Inspection Reports for
Republic Nursing and Rehab
901 State Hwy 174, Republic, MO 65738, MO, 65738
Back to Facility Profile10 Reports
Inspection Report — Jul 24, 2024
Complaint Investigation
Date: Jul 24, 2024
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Federal health survey (CMS-2567) with Missouri State Form; complaint investigation citing MO00239092.
Complaint Details
MO00239092; substantiation not stated.
Findings
Four deficiencies were cited: two federal deficiencies involving failure to notify physicians of resident condition changes and failures in infection prevention practices, and two Missouri state citations mirroring those issues related to infection control/communicable disease and physician notification/change in condition.
Deficiencies (2)
19 CSR 30-85.042(77) Infection Control/Communicable Disease: See the deficiency cited at F880.
19 CSR 30-85.042(78) Dr Notification-Change in Condition: See the deficiency cited at F580.
Report Facts
residents referenced: 3
Inspection Report — Mar 14, 2024
Life Safety
Date: Mar 14, 2024
Visit Reason
Federal Life Safety survey (CMS-2567) and Missouri Department of Health and Senior Services State Form; the survey type is not stated.
Findings
Seven deficiencies were cited: four federal Life Safety findings addressing building construction/ceiling penetrations, corridor door closure/blocking, smoke barrier integrity, and electrical panel clearance/maintenance; and three Missouri state licensure findings referencing smoke section walls/doors, facility construction/maintenance, and electrical wiring/equipment.
Deficiencies (3)
19 CSR 30-85.022(29) Smoke Section Walls/Doors: Please refer to K-372.
19 CSR 30-85.032(2) Substantially Constructed/Maintained: Please refer to K-161 and K-372.
19 CSR 30-85.032(31)(A) Electrical Wiring & Equipment Maintained: Please refer to K-911.
Report Facts
residents potentially affected: 57
residents potentially affected: 43
Inspection Report — Mar 14, 2024
Routine
Date: Mar 14, 2024
Visit Reason
CMS-2567 federal health survey and Missouri Department of Health and Senior Services State Form; the survey type is not stated.
Findings
Sixteen deficiencies were cited: eight federal deficiencies covering assessment accuracy, care planning, hospice orders and documentation, transfer/supervision and smoking safety, respiratory/CPAP care, trauma-informed care, food safety, and sanitary kitchen conditions; and eight Missouri state licensure deficiencies that cross-reference the federal findings.
Deficiencies (8)
19 CSR 30-85.042(45) Written Orders; Restraints: See the deficiency cited at F658.
19 CSR 30-85.042(65) Protective Oversight, Voluntary Leave: See the deficiency cited at F689.
19 CSR 30-85.042(66) Nursing Care per Res Condition: See the deficiency cited at F695 and F699.
19 CSR 30-87.020(12) Floor Surfaces: See the deficiency cited at F921.
19 CSR 30-87.020(15) Walls/Ceilings/Doors/Windows Clean: See the deficiency cited at F921.
19 CSR 30-87.020(19) List Fixtures, Vent Covers, Décor Cleanable: See the deficiency cited at F921.
19 CSR 30-87.030(13) Food-Protected, Temp, Need to Contact DHSS: See the deficiency cited at F812.
19 CSR 30-87.030(84) Equip/Utensils Air Dried, Self-Drain Utensils: See the deficiency cited at F812.
Inspection Report — Jul 29, 2023
Complaint Investigation
Date: Jul 29, 2023
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Federal health survey (CMS-2567) and Missouri state licensure survey (State Form); complaint investigation (MO00222179) is documented in the file.
Complaint Details
MO00222179; substantiation not stated in the documents.
Findings
Two deficiencies were cited: one federal deficiency for resident abuse/neglect involving observed verbal and physical abuse of a resident, and one Missouri rule deficiency for failure to provide protective oversight/voluntary leave procedures referencing the federal finding.
