32
Inspections
41
Deficiencies
1
Actual Harm or Above
69
Occurrences
June 17, 2026
Last Inspection
S/S D/E/F Potential for harmS/S G Actual harm

The most recent inspection of PIONEER HEALTH CARE CENTER on record is dated June 17, 2026. Across 32 published inspections, state surveyors cited 41 deficiencies, 1 of which reached actual harm or immediate jeopardy.

Colorado publishes inspections on a rolling window, so older surveys may no longer appear. Citation codes 0000 and 9999 are the surveyor's opening and closing comments, not deficiencies, and are excluded from the counts above. Where the state required one, the facility's own plan of correction is shown beneath the finding it answers.

Provider Information

Status
Active
Facility Type
SNF/NF Dual Certification
Administrator
DiPasquale, Mary
Owner
12TH STREET OPERATIONS, LLC
Phone
(719) 254-3314
Payor Source
Medicare, Medicaid, Private Pay
City
ROCKY FORD
ZIP
81067

Inspections & Citations

32 inspections · 41 deficiencies
6/17/2026Complaint Survey · ID 23633F-H1No deficiencies
0000INITIAL COMMENTSSurveyor note
Findings
A complaint survey, prompted by #CO2625346, #CO2660181, #CO2660476, #CO3025850, Incident #3034205, Incident #3034318 and Incident #3034399 was conducted on 6/16/26 to 6/17/26. No deficiencies were cited.
Plan of correction
The state did not require a plan of correction for this citation.
6/17/2026Licensure Complaint Survey · ID 236341-H1No deficiencies
0000Initial CommentsSurveyor note
Findings
A survey with #CO3025851 was completed on 6/16/26 to 6/17/26. No deficiencies were cited.
Plan of correction
The state did not require a plan of correction for this citation.
9/11/2025Complaint Survey · ID VP6Z11No deficiencies
0000INITIAL COMMENTSSurveyor note
Findings
A complaint survey, prompted by #CO2613734 and Incident #1942991 was completed on 9/10/25 to 9/11/25. No deficiencies were cited.
Plan of correction
The state did not require a plan of correction for this citation.
5/15/2025Complaint Survey · ID OMG911No deficiencies
0000INITIAL COMMENTSSurveyor note
Findings
A complaint survey, prompted by #CO39845 and #CO40023 was conducted on 5/15/25. No deficiencies were cited.
Plan of correction
The state did not require a plan of correction for this citation.
4/24/2025Revisit: Complaint Survey · ID X04K12No deficiencies
0000INITIAL COMMENTSSurveyor note
Findings
A revisit survey was completed on 4/24/25 for all previous deficiencies cited on 3/4/25. The facility is in compliance with all regulations surveyed.
Plan of correction
The state did not require a plan of correction for this citation.
3/4/2025Complaint Survey · ID X04K111 deficiency
0000INITIAL COMMENTSSurveyor note
Findings
A complaint survey, prompted by #CO39394, #CO39398, #CO39420, Incident #39335 and Incident #39408 was conducted on 3/3/25 to 3/4/25. One deficiency was cited.
Plan of correction
The state did not require a plan of correction for this citation.
0600Free from Abuse and NeglectS/S D
Findings
Based on observations, record review and interviews, the facility failed to ensure two (#4 and #6) of four residents reviewed for abuse out of seven sample residents were kept free from abuse. Specifically, the facility failed to:-Protect Resident #4 from physical abuse by Resident #5; and, -Protect Resident #6 from physical abuse by Resident #2. Findings include:I. Facility policy and procedureThe Abuse and Neglect policy, undated, was provided by the director of nursing (DON) on 3/4/25 at 11:14 a.m. It read in pertinent part, "Abuse is defined as the willful infliction of injury, unreasonable confinement, intimidation, or punishment with resulting physical harm, pain or mental anguish."The physician and staff will help identify risk factors for abuse within the facility. "The facility management and staff will institute measures to address the needs of residents and minimize the possibility of abuse and neglect."II. Incident of physical abuse towards Resident #4 by Resident #5 on 2/8/25 A. Facility investigationThe investigation documented the following:On 2/8/25 it was alleged that Resident #5 hit Resident #4 in the head while walking past her in the hall. The incident was witnessed by Resident #7. Both residents were placed on 15-minute checks. The facility substantiated the abuse. A. Resident #5 (assailant) 1. Resident statusResident #5, age greater than 65, was admitted on 11/11/17 and readmitted on 12/12/22. According to the March 2025 computerized physician orders (CPO), diagnosis included schizophrenia, unspecified dementia with behavioral disturbances and wandering. The 1/16/25 minimum data set (MDS) assessment revealed, per staff assessment, the resident was rarely or never understood. He had short and long-term memory problems. His cognitive skills for daily living were moderately impaired. He had inattention and disorganized thinking which fluctuated. He required moderate assistance with bathing. He was independent with positioning, transfers and walking. He received an antipsychotic (medication to treat psychosis) and an antidepressant. 2. Record reviewResident #5's comprehensive behavioral care plan, initiated 10/3/22, documented the resident had behaviors related to schizophrenia and dementia. He had verbal aggression, physical aggression, obsessive pattern walking and had had resident-to-resident aggression. Pertinent interventions included administering medications as ordered, redirecting the resident to a calm environment, responding to the resident calmly, distracting and redirecting the resident, using consistent direction to calm changes gradually, having a quiet area to walk and checking on the residents location and ensuring safety every 15 minutes. A nursing progress note, dated 2/8/25 at 7:33 p.m., documented at approximately 4:00 p.m. the nurse was informed of the incident. Resident #4 reported Resident #5 made contact with her right eye. Both residents were separated and no injury was noted to Resident #5. A nursing progress note, dated 2/9/25 at 11:28 a.m., documented it was reported to the mental health physician that Resident #5's pacing was more than usual and was irritable with the staff. Frequent checks were initiated on the resident. C. Resident #4 (victim) 1. Resident statusResident #4, age greater than 65, was admitted on 8/12/19 and readmitted on 6/29/23. According to the March 2025 CPO, diagnosis included bipolar disorder (mental illness), abnormalities of gait and mobility, weakness, unsteadiness on her feet, lack of coordination, difficulty in walking and delusional disorders. The 2/27/25 MDS assessment revealed, per staff assessment, her skills for daily decision making were moderately impaired. She had no behaviors and did not reject care. She used a wheelchair and required maximal assistance with toileting hygiene, bathing and lower body dressing. She required moderate assistance with personal hygiene, sit to stand and transfers. 2. Resident #4's interviewResident #4 was interviewed on 3/4/25 at 11:16 p.m. Resident #4 said Resident #5 was mean and had attacked other women in the facility as well. She said Resident #5 punched her for no reason causing pain, redness and swelling to her right eye. She said the staff applied ice to her right eye/forehead and the following days she was left with bruising to her forehead. 3. Record reviewResident #4's social behavioral care plan, initiated 11/30/22, documented the resident expressed inappropriate social behaviors verbally/physically towards staff and other residents. She had the potential to be physically aggressive related to anger, depression, poor impulse control, refusing psychotropic medications, throwing dishes and breaking them while in a manic phase. Pertinent interventions included administering medications as ordered, notifying the psychiatrist if the resident was refusing medications, if resident was in a safe location and away from others while being verbally or physically aggressive let her decompress before reengaging with her or trying to redirect her to a different location, notifying the resident's family and physician of increased behavioral concerns, observing the resident during smoke breaks for potential triggers from other residents when she was manic and observing the resident often for self safety and the safety of others. Resident #4's behavioral care plan, initiated 2/8/25, documented the resident had a behavioral problem related to bipolar disorder and delusional disorder. Resident #4 had severe episodes of manic and depressive phases. She could become verbally aggressive/argumentative and had been physically aggressive. She had made inappropriate comments about other residents putting her at risk for harm. Pertinent interventions included acknowledging the resident's delusional beliefs and not arguing with the resident, administering medications as ordered, notifying the physician of refusals, anticipating and meeting the resident's needs, attempting/encouraging aromatherapy to de-escalate when manic and crisis intervention and advocacy as needed, encouraging/assisting the resident away from other residents as allowed when in a manic phase and monitoring behavior episodes and attempting to determine the underlying cause. A nursing progress note, dated 2/8/25 at 7:46 p.m., documented at approximately 4:00 p.m. the nurse was informed of the incident. Resident #4 reported Resident #5 made contact with her right eye. Both residents were kept separated. Resident #4 was assessed and noted to have a discolored reddish area above her right eye. The resident accepted ice wrapped in a towel. A nursing progress note, dated 2/9/25 at 10:36 p.m., documented Resident #4's neurological checks were being monitored and the site above her right eyebrow remained discolored yellow and green. D. Additional resident interviewsResident #7 was interviewed on 3/4/25 at 11:18 a.m. Resident #7 said she was walking down the hallway and witnessed Resident #5 hit Resident #4 in the face. E. Staff interviewsCertified nurse aide (CNA) #2 was interviewed on 3/4/25 at 11:20 a.m. CNA #2 said Resident #5 wandered at times and paced. She said he liked his personal space and usually stayed to himself. She said she had heard he had aggressive behaviors with his peers, but had never witnessed those behaviors herself. Licensed practical nurse (LPN) #1 was interviewed on 3/4/25 at 11:25 a.m. LPN #1 said Resident #5 usually kept to himself. She said when he rejected care or said "no," the staff knew to reapproach at a later time to avoid aggressive behaviors. She said she assumed Resident #4 was sitting in her wheelchair in the hallway where Resident #5 was pacing at the time of the incident. She said Resident #4 was very friendly and probably said "hi" to him, and Resident #5 may not have understood. LPN #1 said Resident #4 yelled "my eye, my eye he got me in the eye." She said she placed ice wrapped in a towel on her right eye which was red. She said bruising developed the following days. The social services assistant (SSA) was interviewed on 3/4/25 at 2:25 p.m. The SSA said he had only been in his position for three weeks. He said he had not had any interactions with Resident #5 and was still in his training process. He said he had not heard of Resident #5 having any behaviors. He said he was still trying to learn who the residents were. He said he was in the process of familiarizing himself with the resident care plans and it was a work in progress. The DON was interviewed on 3/4/25 at 2:36 p.m. The DON said Resident #5 liked to pace back and forth and could have verbal outbursts and physical aggression but never actually hit a resident. She said the last incident involved physical contact with Resident #4. She said the staff would redirect him when he escalated. She said they had even tried a sensory program with therapy to identify a root cause for his behaviors. III. Incident of physical abuse between Resident #6 and Resident #2 on 2/16/25 A. Facility investigationThe investigation documented the following:On 2/16/25 it was alleged that Resident #6 pushed Resident #2. However, after review of the facility cameras, it was determined that Resident #2 pushed Resident #6. Resident #6 said Resident #2 hit and pushed her. Resident #2 was placed on line of sight monitoring. The facility unsubstantiated the abuse allegation. -However, abuse occurred when Resident #2 pushed Resident #6. A. Resident #2 (assailant) 1. Resident status Resident #2, age greater than 65, was admitted on 3/31/23 and readmitted on 11/1/24. According to the March 2025 CPO, diagnoses included unspecified dementia with behavioral disturbances, Alzheimer's disease, bipolar disorder, insomnia due to mental disorder, vascular dementia, restlessness and agitation. The 12/12/24 MDS assessment revealed the resident had moderate cognitive impairments with a brief interview for mental status (BIMS) score of 10 out of 15. She required moderate assistance with bathing. She required set-up assistance with oral hygiene, upper/lower body dressing, personal hygiene, putting on/off footwear, sitting to stand, toilet transfers and walking. She received an antipsychotic medication and an antidepressant medication. 