Inspection Reports for
Advanced Care of St Joseph

The complaint investigation found that two residents (Residents #1 and #2) were moved multiple times without written notification or consent, causing emotional distress. The Social Services Director confirmed that notifications were often last minute and no written notices were provided.

The facility failed to protect two residents' rights to choice by not providing written notification of room changes and moving residents without their consent, causing distress. The facility had no policy or process for room changes and notifications were often given at the last minute or not at all.

The complaint investigation was triggered by resident reports of catheter bags not being emptied frequently enough, resulting in discomfort and distress. The resident called the reception desk multiple times and used the call light repeatedly without timely staff response. The complaint was substantiated with observations and interviews confirming inadequate catheter care and delayed response times.

The facility failed to ensure proper catheter care, including cleaning catheter tubing away from the insertion site and timely emptying of the urinary collection bag, resulting in potential risk for urinary tract infections. Staffing shortages contributed to delays in responding to resident call lights for catheter care.

The complaint investigation was triggered by allegations of failure to maintain resident dignity, retaliation or intimidation of a resident, failure to provide timely incontinence care, and failure to address resident grievances properly. Some grievances involved concerns about food quality, staff behavior, and showering frequency.

The facility failed to maintain resident dignity by not removing unwanted facial hair and providing timely incontinence care, failed to act promptly on resident council grievances, failed to ensure residents knew how to file grievances and follow up on them, failed to provide showers timely for some residents, and failed to maintain proper food safety and hygiene standards in the kitchen.

The facility was found deficient in multiple areas including failure to maintain resident dignity, inadequate response to resident grievances, incomplete care planning, delayed showers, medication administration errors, improper catheter care, inadequate pain management, food quality concerns, and infection control lapses.

The complaint investigation found that the facility did not substantiate proper neurological assessments after a resident's fall. The resident was found on the floor with bruises and confusion, and the staff failed to notify the nurse immediately. The resident was later hospitalized with a fractured collar bone.

The facility failed to meet professional standards by not completing neurological assessments for a resident who fell and was found on the floor. Staff did not notify the nurse immediately, and the resident suffered bruises and a fractured collar bone without timely neurological evaluation.

The complaint investigation found that the facility did not follow policies requiring neurological assessments after falls, failed to notify nursing staff promptly, and did not document the fall on 12/4/24. The resident suffered increased confusion and a fractured collar bone as a result.

The facility failed to initiate neurological assessments after an unwitnessed fall of Resident #1, who was found on the floor with bruises and increased confusion. Certified Nursing Assistants assisted the resident off the floor without notifying nursing staff immediately, and the fall was not documented on the day it occurred. The resident later was found to have a fractured collar bone and was sent to the hospital.

The facility failed to maintain accurate accounting and records of personal funds, with discrepancies in petty cash balances and missing records. Additionally, the facility did not consistently provide care and treatment according to professional standards, including timely medication administration and wound care.

The facility failed to maintain accurate accounting of residents' personal funds, with discrepancies in petty cash balances and missing records for six months. Additionally, licensed nursing staff failed to administer medications timely for three residents and left blanks in medication and treatment administration records, indicating non-compliance with professional standards of care.

The facility was found to be in noncompliance with life safety code requirements related to egress doors and exit signage. Specific deficiencies included a delay-egress locking system that did not release properly and exit doors lacking illuminated exit signs, potentially affecting 129 residents.

The complaint investigation found deficiencies related to failure to provide proper transfer notices, bed hold policy notification, accurate assessments, PASARR screening, comprehensive care planning, respiratory care, medication management, infection control, and pest control. The complaint was substantiated with multiple Level 1 deficiencies.

The facility was found not to be in substantial compliance with 42 CFR 483 subpart B. Deficiencies were identified related to notice requirements before transfer/discharge, bed hold policies, accuracy of assessments, PASARR screening, comprehensive care plans, respiratory care, medication management, infection control, and pest control among others.

