Inspection Reports for
Crown Rehab and Healthcare Center
3001 EAST ELM, HARRISONVILLE, MO, 64701-1196
Back to Facility Profile17 Reports
Inspection Report — Jul 21, 2023
Annual Inspection
Date: Jul 21, 2023
Visit Reason
Annual inspection survey conducted to assess compliance with federal and state regulations for Crown Rehab and Healthcare Center.
Findings
The facility was found to have multiple deficiencies including failure to ensure advance directives were properly documented, incomplete care plan revisions, inadequate medication storage and control, failure to provide timely dental services, and lapses in infection control and food safety practices. The facility census was 88 residents with a licensed capacity of 118 beds at the time of the survey.
Deficiencies (22)
F578 Request/Refuse/Discontinue Treatment; Advance Directives: The facility failed to ensure one sampled resident had a code status upon admission and did not properly document advance directives.
F657 Care Plan Timing and Revision: The facility failed to reassess and revise care plans timely for one sampled resident, missing documentation of resident needs and behaviors.
F658 Services Provided Meet Professional Standards: The facility failed to complete labs as ordered for one sampled resident and did not meet professional standards of care.
F677 ADL Care Provided for Dependent Residents: The facility failed to provide adequate nail care and timely response to call lights for sampled residents.
F755 Pharmacy Services/Procedures/Pharmacist/Records: The facility failed to ensure narcotic count sheets were properly signed and accounted for by nursing staff.
F761 Label/Store Drugs and Biologicals: The facility failed to store medications securely, maintain proper refrigeration temperatures, and ensure medication carts were locked and monitored.
F791 Routine/Emergency Dental Services: The facility failed to ensure timely dental services for sampled residents and lacked proper documentation of dental care.
F803 Menus Meet Resident Needs/Preparation in Advance/Followed: The facility failed to follow pre-prepared menus to meet nutritional needs of residents and maintain food safety standards.
F812 Food Procurement, Store, Prepare, Serve - Sanitary: The facility failed to maintain sanitary conditions in food storage and preparation areas, risking food safety.
F825 Provide/Obtain Specialized Rehab Services: The facility failed to provide restorative care and therapy services as ordered for sampled residents.
F880 Infection Prevention & Control: The facility failed to establish and maintain an effective infection control program including surveillance, hand hygiene, and TB testing.
F4075 Resident Groomed/Dressed Appropriately: The facility failed to ensure residents were well-groomed and dressed appropriately according to their preferences and medical conditions.
F4086 Infection Control/Communicable Disease: The facility failed to follow infection control procedures to prevent spread of communicable diseases among residents.
F4055 Safe/Effective Medication System: The facility failed to maintain a safe and effective medication distribution and administration system.
F4064 Medication Storage: The facility failed to store medications at appropriate temperatures and secure controlled substances properly.
F4065 Nursing Care per Resident Condition: The facility failed to provide personal attention and nursing care consistent with residents' conditions.
F4100 Social Service Program: The facility failed to designate qualified staff responsible for social services and to provide needed social services to residents.
F5016 Special Diets - Menus Reviewed/Approved: The facility failed to review and approve menus for special prescribed diets as required.
F7015 Food-Protected, Temp, Need to Contact DHSS: The facility failed to protect food from contamination and maintain proper temperatures during storage and service.
F7048 Safe Plastic/Rubber Items, Food Contact: The facility failed to ensure safe use and sanitization of plastic and rubber items in food service.
F7065 Food-Contact Surfaces Washed/Rinsed/Sanitized: The facility failed to properly wash, rinse, and sanitize food-contact surfaces to prevent contamination.
F8010 Advance Directive Requirements: The facility failed to inform residents or their representatives about advance directives and document accordingly.
Report Facts
Sampled residents: 18
Sampled residents for labs: 5
Sampled residents for medication: 18
Sampled residents for dental: 18
Inspection Report — Jul 21, 2023
Life Safety
Date: Jul 21, 2023
Visit Reason
An Emergency Preparedness portion of a Life Safety Code Survey was conducted to assess compliance with Medicare/Medicaid emergency preparedness requirements and life safety code provisions.
