Inspection Reports for
Clark County Nursing Home
1260 N JOHNSON ST, KAHOKA, MO, 63445-1100
Back to Facility ProfileDeficiencies (last 5 years)
Deficiencies (over 5 years)
17.6 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
220% worse than Missouri average
Missouri average: 5.5 deficiencies/yearDeficiencies per year
36
27
18
9
0
Occupancy
Latest occupancy rate
52% occupied
Based on a March 2025 inspection.
Occupancy rate over time
Inspection Report
Plan of Correction
Census: 54
Deficiencies: 2
Date: Mar 4, 2025
Visit Reason
The inspection was conducted as a state survey of Clark County Nursing Home to assess compliance with resident rights and related regulations.
Findings
The facility failed to obtain written permission or verbal consent from a resident or their emergency contact prior to collecting a urine sample via straight catheter for a drug screen. The facility lacked a policy for obtaining drug screens on residents or following physician orders.
Deficiencies (2)
F550 Resident Rights/Exercise of Rights: The facility failed to obtain consent from Resident #1 or their emergency contact before performing a urine drug screen via straight catheter. The facility lacked a policy for obtaining drug screens or following physician orders.
A8013 Right to Plan Care/Refuse Treatment: The facility did not meet requirements for documenting resident refusal of treatment and informing residents or their representatives of possible consequences.
Report Facts
Facility census: 54
Inspection Report
Complaint Investigation
Census: 54
Deficiencies: 1
Date: Mar 4, 2025
Visit Reason
The inspection was conducted due to a complaint regarding the facility's failure to obtain notification and permission from a resident or their emergency contact before performing a urinary catheterization and urine drug screen.
Complaint Details
The complaint investigation found that the facility did not have a physician order or resident/emergency contact permission for a urine drug screen performed after a straight catheterization. The resident's physician and facility staff interviews confirmed the lack of consent and orders. The facility also lacked a policy for urine drug screening procedures.
Findings
The facility failed to obtain consent from Resident #1 or their emergency contact prior to performing a straight catheterization and urine drug screen. There was no physician order for the urine drug screen, and the facility lacked a policy for obtaining such tests or following physician orders. The resident's physician and facility staff confirmed these deficiencies.
Deficiencies (1)
Failure to provide for the rights of one resident by performing urinary catheterization and urine drug screen without notification and permission from the resident or emergency contact.
Report Facts
Residents Affected: 1
Facility Census: 54
Employees mentioned
| Name | Title | Context |
|---|---|---|
| DON | Director of Nursing | Interviewed regarding the catheterization and urine drug screen procedures without consent or physician order |
| Administrator | Facility Administrator | Interviewed about expectations for physician orders and resident permission for urine drug screens |
| Resident's Physician | Physician | Interviewed about facility's capability to test urine for drugs and need for permission |
Inspection Report
Plan of Correction
Census: 59
Deficiencies: 12
Date: Jan 29, 2025
Visit Reason
The document is a Plan of Correction submitted by Clark County Nursing Home following a survey conducted from January 21 to January 24, 2025, addressing deficiencies cited during the inspection.
Findings
The Plan of Correction addresses multiple deficiencies related to resident rights, medication management, transfer/discharge notices, comprehensive assessments, wound care, pressure ulcer prevention, infection control, food safety, and other regulatory requirements. The facility outlines corrective actions and timelines for compliance.
Deficiencies (12)
F 604 Right to be free from physical restraints. The facility failed to ensure that a resident was free from physical restraints related to an unsteady gait and pressure alarms were improperly used as restraints.
F 623 Notice requirements before transfer/discharge. The facility failed to notify residents or their representatives of transfers or discharges in accordance with regulations.
F 625 Bed hold policy before/after transfer. The facility did not have a bed hold policy or provide written notice to residents before transfer to a hospital.
F 637 Comprehensive assessment after significant change. The facility failed to complete comprehensive assessments within required timeframes after significant changes in residents' conditions.