Deficiencies (1)
19 CSR 30-85.042(65) Protective Oversight, Voluntary Leave: Please refer to F600.
Inspection Report — Feb 25, 2022
Complaint Investigation
Date: Feb 25, 2022
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Federal CMS-2567 health survey and Missouri Department of Health and Senior Services State Form; complaint investigation. Complaint #MO00196147 is cited in the file.
Complaint Details
Complaint MO00196147 is cited in the file; the report references the complaint number but does not state whether the allegation was substantiated.
Findings
Eleven deficiencies were cited: six federal health survey deficiencies addressing medication misappropriation and medication security, employee screening/background checks, falls and supervision, bed rail assessments/maintenance, dementia care/intervention effectiveness, and a sanitary/environmental issue in the kitchen; and five Missouri state licensure deficiencies addressing the medication system, protective oversight/voluntary leave, nursing care per resident condition, floor surfaces, and development/implementation of abuse/neglect policies.
Deficiencies (5)
19 CSR 30-85.042(46) Safe/Effective Medication System: Please refer to the deficiency cited at F602. Complaint #MO00196147.
19 CSR 30-85.042(65) Protective Oversight, Voluntary Leave: Please refer to the deficiency cited at F689.
19 CSR 30-85.042(66) Nursing Care per Res Condition: Please refer to the deficiencies cited at F700 and F744.
19 CSR 30-87.020(12) Floor Surfaces: Please refer to the deficiency cited at F921.
19 CSR 30-88.010(23) Develop/Implement A/N Policies: Please refer to the deficiency cited at F607.
Report Facts
Inspection Report — Feb 25, 2022
Life Safety
Date: Feb 25, 2022
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CMS-2567 life safety survey with K-tag deficiencies and accompanying Missouri Department of Health and Senior Services State Form; the survey type is not otherwise stated.
Findings
There are 5 federal life-safety deficiencies (K-tags) related to means of egress signage, fire alarm testing and notification, sprinkler system maintenance/escutcheons, smoke barrier construction, and evacuation/relocation planning; and 4 Missouri state licensure deficiencies referencing fire alarm inspections/certifications, sprinkler testing/maintenance, smoke section walls/doors, and evacuation diagram posting.
Deficiencies (4)
19 CSR 30-85.022(10)(C) Fire Alarm System-Inspections/Certifications: Please refer to K-345.
19 CSR 30-85.022(11)(C) Sprinkler System-Test/Maintain: Please refer to K-353.
19 CSR 30-85.022(29) Smoke Section Walls/Doors: Please refer to K-372.
19 CSR 30-85.022(33)(C) Plan Accessible/Evacuation Diagram Posted: Please refer to K-711.
Report Facts
number of fire alarm notifiers tested (annual inspection): 12
number of fire alarm notifiers tested (semi-annual inspection): 10
Inspection Report — Jul 12, 2019
Routine
Date: Jul 12, 2019
Visit Reason
Contains a CMS-2567 federal health survey and Missouri Department of Health and Senior Services State Form licensure pages; the survey type is not stated.
Findings
Six federal health deficiencies cited problems with Medicare/Medicaid notices, failure to check the employee disqualification list, untimely MDS assessments, incomplete discharge summary, failures in restorative nursing/mobility services, and dialysis communication. Four Missouri state licensure deficiencies referenced employee/volunteer disqualification (EDL), nursing care per resident condition, restorative nursing/out-of-bed, and records required for transfer.
Deficiencies (4)
19 CSR 30-85.042(19) Employee/Volunteer Not on EDL: Please refer to F607.
19 CSR 30-85.042(67) Nursing Care per Res Condition: Please see F698.
19 CSR 30-85.042(73) Restorative Nursing, Res Out of Bed: Please refer to F688.
19 CSR 30-85.042(106) Records Required for Transfer: Please refer to F661.
Report Facts
residents sampled: 3
employees sampled: 12
residents sampled: 20
late assessments: 40
Inspection Report — Jul 12, 2019
Life Safety
Date: Jul 12, 2019
Visit Reason
CMS-2567 Life Safety (K-tag) survey and Missouri Department of Health and Senior Services State Form; the Emergency Preparedness initial comments state this was an annual recertification survey.