Findings
The facility was found to be in compliance with emergency preparedness requirements but failed to meet applicable provisions of the 2012 Life Safety Code related to self-closing doors, hazardous areas, cooking facilities, fire alarm system testing and maintenance, sprinkler system maintenance, and other fire safety features. Deficiencies had the potential to affect all residents, visitors, volunteers, and staff.
Deficiencies (12)
K223 Doors with Self-Closing Devices: The facility failed to ensure doors to hazardous areas with self-closing devices had no impediments to closing or latching as required by NFPA standards.
K321 Hazardous Areas - Enclosure: The facility failed to ensure all doors to hazardous areas were self-closing and latching, and combustible storage and other hazardous areas were not properly enclosed or protected.
K324 Cooking Facilities: The facility failed to ensure range hood fire suppression system nozzles were adequately positioned according to NFPA standards.
K345 Fire Alarm System - Testing and Maintenance: The facility failed to provide comprehensive documentation of professional inspections and maintenance of the fire alarm system.
K353 Sprinkler System - Maintenance and Testing: The facility failed to provide complete weekly fire sprinkler valve inspections and documentation as required by NFPA standards.
K354 Sprinkler System - Out of Service: The facility had a sprinkler system impairment without proper notification and risk assessment as required.
K700 Operating Features - Other: The facility failed to adequately clean clothes dryer lint traps and fireboxes, creating a fire hazard.
K711 Evacuation and Relocation Plan: The facility failed to ensure the overhead paging system was operable to announce emergency codes and provide adequate evacuation route maps.
K712 Fire Drills: The facility failed to provide thorough documentation of monthly fire drills including varied simulated conditions and successful transmission of fire alarm signals.
K761 Maintenance, Inspections, and Testing - Doors: The facility failed to provide itemized documentation of annual fire door inspections and ensure fire door assemblies were properly maintained.
K918 Electric Systems - Essential Electrical System: The facility failed to maintain sufficient work area around electrical panels and provide comprehensive documentation of annual electrical inspections.
K929 Gas Equipment - Precautions for Handling Oxygen: The facility failed to ensure combustibles were not stored with oxygen tanks and associated equipment was properly protected.
Report Facts
Deficiency completion dates: Various corrective action completion dates mostly 9/4/23
Inspection Report — Dec 14, 2022
Routine
Date: Dec 14, 2022
Visit Reason
A COVID-19 Focused Emergency Preparedness and Infection Control survey was conducted to assess compliance with relevant federal regulations and CDC recommended practices.
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 — Mar 7, 2022
Plan of Correction
Date: Mar 7, 2022
Visit Reason
The document is a Plan of Correction submitted in response to a facility inspection conducted on 03/07/2022 at Crown Rehab and Healthcare Center.
Findings
The Plan of Correction addresses deficiencies related to abuse/neglect policies, bed hold policy, medication administration, ADL care, quality of care, nursing staff competency, drug regimen review, and immunization policies. The facility failed to meet several regulatory requirements including proper employee background checks, bed hold notices, medication administration per manufacturer instructions, adequate bathing assistance, and proper documentation and monitoring of nursing staff and medication regimens.
Deficiencies (9)
F607: The facility failed to develop and implement written policies and procedures to prevent abuse, neglect, and exploitation of residents and to investigate allegations. Background checks were incomplete for some employees.
F625: The facility failed to provide a bed hold policy notice within 24 hours of resident discharge to the hospital for two sampled residents.
F658: The facility failed to administer medication according to the manufacturer's instructions for Synthroid to two residents and failed to document medication administration properly.
F677: The facility failed to provide regular bathing assistance for seven sampled residents, with documentation showing missed or inadequate bathing.
F684: The facility failed to identify and treat edema and skin issues for residents, including failure to notify the physician and properly document treatments.
F726: The facility failed to ensure nursing staff had the competencies and skills necessary to provide care, including training and annual competency evaluations.
F732: The facility failed to post nursing staff information in a prominent place accessible to residents and visitors.
F756: The facility failed to conduct monthly drug regimen reviews for each resident and failed to follow through with pharmacy recommendations to reduce anti-psychotic medications.
