Inspection Reports for
Creekwood Nursing & Rehabilitation
107 BOYLES DRIVE, RUSSELLVILLE, KY, 42276
Back to Facility ProfileDeficiencies (last 3 years)
Deficiencies (over 3 years)
6 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
28% worse than Kentucky average
Kentucky average: 4.7 deficiencies/yearDeficiencies per year
16
12
8
4
0
Inspection Report
Routine
Deficiencies: 4
Date: Oct 31, 2024
Visit Reason
The inspection was conducted to assess compliance with regulatory standards related to resident care, medication management, food safety, and infection control at Creekwood Nursing & Rehabilitation.
Findings
The facility was found deficient in multiple areas including improper handling of feeding tubes by CNAs, discrepancies in controlled medication counts and narcotic waste procedures, failure to properly store and label food items in the kitchen, and inadequate infection prevention practices related to gastrostomy tube care.
Deficiencies (4)
F 0684: The facility failed to ensure residents received treatment and care according to professional standards, as a CNA detached and placed a resident's feeding tube pump on hold without proper education or authorization.
F 0755: The facility failed to maintain accurate controlled drug counts and ensure proper narcotic waste procedures for two residents receiving narcotic medications.
F 0812: The facility failed to store, prepare, distribute, and serve food in accordance with professional standards, as multiple food items in the walk-in freezer were not sealed or dated when opened.
F 0880: The facility failed to establish and maintain an infection prevention and control program, as a CNA detached a resident's gastrostomy tube leaving the tubing uncapped and exposed, risking contamination.
Report Facts
Residents affected: 1
Residents affected: 2
Residents affected: 85
Residents affected: 18
Residents affected: 1
Medication count discrepancy: 1
Medication count discrepancy: 1
Employees mentioned
| Name | Title | Context |
|---|---|---|
| CNA2 | Certified Nurse Aide | Named in feeding tube care deficiency for detaching and placing feeding tube pump on hold |
| RN1 | Registered Nurse | Interviewed regarding feeding tube detachment and care |
| LPN Staff Development Coordinator | Licensed Practical Nurse Staff Development Coordinator | Provided information on CNA orientation and feeding tube care education |
| Director of Nursing | Director of Nursing | Provided expectations on feeding tube care and narcotic medication management |
| Administrator | Facility Administrator | Provided expectations on feeding tube care and narcotic medication management |
| KMA4 | Kentucky Medical Assistant | Observed narcotic medication count discrepancies |
| KMA1 | Kentucky Medical Assistant | Observed narcotic medication count discrepancies |
| Dietary Manager | Dietary Manager | Interviewed regarding food storage and safety deficiencies |
| C2 | Dietary Staff | Interviewed regarding food storage and safety deficiencies |
| C3 | Cook | Interviewed regarding food storage and safety deficiencies |
Inspection Report
Deficiencies: 1
Date: Sep 25, 2019
Visit Reason
The inspection was conducted to assess the facility's compliance with infection prevention and control standards, specifically related to providing a sanitary environment to prevent infection development.
Findings
The facility failed to provide a sanitary environment during incontinent care for one resident, resulting in contamination of an open wound. Observations and interviews confirmed improper technique by a Certified Nurse Aide, leading to potential infection risk.
Deficiencies (1)
F 0880: The facility failed to provide and implement an infection prevention and control program. A Certified Nurse Aide contaminated an open wound on Resident #50 during incontinent care by wiping feces over the wound and patting it dry improperly.
Report Facts
Residents sampled: 25
Residents affected: 1
BIMS score: 7
Inspection Report
Routine
Deficiencies: 13
Date: Jul 3, 2018
Visit Reason
Routine inspection survey conducted to assess compliance with regulatory requirements for nursing home care.
Findings
The facility was found deficient in multiple areas including failure to maintain resident dignity, failure to notify physicians timely of significant changes, inadequate care planning, improper use of antipsychotic medication, failure to maintain safe and sanitary environment, and failure to ensure proper immunizations and food safety.
Deficiencies (13)
F 0550: The facility failed to honor residents' rights to dignity by not using catheter dignity bags for Resident #10 and allowing soiled footwear on Resident #46.
F 0580: The facility failed to notify physicians timely of significant changes in condition for Residents #37 and #54, resulting in delayed treatment.
F 0584: The facility failed to maintain a comfortable environment due to excessive loud and frequent overhead paging.
F 0656: The facility failed to develop comprehensive care plans addressing diagnoses such as UTI, sepsis, and dehydration for Residents #27 and #37.
F 0684: The facility failed to provide treatment and care according to orders and resident preferences for Resident #37, who experienced delayed recognition of lethargy and decline.
F 0692: The facility failed to ensure Resident #54 was placed on weekly weights after significant weight loss was identified.
F 0732: The facility failed to post accurate and current nurse staffing information in a prominent place accessible to residents and visitors.
F 0744: The facility failed to implement an individualized dementia care program for Resident #67 diagnosed with dementia.
F 0758: The facility failed to ensure appropriate diagnosis for use of antipsychotic medication for Resident #49 receiving Zyprexa.
F 0804: The facility failed to ensure recipes were followed during meal preparation, as Dietary Aide #1 made bean soup without a recipe.
F 0812: The facility failed to store, prepare, and serve food in accordance with professional standards, including storing expired foods, unlabeled foods, and dirty kitchen equipment.
F 0883: The facility failed to ensure residents #10, #11, #32, and #37 were offered and documented pneumococcal and influenza immunizations as required.
F 0921: The facility failed to provide a safe, functional, sanitary, and comfortable environment related to uncovered bath basins and bed pans stored on bathroom floors and soiled privacy curtains in resident rooms.
Report Facts
Residents sampled: 18
Weight loss percentage: 10.65
BIMS scores: 99
BIMS scores: 7
BIMS scores: 4
BIMS scores: 6
BIMS scores: 13
BIMS scores: 3
Zyprexa dosage: 2.5
Residents receiving food: 88
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Licensed Practical Nurse #1 | LPN | Interviewed regarding soiled boots on Resident #46 |
| Assistant Director of Nursing | ADON | Interviewed regarding multiple deficiencies including dignity bags, physician notification, care plans, weight monitoring, staffing, and environment |
| Director of Nursing | DON | Interviewed regarding multiple deficiencies including dignity bags, physician notification, care plans, antipsychotic medication, staffing, and environment |
| Registered Dietitian | RD | Interviewed regarding weight monitoring and food safety |
| Dietary Manager | Dietary Manager | Interviewed regarding recipe adherence and food safety |
| Facility Administrator | Administrator | Interviewed regarding staffing and immunization documentation |
| Certified Nurse Aide #1 | CNA | Interviewed regarding care plans for dementia |
| Certified Nurse Aide #4 | CNA | Interviewed regarding care plans and environment |
| Certified Nurse Aide #9 | CNA | Interviewed regarding dementia care plans |
| Certified Nurse Aide #10 | CNA | Interviewed regarding dementia care plans |
| Housekeeping Supervisor | HKS | Interviewed regarding privacy curtain cleaning |
| Licensed Practical Nurse #2 | LPN | Interviewed regarding physician notification and dementia care plans |
| Advanced Practice Registered Nurse #1 | APRN | Interviewed post-survey regarding antipsychotic medication use |
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