F 658 Services provided meet professional standards. The facility failed to ensure insulin pens were not shared among residents, risking cross-contamination.
F 686 Treatment/services to prevent/heal pressure ulcers. The facility failed to provide adequate treatment and prevention for pressure ulcers, including proper wound care and pressure relief measures.
F 689 Free of accident hazards/supervision/devices. The facility failed to provide adequate supervision and assistance to prevent accidents and injuries among residents.
F 699 Trauma informed care. The facility failed to provide trauma informed care and appropriate interventions for residents with trauma histories.
F 700 Bedrails. The facility failed to assess and document the risk of entrapment and obtain consent for use of bed rails for residents.
F 761 Label/store drugs and biologicals. The facility failed to properly store and label medications, including insulin and controlled substances, and failed to discard expired medications.
F 812 Food safety requirements. The facility failed to maintain proper food storage temperatures, label food items correctly, and ensure food safety practices were followed.
F 880 Infection prevention and control. The facility failed to establish and maintain an infection prevention and control program, including proper cleaning and disinfection of equipment and monitoring for Legionella.
Report Facts
Facility census: 59
Plan of Correction completion dates: Various corrective actions scheduled for completion by 3/7/2025 and 3/6/2025
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Daniel Ramsey | Administrator, RN | Signed the Plan of Correction document |
Inspection Report
Routine
Census: 59
Deficiencies: 14
Date: Jan 29, 2025
Visit Reason
The inspection was conducted as a routine regulatory survey of Clark County Nursing Home to assess compliance with healthcare facility regulations, including resident care, safety, and infection control.
Findings
The facility was found deficient in multiple areas including failure to assess and document restraint use, failure to provide timely discharge and bed hold notices, incomplete significant change assessments, improper medication administration techniques, inadequate pressure ulcer care, lack of restorative nursing services for range of motion, unsafe wheelchair propulsion practices, improper labeling and storage of medications and food, failure to follow infection control practices, and lack of a comprehensive Legionella water management program.
Deficiencies (14)
Failed to assess use of pressure alarms as restraints and failed to document restraint evaluation.
Failed to provide written notice of discharge and transfer rights to residents and representatives.
Failed to provide written notice of bed hold policy to residents and representatives.
Failed to complete significant change status assessments within 14 days for residents with declines in condition.
Failed to follow proper medication administration techniques for insulin pens and eye drops.
Failed to provide appropriate pressure ulcer care including updated care plans, pressure relief, and proper mattress settings.
Failed to provide restorative nursing services to maintain or improve range of motion and prevent contractures.
Failed to ensure safe wheelchair propulsion with foot pedals and proper supervision.
Failed to label and discard expired medications and insulin vials/pens, and failed to secure controlled substances properly.
Failed to label and discard expired or opened food items and failed to maintain food service equipment cleanliness.
Failed to follow infection control standards for blood glucose monitoring and oxygen/nebulizer equipment storage and cleaning.
Failed to develop and implement a comprehensive Legionella water management program including risk assessment, water flow mapping, monitoring, and staff education.
Failed to assess resident risk for side rail use, obtain consent, and document entrapment risk prior to use of side rails.
Failed to provide trauma informed care and assessment for a resident with PTSD, including identification of triggers and care plan interventions.
