Inspection Reports for
Audubon Health and Rehab
2110 AUDUBON AVENUE, THIBODAUX, LA, 70301
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Inspection Report — Sep 18, 2025
CMS
Date: Sep 18, 2025
Visit Reason
The inspection was conducted to evaluate compliance with discharge planning requirements and infection prevention and control protocols at Audubon Health and Rehab.
Findings
The facility failed to include a cognitively intact resident in discharge planning discussions despite documented requests to be discharged. Additionally, staff failed to wear required personal protective equipment during care for a resident on Enhanced Barrier Precautions.
Deficiencies (2)
F 0627: The facility failed to ensure Resident #8 was included in discharge planning discussions despite having a BIMS score of 13 and expressing a desire to be discharged. Discharge planning was only discussed with the resident's family.
F 0880: The facility failed to ensure staff wore gowns during personal hygiene care for Resident #39 who was on Enhanced Barrier Precautions, violating infection control policies.
Report Facts
Residents sampled for discharge requirements: 3
Residents on Enhanced Barrier Precautions sampled: 8
Employees mentioned
| Name | Title | Context |
|---|---|---|
| S2 Director of Nursing | Director of Nursing | Confirmed Resident #8 had spoken about discharge desire and staff should have worn gowns during Resident #39's care |
| S5 Social Services Director | Social Services Director | Acknowledged Resident #8's discharge preferences were not discussed with the resident and not informed of discharge request |
| S7 Licensed Practical Nurse | Licensed Practical Nurse | Indicated Resident #8 expressed desire to go home |
| S4 Admissions Coordinator | Admissions Coordinator | Indicated Resident #8 expressed desire to go home |
| S8 CNA Supervisor | CNA Supervisor | Confirmed staff should have worn gown during Resident #39's personal hygiene care |
| S9 Certified Nursing Assistant | Certified Nursing Assistant | Observed shaving Resident #39 without wearing gown and unaware gown was required |
| S6 Assessment Nurse | Assessment Nurse | Indicated discharge planning goals were not discussed with Resident #8 during care plan meetings |
| S1 Administrator | Administrator | Indicated social services should have been notified of Resident #8's discharge request and resident should have been included in discharge planning |
Inspection Report — Sep 25, 2024
CMS
Date: Sep 25, 2024
Visit Reason
The inspection was conducted to assess compliance with safety and infection control regulations, including ensuring residents did not have prohibited items such as cigarette lighters and that clean items were properly stored in the laundry area.
Findings
The facility failed to ensure residents did not have cigarette lighters in their possession or rooms, contrary to the facility's smoking policy. Additionally, clean items in the laundry room were improperly stored in the contaminated area, violating infection prevention protocols.
Deficiencies (2)
F 0689: The facility failed to ensure residents did not have cigarette lighters in their possession or rooms, contrary to the smoking policy. Residents #32 and #79 were found with functional cigarette lighters in their rooms or possession.
F 0880: The facility failed to ensure clean items in the laundry room were not kept in the contaminated area. Clean mop heads and microfiber cloths were observed hanging in the contaminated laundry area.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| S2 Director of Nursing | Director of Nursing | Interviewed regarding awareness of smoking policy and cigarette lighter possession. |
| S1 Administrator | Administrator | Confirmed facility's smoking policy prohibiting residents from keeping cigarette lighters. |
Inspection Report — Sep 28, 2023
Routine CMS
Date: Sep 28, 2023
Visit Reason
Routine inspection of Audubon Health and Rehab nursing home to assess compliance with regulatory requirements including resident care, infection control, and PASARR evaluations.
Findings
The facility was found deficient in multiple areas including failure to provide an adaptive call bell for a resident with limited hand mobility, failure to notify physicians and responsible parties of changes in resident conditions, failure to refer a resident for PASARR Level II evaluation after new mental illness diagnosis, failure to update care plans after resident incidents, improper perineal and catheter care, and inadequate hand hygiene and linen handling practices.
Deficiencies (6)
F 0558: The facility failed to provide an adaptive call bell for Resident #44 who had limited hand mobility and was unable to use the standard call bell, requiring her to holler for assistance.
F 0580: The facility failed to notify physicians, responsible parties, and hospice agencies of changes in condition for Residents #44, #67, and #87, including new wounds and bruising.
F 0644: The facility failed to refer Resident #47 for a PASARR Level II evaluation after a new diagnosis of unspecified psychosis.
F 0656: The facility failed to update Resident #102's care plan after an elopement attempt, missing reassessment and new interventions.
F 0690: The facility failed to ensure proper infection control during perineal care for Residents #44 and #87, including wiping from back to front and allowing catheter drainage valve to touch the floor.
F 0880: The facility failed to ensure staff performed hand hygiene per policy during catheter care and meal tray delivery, and improperly handled soiled linen by placing it on the floor and clean linen cart.
Report Facts
Residents reviewed for call bell use: 30
Residents included in final resident sample: 25
Residents reviewed for PASARR: 2
Residents investigated for dementia care: 3
Residents observed for perineal care: 2
Employees mentioned
| Name | Title | Context |
|---|---|---|
| S2 Director of Nursing | Director of Nursing | Confirmed failure to accommodate adaptive call bell and failure to notify physicians and responsible parties |
| S8 Treatment Nurse | Treatment Nurse | Failed to notify physician and responsible party of new wounds and documented notification incorrectly |
| S7 Licensed Practical Nurse | Licensed Practical Nurse | Responsible for notifying physicians of new wounds but failed to do so timely |
| S21 Certified Nursing Assistant | Certified Nursing Assistant | Performed improper perineal care and catheter care, failed hand hygiene, and mishandled linen |
| S16 Certified Nursing Assistant | Certified Nursing Assistant | Performed improper perineal care and mishandled soiled linen |
| S12 Certified Nursing Assistant | Certified Nursing Assistant | Failed to perform hand hygiene when delivering meal trays |
| S6 CNA Supervisor | CNA Supervisor | Confirmed deficiencies in hand hygiene and perineal care practices |
| S20 Social Worker | Social Worker | Unaware of requirement to refer resident for PASARR evaluation |
| S4 Careplan | Careplan Staff | Not informed of resident elopement attempt and failure to update care plan |
Inspection Report — Mar 16, 2023
Annual Inspection CMS
Date: Mar 16, 2023
Visit Reason
The inspection was conducted as a standard annual survey to assess compliance with infection prevention and control policies, specifically focusing on wound care procedures.
Findings
The facility failed to ensure that the Treatment Nurse performed hand hygiene according to facility policy during wound care for two residents. Observations and interviews confirmed multiple instances where hand hygiene was not performed between wound care steps, posing a risk of infection.
Deficiencies (1)
F 0880: The facility failed to ensure the Treatment Nurse performed hand hygiene per policy during wound care for Resident #3 and Resident #5. The nurse did not perform hand hygiene between removing old dressings, cleaning wounds, applying barrier cream, and applying new dressings.
Report Facts
Residents reviewed for wound care: 5
Residents affected: 2
Employees mentioned
| Name | Title | Context |
|---|---|---|
| S3 Treatment Nurse | Named in multiple wound care hand hygiene deficiencies | |
| S2 Assistant Director of Nursing | Assistant Director of Nursing | Provided statements on hand hygiene expectations |
| S1 Quality Improvement Nurse | Quality Improvement Nurse | Provided statements on hand hygiene expectations |
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