Findings
Two deficiencies were cited: one Life Safety deficiency for corridor doors not fitting tightly allowing passage of smoke, and one Missouri state licensure deficiency for smoke section walls/doors which refers to the Life Safety finding.
Deficiencies (1)
19 CSR 30-85.022(29) Smoke Section Walls/Doors: Please refer to K363.
Inspection Report — Aug 13, 2018
Life Safety
Date: Aug 13, 2018
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CMS-2567 Life Safety survey (K-tag deficiencies) and Missouri State Form; the CMS form indicates an annual recertification survey.
Findings
Ten deficiencies were cited: five Life Safety Code (K) deficiencies involving egress/locking doors, self-closing doors, cooking/kitchen hood, emergency generator fuel testing, and electrical outlets/equipment; and five Missouri state licensure deficiencies referencing hazardous areas, range hood certification, exit requirements, facility construction/maintenance, and electrical wiring/equipment.
Deficiencies (5)
19 CSR 30-85.022(4) Hazardous Areas: 1. Please refer to K223.
19 CSR 30-85.022(9) Range Hood Certification: 1. Please refer to K324.
19 CSR 30-85.022(12) Exit Requirements: 1. Please refer to K222.
19 CSR 30-85.032(2) Substantially Constructed/Maintained: 1. Please refer to K918.
19 CSR 30-85.032(31)(A) Electrical Wiring & Equipment Maintained: 1. Please refer to K919.
Inspection Report — Aug 13, 2018
Routine
Date: Aug 13, 2018
Visit Reason
Federal health survey (CMS-2567) with Missouri Department of Health and Senior Services State Form; the survey type is not stated.
Findings
Ten deficiencies were cited: five federal health citations addressing advance directives/code status accessibility, restorative nursing/mobility services, accident hazards/supervision (call light accessibility), medication administration/insulin errors, and the resident call system; and five Missouri state citations reflecting the call system, safe/effective medication system, protective oversight/voluntary leave, restorative nursing, and advance directive requirements.
Deficiencies (5)
19 CSR 30-85.032(27) Call System Requirements: Please refer to F919.
19 CSR 30-85.042(47) Safe/Effective Medication System: Please refer to F759.
19 CSR 30-85.042(66) Protective Oversight, Voluntary Leave: Please refer to F689.
19 CSR 30-85.042(73) Restorative Nursing, Res Out of Bed: Please refer to F688.
19 CSR 30-88.010(10) Advance Directive Requirements: Please refer to F578.
Report Facts
residents sampled: 18
20 CMS Surveys
Inspection Report — Jul 24, 2024
Complaint Investigation
Date: Jul 24, 2024
Visit Reason
Federal health survey (CMS-2567) with Missouri State Form; complaint investigation citing MO00239092.
Complaint Details
MO00239092; substantiation not stated.
Findings
Four deficiencies were cited: two federal deficiencies involving failure to notify physicians of resident condition changes and failures in infection prevention practices, and two Missouri state citations mirroring those issues related to infection control/communicable disease and physician notification/change in condition.
Deficiencies (2)
F580 Notify of Changes (Injury/Decline/Room, etc.): The facility failed to notify the physician in a timely manner of a change in a resident's condition and abnormal laboratory results for one resident, resulting in delayed notification and subsequent transfer to the hospital.
F880 Infection Prevention & Control: The facility failed to use appropriate infection prevention and control measures (including failing to provide a clean barrier for supplies, failing to appropriately wash hands, and failing to appropriately use personal protective equipment) during wound care and during blood glucose testing/insulin administration for residents.