2. Record reviewResident #2's mood/behavior care plan, initiated on 4/17/23, documented she had mood/behavior problems related to bipolar disorder, vascular dementia, Alzheimer's disease, insomnia, restlessness, agitation and making false accusations about other residents. She had resident-to-resident altercations which she initiated and was the aggressor. Pertinent interventions included administering medications as ordered, anticipating and meeting the residents needs, providing behavioral health consults, ensuring the resident was in line of sight when out of her room, providing frequent checks for the resident's safety, redirecting the resident and providing one-to-one care when needed. A nursing progress note, dated 2/16/25 at 9:28 p.m,. documented the staff reported a resident-to-resident altercation between Resident #2 and Resident #6 took place in the hallway. The residents were separated, interviewed and assessed for injury. No injuries were observed on either resident. Labs were ordered for Resident #6. A risk review note, dated 2/18/25 at 10:01 a.m., documented Resident #2 reported to staff that Resident #6 made contact with her on the previous shift. The incident was not observed by staff at the time of the report. Upon further investigation it was noted that in fact the initial alleged victim (Resident #2) was the aggressor. C. Resident #6 (victim) 1. Resident statusResident #6, age greater than 65, was admitted on 2/17/23. According to the March 2025 CPO, diagnoses included major depressive disorder, unspecified dementia, anxiety disorder, muscle weakness, vascular dementia and collapsed vertebra (back). The 2/6/25 MDS assessment revealed the resident had severe cognitive impairments with a BIMS score of seven out of 15. Shehad hallucinations and delusions. She required maximal assistance with toileting hygiene and bathing. She was independent with positioning, transfers and walking. She received an antipsychotic medication. 2. Resident interviewResident #6 was interviewed on 3/4/25 at 11:03 a.m. Resident #6 said Resident #2 pushed her and she fell. She said she did not know why. She said it hurt, but she did not get injured. 3. Record reviewResident #6's behavior care plan, initiated 4/17/23, documented she had mood/behavior problems related to vascular dementia, anxiety, major depressive disorder and could become aggressive with other residents. Resident #6 had become physically agitated with other residents. Pertinent interventions included administering medications as ordered, anticipating and meeting the residents needs, providing a psychiatric consult, assisting the resident to develop more appropriate methods of coping and interacting, providing frequent checks for the safety of others and keeping the resident in line of sight when she was out of her room. A nursing progress note dated 2/16/25 at 10:22 p.m. documented the alleged victim (Resident #2) claimed Resident #6 made contact with her. The altercation was not witnessed and the residents were separated and taken to separate rooms for assessments. There were no injuries observed. A risk review note, dated 2/18/25 at 10:02 a.m., documented Resident #2 reported to staff that Resident #6 made contact with her on the previous shift. The incident was not observed by staff at the time of the report. Upon further investigation it was noted that in fact the inital alleged victim (Resident #2) was the aggressor. 4. Staff interviewsCNA #1 was interviewed on 3/4/25 at 11:08 a.m. CNA #1 said Resident #2 could get grumpy at times. He said he was not working the day of the altercation and had never seen Resident #2 become aggressive. LPN #1 was interviewed on 3/4/25 at 11:11 a.m. LPN #1 said Resident #2 liked to straighten and organize things. She said Resident #2 preferred to stay in her room. She said she was not working the day of the altercation. She said Resident #2 was not usually aggressive but could get frustrated. The SSA was interviewed on 3/4/25 at 2:25 p.m. The SSA said he was not aware of any aggressive behaviors from Resident #2. He said she usually just walked from her room to the dining room. He said he was not aware of the altercation. The DON was interviewed on 3/4/25 at 2:36 p.m. The DON said the previous nursing home administrator (NHA) conducted the investigation. The DON said Resident #2 would report false allegations and liked to fidget with things throughout the day even if the items were not hers. She said Resident #2 reported she fell, but when the NHA reviewed the cameras, Resident #2 pushed Resident #6, but she did not fall. She said she was not working the day of the altercation.
Plan of correction · submitted by the facility
PREPARATION AND EXECUTION OF THIS RESPONSE AND PLAN OF CORRECTION DOES NOT CONSTITUTE AN ADMISSION OR AGREEMENT BY THE PROVIDER OF THE TRUTH OF THE FACTS ALLEGED OR CONCLUSIONS SET FORTH IN THE STATEMENT OF DEFICIENCIES. THE PLAN OF CORRECTION IS PREPARED AND/OR EXECUTED SOLELY BECAUSE IT IS REQUIRED BY THE PROVISIONS OF FEDERAL AND STATE LAW. FOR THE PURPOSES OF ANY ALLEGATION THAT THE FACILITY IS NOT IN SUBSTANTIAL COMPLIANCE WITH FEDERAL REQUIREMENTS OF PARTICIPATION, THIS RESPONSE AND PLAN OF CORRECTION CONSTITUTES THE FACILITY'S ALLEGATION OF COMPLIANCE IN ACCORDANCE WITH SECTION 42 C.F.R. §488.18 AND SECTION 7317A OF THE STATE OPERATIONS MANUAL F600 Free from Abuse, Neglect and Exploitation. Correction: Resident #4 has been free from any further physical abuse from resident #5. Resident #5 had a medication review by in-house psychiatrist which resulted in an increase in his Trazodone dosage to 50 mg three times daily. A decision was made to discontinue Zoloft 50 mg daily which was being prescribed for OCD symptoms. A p.r.n. Trazodone was also ordered when his dosage increase occurred. The increased dosage of Trazodone appeared to result in significant behavioral improvements. #6 has been free from any further physical abuse from resident #2. Residents have been kept apart and engaged with activities of choice while out in commons and line site provided. No noted behaviors from either resident since interventions were put in place. Identification: Residents currently residing in the facility have the potential to be affected by this deficient practice. Residents that are currently being followed for behaviors we identified and audited and behaviors trackers reviewed for appropriate updates. Systemic: The measures the facility will take or systems the facility will alter to ensure thatthe alleged deficient problem will be corrected and attempt prevention to recur:-All staff were in serviced on the facility Abuse Prevention Policy and Procedureand the resident right to be free from verbal, sexual, physical, and mentalabuse, corporal punishment, and involuntary seclusion.-All Facility staff are being in-serviced on the facility Trigger and Approaches Sheets, where they could find them.-All staff were also instructed to notify the SSD (social services director) if they note any new triggers or approaches that work on the Resident that are not on the sheets so that they may be added. This was done on 3/21/25, by the NHA (nursing home administrator)/Social Services Director. -The Social Services Director, with input from the IDT (interdisciplinary team) and facility staff, have been reviewing the Behavior Trigger and Approaches Sheets on each resident. This is to ensure that both the triggers identified currently are accurate and that the approaches are appropriate and still are the best for each resident identified. Then these Trigger and Approaches Sheets will be updated, along with the Residents care plans by the IDT. Staff will be made aware of these updates to the sheets by 3/28/25. -The facility has rolled out an updated Abuse Investigation form which was implemented in part of the training received from the CHCA and Telligen meetings on Abuse prevention. It better assists the facility to develop a thorough investigation to determine the root cause analysis of the circumstances of the situation or behavior which resulted in the allegation of abuse. This also guides the development of the right interventions to address the triggers to address that caused the abuse and to assist the facility to have a greater chance to prevent re-occurrence. -IDT is reviewing the 24-hour report Monday through Friday for residents who are demonstrating behaviors that may show signs of increased agitation, impulsiveness, or aggression. Nurse managers will assess them and discuss this with the Physician regarding next steps. IDT will identify changes needed to the specific Residents plan to address the acute change in Residents condition,and what immediate interventions need to be implemented to prevent a unwanted episode from occurring. These acute changes to a Residents plan will be communicated to the staff via Trigger and Approaches Sheets. Then at such a time it will be reviewed by IDT At Risk Meeting whether this acute change is to become a permanent change to the resident’s plan of care or if the acute situation has resolved and so has the behavior. The Residents care plan will be updated as needed. Monitor NHA (nursing home administrator)/designee will track all occurrences and determined root cause analysis findings of these, any trending issues will be reported to the QAPI Committee Monthly to determine if PIPs should be developed due to identified trends. This will be reviewed monthly x3 or until the QAPI Committee feels that compliance is being maintained. This will be documented on an audit sheet in binder for POC.
1/29/2025Complaint Survey · ID F4U311No deficiencies
0000INITIAL COMMENTSSurveyor note
Findings
A complaint survey, prompted by #CO38855, #CO38857, #CO38860, #CO38864, #CO38866 and Incident #39066 was conducted on 1/28/25 and 1/29/25. No deficiencies were cited.
Plan of correction
The state did not require a plan of correction for this citation.
10/8/2024Revisit: Complaint Survey · ID JQN212No deficiencies
0000INITIAL COMMENTSSurveyor note
Findings
A revisit survey was completed on 10/8/24 for all previous deficiencies cited on 8/29/24. The facility is in compliance with all regulations surveyed.
Plan of correction
The state did not require a plan of correction for this citation.
8/29/2024Complaint Survey · ID JQN2113 deficiencies
0000INITIAL COMMENTSSurveyor note
Findings
A complaint survey, prompted by #CO37238, #CO37269, and #CO37270 was conducted on 8/27/24 to 8/29/24. Three deficiencies were cited.
Plan of correction
The state did not require a plan of correction for this citation.
