Inspection Reports for
Nhc Healthcare, Maryland Heights
2920 FEE FEE RD, MARYLAND HEIGHTS, MO, 63043-1915
Back to Facility ProfileDeficiencies (last 4 years)
Deficiencies (over 4 years)
4.3 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
22% better than Missouri average
Missouri average: 5.5 deficiencies/yearDeficiencies per year
8
6
4
2
0
Census
Latest occupancy rate
191 residents
Based on a May 2024 inspection.
Occupancy over time
Inspection Report
Routine
Census: 191
Deficiencies: 6
Date: May 6, 2024
Visit Reason
The inspection was conducted to evaluate the facility's compliance with regulations related to resident environment cleanliness, accident prevention, respiratory care, medication storage, laboratory services, and infection control during meal service.
Findings
The facility was found deficient in maintaining a clean and homelike environment, ensuring accident hazards were minimized, providing proper respiratory care, storing medications correctly, ensuring quality laboratory services, and enforcing hand hygiene during meal service. Specific issues included soiled furniture, missing toilet paper and hand towels, missing toilet tank lids, improper chemical storage, unsafe wheelchair assistance, wet floors without adequate signage, expired or undated medications, improper cleaning of BiPAP equipment, and failure of staff to perform hand hygiene during meal service.
Deficiencies (6)
Failed to provide a clean and homelike environment; furniture in common areas was visibly soiled and stained, and resident rooms lacked adequate toilet paper and hand towels.
Failed to ensure accident hazards were minimized; unsafe wheelchair assistance, trip hazards in shower room, improper chemical storage accessible to residents, and wet floors without adequate signage.
Failed to provide respiratory care consistent with professional standards; no physician orders for cleaning BiPAP machine, mask, and tubing, and staff unaware of cleaning requirements.
Failed to ensure medications were within expiration dates or properly labeled; multiple medication rooms and carts contained undated or expired medications.
Failed to ensure quality laboratory services; blood glucose test strips were not dated upon opening as required.
Failed to ensure staff performed hand hygiene during meal service; multiple observations showed staff handling food, residents, and equipment without washing or sanitizing hands.
Report Facts
Residents sampled: 35
Facility census: 191
Residents with wandering behavior: 20
Residents on Meadow unit: 27
Falls documented: 9
Wet floor signs: 3
Employees mentioned
| Name | Title | Context |
|---|---|---|
| CNA F | Certified Nursing Assistant | Named in unsafe wheelchair assistance and hand hygiene observations |
| Housekeeping Supervisor | Named in furniture cleanliness and chemical storage findings | |
| Administrator | Named in furniture cleanliness, accident prevention, and hand hygiene expectations | |
| CNA S | Certified Nurse Aide | Named in observations and interviews regarding toileting and chemical storage |
| LPN J | Licensed Practical Nurse | Named in toileting, chemical storage, and accident prevention findings |
| Director of Nurses | DON | Named in respiratory care and accident prevention findings |
| CNA Q | Certified Nurse Aide | Named in toileting and chemical storage findings |
| LPN G | Licensed Practical Nurse | Named in respiratory care findings |
| RN A | Registered Nurse | Named in respiratory care findings |
| CMT I | Certified Medication Technician | Named in hand hygiene during meal service observations |
| CNA U | Certified Nurse Aide | Named in hand hygiene during meal service observations |
| CNA V | Certified Nurse Aide | Named in hand hygiene during meal service observations |
| CNA E | Certified Nurse Aide | Named in hand hygiene during meal service observations |
| CNA D | Certified Nurse Aide | Named in hand hygiene during meal service observations |
| Dietary Manager | Named in hand hygiene expectations | |
| Administrator | Named in hand hygiene expectations | |
| LPN P | Licensed Practical Nurse | Named in medication storage and laboratory services findings |
Inspection Report
Deficiencies: 0
Date: May 3, 2023
Visit Reason
The document is a statement of deficiencies and plan of correction related to a regulatory survey of a nursing home facility.
Findings
No health deficiencies were found during the inspection.
Inspection Report
Annual Inspection
Census: 190
Deficiencies: 5
Date: Oct 3, 2022
Visit Reason
The inspection was conducted as an annual survey to assess compliance with regulatory requirements including resident rights, medication management, personal belongings inventory, and staff vaccination status.