Report Facts
Facility census: 59
Insulin vial open duration: 54
Water temperature: 106.5
Water temperature: 104.2
Water temperature: 107.8
Water temperature: 108.1
Employees mentioned
| Name | Title | Context |
|---|---|---|
| RN B | Registered Nurse | Named in medication administration technique deficiency |
| CMT C | Certified Medication Technician | Named in medication administration and infection control deficiencies |
| DON | Director of Nursing | Provided multiple interviews regarding deficiencies and facility practices |
| Administrator | Facility Administrator | Provided interviews regarding facility policies and deficiencies |
| Wound Care Nurse | Wound Care Nurse | Named in pressure ulcer care deficiencies |
| MDS Coordinator | MDS Coordinator | Named in significant change assessment deficiencies |
| Dietary Manager | Dietary Manager | Named in food labeling and storage deficiencies |
| Dietary Supervisor | Dietary Supervisor | Named in food labeling and storage deficiencies |
| Maintenance Technician | Maintenance Technician | Named in Legionella water management deficiencies |
| Infection Preventionist | Infection Preventionist | Named in infection control and Legionella deficiencies |
| CNA E | Certified Nursing Assistant | Named in oxygen tubing storage deficiency |
| CMT N | Certified Medication Technician | Named in blood glucose monitoring infection control deficiency |
| CNA/CMT M | Certified Nurse Assistant/Certified Medication Technician | Named in wheelchair propulsion deficiency |
Inspection Report
Life Safety
Census: 59
Capacity: 103
Deficiencies: 7
Date: Jan 21, 2025
Visit Reason
The inspection was a Life Safety Code survey conducted to assess compliance with fire safety and related regulations at Clark County Nursing Home.
Findings
The facility failed to meet several Life Safety Code requirements including excess lint buildup in dryers, obstructed means of egress, doors not opening freely, sprinkler head maintenance issues, HVAC dust buildup, smoking regulation violations, and electrical equipment maintenance deficiencies. These deficiencies had the potential to affect residents, staff, and visitors in multiple smoke compartments.
Deficiencies (7)
K100: The facility failed to ensure five gas clothes dryers in the laundry room did not have excess lint buildup, creating a fire hazard.
K211: The facility failed to maintain means of egress free of obstructions, including trash bags blocking emergency exit doors.
K222: Doors within means of egress did not open freely, with some requiring considerable force due to freezing weather and maintenance issues.
K353: Sprinkler heads were dirty, corroded, and had unsealed gaps around escutcheon plates in multiple rooms, risking sprinkler system effectiveness.
K521: Independently motorized ventilation units had dust and debris buildup, posing a fire hazard in multiple smoke compartments.
K741: The facility failed to maintain the staff smoking area and therapy department visitor smoking area properly, with cigarette butts improperly disposed.
K919: Electrical wiring and equipment were not properly maintained, including missing cover plates and cracked receptacle faceplates in several areas.
Report Facts
Facility capacity: 103
Census: 59
Residents affected: 30
Residents affected: 37
Residents affected: 7
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Sammy McDaniel Ramsey | Administrator RN | Signed the report and plan of correction |
Inspection Report
Routine
Census: 59
Deficiencies: 9
Date: May 4, 2023
Visit Reason
The inspection was a routine regulatory survey of Clark County Nursing Home to assess compliance with healthcare facility regulations, including care planning, fall prevention, infection control, and vaccination policies.
Findings
The facility failed to develop and implement timely baseline care plans, update care plans to reflect current resident needs, ensure safe resident transfers and wheelchair transport, provide continuous oxygen therapy as ordered, obtain informed consent and assess for safe use of bed rails, maintain food safety and hygiene standards, and implement proper infection control practices including hand hygiene and nebulizer mask storage. Additionally, the facility lacked policies for pneumococcal vaccination administration and failed to provide or document vaccination education and administration per CDC guidelines.
Deficiencies (9)
Failed to develop and implement baseline care plans within 48 hours of admission for residents.
Failed to update resident care plans to reflect current care needs and interventions.
Failed to use proper technique and gait belts during resident transfers and failed to use foot rests during wheelchair transport.
Failed to provide continuous oxygen therapy during resident transport as ordered, resulting in low oxygen saturation.
Failed to obtain informed consent, educate residents or representatives, and assess for safe use of bed rails including entrapment zone measurements.
Failed to ensure food items were properly labeled, dated, sealed, and discarded when expired; failed to ensure staff used sanitary practices and wore hair restraints.
Failed to ensure nursing staff performed proper infection control practices including hand hygiene, glove use, and nebulizer mask coverage.
Failed to develop and implement policies and procedures for pneumococcal vaccinations and failed to provide vaccinations or education per CDC recommendations.
Failed to regularly inspect bed frames, mattresses, and bed rails for safety and entrapment risks and to document such inspections.