0584Safe/Clean/Comfortable/Homelike EnvironmentS/S E
Findings
Based on observations and staff interviews, the facility failed to maintain a sanitary, orderly and comfortable environment for residents in 28 of 55 resident rooms. Specifically, the facility failed to ensure:-The walls, ceilings, baseboards and floors were properly maintained;-The resident's rooms were cleaned and free of mice feces, flies; and, -The wooden handrails in the hallways were cleaned and free of wood splinters. Findings include: I. ObservationsObservations of the resident's living environment were conducted on 8/27/24 at 9:44 a.m. and revealed the following:Room #100: The ceiling had three missing 12 inch by 12 inch tiles. The walls had several sections approximately four inches in circumference on the wall next to the bathroom. The resident had a five drawer dresser in the corner of his room with each drawer containing dried mice droppings. The floor was sticky. There were tissues and other trash under the resident's bed. Room #113: The wall next to the bathroom had chipped and peeling plaster approximately 14 inches high by four inches wide. The floors were sticky and there was a strong odor of urine. The window blinds had four broken slats with seven missing slats close to the bottom of the blinds. The ceiling tiles outside of room #113 had a large water stain approximately 48 inches long by 50 inches wide. Room #101: The bottom of the baseboard next to the bathroom was missing. The resident had a five drawer dresser, which had mice droppings in all of the drawers. There were three unpainted areas next to the bathroom approximately three inches in circumference. The floors were sticky and had not been cleaned, with remnants of spilled liquids. Room #102: There was a puddle of urine underneath the resident's bed. The walls in the room had five areas of unfinished repair work. The five drawer dresser had mice feces in all drawers. Room #112: The wall north of the sink had five areas of chipped and peeling paint. There were two other large chips above the sink approximately three inches in circumference. The ceiling had approximately six 12 inch by 12 inch tiles missing. The baseboard cover, which covered the joint between the wall and the floor next to the bed, was missing a section approximately 24 inches long by four inches wide. The floor was dusty, had dried urine stains, was cluttered and had debris underneath the beds. Room #101: The resident room had several areas of white repair work on the green wall which had not been completed. The floors were sticky and stained with urine. Room #111: The wall next to the bed was missing a section of the baseboard that was approximately 12 feet long by four inches wide. The wall had deep scratches. The corner edging, which protected the corners from damage, was missing a section which was approximately five feet high by four inches wide. The lights above the residents' beds had chipped and peeling paint approximately four feet long by six inches wide. The hand sanitizer next to the door had an area surrounding it that was approximately 12 inches long by six inches wide of chipped paint. The floor in the whole room was cluttered with trash, food packages, tissue and an empty plastic cup. Room #103: The wall underneath the sink had an area approximately 30 inches by 29 inches of bubbling paint from water damage. There were 10 areas of unfinished hole spackled repair work next to both beds. The corner wall next to the bathroom had chipped and cracked paint approximately 12 inches high by eight inches wide. The floors were sticky with urine stains. The floor in the whole room had dirt accumulation and was cluttered with debris underneath the beds. Room #108: The wall which the light fixture was mounted to had chipped and peeling paint approximately four feet long by six inches wide. The walls above both of the beds had chipped and peeling paint approximately five inches in circumference. The corner strip on the wall was missing a section which was approximately five feet high by four inches wide. The five drawer dresser had mice feces in all of the drawers. The floors were sticky with remnants of spilled liquid. Room #104: The wall behind the resident's bed was damaged from the bed being lifted and lowered. The wall which the light was mounted to had chipped and peeling paint approximately four feet long by six inches wide. The baseboard cover, which covered the joint between the wall and the floor, was missing next to the bathroom. There was a large chipped area approximately 10 inches long by five inches wide next to the door. The floor had an accumulation of dirt and was sticky from liquid being spilled. Room #105: The floors were stained with urine and sticky and the bathroom had a strong odor of urine. Room #106: The wall next to the closet had chipped and missing plaster approximately 12 inches high by six inches wide. The floors were sticky and had dirt build up under the bed. Room #118: The wall next to the door had an area approximately eight inches high by four inches wide of chipped and peeling plaster. There were several areas of chipped and peeling paint next to the sink. The window next to the resident's bed had a large piece of plywood covering the window. The floor was sticky and had remnants of spilled liquid. Room #117: The wall next to the bathroom had chipped and peeling plaster approximately six inches high by four inches wide. The wall behind the dresser had an area approximately 24 inches by 24 inches wide which had chipped and peeling paint. The room had a strong odor of urine. The floors were sticky and stained with urine. The resident had a five drawer dresser. There was mice feces in all of the drawers. Room #113: The room had a strong odor of urine. The floors were sticky and stained with urine. There was urine around the base of the toilet. The resident had a five drawer dresser. All of the drawers had mice feces. The floor was cluttered with used tissues, empty plastic cups and plastic silverware was underneath the beds. Room #114: The lights above the residents' beds had chipped and peeling paint approximately four feet long by six inches wide. The floors were dirty and sticky. The wall next to the dining room was missing a section of wood railing approximately eight feet long. Room #9: The air conditioner was not working and had a large amount of dust on the outside of the unit. The wall next to the resident's bed had four dime sized holes with an outline of the electrical system approximately 32 inches high by two inches wide when it was removed. The room was cluttered and the floors were sticky. Room #2: The wall next to the bathroom had chipped and peeling paint approximately 24 inches high by three inches wide. The floors were sticky and there was a strong odor of urine in the room. Room #8: The wall next to the resident's bed had three areas approximately three inches in circumference which had not been repaired. The floors were sticky and had remnants of spilled juice. Room #3: The room had approximately 14 areas of spackled hole repair work next to the resident's bed. Room #4: The room had several exposed glue traps on the floor with several large bugs on them. Room #17: The wall next to the bathroom had three dime sized holes and peeling paint. The wall next to the door had an area approximately six by three which was unpainted. Room #35: The floors had an accumulation of dirt built up with dust mites underneath the bed. Room #23: The window blinds were broken with six broken slats and approximately six slats missing and the floors were sticky with urine stains. Room #27: The floors were sticky and water stained. Room #26: The floors were sticky and had an accumulation of dirt and urine stains. There was a strong odor of urine in the bathroom. Room #24: The floors were sticky. There was a strong odor of urine and there were urine stains on the bathroom floor. The floor had chipped tiles approximately 12 inches by 12 inches. Room #21: The floors were sticky with remnants of spilled liquid. The hallway next to room #20 had damaged floor tile approximately 12 feet long by 12 inches wide. The shower room on the south hall had approximately 18 12 inch by 12 inch ceiling tiles missing. The sheetrock on the walls had water damage and repair had not been completed. The hand rail from room #100 to room #113 was dirty and sticky and had chipped and splintering wood. The plastic rail bracket was broken with sharp edges between room #103 and Room #104. The shower room on the south hall had approximately 18 12 inch by 12 inch ceiling tiles missing. The sheetrock on the walls had water damage and repair had not been completed. The maintenance closet had a glue trap with several large bugs in it. The wall next to the dining room was missing a section of wood railing approximately eight feet long. II. Environmental tour and staff interviewThe environmental tour was conducted with the maintenance supervisor (MS) on 8/28/24 at 11:06 a.m. The above detailed observations were reviewed. The MS said the facility utilized work orders as well as a computer system to identify environmental issues. The MS said he did not have work orders for the damage identified during the environmental tour. The MS said repairs should have been repaired and addressed in a timely manner. The MS said the mice were an ongoing problem. He said with the bad weather, the mice were coming into the facility. He said the building was old and the heat vents gave mice easy access to the facility. The MS said housekeeping had initiated a new program called safety culture. He said the program had been going on for about two months and he was hoping it would result in a better cleaning system. The nursing home administrator (NHA) was interviewed on 8/29/24 at 8:40 a.m. The NHA said he was not aware of the fly issues in the facility but he would look into it. He said the facility did have a mouse problem, but he said he did not know it was an ongoing issue. He said the mice dropping should have been cleaned with the cleaning schedule and he was surprised the droppings were still there. He said the residents were always spilling and making a mess on the floors in both units. He said cleaning these spills was an ongoing battle.
Plan of correction
The state did not require a plan of correction for this citation.
0695Respiratory/Tracheostomy Care and SuctioningS/S D
Findings
Based on observations, record review and interviews, the facility failed to ensure residents received proper respiratory treatment and care for three (#3, #2 and #7) of four residents reviewed for supplemental oxygen use out of 10 sample residents. Specifically, the facility failed to:-Administer oxygen in accordance with the physician's order for Resident #3 and #2; and,-Ensure a physician's order was in place for Resident #7's continuous use of oxygen. Findings include:I. Facility policy The Oxygen Administration Policy, revised October 2010, was provided on 8/29/24 at 10:47 a.m. by the corporate consultant (CC). It read in pertinent part, "The purpose of this procedure is to provide guidelines for safe oxygen administration." II. Resident # 3 A. Resident status Resident #3, age 74, was admitted on 3/19/21. According to the August 2024 computerized physician orders (CPO), diagnoses included depression, delusional disorder, chronic obstructive pulmonary disease (COPD). According to the 7/17/24 minimum data set (MDS) assessment, the resident had no cognitive impairment with a brief interview for mental status (BIMS) score of 15 out of 15. The resident had no behavioral symptoms. The resident had no upper or lower body impairment. The assessment did not identify the resident used oxygen. B. Observations and interviews On 8/28/24 at 4:00 p.m. Resident #3 was observed in the hallway sitting in her wheelchair with her oxygen nasal cannula on and connected to a portable oxygen concentrator. The resident's portable oxygen concentrator was set on 2 LPM.Resident #3 said she had been out of her room since lunch. She said she could not remember when anyone checked her portable oxygen concentrator last. At 4:00 p.m. registered nurse (RN) #2 was asked to check the resident's oxygen saturation level (measure of oxygen in the blood) and the resident's portable oxygen concentrator. RN #2 checked Resident #3's oxygen saturation level which read 90 % (percent). RN #2 checked Resident 3's portable oxygen concentrator. RN #2 said the portable oxygen concentrator was empty. RN #2 wheeled the resident into her room and placed the resident on her room's oxygen concentrator. RN #2 exited the resident's room and proceeded to take the portable oxygen concentrator to fill it up with oxygen. At 4:10 p.m. Resident #3 said, "No wonder I was feeling a little loopy."C. Record review The care plan, initiated 3/22/21 and revised 8/25/24, identified the resident had oxygen therapy related to ineffective gas exchange due to COPD and impaired respiratory status related to hypoxia (low levels of oxygen in the body's tissues). Interventions included evaluating for signs and symptoms of respiratory distress and reporting to medical doctor (MD) as needed (respirations, pulse oximetry, increased heart rate (tachycardia), restlessness, diaphoresis, headaches, lethargy, confusion, atelectasis, hemoptysis, cough and, pleuritic pain). The August 2024 CPO included a physician's order dated 5/13/24 for the continuous use of oxygen at 2 liters per minute (LPM) via nasal cannula. D. Staff interview RN #2 was interviewed on 8/28/24 at 4:15 p.m. He said oxygen was a medication. RN #2 said Resident #3's oxygen concentrator was usually filled up in the morning and staff refilled all residents' portable oxygen concentrators again in the afternoon. RN #2 said a negative outcome for having an empty portable oxygen concentrator would be hypoxia and confusion. III. Resident #2 A. Resident status Resident #2, age 70, was admitted on 6/1/23. According to the August 2024 CPO, diagnoses included chronic respiratory failure whether with hypoxia or hypercapnia (too much carbon dioxide in the blood), schizoaffective disorder, bipolar, COPD. According to the 6/4/24 MDS assessment, the resident had severe cognitive impairment with a BIMS score of six out of 15. The resident had no behavioral symptoms. The assessment indicated the resident received oxygen therapy. B. Observation On 8/27/24 at 11:35 a.m. Resident #2 was sleeping with his nasal cannula on. His oxygen concentrator was at the foot of his bed and was set at 2 LPM.-However, the physician's order indicated the resident should be receiving 3 LPM of oxygen (see record review below). On 8/28/24 at 11:20 a.m. Resident #2 was lying in bed watching television in his room. He was wearing his nasal cannula with his oxygen concentrator set at 2 LPM.-However, the physician's order indicated the resident should be receiving 3 LPM of oxygen (see record review below). C. Record Review The care plan, initiated 6/3/23 and revised, on 8/1/24, identified the resident had altered respiratory status, difficulty breathing/ shortness of breath (SOB) related to COPD, chronic respiratory failure, unspecified and asthma. Interventions include providing oxygen as ordered. -The August 2024 CPO included a physician's order dated 7/27/23 for the continuous use of oxygen at 3 LPM via nasal cannula to maintain an oxygen saturation level at or above 88% percent. D. Staff interview RN #1 interviewed on 8/28/24 at 11:20 a.m. RN #1 said oxygen was a medication. She said Resident #2 was supposed to be on 3 LPM of oxygen continuously. RN #1 said she adjusted Resident #2's oxygen to 3 LPM per the physician's order, instead of 2 LPM. She said a negative outcome of receiving the wrong amount of oxygen could be the resident getting confused and hypoxic. IV. Resident #7Resident #7, age 69, was admitted on 8/1/23 and readmitted on 7/26/24. According to the August 2024 CPO, diagnoses included respiratory arrest, schizoaffective disorder, bipolar, COPD, acute respiratory failure with hypoxia, major depression. According to the 7/4/24 MDS assessment, the resident had no cognitive impairment with a BIMS score of 15 out of 15. The resident had verbal behaviors directed at others. The assessment indicated the resident received oxygen therapy. C. Record review The care plan, initiated 8/1/23 and revised 7/22/24, identified the resident had COPD related to smoking. The resident was encouraged to wear his oxygen and stated that staff were idiots and he did not need his oxygen. Interventions included administering 10 LPM of oxygen continuously as the resident allowed, observing for difficulty breathing on exertion, and reminding the resident not to push beyond his tolerated endurance. -The August 2024 CPO did not include a physician's order for oxygen. C. ObservationOn 8/27/24 at 10:35 a.m. Resident #7 was sleeping in his room. The resident was wearing an oxygen nasal cannula and an oxygen concentrator was next to his dresser and set to 3 LPM.On 8/28/24 at 8:50 a.m. Resident #7 was lying down in his bed. The resident was wearing an oxygen nasal cannula and his oxygen concentrator was set at 3 LPM. D. Staff interview Licensed practical nurse (LPN) #1 was interviewed on 8/29/24 at 9:00 a.m. LPN #1 said oxygen was a medication and required a physician's order. LPN #1 checked her computer to verify the physician's order for oxygen for Resident #7. She said Resident #7 did not have a physician's order for his oxygen. She said the resident should have had a physician's order to receive oxygen. V. Additional staff interviewThe assistant director of nursing (ADON) was interviewed on 8/29/24 at 12:13 p.m. The ADON said oxygen was a medication. She said staff should be checking all portable oxygen concentrators for all residents to ensure they were not empty. She said staff should ensure all oxygen was being administered in accordance with the physician's orders and all residents who were on oxygen should have a physician's order in place for the use of oxygen. The ADON said a negative outcome from not being administered oxygen when ordered could be altered mental status, dizziness, falls and hypoxic events. She said not receiving the correct amount of oxygen could put the residents in respiratory distress.