Findings
The facility was found deficient in multiple areas including failure to perform annual reviews of residents' advanced directives, incomplete personal inventory sheets for residents' belongings, improper controlled substance inventory and storage, and incomplete staff COVID-19 vaccination compliance.
Deficiencies (5)
Failed to perform an annual review of code status and advanced directives for eight of 35 sampled residents.
Failed to ensure personal inventory sheets were completed or updated for five residents to track personal belongings.
Failed to complete controlled substance inventory sheets appropriately, with multiple blanks and missing signatures on narcotic count sheets.
Failed to store narcotic medications in double locked compartments and pre-pulled medications were stored unlabeled in medication carts.
Failed to ensure all staff were fully vaccinated against COVID-19 or had approved exemptions; three staff members were not fully vaccinated.
Report Facts
Residents sampled: 35
Facility census: 190
Staff members: 285
Staff not fully vaccinated: 3
Blank opportunities on controlled substance sheets: 85
Opportunities with only one staff initial: 62
Opportunities with two staff initials but no count: 4
Narcotic counts with no initials: 4
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Social Worker S | Social Worker | Interviewed regarding advanced directives process and resident code status |
| Social Worker T | Social Worker | Interviewed regarding missing resident belongings and inventory process |
| Social Services Manager I | Social Services Manager | Interviewed regarding personal inventory sheets and missing items |
| Director of Nursing | Director of Nursing (DON) | Interviewed regarding controlled substance inventory and staff vaccination policy |
| Administrator | Administrator | Interviewed regarding code status review and staff vaccination policy |
| Staff AA | Staff member not fully vaccinated against COVID-19 | |
| Staff BB | Staff member not fully vaccinated against COVID-19 | |
| Staff CC | Staff member not fully vaccinated against COVID-19 |
Inspection Report
Complaint Investigation
Census: 189
Deficiencies: 6
Date: Apr 22, 2019
Visit Reason
The inspection was conducted due to complaints regarding failure to report and investigate resident-to-resident abuse, failure to investigate bruises of unknown origin, inadequate pressure ulcer care, medication errors, and failure to manage resident pain appropriately.
Complaint Details
The complaint investigation focused on allegations of failure to report and investigate resident-to-resident abuse, failure to investigate bruises of unknown origin, inadequate pressure ulcer care, medication errors, and failure to manage resident pain appropriately. The investigation substantiated multiple deficiencies in these areas.
Findings
The facility failed to timely report a resident-to-resident altercation to the Department of Health and Senior Services, failed to thoroughly investigate incidents of abuse and bruises of unknown source, failed to document and manage pressure ulcers properly, failed to administer IV antibiotics correctly, and failed to address a resident's complaints of pain related to shingles.
Deficiencies (6)
Failure to timely report a resident-to-resident altercation to the Department of Health and Senior Services.
Failure to thoroughly investigate incidents of resident-to-resident abuse and bruises of unknown source.
Failure to notify physician timely and document thoroughly regarding a resident's red/inflamed skin and pressure ulcer care.
Failure to document and assess pressure ulcers thoroughly and obtain physician orders timely.
Failure to address resident's complaints of pain related to shingles and failure to provide appropriate pain management.
Failure to ensure correct dose and infusion rate of intravenous antibiotic for a resident.
Report Facts
Census: 189
Deficiencies cited: 6
Pressure ulcer size: 2.5
Pressure ulcer size: 2
Pressure ulcer size: 1
Pressure ulcer size: 1
IV antibiotic dose: 2
IV antibiotic infusion rate: 200
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Nurse A | Registered Nurse | Involved in IV antibiotic medication error for Resident #476 |
| Nurse G | Registered Nurse | Completed skin assessment on Resident #129 but failed to document wound description and measurements |
| CNA L | Certified Nurse Aide | Witnessed resident-to-resident altercation and provided statement |
| Nurse M | Registered Nurse | Failed to report resident-to-resident altercation to administrator and Director of Nurses |
| DON | Director of Nurses | Interviewed regarding failures in reporting, investigation, wound care, and medication administration |
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