Report Facts
residents referenced: 3
Inspection Report — Mar 14, 2024
Life Safety
Date: Mar 14, 2024
Visit Reason
Federal Life Safety survey (CMS-2567) and Missouri Department of Health and Senior Services State Form; the survey type is not stated.
Findings
Seven deficiencies were cited: four federal Life Safety findings addressing building construction/ceiling penetrations, corridor door closure/blocking, smoke barrier integrity, and electrical panel clearance/maintenance; and three Missouri state licensure findings referencing smoke section walls/doors, facility construction/maintenance, and electrical wiring/equipment.
Deficiencies (4)
K161 Building Construction Type and Height: Based on observation, record review, and interview, the facility failed to maintain the one-hour fire rating of ceilings due to unsealed penetrations between the attic and areas below, allowing smoke to pass into resident-use areas.
K363 Corridor - Doors: Based on observation, interview, and record review, the facility failed to maintain the smoke resistive properties of corridor doors by allowing doors to be held open or blocked by items, preventing proper closure and creating the potential for smoke to pass into exit corridors.
K372 Subdivision of Building Spaces - Smoke Barrier: Based on observation and interview, the facility failed to maintain the smoke resistive properties of smoke barrier walls, with gaps, drywall tape falling, and holes/penetrations that could allow smoke passage to adjoining compartments.
K911 Electrical Systems - Other: Based on observation and interview, the facility failed to maintain electrical systems by allowing storage and furniture obstructing electrical circuit panels and not maintaining required clearances, creating a hazard in the event of an electrical emergency.
Report Facts
residents potentially affected: 57
residents potentially affected: 43
Inspection Report — Mar 14, 2024
Routine
Date: Mar 14, 2024
Visit Reason
CMS-2567 federal health survey and Missouri Department of Health and Senior Services State Form; the survey type is not stated.
Findings
Sixteen deficiencies were cited: eight federal deficiencies covering assessment accuracy, care planning, hospice orders and documentation, transfer/supervision and smoking safety, respiratory/CPAP care, trauma-informed care, food safety, and sanitary kitchen conditions; and eight Missouri state licensure deficiencies that cross-reference the federal findings.
Deficiencies (8)
F641 Accuracy of Assessments: The facility failed to ensure the Minimum Data Set (MDS) included accurate nutritional and weight-loss information for one resident (Resident #28), despite documented weight changes.
F656 Develop/Implement Comprehensive Care Plan: The facility failed to complete comprehensive, individualized care plans including interventions related to antianxiety medications for one resident (Resident #56) and to reflect hospice services for one resident (Resident #89).
F658 Services Provided Meet Professional Standards: The facility failed to provide care per professional standards when staff did not obtain a physician's order for hospice and did not update the resident's care plan to reflect hospice admission for one resident (Resident #6).
F689 Free of Accident Hazards/Supervision/Devices: The facility failed to ensure residents' environment remained as free from accident hazards as possible and failed to follow safe transfer methods and limit access to smoking materials, resulting in unsafe transfer practices and unsecured smoking supplies for residents.
F695 Respiratory/Tracheostomy Care and Suctioning: The facility failed to provide respiratory care consistent with standards when staff did not document a physician diagnosis for CPAP use or ensure CPAP use and related care were reflected on the MDS and care plan for one resident (Resident #83).
F699 Trauma Informed Care: The facility failed to ensure a resident's PTSD diagnosis was documented and incorporated into the care plan with appropriate triggers and interventions, and staff were not knowledgeable of the resident's PTSD history (Resident #17).
F812 Food Procurement,Store/Prepare/Serve-Sanitary: The facility failed to keep food safe from contamination when staff stacked wet dishware trapping moisture, stored dented canned goods, and left dry food items in open bags unprotected.
F921 Safe/Functional/Sanitary/Comfortable Environ: The facility failed to ensure a sanitary environment in the kitchen area, with walls, baseboards, vents and other kitchen surfaces observed dirty with grease, lint, and debris.