Report Facts
Residents sampled: 19
Facility census: 59
Deficiency count: 9
Employees mentioned
| Name | Title | Context |
|---|---|---|
| CNA F | Certified Nurse Aide | Named in findings related to improper transfer technique and failure to perform hand hygiene during perineal care. |
| CNA G | Certified Nurse Aide | Named in findings related to improper transfer technique and failure to perform hand hygiene during perineal care. |
| Quality Assurance Nurse | Quality Assurance Nurse | Provided information on facility policies and deficiencies during interviews. |
| Director of Nursing | Director of Nursing | Provided information on expectations for care plans, oxygen use, bed rail use, and infection control. |
| Administrator | Facility Administrator | Provided information on facility policies and expectations during interviews. |
| CMT B | Certified Medication Technician | Observed transporting resident without oxygen and not using portable oxygen during transport. |
| CMT C | Certified Medication Technician | Observed administering nebulizer treatment and transporting resident without covering nebulizer mask. |
| Dietary Staff O | Dietary Staff | Observed not wearing gloves when handling ready to eat food. |
| NA L | Nursing Assistant | Observed feeding resident with bare hands and failing to perform hand hygiene during perineal care. |
| Activity Aide M | Activity Aide | Observed touching resident food with bare hands without hand hygiene. |
Inspection Report
Life Safety
Census: 59
Capacity: 103
Deficiencies: 15
Date: May 4, 2023
Visit Reason
The inspection was conducted as an emergency preparedness and life safety code survey to assess compliance with fire safety regulations and related provisions.
Findings
The facility failed to meet several life safety code requirements including proper enclosure of vertical openings, fire extinguisher knowledge and use, sprinkler system maintenance, corridor door closures, electrical receptacle safety, and proper storage of oxygen cylinders. These deficiencies had the potential to affect residents and occupants in multiple areas of the facility.
Deficiencies (15)
K311 Vertical openings were not properly enclosed with at least a one-hour fire separation between the first floor and attic, with multiple unsealed penetrations observed in ceilings throughout the facility.
K324 Dietary staff lacked proper knowledge of fire extinguisher use and failed to follow correct procedures for grease fires in the kitchen, risking resident safety.
K353 The sprinkler system was not properly maintained; obstructions and lint accumulation were found on sprinkler heads in multiple locations, affecting fire protection.
K363 Corridor doors did not close tightly or seal properly, creating smoke-tight seal failures in four of seven smoke compartments, endangering occupants.
K912 Electrical outlets near water sources lacked ground-fault circuit interrupter (GFCI) protection, exposing occupants to electrocution hazards.
K918 The facility failed to conduct annual inspections and testing of the emergency generator, risking power failure during emergencies.
K920 Unsafe electrical wiring practices were observed including use of extension cords for permanent wiring and improper surge protector use, endangering occupants.
K923 Oxygen cylinders were improperly stored in a resident's room with combustibles nearby and no confirmation of hospice pickup, creating fire and safety hazards.
A1088 Doors between rooms and corridors lacked required louvers or transoms and did not meet fire-resistance standards, compromising fire containment.
A2007 Noncombustible material was not properly used between floors to prevent fire and smoke passage, violating fire safety regulations.
A2010 Oxygen storage did not comply with NFPA 99 standards; cylinders were not secured or stored properly, risking fire hazards.
A2017 The facility failed to maintain and certify range hood extinguishing systems as required, risking fire safety in cooking areas.
A2034 Sprinkler system maintenance and testing were inadequate, failing to meet inspection and operational standards.
A3030 Electrical wiring and equipment were not maintained according to NFPA 70 standards, risking electrical hazards.
A3037 Extension cords and duplex receptacles were improperly used and not UL-approved, creating electrical safety risks.
