Inspection Reports for
Communities of Wildwood Ranch

19 CSR 30-85.042(65) Protective Oversight, Voluntary Leave: Please refer to F689.

19 CSR 30-85.042(65) Protective Oversight, Voluntary Leave: See the deficiency cited at F689.

19 CSR 30-85.042(17) Criminal Background Check Request: Please refer to F607.

19 CSR 30-85.042(65) Protective Oversight, Voluntary Leave: Please refer to F689.

19 CSR 30-88.010(23) Develop/Implement A/N Policies: Please refer to F607.

19 CSR 30-85.022(6) Oxygen Storage: Please refer to K-923.

19 CSR 30-85.042(46) Safe/Effective Medication System: See F602.

19 CSR 30-85.042(67) Nursing Care per Res Condition: 1. Please refer to F684.

19 CSR 30-85.042(78) Infection Control/Communicable Disease: 1. Please refer to F690. 2. Please refer to F880.

19 CSR 30-88.010(29) Dignity/Privacy: 1. Please refer to F550.

19 CSR 30-85.042(78) Infection Control/Communicable Disease: See the deficiency cited at F880.

19 CSR 30-85.032(2) Substantially Constructed/Maintained: Please refer to K363.

19 CSR 30-85.042(27) Communicable Disease-Employees: Based on interview and record review, the facility failed to complete the second step of the two-step Tuberculosis (TB) screening for selected staff and did not document completion of required testing when supplies were unavailable.

19 CSR 30-85.042(47) Safe/Effective Medication System: Please refer to F759.

19 CSR 30-85.042(67) Nursing Care per Res Condition: Please refer to F695 and please refer to F700.

19 CSR 30-85.022(1)(D) Complete Sprinkler System: Please refer to K353.

19 CSR 30-85.042(27) Communicable Disease-Employees: Based on interview and record review, the facility failed to complete the two-step Tuberculosis (TB) test for two staff members out of a selected sample of eight staff members.

F757 Drug Regimen is Free from Unnecessary Drugs: Based on record review and interview, the facility failed to ensure all residents were free from unnecessary medications when staff administered a blood pressure medication to one resident (Resident #22) when the resident's blood pressure was outside the physician-ordered parameters. The resident's records did not document why hydralazine HCl was administered with systolic blood pressure below the ordered parameter.

F 689 Free of Accident Hazards/Supervision/Devices: Staff failed to ensure the environment was free of accident hazards and did not implement or follow planned fall interventions for Resident #1, resulting in a fall with facial injuries requiring hospital transfer.

F689 Free of Accident Hazards/Supervision/Devices: Based on interview and record review the facility failed to ensure all residents were as free from accident hazards as possible when staff completed a slide transfer for one resident, resulting in the resident's leg getting caught in a blanket and causing pain.

F607 Develop/Implement Abuse/Neglect Policies: Based on interview and record review, facility staff failed to ensure required criminal background checks, EDL checks, and CNA registry checks were completed prior to some employees beginning employment. Several personnel records reviewed lacked timely or completed background/registry verification.

F625 Notice of Bed Hold Policy Before/Upon Trnsfr: Based on interview and record review, the facility failed to give written notice of the facility's bed-hold policy to the resident and/or resident's representative for four residents transferred to the hospital, and documentation of providing the bed-hold notice was not present in the medical records.

F689 Free of Accident Hazards/Supervision/Devices: Based on observation, interview, and record review, the facility failed to provide protective oversight and ensure wander/elopement guard devices alarmed at all panels and pagers and failed to follow policy when a resident exited the building; staff did not consistently check or document wanderguard function as ordered.

K923 Gas Equipment - Cylinder and Container Storage: Based on observation and interview, the facility failed to properly separate full and empty oxygen cylinders in multiple oxygen storage areas, with full and empty tanks intermixed.

F 602 Free from Misappropriation/Exploitation: Based on record review and interview, the facility failed to protect residents from misappropriation when tablets of one resident's Belsomra went missing while in possession of the facility.