F883: The facility failed to develop and implement policies to ensure residents received influenza and pneumococcal immunizations and failed to document immunization status for sampled residents.
Report Facts
Sampled residents: 18
Completion dates: Plan of Correction completion dates range from 4/15/22 to 4/16/22
Inspection Report — Mar 7, 2022
Life Safety
Date: Mar 7, 2022
Visit Reason
An Emergency Preparedness portion of a Life Safety Code Survey was conducted to assess compliance with Medicare/Medicaid emergency preparedness requirements and life safety codes.
Findings
The facility was found not in compliance with several Life Safety Code requirements including hazardous area enclosures, fire alarm system testing and maintenance, sprinkler system maintenance, corridor door latching, fire drills, and electrical system safety. Multiple deficiencies were cited related to fire safety and emergency preparedness.
Deficiencies (6)
K321 Hazardous Areas - The facility failed to ensure a door within a hazardous area self-closed and latched to resist fire or smoke passage and failed to distance combustibles from a gas-powered furnace in a storage area.
K345 Fire Alarm System - The facility failed to provide and maintain complete and current documentation of the annual fire alarm inspection as required by NFPA codes and guidelines.
K353 Sprinkler System - The facility failed to maintain the sprinkler system in accordance with NFPA standards by not completing quarterly inspections and having blocked sprinkler heads and missing escutcheon plates.
K363 Corridor Doors - The facility failed to ensure corridor doors positively latched to prevent smoke containment failure, affecting family members and residents in smoke compartments.
K712 Fire Drills - The facility failed to conduct quarterly fire drills on each shift and verify completion, affecting scheduled employee work shifts.
K918 Electrical Systems - The facility failed to prevent storage of items closer than 3 feet from electrical panels in several locations, potentially affecting all residents, visitors, and staff.
Report Facts
Deficiency counts: 6
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Shaylin Can | Executive Director | Named in signature on multiple pages related to plan of correction and inspection |
| Maintenance Director | Interviewed regarding fire safety deficiencies and corrective actions |
Inspection Report — Nov 15, 2021
Abbreviated Survey
Date: Nov 15, 2021
Visit Reason
A COVID-19 Focused Emergency Preparedness and Infection Control Survey was conducted to assess compliance with relevant 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 — Sep 8, 2021
Complaint Investigation
Date: Sep 8, 2021
Visit Reason
A COVID-19 focused emergency preparedness survey was conducted due to suspected or confirmed COVID-19 cases and related complaint allegations regarding failure to notify residents and families and failure to conduct required COVID-19 testing.
Complaint Details
The investigation was complaint-related due to allegations of failure to notify residents and families of COVID-19 cases and failure to conduct required COVID-19 testing. The complaint was substantiated as the facility failed to meet notification and testing requirements.
Findings
The facility failed to notify residents, their representatives, and families of suspected or confirmed COVID-19 cases in a timely manner and did not provide a policy for facility notification of positive COVID-19 test results. The facility also failed to perform routine and outbreak COVID-19 testing as required by CMS guidelines.
Deficiencies (6)
F885 COVID-19 reporting. The facility failed to inform residents, representatives, and families of suspected or confirmed COVID-19 cases by 5 p.m. the next calendar day following identification of positive cases.
F886 COVID-19 testing. The facility failed to perform routine and outbreak testing of residents and staff as required by CMS guidelines, including failure to complete outbreak testing when a new case was identified.
A4085 Infection Control/Communicable Disease. The facility failed to implement acceptable infection control procedures to prevent the spread of infection and failed to report communicable diseases to the state within seven days.
F887 COVID-19 Immunization. The facility failed to ensure provision and documentation of education regarding COVID-19 vaccination benefits, risks, and side effects to residents and staff who refused vaccination.
F684 Quality of Care. The facility failed to ensure a tracking system was in place for facility-wide wounds and failed to complete weekly skin assessments and wound care documentation for one sampled resident.
A4074 Nursing Care per Resident Condition. The facility failed to provide personal attention and nursing care consistent with acceptable nursing practice for one resident.
