| 4857 |
SIDNEY CARE AND REHABILITATION CENTER, LLC |
285113 |
1435 TOLEDO STREET |
SIDNEY |
NE |
69162 |
2018-03-06 |
835 |
H |
0 |
1 |
9WK311 |
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Licensure Reference Number: 175 NAC 12-006.01 (4) Based on observations, record reviews, and interviews, the facility administration failed to identify and correct issues to maintain compliance and ensure the provision of care and treatment for [REDACTED]. Facility census was 27. Findings are: Entrance to the facility on [DATE], the facility provided a personnel form which identified the facility employed a full-time licensed Administrator responsible for managing the facility and day to day operations. Due to risk of retaliation by the company or the administration of the facility, various staff members, residents, and families were interviewed under requests for anonymity. These interviews were conducted during a complaint drop in visit conducted on 2/23/2018 between 1:25 p.m. and 3 p.m. and during the annual survey conducted beginning on 2/27/18 through 3/6/18. These interviews resulted in the following concerns being expressed: - shortages in direct care nursing staff resulting in delays of call lights, bathing not being done as scheduled, no restorative nursing program, delays in attending to resident condition changes, and lack of response by administration in dealing with concerns and issues brought to administration attention. During the survey conducted from 2/27/18 through 3/1/18, the facility was cited for the following issues related to systems failure or standards of care breaks resulting in patterns of, or widespread failure in the facility: - F561- bathing not provided for residents as requested. Interviews with staff and residents revealed this was related to nurse staffing shortages. - F684- Activity programs being canceled related to one employee in the department being pulled to do resident transport duties to and from medical and other appointments in addition to performing Social Service duties four days a week. In addition, the facility was not employing a full-time Activities Director as specified in the Facility Assessment Tool. - F689- Accidents resulting in harm to residents due to systems failures in nursing assessment and care planning. - F725- Inadequate direct care staffing related to mechanical lift transfers being done without a second person per standards of practices and individualized care planning. Interviews with staff and residents attribute this practice due to lack of direct care staffing on the floor. No restorative program verified by interviews with staff, therapy, and administration. Medication error rates attributed to being rushed to complete medication duties and charge nurse duties. Bathing not being completed based on interviews with staff and residents attributing this to staff shortages. - F727- The Director of Nursing hired on 2/8/18 had been working 24-36 hours per week in the capacity of night shift charge nurse resulting in failure to devote the required 35 hours per week to directing nursing care for the facility. This resulted in no direction or supervision over nursing staff resulting in additional deficiencies cited for medication errors, Infection Control programming, Pain management, accidents, medication labeling, and medications and nutritional supplements being obtained for administration as ordered. Medication being unavailable resulted in increased changes in condition, pain, and additional medical attention. - F745- Lack of providing essential social services for residents. Wheelchair issues brought to the attention of administration and Social Services were not addressed verified by care plan documentation, progress notes, and family interview. In addition, the facility was not employing a full-time Social Service Director as specified in the Facility Assessment Tool as they were employing the Social Services Director one day per week and additional hours were being supplemented by the Activity Director consisting of an average of 2 hours per day four days per week. - F809 failure to address repeated Resident Council concerns regarding evening snacks. - F837- Essential services including Medical Director, Consulting Pharmacist, Pharmaceutical suppliers, food suppliers, medical equipment suppliers, Fire and Safety inspections, Generator rental, and plumbing contractors not being paid and all with past due accounts. Some of these issues have resulted in delays or refusal to provide further services. Interviews and past due accounts and invoices were reviewed supporting the lack of payment. - F841- The Medical Director had not been supplied a current contract identifying policies and services required for the position. The specific observations, record reviews, and interviews related to these deficiencies may be referenced in support of the dificiencies that were patterned or widespread. |
2020-03-01 |