Warren Operations Ri, LLC Dba Warren Center

Inspectors wroteBased on record review and staff interview, it has been determined that the facility failed to implement comprehensive person-centered care plans for 4 of 6 residents reviewed for anticoagulation therapy (a medication that is prescribed to increase the amount of time it takes for blood to clot), Resident ID #s 4, 8, 62, and 64.

Inspectors wroteBased on record review and staff interview, it has been determined that the facility failed to ensure that services provided meet professional standards of practice relative to physician's orders, for 1 of 1 resident who receives dialysis ( a medical procedure used to remove waste products and excessive fluid from the blood when the kidneys are no longer able to perform this function effectively), Resident ID #7.

Inspectors wroteBased on record review and staff interview, it has been determined that the facility failed to provide appropriate treatment and services for 2 of 3 residents reviewed with an indwelling catheter (a flexible tube that collects urine from the bladder and leads to a drainage bag), Resident ID #s 9, and 62.

Inspectors wroteBased on record review and staff interview it has been determined that the facility failed to have sufficient staff who provide direct services to residents with the appropriate competencies and skill sets to provide nursing and related services, including training on caring for residents with mental and psychosocial disorders as well as residents with a history of trauma and/or post-traumatic stress disorder.

Inspectors wroteBased on record review and staff interview, it has been determined that the facility failed to ensure that residents are free from any significant medication errors for 1 of 1 dialysis resident reviewed, Resident ID #7, and for 1 of 3 residents reviewed relative to blood pressure parameters, Resident ID #38.

Inspectors wroteBased on surveyor observation, record review, and staff interview, it has been determined that the facility failed to provide residents with the right to personal privacy and confidentiality of his/her personal and medical records relative to the posting of past survey results.

Inspectors wroteBased on surveyor observation, record review, and staff interview, it has been determined that the facility failed to ensure that residents receive treatment and care in accordance with professional standards of practice relative to monitoring of intake and output for 1 of 1 resident reviewed, Resident ID #59.

Inspectors wroteBased on record review and staff interview, it has been determined that the facility failed to ensure that residents are free of any significant medication errors for 1 of 3 residents reviewed, Resident ID #1.

Inspectors wroteBased on surveyor observation, record review, and staff interview, it has been determined that the facility failed to meet professional standards of quality for 1 of 1 resident reviewed with a physician's order for a Lidocaine patch, Resident ID #8; for 1 of 2 residents reviewed with orders for heel protectors, Resident ID #22; for 1 of 1 resident reviewed with a physician's order for TED stockings, Resident ID #26; and for 2 of 6 residents reviewed for weight loss, Resident ID #s 29 and 34.

Inspectors wroteBased on record review and staff interview, it has been determined that the facility failed to complete an annual performance review for every nurse aide (nursing assistant; NA), at least once every 12 months, for 3 of 3 NA personnel records reviewed, Staff H, I, and J.

Inspectors wroteBased on record review and staff interview, it has been determined that the facility failed to ensure that residents are free of any significant medication errors for 2 of 2 residents reviewed for insulin administration, Resident ID #s 15 and 204.

Inspectors wroteBased on record review and staff interview, it has been determined that the facility failed to develop and implement a comprehensive person-centered care plan for 1 of 2 residents reviewed relative to falls resulting in injury, Resident ID #24.

Inspectors wroteBased on surveyor observation, record review and staff interview, it has been determined that the facility failed to ensure that each resident receives adequate supervision by staff to prevent accidents relative to 1 to 1 supervision while eating for 1 of 4 residents reviewed, Resident ID #255.

Inspectors wroteBased on surveyor observation, record review, and staff interview, it has been determined that the facility failed to maintain medical records that are accurately documented in accordance with professional standards and practices for 5 of 13 residents reviewed related to documentation in the medical record, Resident ID #s 8, 22, 26, 29 and 34.

Inspectors wroteBased on record review and staff interview, it has been determined the facility failed to provide written information to the resident or resident representative that specifies the facility's bed-hold bed payment policy before and upon transfer to a hospital from the facility for 5 of 6 residents transferred to the hospital, Resident ID #s 15, 21, 24, 51, and 205.

Inspectors wroteBased on record review and staff interview, it has been determined that the facility failed to ensure that the assessment accurately reflected the resident's status for 1 of 1 resident reviewed for the use of mechanical lifts, Resident ID #1.

Inspectors wroteBased on surveyor observations, record review, and staff interview, it has been determined that the facility failed to ensure that the residents' environment remains as free from accident hazards as possible for 1 of 2 residents reviewed with an actual fall, Resident ID #1.

Inspectors wroteBased on record review and staff interview, it has been determined that the facility failed to document a facility-wide assessment to determine what resources are necessary to care for its residents competently during both day-to-day operations and emergencies which must be reviewed and updated as necessary, and at least annually. Additionally, the facility failed to review and update the assessment whenever there is, or the facility plans for, any change that would require a substantial modification to any part of this assessment.

Inspectors wroteBased on record review and staff interview, it has been determined that the facility failed to ensure that residents who require a feeding tube receive the appropriate treatment and services to prevent complications for 1 of 1 resident reviewed who receives nutrition via feeding tube, Resident ID #22.

Inspectors wroteBased on surveyor observation, record review, and staff interview it has been determined that the facility failed to ensure each resident's medication regimen is free from a medication error rate of 5% or greater. Based on 27 opportunities for errors observed during the medication administration task, there were 3 errors resulting in an error rate of 11.1%.

Inspectors wroteBased on surveyor observation, record review, and staff interview, it has been determined that the facility failed to maintain medical records that are accurately documented in accordance with professional standards and practices for 1 of 8 residents reviewed for opioid administration, Resident ID #18