The facility was found deficient in multiple areas including failure to provide timely written transfer notices and bed hold policy notifications, inaccurate Minimum Data Set coding, incomplete care planning for skin conditions, inadequate respiratory care and equipment sanitation, failure to post daily nurse staffing information, lack of behavior monitoring for psychotropic medication use, improper medication storage, ineffective infection control practices including isolation and barrier precautions, failure to maintain a pest control program, and lapses in hand hygiene during meal service.

The facility failed to ensure a safe environment free of accident hazards and adequate supervision for residents. Illegal drugs and drug paraphernalia were found in residents' rooms, and the facility lacked a policy regarding supervision or accident prevention. Multiple incidents involving residents and illegal drug use were documented, with inadequate interventions and oversight.

The complaint investigation revealed that Resident #1 repeatedly brought illegal drugs into the facility, resulting in multiple overdoses requiring Narcan administration. Resident #2, the roommate, was severely cognitively impaired and dependent on staff, and was exposed to unsafe conditions. The facility failed to implement effective interventions or supervision to prevent drug use or protect residents. The resident's responsible parties and guardians were not consistently notified. The facility acknowledged the issues but lacked adequate measures to address them, leading to a discharge notice for Resident #1 due to safety concerns.

The facility failed to operationalize its Illegal Drug Use policy to ensure a safe environment, as illegal drugs and paraphernalia were repeatedly found in a shared room occupied by two residents. Resident #1 experienced multiple overdoses requiring Narcan administration, and the facility lacked adequate supervision and interventions to prevent drug use and ensure resident safety.

The complaint involved an allegation of sexual abuse by Resident #4 against Resident #3. The investigation was inconclusive due to incomplete interviews and documentation. Resident #4 denied the allegation and was moved to a new room with restrictions. Law enforcement was involved and interviewed residents and staff.

The facility failed to thoroughly investigate the sexual abuse allegation, including incomplete staff and resident interviews and inadequate documentation. Additionally, licensed nursing staff failed to ensure physician orders were followed for two residents, with missing medication and treatment documentation and improper medication handling.

The complaint involved an allegation of sexual abuse by Resident #4 against Resident #3. The investigation was inconclusive due to incomplete interviews and documentation. The allegation was not substantiated.

The facility failed to thoroughly investigate the sexual abuse allegation, missing interviews with all staff and residents, and incomplete documentation. Medication administration was deficient with missing documentation and improper medication storage. Food service safety was compromised due to unsanitary kitchen conditions, improper food storage, lack of temperature monitoring, inadequate sanitation practices, and poor hand hygiene among staff.

The facility failed to ensure adequate supervision and accident hazard prevention, resulting in a resident elopement that led to intoxication and hospitalization. The facility lacked proper care planning for elopement and wandering risks and did not fully implement required interventions or reporting procedures.

The complaint investigation found that the facility staff failed to prevent the elopement of Resident #1 on 12/5/23. The resident left the facility unsupervised, became intoxicated, and was hospitalized. The resident's Durable Power of Attorney was notified, and law enforcement was involved. The facility did not implement new interventions post-elopement and did not report the incident to the Department of Health and Senior Services. The resident threatened to leave again and signed a form regarding leaving against medical advice.

The facility failed to adequately supervise and prevent the elopement of Resident #1, who left the facility unsupervised, became intoxicated, and was hospitalized. The resident's care plan did not include elopement or wandering risk, and no new interventions were implemented after the incident. Staff and administration responses to the elopement were documented, including notification of family and law enforcement involvement.

The facility failed to provide timely notice and final accounting of personal funds upon resident discharge, affecting six sampled residents. Additionally, the facility did not ensure timely payment of utility bills and lacked policies addressing Resident Trust Funds and paying bills in a timely manner.

The facility failed to provide personal funds and a final accounting within thirty days upon discharge for six sampled residents and did not have a policy regarding Resident Trust Funds. Additionally, the facility failed to ensure timely payment of city water and sewer bills, resulting in a large outstanding balance, and lacked a policy addressing timely bill payments.