Inspection Report — Jul 29, 2023
Complaint Investigation
Date: Jul 29, 2023
Visit Reason
Federal health survey (CMS-2567) and Missouri state licensure survey (State Form); complaint investigation (MO00222179) is documented in the file.
Complaint Details
MO00222179; substantiation not stated in the documents.
Findings
Two deficiencies were cited: one federal deficiency for resident abuse/neglect involving observed verbal and physical abuse of a resident, and one Missouri rule deficiency for failure to provide protective oversight/voluntary leave procedures referencing the federal finding.
Deficiencies (1)
F600 Free from Abuse and Neglect: The facility failed to protect Resident #1 from verbal and physical abuse by staff; staff were observed to push and force the resident to sit, knock the resident's glasses off, and use profane language toward the resident, and multiple staff interviews and the facility investigation documented these allegations.
Inspection Report — Feb 25, 2022
Complaint Investigation
Date: Feb 25, 2022
Visit Reason
Federal CMS-2567 health survey and Missouri Department of Health and Senior Services State Form; complaint investigation. Complaint #MO00196147 is cited in the file.
Complaint Details
Complaint MO00196147 is cited in the file; the report references the complaint number but does not state whether the allegation was substantiated.
Findings
Eleven deficiencies were cited: six federal health survey deficiencies addressing medication misappropriation and medication security, employee screening/background checks, falls and supervision, bed rail assessments/maintenance, dementia care/intervention effectiveness, and a sanitary/environmental issue in the kitchen; and five Missouri state licensure deficiencies addressing the medication system, protective oversight/voluntary leave, nursing care per resident condition, floor surfaces, and development/implementation of abuse/neglect policies.
Deficiencies (6)
F602 Free from Misappropriation/Exploitation: The facility failed to protect residents from misappropriation of controlled medications when narcotics were found missing from medication carts for two residents and medication carts/narcotic keys were left unsecured with discrepancies in counts.
F607 Develop/Implement Abuse/Neglect Policies: The facility failed to document completion of a Nurse Aide (NA) registry/background check prior to the start date for one staff member (Housekeeper A).
F689 Free of Accident Hazards/Supervision/Devices: The facility failed to complete routine fall risk assessments, implement and monitor fall interventions, ensure proper fit and locking of wheelchairs, and had an unlocked door to an enclosed courtyard that allowed unsupervised resident access/egress.
F700 Bedrails: The facility failed to complete reassessments and monitoring for bed rails and failed to ensure bed rail dimensions/installation were appropriate and safe for residents; observations showed side rails loose or wobbly and inadequate documentation of inspections.
F744 Treatment/Service for Dementia: The facility failed to routinely assess the effectiveness of interventions for residents with dementia and failed to complete person-centered care plans and documentation of behavioral interventions for multiple residents in the special care unit.
F921 Safe/Functional/Sanitary/Comfortable Environ: The facility failed to ensure the floor under the ice machine in the kitchen was kept clean and free of debris, and cleaning schedules/records did not demonstrate that the area was being cleaned as required.
Report Facts
Inspection Report — Feb 25, 2022
Life Safety
Date: Feb 25, 2022
Visit Reason
CMS-2567 life safety survey with K-tag deficiencies and accompanying Missouri Department of Health and Senior Services State Form; the survey type is not otherwise stated.
Findings
There are 5 federal life-safety deficiencies (K-tags) related to means of egress signage, fire alarm testing and notification, sprinkler system maintenance/escutcheons, smoke barrier construction, and evacuation/relocation planning; and 4 Missouri state licensure deficiencies referencing fire alarm inspections/certifications, sprinkler testing/maintenance, smoke section walls/doors, and evacuation diagram posting.
Deficiencies (5)
K 200 Means of Egress Requirements - Other: Based on observation and interview, doors that led to the outside but not to a public way did not have 'no exit' signage and the door to a small interior courtyard could be mistaken for an exit.