Plan of correction
The state did not require a plan of correction for this citation.
0925Maintains Effective Pest Control ProgramS/S F
Findings
Based on observations, record review and interviews, the facility failed to provide an effective pest control program to ensure the facility was free of pests. Specifically, the facility failed to take the appropriate measures to control a fly infestation in the facility. Findings include: I. Professional reference According to the Center for Disease Control (CDC) Guidelines for Environmental Infection Control in Health-Care Facilities, updated 2/15/19, pp. 94-95, retrieved on 9/5/24 from https://www.cdc.gov/infection-control/media/pdfs/Guideline-Environmental-H.pdf, "Cockroaches, spiders, and mice are among the typical pest populations found in health-care facilities. Insects and rodents can serve as agents for the mechanical transmission of microorganisms, or as active participants in the disease transmission process by passing pathogens from one source to another. Insects and rodents should be kept out of all areas of a health-care facility. "From a public health and hygiene perspective, pests should be eradicated from all indoor environments. Approaches to institutional pest management should focus on: -Eliminating food sources, indoor habitats, and other conditions that attract pests;-Excluding pests from entering the indoor environments; and,-Applying pesticides as needed. "Insect habitats are characterized by warmth, moisture, and availability of food." II. Observations/resident interviews:On 8/27/24 at 9:50 a.m. room #100 was observed. The resident who resided in the room was lying in bed. The resident was swatting flies away from his face. On 8/27/24 at 9:55 a.m. room #113 was observed. One of the residents who resided in the room was sitting on the end of his bed and his roommate was sleeping. Flies were observed throughout the room flying on or around the residents' faces. There was a fly glue ribbon hanging from the ceiling. The fly trap was full of dead flies. On 8/27/24 at 9:57 a.m. room #101 was observed. Flies were observed throughout the room landing on resident's personal items, such as drinking cups. On 8/27/24 at 10:00 a.m. room #102 was observed. The resident who resided in the room was lying in bed with flies landing on his head and face. On 8/27/24 at 10:04 a.m. room #111 was observed. The resident who resided in the room was sitting on her bed and was swatting flies away from her face. The room had two glue fly ribbons on each side of the room. The fly traps were full of dead flies. On 8/27/24 at 10:07 a.m. room #103 was observed. Flies were observed throughout the room landing on the residents' personal belongings. On 8/27/24 at 10:12 a.m. room #108 was observed. The room had two glue fly ribbons hanging from the ceiling. The glue traps were full of flies. On 8/27/24 at 10:16 a.m. room #104 was observed. The resident who resided in the room was lying in bed sleeping with flies landing on his head and pillows. The resident had a drinking cup on his dresser with dead flies in the bottom of the glass. On 8/27/24 at 10:21 a.m. room #105 was observed. Flies were observed throughout the room landing on personal items. On 8/27/24 at 10:35 a.m. room #9 was observed. The resident who resided in the room was eating her breakfast and swatting flies away from her food. The resident said the flies were terrible but they were even worse when it was hotter. She said they got on her face and her food and they were just a bother. On 8/27/24 at 10:42 a.m. room #2 was observed. Flies were observed throughout the room landing on the resident who resided in the room and his personal belongings. The resident said the flies were a problem because they were all over the place. On 8/27/24 at 10:55 a.m. room #23 was observed. Flies were observed throughout the room landing on personal items of the resident who resided in the room. The resident had a fly swatter at the foot of his bed. The resident said the flies were the worst, especially since they got on his food. On 8/27/24 11:00 a.m. room #30 was observed. Flies were observed throughout the resident's room landing on the personal items of the resident who resided in the room. The resident said the flies were a problem but felt like the flies were only in his room. III. Building observations Throughout the survey (8/27/24 to 8/29/24) flies were observed in all areas of the secure unit and long term care living environment of the facility. IV. Staff interviewsRegistered nurse (RN) #1 was interviewed on 8/28/24 at 11:20 a.m. RN #1 said the flies had been getting worse ever since the area had been getting a high amount of rain. She said the flies were mainly in the residents' rooms. Licensed practical nurse (LPN) #1 was interviewed on 8/28/24 at 11:40 a.m. LPN #1 said the flies had been getting worse in the secure unit. She said staff had been trying to keep the main doors closed to try to keep the flies from coming into the building. Housekeeper (HSK) #1 was interviewed on 8/28/24 at 11:58 a.m. HSKP #1 said the flies had been a problem and they seemed to be getting worse. She said facility staff tried not to let the doors stay open for any long periods of time but it was hard to keep them closed with the residents frequently going in and out. LPN #2 was interviewed on 8/29/24 at 8:59 a.m. LPN #2 said the flies seemed to be in the residents' rooms much more than anywhere else in the building. She said the facility had a blue light in the dining areas and that appeared to keep the flies out of the dining room. LPN #2 said the flies were bad in the residents' rooms. She said some residents' families got the residents fly swatters for their rooms. The maintenance supervisor (MS) was interviewed on 8/28/24 at 11:06 a.m. The MS said the flies were a problem because of the area the facility was located in. He said the weather had also been a factor in the increase of flies. He said the facility had placed glue fly traps in three rooms. He said the fly traps were high enough to be out of the residents' way and they were supposed to be changed regularly. The MS said the fly traps should have been changed monthly or as needed when they were full of dead flies. The NHA was interviewed on 8/29/24 at 8:40 a.m. The NHA said he was not aware of the fly issues in the facility but he would look into it.
Plan of correction
The state did not require a plan of correction for this citation.
8/16/2024Revisit: Recertification Survey · ID 7VIA22No deficiencies
0000INITIAL COMMENTSSurveyor note
Findings
A document revisit was completed with all deficiencies being corrected. No other deficiencies were cited and no response is needed.
Plan of correction
The state did not require a plan of correction for this citation.
6/7/2024Revisit: Complaint, Recertification Survey · ID 7VIA12No deficiencies
0000Initial CommentsSurveyor note
Findings
A revisit survey was completed on 6/7/24 for all previous deficiencies cited on 4/18/24. The facility is in compliance with all regulations surveyed.
Plan of correction
The state did not require a plan of correction for this citation.
5/1/2024Recertification Survey · ID 7VIA2112 deficiencies
0000INITIAL COMMENTSSurveyor note2 building records
Findings · record 1 of 2
INITIAL COMENTS (ID Prefix Tag #K000) are informational only and a representation of the facility's general characteristics. This survey was conducted in accordance with the Federal Register at Section 42 CFR 483.70(a). This facility licensed for 101 beds and consist of two structures. This re-certification survey conducted on May 1, 2024 was for compliance with the National Fire Protection Association, (NFPA 101) Life Safety Code (2012) Chapter 19, "Existing Health Care Occupancies". The deficiencies cited were discussed with the Director of Nursing and Maintenance staff during the exit conference conducted at the end on-site survey. As previously mention, the facility consists of two buildings, which are known as the South Building and the North Building. The buildings are connected by a below-grade tunnel with a two-hour, fire rated separation at the tunnel entrance to the North Building. The basement of both buildings, neither of which are accessible to the residents, used for support services only. A1-South Building: The South Building is a one-story Type II (200) structure with a basement. It was originally constructed in 1954 as a hospital. The South Building is protected throughout by a National Fire Protection Association (NFPA) 13 automatic fire suppression systems and is classified as Fully Sprinklered.
Findings · record 2 of 2
INITIAL COMENTS (ID Prefix Tag #K000) are informational only and a representation of the facility's general characteristics. This survey was conducted in accordance with the Federal Register at Section 42 CFR 483.70(a). This facility licensed for 101 beds and consist of two structures. This re-certification survey conducted on May 1, 2024 was for compliance with the National Fire Protection Association, (NFPA 101) Life Safety Code (2012) Chapter 19, "Existing Health Care Occupancies". The deficiencies cited were discussed with the Director of Nursing and Maintenance staff during the exit conference conducted at the end on-site survey. As previously mention, the facility consists of two buildings, which are known as the South Building and the North Building. The buildings are connected by a below-grade tunnel with a two-hour, fire rated separation at the tunnel entrance to the North Building. The basement of both buildings, neither of which are accessible to the residents, used for support services only. A2-Building: The North Building known as A2 is a one-story building Type V (111) structure with a partial basement. Constructed in two phases separated by a ten-year span of time. The original western portion of the building was constructed 1964, with eastern portion of the building constructed in 1974. The North Building is also protected throughout by a National Fire Protection Association (NFPA) 13 automatic fire suppression systems and is classified as Fully Sprinklered.
Plan of correction
The state did not require a plan of correction for this citation.
0211Means of Egress - GeneralS/S F
Findings
STANDARD not met as evidenced by: Based on observation and staff interview, it was determined that the facility failed to arrange and maintain the means of egress in accordance with Life Safety Code Section 19.2 and Chapter 7. This deficient practice could affect all residents, staff and visitors throughout the facility if an exit discharge to the public way is not provided. Both means of egress exit doors are covered with a vinyl wrap disguising then as a bookshelf's not allowing the path of egress travel obvious and direct. The exit discharge deficiency was discussed with the Director of Maintenance during the survey and again during the exit conference with the Director of Nursing. Life Safety Code Section 7.2.1.1.2 Every door opening and every principal entrance that is required to serve as an exit shall be designed and constructed so that the path of egress travel is obvious and direct.
Plan of correction · submitted by the facility
K 927Corrective action for residents found to have been affected by this deficiency:Place how many residents stated in the deficiency here. Such as: Based on observation and staff interview during the course of the survey it was determined the Vinyl wrap that was on the doors was a safety hazard and can only cover no more than half of the door. Corrective action for other residents that may be affected by this deficiency:Place the audit that you will do and the date that it will be done on. Also have this audit ready to submit to State/Life Safety. Such as: An audit of the entire building to find any other vinyl wraps was completed and no others were found. Staff was educated on the above information. Measures and systemic changes that will be put into place to ensure that this deficiency does not recur include the following;Place the changes\education\continuing audits that you will be doing to keep this from happening again. Have any audits and or education ready to submit to State/ Life Safety Such as: Measures that were put into place to keep this alleged deficiency from happening again is that the Director of Plant Operations educated the staff on the Safety Hazard that the Vinyl wrap causes. Maintenance removed half of the Vinyl on the Doors to ensure Safety standards are upheld. This was completed on 5-2-2024. Measures that will be implemented to monitor the continued effectiveness of the corrective action taken and to ensure that correction is achieved and sustained are as follows:Place how your team will monitor the effectiveness of these actions. Have documentation ready to submit to State/ Life Safety Such as: We will ensure that if vinyl is used on doors in the future or anything else it does not cover the entire door. Will continue to follow in QAPI and present to IDT for discussion for 3 months.
