Westerly Health Center

Inspectors wroteBased on clinical record review and staff interview, the facility failed to notify the Office of the State Long-Term Care Ombudsman, when a resident is hospitalized or discharged and return to the facility is not anticipated, for 2 out of 3 residents reviewed for facility discharges, Resident ID #s 117 and 119.

Inspectors wroteBased on clinical record review, and resident and staff interview, the facility failed to provide necessary services to residents who are unable to carry out activities of daily living (ADLs) relative to scheduled showers, for 2 of 2 residents reviewed who alleged that they were not provided their scheduled showers, Resident ID #s 54 and 81.

Inspectors wroteBased on clinical record review and staff interview, the facility failed to ensure a resident receives adequate supervision to prevent accidents for 3 of 5 residents reviewed who were identified as an elopement risk, Resident ID #s 15, 36, and 129.

Inspectors wroteBased on clinical record review and staff interview, the facility failed to provide appropriate treatment and services for 2 of 3 residents reviewed with an indwelling urinary catheter (a flexible tube that collects urine from the bladder and empties into a drainage bag) related to urine output monitoring, for Resident ID #s 6 and 103.

Inspectors wroteBased on clinical record review and staff interview, the facility failed to store all drugs and biologicals in accordance with currently accepted professional principles for 1 of 1 resident found with medication in his/her room, Resident ID #27, 1 of 3 medication carts, and 2 of 2 medication storage rooms.

Inspectors wroteBased on clinical record review, and resident and staff interviews, the facility failed to provide reasonable accommodation of resident needs and preferences, for 1 of 1 resident reviewed related to providing an electric wheelchair to maintain comfort during independent mobility, Resident ID #44 who has bilateral lower extremity amputations.

Inspectors wroteBased on clinical record review and staff interview, the facility failed to ensure that the assessment accurately reflected the resident's status for 1 of 2 residents reviewed related to smoking, Resident ID #62, and 1 of 3 residents reviewed related to a misspelled name, Resident ID #38.

Inspectors wroteBased on clinical record review and staff interview, the facility failed to develop and implement a baseline care plan, for 1 of 1 newly admitted resident identified as an elopement risk, Resident ID #129.

Inspectors wroteBased on clinical record review and staff interview, the facility failed to ensure that the comprehensive care plan was reviewed and revised by the interdisciplinary team, for 1 of 2 residents reviewed, Resident ID #44.

Inspectors wroteBased on surveyor observation, clinical record review, staff and resident representative interviews, it has been determined that the facility failed to ensure that a resident receives proper treatment to maintain hearing abilities for 1 of 1 resident reviewed for hearing concerns, Resident ID #46.

Inspectors wroteBased on surveyor observation, clinical record review, resident, and staff interview, the facility failed to ensure a resident with limited range of motion (ROM) received appropriate treatment and services to increase ROM and/or to prevent further decrease in ROM for 1 of 1 resident reviewed, Resident ID #10.

Inspectors wroteBased on clinical record review and staff interview, the facility failed to ensure that residents are free from significant medication errors for 1 of 1 resident reviewed for the administration of an intramuscular antibiotic (a medical procedure where the medicine is delivered directly into the muscle tissue), Resident ID #64.

Inspectors wroteBased on record review and staff interview, the facility failed to establish an Infection Prevention and Control Program (IPCP) that must include, at a minimum, an antibiotic stewardship program which includes antibiotic use protocols and a system to monitor antibiotic use to ensure that residents who require an antibiotic, are prescribed the appropriate antibiotic for 2 of 4 residents reviewed for antibiotic use, Resident ID #s 10 and 64.

Inspectors wroteBased on record review and staff interview, it has been determined that the facility failed to ensure that residents maintain acceptable parameters of nutritional status, such as usual body weight for 1 of 3 residents reviewed with a severe weight loss, Resident ID #99.

Inspectors wroteBased on record review and staff interview, it has been determined that the facility failed to meet professional standards of quality related to following physician's orders for 1 of 1 resident reviewed with an order for Mucinex (a medication prescribed to thin mucus), Resident ID #52 and for 1 of 1 resident reviewed with an order for Metoprolol Succinate Extended Release (a medication prescribed to treat high blood pressure), Resident ID #63.

Inspectors wroteBased on surveyor observation, record review and staff interview, it has been determined that the facility failed to ensure resident's records are accurate, complete and readily accessible for 1 of 1 resident reviewed with a physician's order for one to one (1:1) supervision, Resident ID #48.

Inspectors wroteBased on surveyor observation, record review and staff interview, it has been determined that the facility failed to maintain an infection prevention and control program to help prevent the transmission of communicable diseases and infections relative to Enhanced Barrier Precautions (EBP; refers to an infection control intervention designed to reduce transmission of multidrug-resistant organisms [MDRO] that employs targeted gown and glove use during high contact resident care activities), Resident ID #s 22, 55, 215 and 367.

Inspectors wroteBased on record review and staff interview, it has been determined that the facility failed to reconcile all pre-discharge medication orders with the resident's post-discharge medication orders, for 1 of 3 residents reviewed relative to discharge from the facility, Resident ID #2.

Inspectors wroteBased on record review and staff interview, it has been determined that the facility failed to ensure that the results of all alleged abuse investigations are reported in accordance with State law, including to the State Survey Agency (Rhode Island Department of Health; RIDOH), within 5 working days of the incident for 5 of 10 facility reported incidents (FRI) reviewed.

Inspectors wroteBased on surveyor observation, record review, and staff interview, it has been determined that the facility failed to provide respiratory care consistent with professional standards of practice for 4 of 5 residents reviewed for respiratory care, Resident ID #s 4, 20, 105, and 112.

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 3 residents reviewed with blood pressure parameters, Resident ID #64.

Inspectors wroteBased on surveyor observation, record review and staff interview, it has been determined that the facility failed to store and label drugs and biologicals in accordance with currently accepted professional principles for 4 of 4 medication carts and 1 of 1 medication room observed.

Inspectors wroteBased on record review and staff interview, it has been determined that the facility failed to maintain an infection prevention and control program designed to provide a sanitary environment and to help prevent the development of infections for 1 of 1 residents reviewed relative to the use of continuous positive airway pressure (CPAP-a device used to provide breathing support), Resident ID #25 and 1 of 1 residents reviewed with current treatment for Multidrug Resistant Organisms (MDRO-organisms resistant to antibiotics), Resident ID #82.