K 345 Fire Alarm System - Testing and Maintenance: The facility failed to maintain the fire alarm system so that the notifier/strobe in the large interior courtyard did not activate during testing and documentation/policies did not ensure the courtyard notifiers were listed or routinely tested.
K 353 Sprinkler System - Maintenance and Testing: The facility failed to maintain the integrity of building construction by allowing unsealed penetrations and missing or loose escutcheons around sprinkler heads in multiple locations, creating unsealed holes in ceilings.
K 372 Subdivision of Building Spaces - Smoke Barrie Construction: The facility failed to maintain the smoke resistive properties of smoke barrier walls as evidenced by holes, cracks and other gaps in the smoke barrier allowing potential passage of smoke between compartments.
K 711 Evacuation and Relocation Plan: The facility failed to maintain an accurate evacuation route map and evacuation diagrams, with posted maps and the Emergency Operations Plan incorrectly indicating a door off the therapy hall as an emergency exit.
Report Facts
number of fire alarm notifiers tested (annual inspection): 12
number of fire alarm notifiers tested (semi-annual inspection): 10
Inspection Report — Oct 14, 2021
Complaint Investigation
Date: Oct 14, 2021
Visit Reason
Federal CMS-2567 (health and emergency preparedness) complaint investigation; COVID-19 Focused Emergency Preparedness and COVID-19 Focused Infection Control surveys.
Findings
No deficiencies were cited; the facility was found in compliance with COVID-19 focused emergency preparedness and infection control (CMS/CDC recommended practices).
Inspection Report — Jun 23, 2021
Complaint Investigation
Date: Jun 23, 2021
Visit Reason
CMS-2567 federal survey containing a COVID-19 Focused Infection Control (F 000) and COVID-19 Focused Emergency Preparedness (E 000) initial comments; the form text also refers to a complaint investigation.
Complaint Details
No complaint number is provided in the file; the form states 'No deficiencies were cited on this complaint investigation.'
Findings
No deficiencies were cited on this COVID-19 focused infection control and emergency preparedness survey; the form states the facility was found to be in compliance and notes 'No deficiencies were cited on this complaint investigation.'
Inspection Report — Feb 3, 2021
Complaint Investigation
Date: Feb 3, 2021
Visit Reason
Federal CMS-2567 health survey (COVID-19 Focused Infection Control and Emergency Preparedness); the survey document states it was a complaint investigation.
Findings
No deficiencies were cited on this complaint investigation; the survey found the facility in compliance with CMS and CDC recommended practices to prepare for COVID-19.
Inspection Report — Oct 27, 2020
Routine
Date: Oct 27, 2020
Visit Reason
Federal CMS-2567 form (health and emergency preparedness sections). A COVID-19 Focused Infection Control and Emergency Preparedness survey was conducted; the Initial Comments indicate a COVID-19 focused survey.
Findings
No federal health or emergency preparedness deficiencies were cited; the surveyor found the facility in compliance with CMS and CDC recommended practices for COVID-19.
Inspection Report — Oct 7, 2020
Routine
Date: Oct 7, 2020
Visit Reason
Federal CMS-2567 (health and emergency preparedness) documenting a COVID-19 Focused Emergency Preparedness and a COVID-19 Focused Infection Control Survey; the survey type is stated on the form and no complaint numbers are cited.
Findings
No deficiencies were cited on the CMS-2567. Initial Comments state a COVID-19 Focused Emergency Preparedness and Infection Control Survey was conducted and the facility was found to be in compliance with CMS and CDC recommended practices.
Inspection Report — Sep 14, 2020
Routine
Date: Sep 14, 2020
Visit Reason
CMS-2567 federal survey form for a COVID-19 Focused Infection Control and Emergency Preparedness survey as stated on the form.
Findings
No survey deficiencies were cited. The COVID-19 focused infection control and emergency preparedness survey found the facility in compliance with CMS and CDC recommended practices.