Report Facts
Staff members testing positive: 5
Residents sampled for COVID-19 testing: 5
Residents with wounds assessed: 19
Resident #15 skin assessments: 1
Inspection Report — Dec 23, 2020
Routine
Date: Dec 23, 2020
Visit Reason
A COVID-19 Focused Emergency Preparedness and Infection Control survey was conducted to assess compliance with relevant federal regulations and CDC recommended practices.
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 — Nov 18, 2020
Routine
Date: Nov 18, 2020
Visit Reason
A COVID-19 Focused Emergency Preparedness and Infection Control Survey was conducted to assess compliance with relevant CMS and CDC guidelines.
Findings
The facility was found to be in compliance with 42 CFR 483.73 and CMS and CDC recommended practices for COVID-19 preparedness and infection control.
Inspection Report — Sep 18, 2020
Routine
Date: Sep 18, 2020
Visit Reason
A COVID-19 Focused Emergency Preparedness survey and a COVID-19 Focused Infection Control Survey were conducted to assess compliance with related federal regulations and CDC recommended practices.
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 — Aug 12, 2020
Routine
Date: Aug 12, 2020
Visit Reason
A COVID-19 Focused Emergency Preparedness and Infection Control Survey was 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.
Inspection Report — Jul 15, 2020
Plan of Correction
Date: Jul 15, 2020
Visit Reason
The document is a Plan of Correction submitted by Crown Care Center in response to deficiencies cited during a survey conducted on 2020-07-15.
Findings
The facility was cited for deficiencies related to wound care, including inadequate documentation, treatment, and monitoring of residents' wounds and pressure ulcers. The plan of correction outlines corrective actions to address these issues.
Deficiencies (2)
F684 Quality of care: Resident #3's wound care documentation and treatment were inadequate, including failure to update wound status and communicate changes to the physician and wound care company.
F686 Treatment/Services to Prevent/Heal Pressure Ulcer: The facility failed to provide adequate pressure ulcer prevention and treatment for residents, including incomplete assessments and inconsistent wound care.
Report Facts
Deficiency count: 2
Inspection Report — May 27, 2020
Routine
Date: May 27, 2020
Visit Reason
A COVID-19 focused emergency preparedness and infection control survey was conducted to assess compliance with relevant CMS and CDC guidelines.
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 — Apr 4, 2019
Life Safety
Date: Apr 4, 2019
Visit Reason
Life Safety Code inspection conducted to assess compliance with fire safety regulations and related requirements at Crown Care Center.
Findings
The facility failed to meet several Life Safety Code requirements including sprinkler system deficiencies, fire hazard risks related to mop drying, cooking equipment fire protection, missing fire resistance ratings on doors, and inadequate maintenance of fire/smoke dampers and electrical systems. These deficiencies potentially affected residents, staff, and visitors in multiple smoke zones.
Deficiencies (8)
K161 Building Construction Type and Height: Facility failed to ensure ceilings could resist smoke passage in multiple locations, including kitchen and linen closets, affecting residents and staff in several smoke zones.
K300 Protection - Other: Facility failed to ensure mop heads were air dried and not placed in laundry dryer, creating a fire hazard affecting residents and staff in smoke zones.
K324 Cooking Facilities: Cooking equipment, specifically a tilt skillet, was not protected by a fire-extinguishing system, creating a fire hazard in resident smoke zones.
K521 HVAC: Facility failed to provide documentation demonstrating fire/smoke dampers were exercised and maintained, potentially affecting all residents and staff in smoke zones.
K761 Maintenance, Inspection & Testing - Doors: Facility failed to maintain complete and comprehensive documentation of fire resistance ratings on smoke zone doors and windows, affecting all residents and staff in smoke zones.
K918 Electrical Systems - Essential Electric System: Facility failed to maintain electrical panels and circuit breakers with sufficient documentation and safe conditions, potentially affecting residents and staff.
K920 Electrical Equipment - Power Cords and Extension Cords: Facility failed to maintain secured surge protectors and prevent use of multi-plex adapters in resident rooms, creating fire hazards in multiple smoke zones.