Report Facts
Facility capacity: 103
Resident census: 59
Deficiencies cited: 15
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Tammy McDaniel Ramsey | Administrator | Signed the report and plan of correction |
Inspection Report
Abbreviated Survey
Deficiencies: 0
Date: Nov 12, 2020
Visit Reason
A COVID-19 Focused Emergency Preparedness survey and a COVID-19 Focused Infection Control Survey were conducted to assess compliance with CMS and CDC recommended practices related to COVID-19.
Findings
The facility was found to be in compliance with 42 CFR 483.73 related to emergency preparedness and with CMS and CDC recommended practices for COVID-19 infection control.
Report Facts
Regulatory compliance references: 42
Inspection Report
Abbreviated Survey
Census: 53
Deficiencies: 2
Date: Oct 8, 2020
Visit Reason
A COVID-19 Focused Emergency Preparedness survey was conducted to assess infection prevention and control compliance during the COVID-19 pandemic.
Findings
The facility failed to maintain an effective infection control program related to COVID-19, including inadequate documentation of respiratory symptom monitoring and allowing staff with symptoms to work. Two staff members tested positive for COVID-19 and potentially transmitted the virus to residents.
Deficiencies (2)
F880 Infection Prevention & Control: The facility failed to follow the COVID-19 Screening Policy by inadequately documenting monitoring of residents for respiratory symptoms and allowing symptomatic staff to work, resulting in potential virus transmission to residents.
A4085 Infection Control/Communicable Disease: The facility did not make timely reports to the division when residents were diagnosed with communicable diseases as required by state regulations.
Report Facts
Facility census: 53
Employees tested positive: 2
Residents tested positive: 2
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Licensed Practical Nurse D | Licensed Practical Nurse | Interviewed regarding resident temperature assessments and symptom monitoring |
| Registered Nurse H | Registered Nurse | Interviewed regarding COVID-19 symptom assessments and resident monitoring |
| Registered Nurse I | Registered Nurse | Interviewed regarding symptom assessments and resident interactions |
| Director of Nursing | Director of Nursing | Interviewed regarding COVID-19 screening policy and symptom monitoring |
| Certified Nurse Aide F | Certified Nurse Aide | Worked while symptomatic and tested positive for COVID-19 |
| Certified Nurse Aide L | Certified Nurse Aide | Worked while symptomatic and tested positive for COVID-19 |
| Administrator | Administrator | Interviewed regarding staff screening and COVID-19 symptom protocols |
| Infection Preventionist | Infection Preventionist | Interviewed regarding COVID-19 testing and symptom protocols |
Inspection Report
Abbreviated Survey
Deficiencies: 0
Date: May 22, 2020
Visit Reason
A COVID-19 Focused Emergency Preparedness survey and a COVID-19 Focused Infection Control Survey were conducted on May 22, 2020 to assess the facility's compliance with related CMS and CDC requirements.
Findings
The facility was found to be in compliance with 42 CFR 483.73 related to emergency preparedness and with CMS and CDC recommended practices for COVID-19 infection control.
Inspection Report
Routine
Census: 65
Deficiencies: 3
Date: Sep 19, 2019
Visit Reason
The inspection was conducted to evaluate the facility's compliance with professional standards of care, medication administration, infection control, and other regulatory requirements.
Findings
The facility failed to provide appropriate care to prevent constipation in several residents by not monitoring and documenting bowel movements or administering medications as ordered. Additionally, there were medication administration errors related to insulin dosing and a failure to implement a comprehensive infection prevention program for Legionella.
Deficiencies (3)
Failure to monitor and document bowel movements and administer medications to prevent constipation for multiple residents.
Failure to administer insulin according to manufacturer's recommendations, risking incomplete dosing.
Failure to maintain and implement an infection prevention and control program to prevent water-borne pathogens including Legionella.
