Inspection Reports for Casselman Healthcare and Rehab

The inspection was conducted to assess compliance with care plan development and food safety requirements at Casselman Healthcare and Rehabilitation Center.

The facility failed to revise/update care plans after an incident involving physical aggression between residents and failed to serve food at safe and palatable temperatures, with some food items served below the required temperature.

The inspection was conducted to investigate complaints regarding the facility's failure to ensure licensed practical nurse and nurse aide certifications were current, and failure to follow physician's orders related to bowel protocols for a resident.

The facility failed to ensure a licensed practical nurse's license and a nurse aide's registry certification remained current, allowing them to work while expired. Additionally, the facility failed to follow physician's orders and facility bowel protocols for one resident, resulting in inadequate bowel care. Corrective actions included audits, suspensions, staff education, and ongoing monitoring.

The visit was complaint-related, triggered by concerns about expired licenses and certifications of staff and failure to follow physician's orders for resident care. Substantiation status is not explicitly stated.

The inspection was conducted to assess compliance with regulatory requirements related to resident assessments, care planning, nursing licensure, medication labeling, bowel care protocols, nurse aide registry status, and laboratory testing in the facility.

The facility was found to have multiple deficiencies including inaccurate Minimum Data Set assessments for residents, failure to update care plans to reflect current resident needs, a licensed practical nurse working with an expired license, failure to follow physician orders for bowel protocols, nurse aide registry expiration, improper medication labeling, and failure to obtain ordered laboratory tests.

The inspection was conducted to assess compliance with regulations regarding medication management and pharmaceutical services at Casselman Healthcare and Rehabilitation Center.

The facility was found to have failed in preventing misappropriation of medications for one resident and failed to maintain accurate accounting and documentation of controlled medications for another resident. Both deficiencies were determined to cause minimal harm or potential for actual harm affecting a few residents.

The inspection was conducted to assess compliance with regulatory standards related to resident care, including call bell accessibility and pressure ulcer care.

The facility failed to ensure call bells were within reach for two residents and did not follow wound consultant recommendations for pressure ulcer care for one resident, resulting in minimal harm or potential for actual harm.

The inspection was conducted to assess compliance with regulations regarding maintaining a safe, clean, and homelike environment and ensuring essential equipment is working safely in the facility.

The facility failed to maintain a clean and homelike environment, evidenced by damaged drywall in a resident's room and a blackish-brown removable substance under the second floor ice machine. Additionally, the facility failed to ensure that battery packs in mechanical lifts were replaced as needed, with several batteries exceeding the manufacturer's recommended lifespan.

The inspection was conducted to evaluate compliance with clinical record documentation standards at Casselman Healthcare and Rehabilitation Center.

The facility failed to ensure that clinical records were complete and accurately documented for one of six residents reviewed, specifically Resident 5, due to lack of documented assessment by a registered nurse during a noted decline in the resident's condition.

The inspection was conducted due to a complaint investigation regarding the facility's failure to provide timely written notification to a resident and the resident's representative about a hospital transfer.

The facility failed to provide written notice to Resident 54 and/or the resident's representative about the transfer and reason for hospitalization. The resident was transferred to the hospital after a significant decline, but no written notification was documented.

The complaint investigation found that the facility did not provide written notice to Resident 54 or the resident's representative about the hospital transfer, despite the resident's significant decline and transfer via ambulance. The Nursing Home Administrator confirmed this omission, citing that the resident was her own responsible party.

The inspection was conducted to assess compliance with regulatory requirements related to resident notification of transfers, adherence to physician orders, medication security, and hospice service coordination at Casselman Healthcare and Rehabilitation Center.

The facility was found deficient in providing timely written notification to a resident and their representative regarding hospital transfer, failing to follow physician orders for orthostatic blood pressure monitoring after a fall, leaving medication carts unsecured, and not obtaining required hospice documentation for a resident receiving hospice services.

The inspection was conducted to ensure that the nursing home area is free from accident hazards and provides adequate supervision to prevent accidents, specifically focusing on the facility's hot water temperatures.

The facility failed to maintain an environment free of potential safety hazards related to hot water temperatures, with observed water temperatures in resident sinks ranging from 114 to 125 degrees Fahrenheit, exceeding the policy limit of 110 degrees Fahrenheit. The Maintenance Director and Nursing Home Administrator confirmed the issue and made adjustments to decrease the water temperature.

The inspection was conducted to review the facility's pharmaceutical services and medication administration practices, specifically focusing on the accountability of controlled medications for selected residents.