The facility failed to ensure residents had access to their personal funds, affecting three residents. The facility also failed to issue timely payments to vendors, resulting in service terminations and outstanding balances.

The complaint investigation substantiated that the facility failed to provide timely treatment and notification regarding a resident's clogged feeding tube, leading to missed nutrition and medications and delayed emergency care.

The facility failed to provide timely treatment for a resident whose feeding tube became clogged, delaying emergency care and causing the resident to miss nutrition and medications for over 12 hours. Staff did not notify the guardian or send the resident to the emergency department promptly as required.

The facility failed to provide personal funds and a final accounting within thirty days upon discharge for seven residents, and failed to prepare, store, and serve food in accordance with professional standards, including improper labeling and storage of food items.

The facility failed to provide timely notice and conveyance of personal funds upon resident discharge, evictions, or death, affecting seven residents. Additionally, the facility did not properly prepare, store, and label food items according to safety standards.

The facility failed to ensure residents' rights for visitation were not restricted, as evidenced by a lockdown preventing visitors for about three days during a COVID-19 outbreak. The facility subsequently corrected the visitation policy and reopened visitation following re-education of staff and audits.

The complaint investigation was substantiated. The facility failed to promptly report alleged abuse by a staff member to administration, delaying required reporting. The resident had bruising consistent with abuse, and the alleged perpetrator was identified and terminated.

The facility failed to promptly report alleged abuse by a staff member to administration, causing a delay in meeting reporting requirements. The investigation confirmed bruising on the resident and identified a Certified Nurse Aide as the alleged perpetrator, who was subsequently terminated.

The facility was found to be in compliance with COVID-19 emergency preparedness and infection control practices except for failure to timely report positive PCR test results for residents and staff to the Missouri Department of Health and Senior Services as required.

The facility failed to implement proper source control measures including ensuring staff and residents wore face coverings properly and posting appropriate signage for isolation precautions. Deficiencies were noted in staff education and adherence to CDC guidelines for infection prevention.

The facility was found noncompliant in multiple areas including resident rights, care planning, abuse/neglect policies, infection control, and food service. Deficiencies affected residents' dignity, privacy, care, and safety.

The facility failed to maintain corridor doors to resist smoke passage, did not conduct fire drills as required, failed to conduct annual visual and functional assessments of fire doors, and did not perform or document required electrical receptacle testing. The emergency preparedness plan lacked required annual exercises.

The complaint investigation substantiated that the facility failed to provide proper written notice before transfer or discharge to residents or their responsible parties for three residents. Additional deficiencies were identified related to care planning, medication administration, infection control, and resident care.

The facility failed to provide written notice of transfer or discharge to residents or their responsible parties for three of 21 sampled residents. Deficiencies were found in care plan development and revision, medication administration, infection prevention and control, and provision of necessary services to dependent residents. The facility census was 89 at the time of the survey.

The facility failed to call emergency personnel in a timely manner and did not provide basic life support, including CPR, to a resident whose heartbeat and breathing had stopped. Interviews and record reviews showed staff did not initiate CPR despite the resident having no pulse and clear signs of distress.

No state licensure deficiencies were cited as a result of this inspection and complaint investigation.

The facility failed to develop and implement comprehensive care plans that included measurable objectives and discharge planning for residents. Specifically, discharge planning was not provided for one of 19 sampled residents, and the facility did not involve the resident or legal guardian in discharge planning discussions.

The facility failed to provide an access door for inspection of one of four smoke dampers in the HVAC duct work, which could affect smoke compartments during a fire emergency. The emergency preparedness portion of the survey did not result in deficiencies.

The facility failed to meet several Life Safety Code requirements including emergency preparedness communication plans, fire rating maintenance, means of egress clearance, corridor door integrity, fire drills compliance, and proper storage of oxygen cylinders. Deficiencies had the potential to affect residents' safety during emergencies.

The facility was found to have multiple deficiencies related to resident care, medication administration, infection control, and documentation. Deficiencies included failure to clarify code status, develop comprehensive care plans, provide care consistent with professional standards, and maintain proper medication storage and administration.