0291Emergency LightingS/S F
Findings
STANDARD not met based on observation and staff interviews of the emergency lighting, the facility failed to maintain the battery-powered emergency lights accordance with 7.9.3 and 19.2.9.1. This deficient practice could affect all residents and staff throughout the facility in the event of the loss of primary power. This was evidenced by the following:The battery-powered emergency generator lighting would not illuminate when the test button was pressed. 7.9.3 Periodic Testing of Emergency Lighting Equipment. A functional test shall be conducted on every required emergency lighting system at 30 day intervals for not less than 30 seconds. An annual test shall be conducted on every required battery-powered emergency lighting system for not less than 1 ½ hours. Equipment shall be fully operational for the duration of the test. Written records of visual inspections and tests shall be kept by the owner for inspection by the authority having jurisdiction. The Maintenance Director acknowledge the required testing of the emergency lighting during the tour of the facility.
Plan of correction · submitted by the facility
K 291Place how many residents stated in the deficiency here. Such as: This deficiency has the potential to affect residents, staff and visitors within 1 of 3 smoke compartments. Corrective action for residents found to have been affected by this deficiency:Place the audit that you will do and the date that it will be done on. Also have this audit ready to submit to State/Life Safety. Such as:An audit of the entire building to find nonfunctional emergency exit lighting was done on 5/1/24 and no others were found. Corrective action for other residents that may be affected by this deficiency:Place the changes\education\continuing audits that you will be doing to keep this from happening again. Have any audits and or education ready to submit to State/ Life Safety Such as:Measures that were put into place to keep this alleged deficiency from happening again that the nonfunctional emergency light was repaired on 5-10-2024. Maintenance Director or Designee will perform audits of the emergency exit lights X 3 weeks and then monthly X 3 Months on the emergency lighting. Measures and systemic changes that will be put into place to ensure that this deficiency does not recur include the following;Place how your team will monitor the effectiveness of these actions. Have documentation ready to submit to State/ Life Safety Such as:Team has continued to do weekly checks this was simply a equipment failure. We do the checks on this every week in tellsMeasures that will be implemented to monitor the continued effectiveness of the corrective action taken and to ensure that correction is achieved and sustained are as follows:?Will discuss in QAPI with IDT monthly for 3 months
0321Hazardous Areas - EnclosureS/S F
Findings
STANDARD is not met as evidenced by: Based observation and discussion during the tour of the facility, it was determined the facility failed to install and maintain fire rated doors per NFPA 101 2012 Edition Chapter 8 Section 8.3.3 paragraph 8.3.4.4. Failure to maintain fire rated door and assemblies in hazardous areas has the potential to harm all occupants, staff and visitor in the building if the fire rated doors failed to operate if a fire was to occur. This was evidence by the following. Located in the Basement corridor a 14 inch x 14 inch opening cut into the fire rated ceiling and not protected by a fire rated door assembly. 8.3.3 Fire Doors and Windows. 8.3.3.1 Openings required to have a fire protection rating by Table 8.3.4.2 shall be protected by approved, listed, labeled fire door assemblies and fire window assemblies and their accompanying hardware, including all frames, closing devices, anchorage, and sills in accordance with the requirements of NFPA 80, Standard for Fire Doors and Other Opening Protectives, except as otherwise specified in this Code. The Director of Maintenance acknowledged the condition of doors and assemblies during the tour of the facility.
Plan of correction · submitted by the facility
Place how many residents stated in the deficiency here. Such as:Based on observation and staff interview during the course of the survey it was determined the facility failed to maintain the transfilling of oxygen from one cylinder to another in accordance with NFPA 99 - Health Care Facilities, 11.5.2.3. Corrective action for residents found to have been affected by this deficiency:Place the audit that you will do and the date that it will be done on. Also have this audit ready to submit to State/Life Safety. Such as:An audit of the entire building to find any other oxygen transfilling rooms not vented correctly was done on 5/1/24 no other areas have been identified at this time. Corrective action for other residents that may be affected by this deficiency: Place the changes\education\continuing audits that you will be doing to keep this from happening again. Have any audits and or education ready to submit to State/ Life Safety Such as:Measures that were put into place to keep this alleged deficiency from happening again is that the Director of Plant Operations installed correct venting on 5-9-24. The Director of Plant Operations and Maintenance staff where educated on 5/7/24. The Director of Plant Operations or Designee will perform weekly audits on the venting of the oxygen transfilling rooms x 3 weeks and then will be placed on a monthly audit x 3 months. Measures and systemic changes that will be put into place to ensure that this deficiency does not recur include the following; Place how your team will monitor the effectiveness of these actions. Have documentation ready to submit to State/ Life Safety Such as:We installed the correct Piping into the wall going out to the vent with a vent motor so that we comply with code. Measures that will be implemented to monitor the continued effectiveness of the corrective action taken and to ensure that correction is achieved and sustained are as follows:?Will continue to follow in QAPI and discuss with IDT team for 3 months.
0345Fire Alarm System - Testing and MaintenanceS/S F
Findings
STANDARD not met as evidenced by: During record review, the facility failed to maintain the fire alarm system per NFPA 72 and 2012 Life Safety Code 101. Failure to maintain the fire alarm system has the potential to harm all occupants, staff and visitor within the facility if the fire alarm system failed to operate if a fire was to occur. This was evidenced by the following:Testing records indicated the Dining room 1 smoke detector failed the sensitivity testing and has not been replace at the time of the survey. 2012 Life Safety Code 101 section 9.6.1.5* To ensure operational integrity, the fire alarm system shall have an approved maintenance and testing program complying with the applicable requirements of NFPA 70, National Electrical Code, and NFPA 72, National Fire Alarm and Signaling Code. The fire alarm deficiency was discussed with the Director of Maintenance during the survey and again during the exit conference with the Administrator.
Plan of correction · submitted by the facility
Place how many residents stated in the deficiency here. Such as:This REQUIREMENT is allegedly not met as evidenced by: This was evidenced by:1) -Dining room 1 smoke detector fail sensitivity testingThis deficiency has the potential to affect occupants, who might include residents, staff, and visitors within all smoke compartments. Deficient items were discussed with the maintenance staff and facility administrator during the exit conference. Corrective action for residents found to have been affected by this deficiency:Place the audit that you will do and the date that it will be done on. Also have this audit ready to submit to State/Life Safety. Such as:An audit of Smoke detectors was done on 5-1-24 no other areas have been identified at this time. Corrective action for other residents that may be affected by this deficiency:Place the changes\education\continuing audits that you will be doing to keep this from happening again. Have any audits and or education ready to submit to State/ Life Safety Such as:Contractor was contacted on 5-2-2024 and scheduled to come out to make Required repairs. The DPO will ensure that the paperwork is correctly done and up to date. Measures and systemic changes that will be put into place to ensure that this deficiency does not recur include the following;Place how your team will monitor the effectiveness of these actions. Have documentation ready to submit to State/ Life Safety Such as:We will ensure the documentation is correct from the vendor and that repairs are done promptly. Measures that will be implemented to monitor the continued effectiveness of the corrective action taken and to ensure that correction is achieved and sustained are as follows:??Will continue to follow in QAPI and discuss with IDT for 3 months.
0353Sprinkler System - Maintenance and TestingS/S F
Findings
STANDARD not met as evidenced by: Based on observation, staff interview and record review, it was determined that the facility failed to maintain the automatic sprinkler system in accordance with National Fire Protection Association (NFPA) Standard 13 and Standard 25. This deficient practice could affect all residents, staff and visitors should the automatic sprinkler system fail to operate in a timely and effective manner due to non-code compliant maintenance. This was evidence by the following. Located in the Telephone room, coaxial cable and electrical wire not part of the sprinkler system are attached to the sprinkler pipes. NFPA 25, 2018 section 5.2.2.2 Sprinkler piping shall not be used to support components. The Maintenance Director acknowledge the coaxial attached to the sprinkler piping of the Hydraulic Design Information Sign requirement for the automatic sprinkler system during tour of the facility.
Plan of correction · submitted by the facility
Place how many residents stated in the deficiency here. Such as:This REQUIREMENT is allegedly not met as evidenced by: This was evidenced by:1) Telephone room wires hanging/attached to fire sprinkler lineThis has the hazard of causing leaks within the system. Corrective action for residents found to have been affected by this deficiency: Place the audit that you will do and the date that it will be done on. Also have this audit ready to submit to State/Life Safety. Such as:An audit of Wires touching the sprinkler line was done on 5-1-24 no other areas have been identified at this time. Corrective action for other residents that may be affected by this deficiency:Place the changes\education\continuing audits that you will be doing to keep this from happening again. Have any audits and or education ready to submit to State/ Life Safety Such aMaintenance staff completed this task on 5-6-2024, and removed the cables from the sprinkler lines. Measures and systemic changes that will be put into place to ensure that this deficiency does not recur include the following;Place how your team will monitor the effectiveness of these actions. Have documentation ready to submit to State/ Life Safety Such as:Staff has been informed and trained to ensure that no wires are hanging, touching, or tied to sprinkler lines. Measures that will be implemented to monitor the continued effectiveness of the corrective action taken and to ensure that correction is achieved and sustained are as follows:??Will continue to follow in QAPI and discuss with IDT team for 3 months.
0355Portable Fire ExtinguishersS/S F
Findings
STANDARD is not met as evidenced by: Based on observation, staff interview and record review, it was determined that the facility failed to maintain all portable fire extinguishers as required by NFPA 10 Chapter 4. This deficient practice could affect all residents, staff and visitors should the portable fire extinguishers fail to operate effectively due to non-code compliant maintenance. This was evidence by the following. At the time of the survey records indicated that fire extinguishers west exit and laundry require a six year hydrostatic test. Life Safety Code 101, 2012 Edition, section 9.7.4. Where required by the provision of another section of this code, portable fire extinguishers shall be installed, inspected and maintained in accordance with NFPA 10 Standards for Portable Fire Extinguishers. The Maintenance Director acknowledge the lack of maintenance and inspection requirements of the portable fire extinguishers deficiency during record review of the facility.
Plan of correction · submitted by the facility
K 355 This alleged deficiency was determined the facility failed to have documentation or records that 1 fire extinguishers through-out the facility were subjected to a hydrostatic test, or when specifically indicated by an inspection. This deficient practice could affect all residents and staff throughout the facility, including residents, staff, and visitors, and was discussed with the director of plant operations. An audit of the entire building to find documentation or records that fire extinguishers throughout the facility were subjected to a hydrostatic test 5/1/24, No other items noted at this time. Maintenance at intervals of a hydrostatic test was done by Dignity Fire and was completed on 5-10-24 to meet the compliance date Measures that were put into place to keep this alleged deficiency from happening again is that Education was provided for the Director of Plant Operations and maintenance staff on Maintenance at intervals of hydrostatic testing was done on 5/7/24. The Director of Plant operations or Designee will perform weekly audits on the records systems, and for one month and then will be placed on a monthly audit x 3 months. The audits will be reviewed during monthly QA X 3 months and Safety Committee X 3 Months starting Immediately.
0521HVACS/S F
Findings
STANDARD not met: Based on observation and staff interview during the tour of the facility, it was determined the facility failed to maintain the Heating, Ventilating, and Air-Conditioning Systems in accordance with Section 9.2, 19.5.2.1.9.2, NFPA 90A and 19.5.2.2. This deficient practice could affect all residents and staff within the facility should a fire emergency was to occur. Sheet metal screws utilized to connect the pipe joints on the exhaust vents on both Type 2 clothes dryers in the laundry. NFPA 54, Section 10.4.4.2 Ducts for exhausting clothes dryers shall not be assembled with screws or other fastening means that extend into the duct and that would catch lint and reduce the efficiency of the exhaust system. The dryer vent deficiencies were discussed with the Maintenance Director during the survey.
