased on observation, interviews, and record review, the facility failed to obtain orders for catheter care for a resident admitted with an indwelling Foley catheter for 1 of 1 resident sampled for urinary catheter (Resident #31).

Inspectors wroteBased on observations, interviews, and record reviews, the facility failed to monitor nutritional status in a timely manner for one of one residents reviewed for Dialysis (Resident #22).

Inspectors wroteBased on observations, interviews, and record review, the facility failed to follow tube feeding as per the Physician ' s orders for 1 of 1 resident review for tube feeding (Resident #21).

Inspectors wroteBased on observations, interviews, and record review, the facility failed to provide tracheostomy care in accordance with professional standards of practice and failed to implement appropriate interventions for tracheostomy care for 1 of 1 resident sampled for respiratory care (Resident #21).

Inspectors wroteBased on interview and record review, the facility attending physician failed to document on irregularities identified with recommendations by the consulting pharmacist for 1 of 5 residents sampled for Unnecessary Medications (Resident #2).

Inspectors wroteBased on observation, interview, and record review it was determined that the facility failed to prepare food in a form designed to meet the individual needs of 5 (Residents #23, #24, #26, #36, and #41) of 5 sampled residents with physician ordered pureed diet.

Inspectors wroteBased on observation, interview, and record review, it was determined that the facility failed to follow physician ordered fluid restriction diet for 2 ( Residents #214, and #22) of 2 sampled residents.

Inspectors wroteBased on interviews and record review, the facility failed to accurately document code status for 1 of 29 sampled residents (Resident #50).

Inspectors wroteBased on observations, interviews, and record review, the facility failed to practice hand hygiene while donning and doffing gloves during med administration observation for 2 of 5 residents reviewed for medication pass (Residents #165 and #38), and during tracheostomy care for 1 out of 1 resident reviewed for respiratory care (Resident #38).

Inspectors wroteBased on observations, record reviews, and interviews, the facility failed 1) to maintain the ceiling in a safe and sanitary manner in one of one kitchen observed and, 2) failed to store food in accordance with professional standards, related to storing opened food without a date, in the kitchen and in one of two nourishment refrigerators.

Inspectors wrote2) The following observations were made of staff members wearing surgical masks inappropriately: - On 1/31/23 at 11:09 a.m., identified Staff D, Housekeeper, standing in the entrance to room [ROOM NUMBER] with a surgical mask below the chin. - On 1/31/23 at 11:42 a.m., observed Staff I, Personal Care Assistant (PCA) enter the kitchen from the dining room wearing surgical mask below the nose. The staff member left the kitchen and returned a moment later continuing to wear surgical mask below the nose. - Staff H, Hospice Certified Nursing Assistant (CNA) was observed, on 1/31/23 at 12:05 p.m., standing in the middle hallway of the East wing. The staff member was wearing a surgical mask below the chin as she looked into the units shower room. [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure a resident centered care plan was developed and implemented related to two anti-depressant medications, for one resident (#55) of five residents sampled for unnecessary medications.

Inspectors wroteBased on observations, interviews, and record reviews, the facility failed to 1)provide care and services in accordance with physician's orders and the plan of care for one resident (#271) of three residents sampled for nutrition services and, 2) failed to document an alteration in skin integrity for one resident (#32) of one resident sampled for skin impairments.

Inspectors wroteBased on record review and interviews, the facility failed to monitor behaviors and side effects for psychotropic medications for one resident (#63) out of five residents sampled for unnecessary medications.

Inspectors wroteBased on observations, record reviews, and interviews the facility failed to provide an activity program based on the assessment and care planned preferences for three (#40, #7, and #42) of three residents reviewed for activities out of a total sample of 29 residents.

Inspectors wroteBased on observations, interviews and record review, the facility failed to ensure respiratory equipment was maintained in a sanitary manner for 2 (#1 and #15) of 2 residents.

Inspectors wroteRecord review showed Resident #3 was admitted to the facility on [DATE] and readmitted on [DATE] with diagnoses that included unspecified anxiety disorder, unspecified single episode major depressive disorder, unspecified mood (affective) disorder, and unspecified dementia without behavioral disturbance. The Order Summary Report (OSR) for active physician orders as of 3/26/21 indicated the following psychotropic medications: - Buspirone HCl 5 mg - give one tablet by mouth four times a day for anxiety. Order start date: 2/8/21. - Depakote Delayed Release 250 mg - give one tablet by mouth two times a day for mood disorder. Order start date: 3/14/21. - Melatonin 3 mg tablet - Give one tablet by mouth at bedtime for insomnia. Order start date: 3/9/21. - Risperdal 0.5 mg tablet - Give one tablet by mouth in the morning for Bipolar disorder. Order start date: 3/10/21. [...]

Inspectors wroteBased on record reviews and interviews the facility failed to ensure that it provided accurate written beneficiary notifications to residents that were being discharged from Medicare Skilled Services for two (#10 and #13) of three residents reviewed for Beneficiary Protection Notices.

Inspectors wroteBased on observations, interviews, and record review, the facility failed to ensure that the medication error rate was less than 5.00%. Twenty-nine medication administration opportunities were observed, and five errors were identified for four (#47, #40, #61, and #20) of six residents observed. These errors constituted a 17.24% medication error rate.

Inspectors wroteBased on observations, record reviews, and interviews the facility failed to ensure one (West) out of two treatment carts were locked and inaccessible to visitors and residents when unattended, and one (North) out of three medication carts observed did not contain expired medication and insulin was refrigerated prior to opening.