K929 Gas Equipment - Precautions for Handling Oxygen: Facility failed to properly secure oxygen cylinders and provide adequate storage safeguards, affecting residents and staff in smoke zones.
Report Facts
Inspection Report — Apr 4, 2019
Annual Inspection
Date: Apr 4, 2019
Visit Reason
Annual inspection survey conducted to assess compliance with federal and state regulations for Crown Care Center.
Findings
The facility was found deficient in multiple areas including abuse/neglect policies, baseline care plans, medication administration, infection control, food safety, and dialysis care. Several residents' care plans and documentation were incomplete or missing, and staff failed to follow proper procedures in multiple instances.
Deficiencies (9)
F607 Develop/Implement Abuse/Neglect Policies. The facility failed to check the Certified Nurse Assistant Registry for four sampled employees prior to hire. The facility census was 93 residents.
F655 Baseline Care Plan. The facility failed to provide or document a written baseline care plan for two sampled residents. The facility census was 93 residents.
F657 Care Plan Timing and Revision. The facility failed to update and revise the comprehensive care plan for one sampled resident. The facility census was 93 residents.
F658 Services Provided Meet Professional Standards. The facility failed to clarify orders for blood sugar checks and pain medication administration for one sampled resident. The facility census was 93 residents.
F698 Dialysis. The facility failed to have physician orders for dialysis treatments for one sampled resident. The facility census was 93 residents.
F812 Food Procurement, Store/Prepare/Serve-Sanitary. The facility failed to separate damaged cans in the dry storage area and keep the walk-in refrigerator and freezer floors free from trash and debris. The facility census was 93 residents with a licensed capacity of 118.
F813 Personal Food Policy. The facility failed to educate staff on the policy regarding food brought in by family and visitors. The facility census was 93 residents with a licensed capacity of 118.
F880 Infection Prevention & Control. The facility failed to establish an infection prevention and control program that included proper hand hygiene, glove use, and documentation for one sampled resident. The facility census was 93 residents.
A4029 Communicable Disease-Employees. The facility failed to ensure employees received required two-step tuberculosis screening. There were 127 employees hired since the last annual survey. The facility census was 93 residents.
Report Facts
Employees hired since last annual survey: 127
Inspection Report — Feb 6, 2018
Annual Inspection
Date: Feb 6, 2018
Visit Reason
Annual inspection survey conducted to assess compliance with Medicare and Medicaid regulations at Crown Care Center.
Findings
The facility was found deficient in multiple areas including Medicaid/Medicare coverage notices, safe environment maintenance, comprehensive care planning, drug regimen review, food procurement and storage, and sanitation. Deficiencies affected residents' rights, safety, care plans, medication management, nutrition, and environmental conditions.
Deficiencies (10)
F582 Medicaid/Medicare Coverage/Liability Notice: Facility failed to provide timely Skilled Nursing Facility Advanced Beneficiary Notice (SNFABN) and Notice of Medicare Non-Coverage (NOMNC) forms to sampled residents and did not have a policy for these notices.
F584 Safe/Clean/Comfortable/Homelike Environment: Facility failed to recognize and remove defective slings with tears, potentially affecting 12 residents dependent on mechanical lifts.
F656 Develop/Implement Comprehensive Care Plan: Facility failed to develop comprehensive care plans with measurable objectives and timely updates for residents receiving psychotropic medications.
F657 Care Plan Timing and Revision: Facility failed to update care plans to include target behaviors and interventions related to residents' mood disorders and psychosis.
F658 Services Provided Meet Professional Standards: Facility failed to follow physician orders to remove a U-rail from a resident's bed and failed to audit U-rail and bed orders.
F692 Nutrition/Hydration Status Maintenance: Facility failed to ensure physician orders for diet and ice cream were followed and failed to monitor residents' weight loss and dietary changes.
F756 Drug Regimen Review, Report Irregular, Act On: Facility failed to perform monthly pharmacist drug regimen reviews and failed to document irregularities and dose reductions for psychotropic medications.