F 888 COVID-19 Vaccination of Facility Staff CFR(s): 483.80(i)(1)-(3)(i)-(x): Based on interview and record review, the facility failed to ensure 100% of staff had been fully vaccinated for COVID-19, granted a qualifying medical exemption that was not recognized by CDC guidance, and failed to ensure one staff member received the second dose of a two-dose COVID-19 vaccine in a timely manner.

F550 Resident Rights/Exercise of Rights: Based on observation, interview, and record review, the facility failed to ensure all residents were treated with dignity and respect when one staff member (Certified Medication Technician (CMT) H) interacted with multiple residents in a manner that made them uncomfortable.

F684 Quality of Care: Based on record review and interview, the facility failed to administer wound care as ordered and failed to monitor and fully assess a resident's wound showing signs of infection (Resident #8).

F690 Bowel/Bladder Incontinence, Catheter, UTI: Based on observation, record review, and interview, the facility failed to provide incontinent care in a manner to help prevent possible infection when staff failed to perform hand hygiene before and during incontinent care for three residents.

F880 Infection Prevention & Control: Based on observation, interview and record review, the facility failed to use appropriate infection control procedures, including staff failure to perform hand hygiene after incontinence care for multiple residents.

F 880 Infection Prevention & Control: Based on observation, interview, and record review, the facility failed to implement CDC and CMS recommendations to prevent the spread of COVID-19, including failure to prevent a staff person who reported possible symptoms from working their scheduled shift and failure to ensure staff working on COVID-19 positive units wore appropriate PPE while on the unit.

F 886 COVID-19 Testing-Residents & Staff: Based on record review and interview, the facility failed to perform staff testing for COVID-19 in accordance with CMS guidelines and failed to test staff at the recommended frequency (twice weekly) given the county COVID-19 positivity rate, instead testing staff once weekly.

F 880 Infection Prevention & Control: Based on observation, record review, and interview, staff failed to use appropriate infection control and hand hygiene practices during medication administration and glove changes and failed to wear face coverings properly, placing residents at risk of COVID-19 transmission.

E036 EP Training and Testing: Based on record review and interview, the facility failed to define a process for the training of staff covering aspects of the disaster plan. This deficient practice had the potential to affect all residents, staff, and visitors.

E039 EP Testing Requirements: Based on record review and interview, the facility failed to conduct required emergency preparedness exercises and documented only one tabletop exercise for the past year. This deficient practice had the potential to affect all residents, staff, and visitors.

K363 Corridor - Doors: Based on observation and interview, the facility did not ensure that doors to resident rooms, offices, and other ancillary areas were free of impediments and did not prevent doors from closing; gaps and doorstops were observed. This deficient practice could affect occupants by not preventing the spread of fire and smoke.

F636 Comprehensive Assessments & Timing: Based on record review and interview, facility staff failed to complete required annual comprehensive assessments (Minimum Data Set) for sampled residents within required timeframes.

F638 Qrly Assessment at Least Every 3 Months: Based on record review and interview, facility staff failed to complete required quarterly MDS assessments for multiple sampled residents within the required timeframes.

F640 Encoding/Transmitting Resident Assessments: Based on record review and interview, the facility failed to transmit required encoded MDS data including a Death-in-Facility MDS for one resident within required timeframes.

F695 Respiratory/Tracheostomy Care and Suctioning: Based on observation, interview, and record review, the facility failed to ensure proper CPAP/oxygen management and related orders, documentation, cleaning and staff practices for residents using CPAP or oxygen.

F700 Bedrails: Based on observation, record review, and interview, the facility failed to complete side/bed rail risk assessments, obtain informed consent, document measurements or orders, and otherwise document rationale for use of side rails for multiple residents.

F759 Free of Medication Error Rts 5 Prcnt or More: Based on observation, interview, and record review, the facility's medication error rate exceeded 5% (two errors in 28 opportunities) with failures in correct medication administration and documentation for a resident.

K 353 Sprinkler System - Maintenance and Testing: Observation and interview showed the sprinkler tool box had no spare sprinkler heads and staff reported sprinkler heads from the facility tool box were used and not replaced.

F 868 QAA Committee: Based on record review and interviews, the facility failed to maintain quarterly quality assessment committee (QAA) meetings with the required members.