Plan of correction · submitted by the facility
Place how many residents stated in the deficiency here. Such as:This REQUIREMENT is allegedly not met as evidenced by: This was evidenced by:1) Dryer vent connected with sheet metal screws. Also, Dryer not rated for altitude with the port size. Corrective action for residents found to have been affected by this deficiency: Place the audit that you will do and the date that it will be done on. Also have this audit ready to submit to State/Life Safety. Such as:An audit of The Dryer and the Vents was done on 5-1-24 no other areas have been identified at this time. Corrective action for other residents that may be affected by this deficiency:Place the changes\education\continuing audits that you will be doing to keep this from happening again. Have any audits and or education ready to submit to State/ Life Safety Such aMaintenance staff completed this task on 5-2-2024. Measures that were put into place to keep this alleged deficiency from happening again is that the Director of Plant Operations educated staff on not using screws in duct work for laundry as it is a hazard that can catch lint and clog the chase which could be a fire hazard. Measures and systemic changes that will be put into place to ensure that this deficiency does not recur include the following;Have documentation ready to submit to State/ Life Safety Such as:Team was informed how to properly install duct work for the dryer and will ensure it is done correctly going forward. Place how your team will monitor the effectiveness of these actions. Will continue to follow and discuss with IDT during QAPI for 3 months.
0522HVAC - Any Heating DeviceS/S F
Findings
This STANDARD is not met as evidenced by: Based on observation and staff interview, it was determined that the facility failed to provide an adequate source of input ratings of appliances operating at levels above 2000 feet in accordance with National Fire Protection Association (NFPA) Life Safety Code and NFPA 54 Natural Fuel Gas Code. This deficient practice could affect all residents and staff in the core smoke compartment should the natural gas fueled heating equipment malfunction due to improper settings. This was evidenced by the following:Orifice for cloth dryer number 1is not sized correctly currently set for 0-2000 feet according to dryer data plate at the rate of 4 percent for each 1000 ft (300 m) above sea level. The input ratings of gas fired cloth dryers operating at elevations above 2000 ft (600 m) were not reduced at the rate of 4 percent for each 1000 ft (300 m) above sea level. 11.1.2 High Altitude. Gas input ratings of appliances shall be used for elevations up to 2000 ft (600 m). The input ratings of appliances operating at elevations above 2000 ft (600 m) shall be reduced in accordance with one of the following methods:(1) At the rate of 4 percent for each 1000 ft (300 m) above sea level before selecting appropriately sized appliance(2) As permitted by the authority having jurisdiction(3) In accordance with the manufacturer's installation instructionsThe dryer deficiencies were discussed with the Maintenance Director during the survey and again during the exit conference with the Director of Nursing.
Plan of correction · submitted by the facility
Place how many residents stated in the deficiency here. Such as:This REQUIREMENT is allegedly not met as evidenced by: This was evidenced by:1) Dryer vent connected with sheet metal screws. Also, Dryer not rated for altitude with the port size. Corrective action for residents found to have been affected by this deficiency: Place the audit that you will do and the date that it will be done on. Also have this audit ready to submit to State/Life Safety. Such as:An audit of The Dryer and the Vents was done on 5-1-24 no other areas have been identified at this time. Corrective action for other residents that may be affected by this deficiency:Place the changes\education\continuing audits that you will be doing to keep this from happening again. Have any audits and or education ready to submit to State/ Life Safety Such aMaintenance staff completed this task on 5-2-2024. Measures that were put into place to keep this alleged deficiency from happening again is that the Director of Plant Operations educated staff on not using screws in duct work for laundry as it is a hazard that can catch lint and clog the chase which could be a fire hazard. Measures and systemic changes that will be put into place to ensure that this deficiency does not recur include the following;Have documentation ready to submit to State/ Life Safety Such as:Team was informed how to properly install duct work for the dryer and will ensure it is done correctly going forward. Place how your team will monitor the effectiveness of these actions. Will continue to follow and discuss with IDT during QAPI for 3 months.
0751Draperies, Curtains, and Loosely Hanging FabrS/S F
Findings
STANDARD is not met as evidenced by: Through observation during the facility tour, it was determined the facility failed to provide curtains/draperies that comply with the NFPA 701 standard for flame resistance. Per NFPA 101 2012 Edition, Section 19.7.5.1, Section 10.3.1. This deficient practice could affect all patients, staff and visitors should a fire occur by the non-rated curtains. This was evidenced by the following: Through observation during the walk through of the facility with the Maintenance Director, curtains/draperies do not contain tags or markings showing that they met NFPA 701 requirements in resident's rooms 101,102, 103, 104, 108, 112 and 116The Life Safety Code Section 21.7.5.1 requires that draperies, curtains (including cubicle curtains) and other loosely hanging fabrics and films serving as furnishings or decorations in health care occupancies shall be in accordance with the provisions of 10.3.1. Section 10.3.1 requires that draperies, curtains, and other similar loosely hanging furnishings and decorations be flame resistant as demonstrated by testing in accordance with NFPA 701, Standard Methods of Fire Tests for Flame Propagation of Textiles and Films. The curtain/draperies deficiency item were discussed with the Maintenance Director during the survey and again during the exit conference with the Director of Nursing.
Plan of correction · submitted by the facility
Place how many residents stated in the deficiency here. Such as:Based on observation and staff interview during the course of the survey it was determined the facility failed to maintain proper fire rating for privacy curtains. Corrective action for residents found to have been affected by this deficiency:Place the audit that you will do and the date that it will be done on. Also have this audit ready to submit to State/Life Safety. Such as:An audit of the entire building to find any other proper fire rating for privacy curtains was done on 5/1/24 no other areas have been identified at this time. Corrective action for other residents that may be affected by this deficiency:Place the changes\education\continuing audits that you will be doing to keep this from happening again. Have any audits and or education ready to submit to State/ Life Safety Such as:Measures that were put into place to keep this alleged deficiency from happening again is that the Director of Plant Operations sprayed fire retardant on privacy curtains and created a log on 5-7-24. The Director of Plant Operations and Maintenance staff were educated on 5/7/24. The Director of Plant Operations or Designee will perform weekly audits on the venting of the oxygen transfilling rooms x 3 weeks and then will be placed on a monthly audit x 3 months. Measures and systemic changes that will be put into place to ensure that this deficiency does not recur include the following;Place how your team will monitor the effectiveness of these actions. Have documentation ready to submit to State/ Life Safety Such as:We will continue to ensure the proper documentation is done so the Curtains are FR rated and up to code. Measures that will be implemented to monitor the continued effectiveness of the corrective action taken and to ensure that correction is achieved and sustained are as follows:?Will continue to follow in QAPI and discuss with IDT team for 3 months.
0914Electrical Systems - Maintenance and TestingS/S F
Findings
STANDARD not met: Based on record review and documentation of inspection and testing of the non-hospital grade electrical outlets in patient care areas as required by sections 6.3.4.1.3 and 6.3.4.2.1.1 of NFPA 99, Health Care Facilities Code. This deficient practice could affect all residents, staff and visitors throughout the facility if the continuity of the grounding circuit, polarity of hot and neutral connections, and retention force of the grounding blade were to fail due to lack of testing. No written test records of the continuity of the grounding circuit, polarity of hot and neutral connections, and retention force of the grounding blade in patients care areas was conducted annually. NFPA Standard: NFPA 99 Health Care Facilities Code (2012)6.3.3.2 Receptacle Testing in Patient Care Rooms. 6.3.3.2.1 The physical integrity of each receptacle shall be confirmed by visual inspection. 6.3.3.2.2 The continuity of the grounding circuit in each electrical receptacle shall be verified. 6.3.3.2.3 Correct polarity of the hot and neutral connections in each electrical receptacle shall be confirmed. 6.3.3.2.4 The retention force of the grounding blade of each electrical receptacle (except locking-type receptacles) shall be not less than 115 g (4 oz). 6.3.4.1 Maintenance and Testing of Electrical System. 6.3.4.1.3 Receptacles not listed as hospital-grade, at patient bed locations and in locations where deep sedation orgeneral anesthesia is administered, shall be tested at intervals not exceeding 12 months. 6.3.4.2 Record Keeping. 6.3.4.2.1* General. 6.3.4.2.1.1 A record shall be maintained of the tests required by this chapter and associated repairs or modification. 6.3.4.2.1.2 At a minimum, the record shall contain the date, the rooms or areas tested, and an indication of which items have met, or have failed to meet, the performance requirements of this chapter. The non-hospital grade electrical outlets testing at patient's care areas deficiency was discussed with the Director of Maintenance during the survey and again during the exit conference with the Director of Nursing.
Plan of correction · submitted by the facility
Place how many residents stated in the deficiency here. Such as:This REQUIREMENT is allegedly not met as evidenced by: This was evidenced by:1) No records of grounding blade test on all resident’s task areas in the past yearWithout proper documentation of the grounding blade test, the facility is unable to say weather or not the outlets are safe and operating properly. Corrective action for residents found to have been affected by this deficiency:Place the audit that you will do and the date that it will be done on. Also have this audit ready to submit to State/Life Safety. Such as:An audit of Outlets documentation was done on 5-1-24 no other areas have been identified at this time. Corrective action for other residents that may be affected by this deficiency:Place the changes\education\continuing audits that you will be doing to keep this from happening again. Have any audits and or education ready to submit to State/ Life Safety Such aMaintenance staff completed this test on 5-6-2024. Measures that were put into place to keep this alleged deficiency from happening again is that the Director of Plant Operations will be trained on the documentation required on 5-1-2024. DPO then passed on information and trained maintenance staff on the requirements and went through and tested all rooms and outlets with a ground blade test on 5-6-2024. Measures and systemic changes that will be put into place to ensure that this deficiency does not recur include the following; Place how your team will monitor the effectiveness of these actions. Have documentation ready to submit to State/ Life Safety Such as:Staff has checked all the outlets with the test and documented it. We will continue to do so and ensure the outlets are correctly documented. Measures that will be implemented to monitor the continued effectiveness of the corrective action taken and to ensure that correction is achieved and sustained are as follows:Will continue to follow in QAPI and discuss with IDT for 3 months.
0918Electrical Systems - Essential Electric SysteS/S F
Findings
STANDARD is not met as evidenced by: Based on record review and staff interview during the course of the survey it was determined that the facility failed to maintain emergency power systems in accordance with Section 9.1.3 of the Life Safety Code and the referenced NFPA 110, Standard for Emergency and Standby Power Systems Chapter 8 This deficient practice has the potential to affect all residents, staff and visitors in the event of power loss. This was evidenced by the following. 1. The facility failed to provide documentation at the time of the survey to reflect that the emergency generator was inspected and exercised in the past twelve months. 2. The facility failed to provide documentation at the time of the survey to reflect that the emergency generator was exercised under load at 30 % least monthly for 30 minutes had occurred between May 2023 through May 2024.8.4 Operational Inspection and Testing. 8.4.1* EPSSs, including all appurtenant components, shall be inspected weekly and exercised. under load at least monthly. The emergency power supply system deficiency item was discussed with the Maintenance Director during the survey and again during the exit conference with the Director of Nursing.
Plan of correction · submitted by the facility
K 918Corrective action for residents found to have been affected by this deficiency:Place how many residents stated in the deficiency here. Such as: This REQUIREMENT is allegedly not met as evidenced by: This was evidenced by: 1) Monthly load testing did not meet the required time of 30 minutes. This deficiency has the potential to affect occupants, who might include residents, staff, and visitors within all smoke compartments. Deficient items were discussed with the maintenance staff and facility administrator during the exit conference. Corrective action for other residents that may be affected by this deficiency:Place the audit that you will do and the date that it will be done on. Also have this audit ready to submit to State/Life Safety. Such as: An audit of all generator documentation was done on 5/1/2024 no other areas have been identified at this time. Measures and systemic changes that will be put into place to ensure that this deficiency does not recur include the following;Place the changes\education\continuing audits that you will be doing to keep this from happening again. Have any audits and or education ready to submit to State/ Life Safety Such as: Maintenance staff will complete this test immediately and monthly thereafter. Measures that were put into place to keep this alleged deficiency from happening again is that the Director of Plant Operations will be trained on the documentation required on 5/7/24 Maintenance Director or Designee will perform all generator requirements in when they are required an audit will be done by the Administrator and Regional Director of Plant Operations via the Tels system to make sure these items are done within the time constraints monthly for 3 month, and then annually moving forward. Measures that will be implemented to monitor the continued effectiveness of the corrective action taken and to ensure that correction is achieved and sustained are as follows:Place how your team will monitor the effectiveness of these actions. Have documentation ready to submit to State/ Life Safety Such as: Staff will continue to operate the Generator with monthly load test at 30 min and 10 min rest. Will continue to follow in QAPI and discuss with IDT team for 3 months.