F758 Free from Unnecessary Psychotropic Meds/PRN Use: Facility failed to ensure psychotropic medications were administered appropriately and failed to complete behavioral monitoring for targeted residents.
F812 Food Procurement, Store, Prepare, Serve, Sanitary: Facility failed to maintain proper food storage temperatures, dispose of expired food, and maintain sanitary kitchen conditions, potentially affecting residents.
F921 Safe/Functional/Sanitary/Comfortable Environment: Facility failed to remove bird nests and seal attic openings, potentially affecting 42 residents, and failed to maintain sanitary kitchen and storage areas.
Report Facts
Residents affected by sling deficiency: 12
Residents sampled for psychotropic medication care plan deficiency: 2
Residents sampled for weight loss care plan deficiency: 1
Residents sampled for drug regimen review deficiency: 1
Residents potentially affected by bird nest deficiency: 42
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Director of Social Services | Reviewed SNFABN and NOMNC forms and responsible for education and audits related to Medicaid/Medicare coverage notices | |
| Certified Nurses Aide (CNA) A | Observed defective slings and reported on resident care | |
| Corporate Nurse | Observed defective slings and facility policies | |
| Assistant Director of Nursing (ADON) | Interviewed regarding sling inspections and care plan updates | |
| Education Coordinator | Reported on sling inspection frequency | |
| Director of Nurses (DON) | Interviewed regarding care plan deficiencies, medication monitoring, and audits | |
| Licensed Practical Nurse (LPN) A | Interviewed regarding resident weight loss and care plan updates | |
| Licensed Practical Nurse (LPN) B | Interviewed regarding pharmacy reviews and medication orders | |
| Certified Nursing Assistant (CNA) B | Reported on resident use of U-rail | |
| Assistance Maintenance Director | Interviewed regarding removal of U-rails and maintenance requests | |
| Director of Nutrition Services | Interviewed regarding food storage and kitchen sanitation | |
| Director of Maintenance | Responsible for attic inspections and maintenance | |
| QIPMO Nurse | Provided education on behavioral monitoring |
Inspection Report — Feb 6, 2018
Life Safety
Date: Feb 6, 2018
Visit Reason
The inspection was conducted to assess compliance with life safety code and fire safety regulations at Crown Care Center, including building construction, fire extinguishers, emergency preparedness, and other safety systems.
Findings
The facility was found deficient in multiple areas including emergency preparedness, fire safety systems, building construction compliance, and maintenance of fire extinguishers. Several deficiencies potentially affected all residents, with a census of 98 and licensed capacity of 118.
Deficiencies (8)
E009 Emergency Preparedness plan failed to include phone numbers for State Emergency Management Agencies. The facility census was 98 residents.
E015 Subsistence needs for staff and patients were not met; the facility failed to include temperature ranges, contact information for potable water and generator delivery, and emergency water locations. The facility census was 98 residents.
E022 The facility failed to include a plan to back up the call light system during a power outage, potentially affecting all residents. The facility census was 98 residents.
K161 The facility failed to maintain the fire rating of the attic cover, potentially affecting an unknown number of residents and staff in one smoke zone. The facility census was 98 residents with a licensed capacity of 118.
K322 Laboratories storing flammable materials were not protected by required fire resistance-rated separation, potentially affecting at least 12 residents in two smoke zones. The facility census was 98 residents with a licensed capacity of 118.
K355 Fire extinguishers were obstructed or not installed at correct heights in eight locations, potentially affecting an unknown number of residents in one smoke zone. The facility census was 98 residents with a licensed capacity of 118.
K372 Smoke barriers had gaps and penetrations, potentially affecting at least 35 residents in three smoke zones. The facility census was 98 residents with a licensed capacity of 118.
K920 Electrical equipment power cords and extension cords were not used or installed according to code, potentially affecting numerous residents, visitors, and staff in two smoke zones. The facility census was 98 residents with a licensed capacity of 118.
Report Facts
Deficiencies cited: 8
3 CMS Surveys
CMS Survey — Mar 7, 2022
Mar 7, 2022
CMS Survey — Jul 21, 2023
Jul 21, 2023
CMS Survey — Mar 24, 2025
Mar 24, 2025
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