Report Facts
Residents affected: 3
Residents affected: 1
Residents affected: Few
Census: 65
Employees mentioned
| Name | Title | Context |
|---|---|---|
| RN A | Registered Nurse | Interviewed regarding bowel movement documentation and medication administration |
| CMT B | Certified Medication Technician | Interviewed regarding bowel movement logs and medication administration |
| DON | Director of Nursing | Interviewed regarding bowel movement documentation, medication administration, and infection control policies |
| RN C | Registered Nurse | Observed administering insulin incorrectly and interviewed about insulin administration practices |
| Administrator | Interviewed regarding Legionella prevention policy implementation |
Inspection Report
Annual Inspection
Census: 65
Deficiencies: 3
Date: Sep 19, 2019
Visit Reason
Annual survey of Clark County Nursing Home to assess compliance with federal regulations including quality of care, medication administration, and infection control.
Findings
The facility was found deficient in quality of care related to bowel movement monitoring and medication administration, specifically insulin administration. The infection prevention and control program was also found lacking a comprehensive risk assessment for Legionella.
Deficiencies (3)
F684 Quality of care: The facility failed to provide necessary care and services to maintain or improve residents' physical and mental well-being by not adequately monitoring and documenting bowel movements for residents #33, #35, and #62.
F760 Residents are free of significant medication errors: The facility failed to administer insulin according to manufacturer's recommendations for Resident #4, risking incomplete dosing.
F880 Infection Prevention & Control: The facility failed to maintain a comprehensive infection control program by not implementing a risk assessment for waterborne pathogens including Legionella.
Report Facts
Facility census: 65
Deficiencies cited: 3
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Danny McDaniel Ramsey | Administrator | Signed the statement of deficiencies and plan of correction |
| RN C | Registered Nurse | Observed administering insulin and blood sugar monitoring |
| RN A | Registered Nurse | Interviewed regarding bowel movement documentation procedures |
| Certified Medication Technician B | Certified Medication Technician | Interviewed about bowel movement log procedures |
| Director of Nursing (DON) | Director of Nursing | Interviewed regarding documentation and staff instructions |
Inspection Report
Life Safety
Census: 65
Capacity: 103
Deficiencies: 7
Date: Sep 19, 2019
Visit Reason
The inspection was conducted as a Life Safety Code survey to assess compliance with fire safety regulations and related requirements at Clark County Nursing Home.
Findings
The facility failed to ensure corridor doors resisted the passage of smoke and were positive-latching, failed to maintain smoke barrier doors as self-closing, and did not provide functioning exhaust ventilation in resident restrooms. These deficiencies had the potential to affect multiple residents in various smoke compartments.
Deficiencies (7)
K363 Corridor doors failed to resist passage of smoke, were not positive-latching, and had impediments to closing in multiple locations. This affected 22 residents and others near the west nurse's station and activity rooms.
K374 Smoke barrier doors in the attic were not fully self-closing or maintained, held open approximately ½ inch, and required manual intervention to close. This affected 22 residents in two smoke compartments.
K521 HVAC exhaust ventilation in resident restrooms on the 400 hall was not functional, failing to provide negative airflow to vent odors. This affected 14 residents in one smoke compartment.
K321 Hazardous areas were not protected by self-closing doors, including kitchen and service corridor doors held open. This deficiency affected residents, visitors, and staff near the kitchen, laundry, and employee lounge.
A2054 Smoke section walls/doors were not compliant with fire rating and self-closing requirements, referencing K374 for details.
A3001 Building was not substantially constructed or maintained in good repair per regulatory requirements, referencing K363 and K521 for details.
A2008 Hazardous areas were not separated by one-hour fire-resistant construction with self-closing doors, referencing K321 for details.
Report Facts
Facility capacity: 103
Census: 65
Residents potentially affected: 22
Residents potentially affected: 14
Residents potentially affected: 29
Residents potentially affected: 6
Inspection Report
Annual Inspection
Census: 59
Deficiencies: 4
Date: Jul 13, 2018
Visit Reason
Annual survey conducted to assess compliance with federal regulations for Clark County Nursing Home.
Findings
The facility was found deficient in multiple areas including professional standards for eye medication administration, discharge summaries, catheter care, infection prevention and control, and urinary and bowel incontinence care. Deficiencies were documented with specific resident cases and facility policy reviews.
