Inspection Reports for
Vaiden Community Living Center
868 Mulberry Street, Vaiden, MS, 39176
Back to Facility Profile5 Reports
Inspection Report — Jun 18, 2025
Complaint Investigation CMS
Date: Jun 18, 2025
Visit Reason
The inspection was conducted following a complaint and incident involving Resident #1 who was injured during transport in the facility van when staff failed to properly secure the wheelchair, resulting in a fall and injuries.
Complaint Details
The complaint investigation was substantiated. Resident #1 was injured during transport on 4/28/25 due to improper wheelchair securement by staff. The resident sustained multiple injuries and later passed away due to unrelated acute renal failure. The facility took corrective actions including staff termination and safety training.
Findings
The facility failed to ensure the safety of Resident #1 during transport by not properly securing the wheelchair, causing the resident to sustain a sternal fracture and head lacerations. The responsible staff member was terminated, and corrective actions including van safety in-service and monitoring were implemented prior to the survey.
Deficiencies (1)
F 0689: The facility failed to ensure the safety of one resident during transport by not properly securing the wheelchair with safety belts, resulting in the resident sustaining a sternal fracture and head lacerations. The responsible staff member was terminated for not following facility policy.
Report Facts
Date of incident: Apr 28, 2025
Length of scalp laceration: 3
Length of second laceration: 2
Date of death: May 3, 2025
BIMS score: 15
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Certified Nurse Assistant (CNA #1) | Van driver who failed to properly secure wheelchair, resulting in resident injury and was terminated | |
| Administrator (ADM) | Interviewed regarding incident and facility corrective actions | |
| Director of Nursing (DON) | Involved in investigation and corrective action monitoring | |
| Maintenance Director | Inspected van after incident and confirmed safety equipment was not used properly | |
| Certified Nurse Assistant (CNA #2) | Demonstrated proper wheelchair securement during transport of other residents |
Inspection Report — Oct 17, 2024
Routine CMS
Date: Oct 17, 2024
Visit Reason
The inspection was conducted to assess compliance with regulatory standards related to resident safety, care, medication storage, food safety, and facility maintenance at Vaiden Community Living Center.
Findings
The facility was found deficient in maintaining a safe and clean environment, including unsafe and damaged resident equipment, failure to implement care plans, improper personal hygiene care, unsecured medication storage, and improper food labeling and storage.
Deficiencies (5)
F 0584: The facility failed to maintain a safe, clean, and homelike environment as evidenced by a dirty wheelchair and an overbed table and bed headboard in disrepair for two residents.
F 0656: The facility failed to develop and implement a complete care plan meeting all resident needs, as one resident's Activities of Daily Living care plan was not followed.
F 0677: The facility failed to provide personal hygiene care, evidenced by long facial hair, unkempt hair, and long nails with brown substance for one resident.
F 0761: The facility failed to ensure proper storage of treatment medications and disinfectant wipes, as a treatment cart was left unlocked and unattended in the hallway.
F 0812: The facility failed to ensure food items in the kitchen refrigerator, freezer, and dry storage room were dated and labeled as required.
Report Facts
Residents sampled: 20
Care plans reviewed: 22
Survey days: 3
BIMS score: 6
BIMS score: 12
BIMS score: 5
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Assistant Director of Nursing | Assistant Director of Nursing | Confirmed disrepair of Resident #27's headboard and overbed table and maintenance reporting procedures |
| Maintenance Director | Maintenance Director | Confirmed unreported maintenance issues with Resident #27's headboard |
| Certified Nursing Assistant #1 | Certified Nursing Assistant | Reported night shift responsibility for cleaning wheelchairs |
| Director of Nurses | Director of Nurses | Confirmed wheelchair cleaning responsibilities and observed dirty wheelchair |
| Administrator | Administrator | Confirmed wheelchair cleaning policy and unsecured treatment cart |
| Certified Nursing Assistant #2 | Certified Nursing Assistant | Reported on Resident #6's hygiene status and bathing responsibilities |
| Minimum Data Set Coordinator | Minimum Data Set Coordinator | Confirmed care plan requirements and deficiencies for Resident #6 |
| Licensed Practical Nurse #1 | Licensed Practical Nurse | Observed and reported unlocked treatment cart and broken lock |
| Dietary Manager | Dietary Manager | Reported on food labeling and storage deficiencies in kitchen |
| Dietary Staff | Dietary Staff | Confirmed improper food storage and labeling in dry storage room |
Inspection Report — Jun 15, 2023
Routine CMS
Date: Jun 15, 2023
Visit Reason
The inspection was conducted to assess compliance with regulatory requirements related to resident care, environment, and infection control at Vaiden Community Living Center.