0923Gas Equipment - Cylinder and Container StoragS/S F
Findings
STANDARD not met: Based on observation and staff interview during the course of the survey it was determined the facility failed to maintain the trans-filling of oxygen from one cylinder to another in accordance with NFPA 99 - Health Care Facilities, 11.5.2.3. This deficient practice could affect all residents and staff within the facility should a fire emergency was to occur. The following evidenced this:The oxygen trans-filling room not mechanically ventilated correctly per NFPA 99. 9.3.7.5.3.1 Mechanical exhaust to maintain a negative pressure in the space shall be provided continuously, unless an alternative design is approved by the authority having jurisdiction. 9.3.7.5.3.2 Mechanical exhaust shall be at a rate of 1 L/sec of airflow for each 300 L (1 cfm per 5 ft3 of fluid) designed to be stored in the space and not less than 24 L/sec (50 cfm) nor more than 235 L/sec (500 cfm). 9.3.7.5.3.3 Mechanical exhaust inlets shall be unobstructed and shall draw air from within 300 mm (1 ft) off the floor and adjacent to the cylinder or containers. The Director of Maintenance acknowledged the ventilation issue during a tour of the facility.
Plan of correction · submitted by the facility
Place how many residents stated in the deficiency here. Such as:Based on observation and staff interview during the course of the survey it was determined the facility failed to maintain the transfilling of oxygen from one cylinder to another in accordance with NFPA 99 - Health Care Facilities, 11.5.2.3. Corrective action for residents found to have been affected by this deficiency:Place the audit that you will do and the date that it will be done on. Also have this audit ready to submit to State/Life Safety. Such as:An audit of the entire building to find any other oxygen transfilling rooms not vented correctly was done on 5/1/24 no other areas have been identified at this time. Corrective action for other residents that may be affected by this deficiency:Place the changes\education\continuing audits that you will be doing to keep this from happening again. Have any audits and or education ready to submit to State/ Life Safety Such as:Measures that were put into place to keep this alleged deficiency from happening again is that the Director of Plant Operations installed correct venting on 5-9-24. The Director of Plant Operations and Maintenance staff where educated on 5/7/24. The Director of Plant Operations or Designee will perform weekly audits on the venting of the oxygen transfilling rooms x 3 weeks and then will be placed on a monthly audit x 3 months. Measures and systemic changes that will be put into place to ensure that this deficiency does not recur include the following;Place how your team will monitor the effectiveness of these actions. Have documentation ready to submit to State/ Life Safety Such as:We installed the correct Piping into the wall going out to the vent with a vent motor so that we comply with code. Measures that will be implemented to monitor the continued effectiveness of the corrective action taken and to ensure that correction is achieved and sustained are as follows:??Continue to follow and monitor in QAPI to be discussed with IDT for 3 months.
4/18/2024Complaint, Recertification Survey · ID 7VIA117 deficiencies
0000Initial CommentsSurveyor note2 building records
Findings · record 1 of 2
A recertification survey with complaint #CO35428 and #CO35511 was completed from 4/15/24 to 4/18/24. Seven deficiencies were cited.
Findings · record 2 of 2
An Emergency Preparedness survey was conducted from 4/15/24 to 4/18/24. No deficiencies were cited.
Plan of correction
The state did not require a plan of correction for this citation.
0580Notify of Changes (Injury/Decline/Room, etc.)S/S D
Findings
Based on record review and interviews, the facility failed to notify the provider according to physician orders for one (#29) of three residents reviewed for unnecessary medications out of 28 sample residents. Specifically, the facility failed to notify and document Resident #29's elevated blood sugar levels to the provider as directed on the physician's order. Findings include: I. Facility policy and proceduresThe Diabetic Care Policy, revised November 2020, was provided by the director of nursing (DON) on 4/18/24 at 11:20 a.m. The policy read in pertinent part,"The physician will order desired parameters for monitoring and reporting information related to blood sugar management."The staff will incorporate such parameters into the medication administration record and care plan."II. Resident #29 A. Resident status Resident #29, over the age of 65, was admitted on 7/19/22. According to the April 2024 computerized physician orders (CPO), diagnoses included type II diabetes mellitus with diabetic autonomic polyneuropathy (occurs when there is damage to the nerves that control automatic body functions), chronic obstructive pulmonary disease, hyperlipidemia, and anxiety disorder. The 1/25/2024 minimum data set (MDS) assessment revealed the resident was cognitively intact with a brief interview for mental status (BIMS) score of 15 out of 15. The resident required staff supervision for bed mobility, grooming, toileting, and transfers. The resident had no behaviors. The assessment documented the resident received insulin and injections for seven days during the seven-day assessment look back period. B. Record reviewThe physician's order dated 7/27/23 at 7:45 p.m. revealed to check blood glucose via finger stick at bedtime for diabetic maintenance. If blood glucose is less than 60 mg/dl (milligrams/deciliter) or greater than 350 mg/dl, notify the medical provider . The physician's order dated 2/28/24 at 9:31 a.m. revealed to administer Basaglar Kwikpen subcutaneous solution (insulin glargine) pen-injector 100 units/ml (milliliter). The physician's order dated 3/7/24 at 9:33 a.m. revealed to administer Trulicity Subcutaneous Solution pen-injector 4.5 milligrams (mg)/0.5 ml in the morning every Saturday for diabetes mellitus. A review of the March 2024 medications administration record (MAR) from 3/1/24 to 3/31/24 revealed the following:On 3/2/24 Resident #29's blood sugar was 430 mg/dl, which was above the parameter of 350 mg/dl set in the physician's order;On 3/3/24 Resident #29's blood sugar was 438 mg/dl, which was above the parameter of 350 mg/dl set in the physician's order;On 3/5/24 Resident #29's blood sugar was 421 mg/dl, which was above the parameter of 350 mg/dl set in the physician's order;On 3/8/24 Resident #29's blood sugar was 444 mg/dl, which was above the parameter of 350 mg/dl set in the physician's order;On 3/11/24 Resident #29's blood sugar was 480 mg/dl, which was above the parameter of 350 mg/dl set in the physician's order;.On 3/12/24 Resident #29's blood sugar was 445 mg/dl, which was above the 350 mg/dl set in the physician's order;On 3/13/24 Resident #29's blood sugar was 425 mg/dl, which was above the 350 mg/dl set in the physician's order;On 3/15/24 Resident #29's blood sugar was 484 mg/dl, which was above the 350 mg/dl set in the physician's order;On 3/16/24 was Resident #29's blood sugar was 505 mg/dl, which was above the 350 mg/dl set in the physician's order;On 3/17/24 was Resident #29's blood sugar was 402 mg/dl, which was above the 350 mg/dl set in the physician's order;On 3/18/24 Resident #29's blood sugar was 404 mg/dl, which was above the 350 mg/dl set in the physician's order;On 3/19/24 Resident #29's blood sugar was 398 mg/dl, which was above the 350 mg/dl set in the physician's order;On 3/20/24 Resident #29's blood sugar was 407 mg/dl, which was above the 350 mg/dl set in the physician's order;On 3/22/24 Resident #29's blood sugar was 37 .mg/dl, which was above the 350 mg/dl set in the physician's order; and, On 3/24/24 Resident #29's blood sugar was 437 mg/dl. A review of the April 2024 MAR (4/1/24 to 4/18/24) revealed the following:On 4/12/24 Resident #29 blood sugar was 392 mg/dl, which was above the 350 mg/dl set in the physician's order;.On 4/13/24 Resident #29's blood sugar was 418 mg/dl, which was above the 350 mg/dl set in the physician's order;.On 4/15/24 Resident #29's blood sugar was 416 mg/dl, which was above the 350 mg/dl set in the physician's order, andOn 4/17/24 Resident's #29's blood sugar was 391 mg/dl, which was above the 350 mg/dl set in the physician's order.-A 45 day record review revealed Resident #29 had elevated blood sugar levels 19 times out of the 45 days and there was no documentation to indicate staff notified the physician. The care plan, initiated 8/7/22, revealed Resident #29 had limited physical mobility related to type II diabetes mellitus. The interventions included evaluating the resident, documenting and reporting to the physician, administering medications as ordered. The care plan revealed the resident was noncompliant with her diabetic diet. III. Staff interviews Registered nurse (RN) #1 was interviewed on 4/18/24 at 9:40 a.m. RN #1 said the dates reviewed on the resident's MAR revealed the resident insulin levels were elevated above the parameters indicated on the physician's order. She said there should be documentation in the resident's medical record that indicated the physician was notified. RN #1 said nurses should follow physician orders and inform the provider when results were over the physician's parameters. She said since there was not documentation indicating the physician was notified that Resident #29's blood sugar was not within parameters that indicated it did not happen. She said insulin parameters were important because the resident might have experienced high blood sugar levels which could require the physician to adjust the amount of insulin to administer. She said not notifying the physician for the proper dose of insulin could cause serious health complications. RN #1 said the resident could experience shock and have an increase in symptoms related to her diagnosis. The director of nursing (DON) was interviewed on 4/18/24 at 10:21 a.m. The DON said the dates reviewed on the resident's MAR revealed the resident's blood glucose levels were elevated above the parameters on the physician's order and the staff should have notified the provider and documented in the nursing progress note. The DON said there was no documentation indicating the physician was notified. She said she expected the staff to inform the physician and document in the resident's medical chart of the action taken. The DON said failing to notify the physician of elevated blood glucose levels could have serious health issues leading to death. The DON said she would educate nursing staff to ensure they followed the physician's orders and documented their actions. She said she would inform the physician to incorporate the insulin parameters with the insulin order to prevent such errors in the future.
Plan of correction
The state did not require a plan of correction for this citation.