The facility failed to ensure proper accountability of controlled medications for three of four residents reviewed, with no documented evidence that signed-out doses of controlled drugs were administered as ordered. This was confirmed through review of medication administration records, controlled drug records, and staff interviews.

The inspection was conducted following a complaint investigation regarding allegations of resident-to-resident abuse and failure to update care plans to reflect residents' specific care needs after incidents.

The facility failed to ensure residents were free from abuse, as Resident 1 hit Resident 4 causing a small eye injury. Additionally, the facility failed to update or revise care plans for four residents (Residents 1, 2, 4, and 6) to reflect individualized care and interventions after incidents of behavioral issues and altercations.

The complaint investigation substantiated that Resident 1 physically hit Resident 4, causing a small scleral abrasion and subconjunctival hemorrhage. Multiple statements from residents and staff confirmed the incident. The facility also failed to update care plans for residents involved in behavioral incidents.

The inspection was conducted due to concerns regarding the facility's failure to administer medications timely and to follow treatment recommendations for a resident with a wound infection and pressure ulcers.

The facility failed to timely administer doxycycline for a wound infection and did not follow the wound consultant's recommendations for twice-daily treatment of a Stage 4 pressure ulcer for Resident 1, resulting in delayed treatment and incomplete wound care.

The complaint investigation found substantiated issues related to delayed medication administration and inadequate wound care for Resident 1.

The inspection was conducted to assess compliance with regulatory requirements related to resident care plans, accident prevention, nutritional services, and overall facility operations at Casselman Healthcare and Rehabilitation Center.

The facility was found deficient in developing and implementing individualized care plans for residents, updating care plans to reflect current needs, ensuring the environment was free from accident hazards and implementing fall prevention interventions, obtaining weekly weights as recommended by the dietician, and following the planned menu for residents.

The inspection was conducted to evaluate the facility's compliance with providing appropriate treatment and care according to orders, resident preferences, and goals, specifically related to podiatry care and wound treatment for Resident 2.

The facility failed to ensure podiatry appointments were carried out, did not follow podiatry recommendations, failed to provide weekly surgical wound assessments, and did not provide adequate treatments for an ingrown toenail, resulting in infection and pain for Resident 2.

The inspection was conducted to assess compliance with nursing home regulations including resident rights, quality of care, safety, and management practices.

The facility was found deficient in multiple areas including failure to provide timely Medicare/Medicaid coverage notices, improper storage of wheelchairs affecting the homelike environment, admission agreements waiving liability for personal property losses, failure to follow physician orders for diabetic care and follow-up appointments, failure to ensure physician face-to-face visits, and ineffective Quality Assurance Performance Improvement (QAPI) committee oversight.

The inspection was conducted as a routine regulatory survey to assess compliance with nursing home regulations and quality of care standards.

The facility was found deficient in multiple areas including failure to provide timely Medicare notices, inadequate environment related to wheelchair storage, incomplete and inaccurate Minimum Data Set (MDS) assessments, failure to develop and update individualized care plans, failure to follow physician orders, unsafe environment and accident prevention measures, incomplete respiratory care orders, lack of trauma-informed care assessments, failure to ensure physician face-to-face visits, incomplete nurse aide performance evaluations, and failure to follow planned menus.

The inspection was conducted to investigate complaints regarding failure to timely notify residents' representatives after falls, failure to develop baseline care plans within 48 hours of admission, failure to implement fall prevention interventions, and incomplete clinical documentation.

The facility failed to notify family members timely after residents' falls for three residents, failed to develop and implement baseline care plans within 48 hours for one resident, failed to implement new interventions to prevent further falls or decrease complications after multiple falls for three residents, and failed to maintain complete and accurate clinical records for one resident.

The complaint investigation revealed failures related to notification of family members after falls, baseline care planning, fall prevention interventions, and clinical record documentation for three residents.

The inspection was conducted to evaluate compliance with regulatory standards related to resident rights, nursing services quality, and infection prevention and control practices at Casselman Healthcare and Rehabilitation Center.

The facility was found deficient in maintaining a clean and homelike environment in residents' rooms, ensuring nursing services met professional standards particularly regarding medication administration and documentation, and implementing proper infection control practices during wound care.

The inspection was conducted to assess compliance with regulatory standards related to resident rights, nursing services quality, and infection prevention and control practices at Casselman Healthcare and Rehabilitation Center.

The facility was found deficient in maintaining a clean and homelike environment in residents' rooms, ensuring nursing services met professional standards particularly regarding medication administration and documentation, and implementing proper infection control practices during wound care.