Findings
The facility was found deficient in maintaining a safe, clean, and homelike environment, failing to implement a fluid restriction care plan, and not following infection prevention protocols during medication administration via PEG tube. Several residents were affected by these deficiencies.
Deficiencies (4)
F 0584: The facility failed to clean a visibly soiled overbed light and window blind and replace a broken window blind for two of 58 residents reviewed.
F 0656: The facility failed to implement a fluid restriction care plan for one of 17 care plans reviewed. Resident #9's fluid restriction was not followed by staff.
F 0692: The facility failed to follow a resident's physician prescribed fluid restriction for one of three residents on fluid restriction. Staff provided fluids beyond the prescribed limit to Resident #9.
F 0880: The facility failed to maintain strict aseptic technique during medication administration via PEG tube for one of four observations. Equipment was placed on unclean surfaces and not properly cleaned or disposed.
Report Facts
Residents reviewed: 58
Care plans reviewed: 17
Medication administration observations: 4
Fluid restriction: 1000
Water observed in pitcher: 600
Employees mentioned
| Name | Title | Context |
|---|---|---|
| LPN #2 | Licensed Practical Nurse | Named in infection control deficiency related to PEG tube medication administration |
| RN #1 | Registered Nurse | Involved in PEG tube medication administration and infection control observation |
| Director of Nursing | Director of Nursing | Interviewed regarding fluid restriction care plan and infection control findings |
| CNA #1 | Certified Nurse Assistant | Interviewed about fluid restriction care plan compliance for Resident #9 |
| CNA #2 | Certified Nurse Assistant | Interviewed about fluid restriction care plan compliance for Resident #9 |
| Housekeeping Supervisor | Interviewed regarding cleaning schedules and observations of soiled environment | |
| Maintenance Director | Interviewed regarding maintenance requests and observations of broken blinds | |
| Administrator | Interviewed regarding maintenance follow-up and environmental concerns |
Inspection Report — Mar 30, 2023
CMS
Date: Mar 30, 2023
Visit Reason
The document is a Statement of Deficiencies and Plan of Correction report for Vaiden Community Living Center, documenting the results of a regulatory survey completed on March 30, 2023.
Findings
No health deficiencies were found during the survey.
Inspection Report — Feb 9, 2022
Routine CMS
Date: Feb 9, 2022
Visit Reason
The inspection was conducted to assess compliance with regulatory requirements related to resident transfer notifications, PASARR screening, care planning, oxygen therapy, infection prevention and control, medication administration, and visitor screening at Vaiden Community Living Center.
Findings
The facility failed to notify a resident's representative of hospital transfer, did not complete required PASARR Level 2 screenings, failed to develop an oxygen care plan, and did not follow proper oxygen tubing protocols. Infection control deficiencies included failure to perform hand hygiene during meal and hydration passes, improper medication handling, and failure to screen a contract worker for COVID-19 symptoms.
Deficiencies (5)
F 0623: The facility failed to notify the resident representative in writing of a hospital transfer for one of 22 residents reviewed.
F 0645: The facility failed to accurately complete a PASARR Level 2 change in status form for one of three residents reviewed.
F 0656: The facility failed to develop an oxygen care plan for a resident with a physician's order for oxygen therapy.
F 0695: The facility failed to date oxygen tubing, provide storage bags, and place oxygen in use signage for two residents on oxygen therapy.
F 0880: The facility failed to prevent infection spread by not performing hand hygiene during meal and hydration passes, improper medication handling, and failure to screen a contract worker for COVID-19 symptoms.
Report Facts
Residents reviewed for transfer notification: 22
Residents reviewed for PASARR screening: 3
Residents reviewed for oxygen therapy care plan: 4
Residents reviewed for oxygen tubing and signage: 4
Residents affected by oxygen tubing deficiencies: 2
Days contract worker was not screened: 2
Employees mentioned
| Name | Title | Context |
|---|---|---|
| LPN #1 | Licensed Practical Nurse | Named in medication administration infection control deficiency |
| CNA #1 | Certified Nurse Assistant | Named in hydration pass hand hygiene deficiency |
| NA #3 | Nursing Assistant | Named in meal tray pass hand hygiene deficiency |
| Director of Nursing | Director of Nursing | Interviewed regarding oxygen tubing and infection control deficiencies |
| Administrator | Administrator | Interviewed regarding multiple deficiencies including transfer notification, PASARR screening, oxygen care plan, infection control, and visitor screening |
| Social Service Director | Social Service Director | Interviewed regarding transfer notification deficiency |
| Social Worker | Social Worker | Interviewed regarding PASARR screening deficiency |
| Registered Nurse #1 | Registered Nurse | Interviewed regarding oxygen tubing and signage deficiencies |
| Contract X-ray Technician | Contract X-ray Technician | Named in visitor screening deficiency |
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