Inspection Report — Jul 6, 2020
Routine
Date: Jul 6, 2020
Visit Reason
Federal CMS-2567 health survey; the form states a COVID-19 Focused Emergency Preparedness survey and a COVID-19 Focused Infection Control Survey.
Findings
No federal health or emergency preparedness deficiencies were cited. The surveyor found the facility in compliance with applicable COVID-19 emergency preparedness and infection control requirements and CDC recommended practices.
Inspection Report — Jun 4, 2020
Complaint Investigation
Date: Jun 4, 2020
Visit Reason
Federal CMS-2567 infection control and emergency preparedness survey; COVID-19 Focused Infection Control Survey and COVID-19 Focused Emergency Preparedness survey. The file references a complaint investigation.
Findings
No deficiencies were cited on this complaint investigation. The survey found the facility in compliance with COVID-19 focused emergency preparedness and infection control practices.
Inspection Report — May 22, 2020
Complaint Investigation
Date: May 22, 2020
Visit Reason
CMS-2567 federal health survey (COVID-19 Focused Infection Control) and Emergency Preparedness (COVID-19 Focused) survey; the document states this was a complaint investigation.
Findings
No deficiencies were cited on this complaint investigation; the facility was found in compliance with CMS and CDC recommended practices related to COVID-19 emergency preparedness and infection control.
Inspection Report — Jul 12, 2019
Routine
Date: Jul 12, 2019
Visit Reason
Contains a CMS-2567 federal health survey and Missouri Department of Health and Senior Services State Form licensure pages; the survey type is not stated.
Findings
Six federal health deficiencies cited problems with Medicare/Medicaid notices, failure to check the employee disqualification list, untimely MDS assessments, incomplete discharge summary, failures in restorative nursing/mobility services, and dialysis communication. Four Missouri state licensure deficiencies referenced employee/volunteer disqualification (EDL), nursing care per resident condition, restorative nursing/out-of-bed, and records required for transfer.
Deficiencies (6)
F 582 Medicaid/Medicare Coverage/Liability Notice: Facility staff failed to provide required Skilled Nursing Facility Advance Beneficiary Notice and the Notice of Medicare Non-Coverage to a resident and initiated discharge from Medicare Part A when benefit days were not exhausted.
F 607 Develop/Implement Abuse/Neglect Policies: Facility failed to check the employee disqualification list prior to resident contact for one recently hired employee (Dietary Aide E).
F 638 Qrtly Assessment at Least Every 3 Months: Facility failed to ensure required MDS quarterly/annual assessments were completed within required timeframes for multiple residents, with numerous assessments not completed timely.
F 661 Discharge Summary: Facility failed to complete a comprehensive discharge summary for one resident discharged to the community.
F 688 Increase/Prevent Decrease in ROM/Mobility: Facility failed to provide restorative nursing services and maintain restorative orders/plans so residents did not receive restorative care as directed by therapy.
F 698 Dialysis: Facility failed to provide ongoing communication with the dialysis center for a resident receiving dialysis, including not completing or sending dialysis communication forms.
Report Facts
residents sampled: 3
employees sampled: 12
residents sampled: 20
late assessments: 40
Inspection Report — Jul 12, 2019
Life Safety
Date: Jul 12, 2019
Visit Reason
CMS-2567 Life Safety (K-tag) survey and Missouri Department of Health and Senior Services State Form; the Emergency Preparedness initial comments state this was an annual recertification survey.
Findings
Two deficiencies were cited: one Life Safety deficiency for corridor doors not fitting tightly allowing passage of smoke, and one Missouri state licensure deficiency for smoke section walls/doors which refers to the Life Safety finding.
Deficiencies (1)
K363 Corridor- Doors: Based on observation and interview, the facility failed to ensure corridor doors fit tightly within the doorframe to resist the passage of smoke; several corridor doors had gaps greater than a quarter inch between the door and door frame.
