Washington Care Center

Inspectors wroteBased on observation, staff interviews and facility policy review the facility failed to ensure items in the kitchen refrigerator were dated and labeled and failed to discard food items by the expiration date for one (1) of three (3) dietary tour observations. Findings Include:Review of the facility policy titled, Food Storage Labeling, with a revision date of 08/12, revealed The facility will ensure the safety and quality of food by adhering to proper storage and labeling procedures. 1. a. All temperature-controlled foods and ready to eat foods that are prepared in the facility and held for longer than twenty-four hours will be labeled. Information included on the label: Name of the Food, Date of storage. b. [...]

Inspectors wroteBased on record review, staff interview, and facility policy review, the facility failed to accurately code Section A of the Minimum Data Set (MDS) for a resident identified with a serious mental illness (SMI) through the Preadmission Screening and Resident Review (PASRR) Level II process for one (1) of (16) MDS assessments reviewed. Resident #9Findings include:Review of the facility policy titled Resident MDS Assessment, revised 9/9, revealed, An assessment will be completed on each resident utilizing the MDS. The completed assessment guides staff in identifying key information about the resident and serves as a basis for identifying resident-specific issues and objectives in order to develop a care plan. [...]

Inspectors wroteBased on observation, staff interview, record review, and facility policy review, the facility failed to ensure the implementation of the resident's care plan for oral hygiene for one (1) of (16) care plans reviewed. Resident #4 Findings Include:Record review of the facility policy titled Care Plan Process, revised 12/24, revealed, The facility shall use the results of the assessments to develop, review, and revise the resident's comprehensive plan of care. The facility staff shall follow the care plan. Record review of Resident #4's Care Plan Report revealed under, Focus: Resident is dependent with oral hygiene. Further review revealed under, Interventions: Provide oral hygiene as needed. Provide X (times) 1 (one) staff with oral care at least two times a day & (and) or as indicated. On 4/29/26 at 12:58 PM, observation of Resident #4 revealed he was lying in bed and was non-verbal. [...]

Inspectors wroteBased on observation, staff interview, record review, and facility policy review, the facility failed to provide oral care to a resident dependent on staff for Activities of Daily Living (ADLs) care for one (1) of three (3) residents reviewed for ADLs. Resident #4 Findings Include:Review of the facility policy titled Oral Hygiene, revised 1/24, revealed under Purpose: To clean the mouth, teeth, and gums; To remove particles of food; To remove bacteria and odor; To provide comfort to the resident; To keep the mouth moist. Record review of Resident #4's Order Summary Report revealed an order dated 1/23/26 for NPO (nothing by mouth) diet. An observation on 4/28/26 at 10:38 AM revealed Resident #4 was lying in bed with upper and lower lips that were dry, with cracking and peeling skin on the lower lip. The resident's lower teeth were covered in a thick white substance. [...]

Inspectors wroteBased on record review and staff interviews, the facility failed to ensure the administration of the influenza vaccine in accordance with facility policy to prevent the spread of infection for one (1) of five (5) residents reviewed for immunizations. Resident #10. Findings Include:Review of the facility policy titled Influenza Vaccination Program for Employees and Residents, revised 1/24, revealed, It is the policy of this facility to provide employees and residents with influenza vaccination every year between October and March. This is consistent with recommendations from the CDC (Center for Disease Control and Prevention) and state and local health departments. Record review of Resident #10's Vaccine Information and Consents revealed the Responsible Representative (RR) consented for the resident to receive the annual influenza vaccine on 2/3/26. [...]

Inspectors wroteBased on staff interview and record review, the facility failed to submit accurate staffing information into the Payroll-Based Journal (PBJ) system for one (1) of four (4) quarters reviewed. Second (2nd) Quarter 2024.

Inspectors wroteBased on resident and staff interview, record review, and facility policy review, the facility failed to accurately code a quarterly Minimum Data Set Assessment (MDS) for one (1) of 16 resident assessments reviewed. (Resident # 11)

Inspectors wroteBased on staff interview, record review, and facility policy review, the facility failed to ensure a resident on a PRN (as needed) psychotropic medication had a stop date for one (1) of five (5) medication reviews. Resident #40 Findings Include: Review of the facility policy titled, Psychotropic Medication, revised 10/22, revealed Residents do not receive psychotropic drugs pursuant to a PRN (as needed) order unless that medication is necessary to treat a diagnosed a specific condition that is documented in the clinical record; and PRN orders for psychotropic drugs are limited to 14 days. Review of the Order Summary Report with active orders as of 8/21/24 for Resident #40 revealed an order dated 7/5/2024, Xanax oral tablet 0.5 mg (milligram) (Alprazolam) give (1) tablet by mouth every 6 (six) hours as needed for agitation . There was no stop date for the order. [...]

Inspectors wroteBased on resident representative and staff interview, record review and facility policy review the facility failed to honor a resident's right to return to the facility following a hospitalization for one (1) of three (3) residents reviewed for discharge. Resident #1. Findings Include: Record review of facility policy titled, Discharge Transfer and Planning , revised 9/23, revealed The facility must permit each resident to remain in the facility, and not transfer or discharge the resident from the facility .Before a facility transfers or discharges a resident, the facility must notify the resident and the resident's representative of the transfer or discharge and the reasons for the move in writing and in a language and manner they understand .The Discharge/Transfer notice shall be made by the facility at least 30 days before the resident is transferred or discharged . [...]

Inspectors wroteBased on observation, resident and staff interviews, facility policy review and record review, the facility failed to develop a comprehensive care plan for a resident requiring shaving and failed to implement the care plan for residents requiring nail care for two (2) of 18 residents reviewed.

Inspectors wroteBased on observation, staff interviews, resident interview, facility policy review and record review, the facility failed to provide Activities of Daily Living (ADLs) as evidenced by long and jagged nails, and unshaven facial hair for two (2) of eighteen residents observed.