Deficiencies (4)
F658: Facility staff failed to hold lacrimal duct pressure for one minute following eye medication instillation for two residents, not meeting professional standards of quality.
F661: Facility failed to provide discharge summaries for two discharged residents, lacking recapitulation of stay and post-discharge plans.
F690: Facility failed to provide appropriate catheter and incontinence care for residents, including improper catheter tubing placement and inadequate perineal care.
F880: Facility failed to establish and maintain an infection prevention and control program, including inadequate hand hygiene and improper storage of medical equipment.
Report Facts
Facility census: 59
Date survey completed: Jul 13, 2018
Plan of correction completion dates: Aug 15, 2018
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jimmy McDaniel-Ramsey | Administrator | Signed the report and plan of correction; mentioned as Director of Nursing in interviews |
| LPN A | Licensed Practical Nurse | Observed failing to hold pressure on lacrimal ducts and interviewed regarding eye medication administration |
| CMT H | Certified Medication Technician | Observed administering eye drops and interviewed about proper technique |
| DON | Director of Nursing | Interviewed regarding discharge summary and infection control practices |
Inspection Report
Life Safety
Census: 59
Capacity: 103
Deficiencies: 7
Date: Jul 11, 2018
Visit Reason
The inspection was conducted as a Life Safety Code survey to assess compliance with the 2012 edition of the Life Safety Code of the National Fire Protection Association and related regulations.
Findings
The facility failed to meet several Life Safety Code requirements including maintaining smoke barriers, bathroom ventilation, and functioning nightlights in resident rooms. These deficiencies had the potential to affect multiple residents in various smoke compartments.
Deficiencies (7)
K000: The facility does not meet the applicable provisions of the 2012 Life Safety Code of the National Fire Protection Association and related reference documents.
K374: The facility failed to install a fire-resistant door with a self-closing device in the smoke barrier extending into the administrator's office, affecting two of eight smoke compartments.
K521: The facility failed to maintain bathroom ventilation free from buildup of fuzzy debris, potentially affecting 14 residents in two of nine smoke compartments.
A1096: The heating system, steam system, boilers, and ventilation do not meet all local, state, and NFPA code requirements, as referenced by K521.
A1132: The facility failed to ensure resident rooms had functioning nightlights in multiple rooms, affecting the safety of residents.
A2054: Smoke section walls and doors are not properly separated by one-hour fire-rated walls with self-closing doors, as referenced by K374.
E000: No deficiencies were cited as a result of the emergency preparedness investigation.
Report Facts
Facility capacity: 103
Census: 59
Residents potentially affected: 14
Smoke compartments: 2
Smoke compartments: 7
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Tammy McDaniel Ramsey | Administrator | Signed the statement of deficiencies and plan of correction |
| Myanda Armstrong | Asst. Admin. | Signed initial comments on Life Safety Code deficiencies |
Inspection Report
Plan of Correction
Census: 56
Deficiencies: 2
Date: Apr 13, 2018
Visit Reason
The inspection was conducted in response to allegations of abuse, neglect, exploitation, or mistreatment involving one resident. The facility was required to report such allegations immediately and take corrective action.
Findings
The facility failed to report an allegation of physical and verbal abuse involving one resident within the required two-hour timeframe. Documentation and interviews revealed that a Licensed Practical Nurse verbally abused a resident and the allegation was not reported timely due to the Director of Nursing being on vacation.
Deficiencies (2)
F609: The facility failed to report an allegation of physical and verbal abuse involving one resident within the required two-hour timeframe to the state agency and other officials.
A8025: The facility did not immediately report suspected abuse or neglect to the Department of Health and Senior Services and Department of Mental Health as required by regulation.
Report Facts
Facility census: 56
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Danny McDaniel Ramsey | Administrator | Signed the statement of deficiencies and plan of correction |
| CNA B | Reported that Licensed Practical Nurse A held down and cursed at a resident | |
| Licensed Practical Nurse A | Licensed Practical Nurse | Accused of verbally abusing a resident by cursing and holding the resident down |
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