Inspection Report — Nov 21, 2018
Routine
Date: Nov 21, 2018
Visit Reason
Federal health survey (CMS-2567); the survey type is not stated.
Findings
One federal health deficiency regarding cardiopulmonary resuscitation and staff response to a resident who required emergency care, based on record review and interviews of one resident in a sample of four. Past noncompliance was noted on the form.
Deficiencies (1)
F 678 Cardio-Pulmonary Resuscitation (CPR): Based on interview and record review, facility staff failed to provide basic life support, including CPR, to one resident and did not promptly notify emergency medical services. Staff actions did not follow the facility's CPR policy.
Report Facts
residents affected: 1
residents sampled: 4
Inspection Report — Aug 13, 2018
Life Safety
Date: Aug 13, 2018
Visit Reason
CMS-2567 Life Safety survey (K-tag deficiencies) and Missouri State Form; the CMS form indicates an annual recertification survey.
Findings
Ten deficiencies were cited: five Life Safety Code (K) deficiencies involving egress/locking doors, self-closing doors, cooking/kitchen hood, emergency generator fuel testing, and electrical outlets/equipment; and five Missouri state licensure deficiencies referencing hazardous areas, range hood certification, exit requirements, facility construction/maintenance, and electrical wiring/equipment.
Deficiencies (5)
K222 Egress Doors: Based on observation, interview, and record review, the facility failed to maintain delayed-egress/locking arrangements so the front entrance doors and doors into the Special Care Unit did not operate/unlock properly and could remain individually locked, potentially preventing egress.
K223 Doors with Self-Closing Devices: Based on observation and interview, the door between the kitchen and dining room remained unsealed/ajar and did not close completely upon activation of the fire alarm, allowing the potential passage of smoke into the exit corridor.
K324 Cooking Facilities: Based on observation, interview, and record review, the facility failed to ensure proper operation of the kitchen hood by allowing gaps between hood filters (approximately 1/2 inch), permitting grease-laden vapors to pass around the filters.
K918 Electrical Systems - Essential Electric System: Based on record review and interview, the facility failed to assure proper operation of the emergency generator by not conducting an annual fuel quality test of the stored diesel fuel and no fuel quality test result could be found.
K919 Electrical Equipment - Other: Based on observation and interview, the facility failed to maintain the electrical system by allowing multiple resident room outlets to be loose, without covers, or have furniture/objects pressing against plugs, creating risk of electrical short or fire.
Inspection Report — Aug 13, 2018
Routine
Date: Aug 13, 2018
Visit Reason
Federal health survey (CMS-2567) with Missouri Department of Health and Senior Services State Form; the survey type is not stated.
Findings
Ten deficiencies were cited: five federal health citations addressing advance directives/code status accessibility, restorative nursing/mobility services, accident hazards/supervision (call light accessibility), medication administration/insulin errors, and the resident call system; and five Missouri state citations reflecting the call system, safe/effective medication system, protective oversight/voluntary leave, restorative nursing, and advance directive requirements.
Deficiencies (5)
F578 Request/Refuse/Discntnue Trmnt;Formlte Adv Dir: Based on observation, interview, and record review, the facility failed to ensure a resident's advance directive/code status was consistently accessible and matched across medical records (Resident #146).
F688 Increase/Prevent Decrease in ROM/Mobility: The facility failed to consistently provide restorative nursing services and follow restorative program requirements, resulting in Resident #37 not receiving prescribed restorative therapy.
F689 Free of Accident Hazards/Supervision/Devices: The facility failed to ensure adequate supervision and that a call light was within reach for a visually impaired resident, placing Resident #37 at risk of accidents.
F759 Free of Medication Error Rts 5 Prcnt or More: The facility failed to ensure medication administration and blood glucose monitoring were performed per physician orders, resulting in medication/insulin errors for multiple residents.
F919 Resident Call System: The facility omitted call light activation switches in two toilet rooms near the front entrance, preventing residents from activating the call system.
Report Facts
residents sampled: 18
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