0676Activities Daily Living (ADLs)/Mntn AbilitiesS/S D
Findings
Based on observations, record review and interviews, the facility failed to provide assistance with activities of daily living (ADL) for one (#8) of five residents reviewed for ADL care out of 28 sample residents. Specifically, the facility failed to ensure Resident #8 received oral and personal hygiene daily. A. Resident statusResident #8, age 67, was admitted on 11/20/23. According to the April 2024 computerized physician orders (CPO), diagnoses included acute embolism and thrombosis of unspecified deep veins of right lower extremity (blood clot), unspecified fracture of lower end of right tibia (larger bone of the two lower leg bones) and multiple sclerosis (deterioration of the nerves). The 12/1/23 minimum data set (MDS) assessment revealed the resident was cognitively intact with a brief interview for mental status (BIMS) score of 15 out of 15. She required set-up or clean up assistance with oral hygiene and eating. She required partial/moderate assistance with personal hygiene, showering/bathing and upper body dressing. B. Resident interview and observationsResident #8 was interviewed on 4/15/24 at 10:53 a.m. Resident #8 said the staff did not offer for her to wash her hands and face in the morning when she woke up. She said the staff did not bring her toothbrush for her to brush her teeth in the morning. She said it was important for her to have her oral hygiene completed in the morning because it made her feel complete. Resident #8 was interviewed again on 4/16/24 at 4:07 p.m. Resident #8 said she was not provided with oral and personal hygiene this morning (4/16/24). She said her care provider came to visit her this afternoon and wrote a note that stated, "Morning and night give Resident #8 her pink basin with warm water and fresh washcloth daily for personal hygiene." The note was posted on the bathroom door. The resident said she was only provided with her toothbrush to brush her teeth last night (4/15/24). She said her face and hands were not washed before getting ready for bed. Resident #8 was interviewed again on 4/17/24 at 2:37 p.m. Resident #8 said staff did not provide her morning hygiene. She said she spoke with the nursing home administrator (NHA) this morning (4/17/24) and showed him her sign. She said the NHA said it was a great idea and he said he was going to work on it. She said when she was not provided with morning hygiene it made her feel incomplete for the day. She said it made her feel bewildered and surprised that oral and personal hygiene were not completed in the morning. Resident #8 said she did not let staff know about wanting her oral and personal hygiene done in the morning because she did not want to upset the staff. She said her care provider had voiced the concerns to staff. She said she was hoping the staff would look at the note and she would not have to say anything. C. Record reviewThe activities of daily living (ADL) care plan, dated 11/25/23, documented Resident #8 had an ADL self-care performance deficit. The interventions included personal hygiene, providing moderate assistance by one staff with personal hygiene and oral care, encouraging the resident to participate to the fullest extent possible with each interaction, encouraging the resident to use her call bell to call for assistance and praising all efforts at self-care. The comprehensive care plan, dated 4/17/24 (during the survey), documented Resident #8 preferred to have her showers on Monday, Wednesday and Friday mornings. She liked to have a warm basin of water and wash cloth provided upon awakening to wash her face off and to promote independence in doing so. The interventions included offering showers in the morning on her preferred shower days. D. Staff interviewsRegistered nurse (RN) #3 was interviewed on 4/18/24 at 9:56 a.m. RN #3 said Resident #8 required set up assistance with her toothbrush and was able to brush her teeth on her own. He said when staff got her the supplies she was able to do everything on her own. He said ADL care should be provided every day. He said the certified nurse aides (CNA) were responsible for providing oral and personal hygiene care to the residents. He said the CNAs should be providing oral and personal hygiene every morning when the resident got up. He said Resident #8 should have received personal and oral hygiene care every morning. CNA #5 was interviewed on 4/18/24 at 10:13 a.m. CNA #5 said residents should be provided with personal and oral hygiene daily. He said he was responsible for providing personal and oral hygiene to the residents. He said Resident #8 required set-up assistance for personal hygiene as she was able to wash her own face. He said Resident #8 should be provided with personal and oral hygiene every day, however, he said he had never provided personal and oral hygiene for Resident #8. The DON was interviewed on 4/18/24 at 10:54 a.m. The DON said the CNAs were responsible for providing personal and oral hygiene for all the residents. She said personal and oral hygiene was part of the CNAs job duties. She said providing personal and oral hygiene should be done everyday. She said she spoke with Resident #8 on 4/17/24 (during the survey process) and put in an order to put her basin at her bedside upon awakening. She said Resident #8 required extensive assistance due to her physical functional ability. She said Resident #8 had good days and tried to be independent and other days she needed more help.
Plan of correction
The state did not require a plan of correction for this citation.
0689Free of Accident Hazards/Supervision/DevicesS/S G
Findings
Based on observations, record review and interviews, the facility failed to ensure the residents environment remained as free of accident hazards as possible and each resident received adequate supervision to prevent accidents for one (#13) of three residents reviewed for accidents/hazards out of 28 samples residents. Resident #13 had been evaluated and determined to be a supervised smoker, which included she was not able to keep smoking supplies with her. The supplies were to be kept and monitored by the facility. During the scheduled smoke breaks, the facility would provide the resident with the cigarette and light the cigarette with a lighter. On 3/29/24 at 12:30 a.m. certified nurse aide (CNA) #8 heard screams coming from Resident #13's room. When she went in the room to check on Resident #8 she found the dressing on her lower left leg on fire. CNA #8 yelled for help and put out the fire with a towel and water. Resident #8 was transferred to the emergency department (ED) where it was determined she had first and second degree burns. Upon investigation and a care conference with the family, it was determined that, during a family visit, a family member had left a lighter with the resident. The facility failed to implement safety procedures to prevent a family member from providing a lighter to a supervised smoker. Findings include:Record review and interviews confirmed the facility corrected the deficient practice prior to the onsite investigation on 4/15/24 to 4/18/24, resulting in the deficiency being cited as past noncompliance with a correction date of 4/2/24. I. Incident on 3/29/24The facility failed to ensure Resident #13, who had been assessed and determined to be a supervised smoker who's smoking supplies were to be kept locked up by the facility, did not have a lighter in her personal possession. This resulted in Resident #13 attempting to use a lighter she had obtained from her family to burn a dangling thread off of a bandage on her leg in her room on 3/29/24. Due to the facility's failures, the bandage on Resident #13's leg caught on fire. CNA #8 was able to smother the bandage fire with a towel, however, Resident #13 was transferred to the hospital on 3/29/24 where she was discovered to have first and second degree burns to her leg. Record review and interviews during the complaint investigation confirmed the deficient practice had been corrected and the facility was in substantial compliance at the time of the survey from 4/16/24 to 4/17/24. II. Facility correctionA. Immediate actionThe corrective action plan the facility implemented in response to Resident #13's lighter accident on 3/29/24 was provided by the director of nursing (DON) on 4/17/24 at 12:00 p.m. On 3/29/24 a sweep of the supervised smokers for lighters was completed. No lighters were found. On 3/29/24 staff were re-educated on safe smoking practices, ensuring supervised smokers did not have lighters and the facility smoking policy. B. Systemic changesOn 3/29/24 the social services assistant (SSA) completed an audit of all the smokers to re-determine if the smoker was supervised or unsupervised. The facility implemented smoking aprons for all smokers regardless of smoking status. On 3/29/24 the facility reached out to families to provide education on the importance of not providing smoking supplies to the smoking residents. Families were educated to give the smoking supplies to the nurses. On 3/29/24 the one unsupervised smoker in the facility was re-educated on the importance of keeping control of his lighter and not giving it to supervised smokers. The unsupervised smoker was receptive to the re-education understanding the severity of the situation and agreed not to share his lighter with supervised smokers. On 3/29/24 housekeeping staff were educated to be more critical and observant for lighters when in a smoker's room. Education included, if a lighter was found, it was to be given to the nurse on duty immediately. On 3/29/24 nursing staff were educated if staff turned in a lighter from a supervised smoker to notify the DON. On 3/30/24 Resident #13 was moved to a different hall with more staff monitoring. Resident #13 was provided with a vape pen in lieu of cigarettes and the vape pen supplies were kept locked up by the facility. On 4/2/24 the facility completed a care conference with the family. During the conference, the family admitted they had given Resident #13 the lighter. The resident's family was educated on the importance of not providing the resident with a lighter. C. MonitoringOn 3/29/24 audits of smokers were started and continued weekly to ensure lighters were not in the possession of supervised smokers and if found, family education was conducted. All audits and education were to be reviewed during weekly interdisciplinary team (IDT) meetings and during monthly quality assurance and performance improvement (QAPI) meetings. Interviews and record reviews during the recertification survey revealed corrective actions to identify the resident and other residents having the potential to be affected by the deficient practice, systemic changes to prevent its recurrence and monitoring to ensure sustained correction were in place. III. Resident statusResident #8, age younger than 65, was admitted on 5/7/18 and readmitted on 12/2/19. According to the April 2024 computerized physician's order (CPO), diagnoses included hemiplegia on the right side, cerebral infarction (stroke) on the right side and need for assistance with personal care. The 3/1/24 minimum data set (MDS) assessment documented the resident was moderately cognitively impaired with a brief interview for mental status (BIMS) score of 10 out of 15. The assessment identified the resident had impairment on one side (right) and she utilized a wheelchair for mobility. She required one to two staff members for transfers. IV. Record reviewThe care plan, initiated on 3/1/24, identified Resident #8 had impaired cognitive function. Interventions included to keep her routine consistent. The care plan, initiated on 3/12/24, identified Resident #8 was a supervised smoker. Interventions included notifying the charge nurse if the resident violated the facility smoking policy, observing the resident's clothing and skin for signs of cigarette burns, conducting a smoking assessment quarterly and as needed and smoking materials were to be kept by staff. The smoking safety screen assessment dated 3/12/24, documented the resident needed supervision for smoking which included supervised smoking with the staff, a smoking apron and the facility holding her smoking materials. The progress note dated 3/29/24 at 2:21 a.m. documented CNA #8 heard screams coming from Resident #8's room at 12:30 a.m. When she ran into the room she saw the dressing on Resident #8's leg was in flames. CNA #8 smothered the flame with a towel then doused the area with water. The dressing was removed. The provider was notified at 12:40 a.m. The assistant director of nursing (ADON) was notified at 12:45 a.m. The resident was transported by ambulance to the hospital at 1:16 a.m. The progress note written by registered nurse (RN) #4 on 3/29/24 at 5:01 a.m. documented the discharge report was taken from the ED nurse and the resident returned back to the facility with a kerlix (gauze) wrap intact to her lower left leg and it was clean and dry. The hospital records dated 3/29/24 documented Resident #8 was reportedly trying to burn a string hanging from her previous dressing when she lit her entire bandage on fire. The hospital identified the injuries as first and second degree burns. The hospital visit note dated 3/29/24 documented the nursing home staff said the resident had a lighter. The facility was unsure how she had one. The resident was reportedly trying to possibly burn a string on her previous dressing when she lit her entire dressing on fire. CNA (#8) was able to use a towel to put out the flames and the resident's wounds were soaked in cool water. On arrival to the ED, the resident had mid lower extremity circumferential first degree burns with a few second degree burns. The progress note written by RN #3 on 3/29/24 at 3:46 p.m. documented the wound to her lower left leg was 13.0 centimeters (cm) by 20 cm around the circumference of her ankle. The affected area appeared to be blistered to the medial (inner) aspect. Silvadene was applied as the ordered treatment regimen. She had been receiving ibuprofen 600 milligrams (mg) and had not complained of breakthrough pain. The progress note written by the wound care nurse (WCN) dated 3/29/24 at 8:24 p.m. documented the wound on the resident's shin was 13.2 cm by 10.8 cm by 0 cm. There was scant serous (pale yellow or transparent) drainage without odor. The provider note date 4/1/24 documented Resident #13 burned the bandage on her leg which apparently then erupted in flames. From the description given by staff, there seemed to be a loose thread hanging from the bandage and due to her extremely poor judgment and executive dysfunction, she decided to burn the dangling thread. Resident #13 was not able to foresee that the burning thread would soon burn the bulk of the bandage. She was sent to the emergency room where she was treated physically, as this did not appear to be a suicide attempt or a serious attempt at self harm. V. InterviewsThe nursing home administrator (NHA) was interviewed on 4/16/24 at 5:27 p.m. The NHA said after the resident was transported to the hospital, the staff completed a "sweep" of all the supervised smokers to ensure they did not have a lighter. He said immediately the facility decided all smokers would have to wear a smoking apron. He said the facility called the family and after a conversation about the resident burning herself, the family had admitted to leaving the lighter with the resident. The facility, along with the family, had decided to make all visits with the family supervised, and moved the resident to another hall. He said the family was educated on the importance of not providing supervised smokers with a lighter to ensure the safety of everyone. CNA #6 was interviewed on 4/16/24 at 5:29 p.m. She said when she was the staff member to go out with the supervised smokers, she walked around them during the break ensuring all the aprons were on correctly. She said all the supervised smokers used an apron. She said she did not know if during family visits if Resident #13's family would take her out for a cigarette without staff. She said the management were the people who determined if someone was a supervised smoker. She said the smoking supplies, including the lighter, were locked up at the nurses station. She said only the nurses had a key to the cigarettes. RN #2 was interviewed on 4/16/24 at 5:37 p.m. RN #2 said the residents had set times for smoking. He said the times were posted at the nurses station where the residents could see. He said he would delegate a CNA to assist the residents to the smoking area where they would ensure the oxygen was removed. He said the CNAs assisted the residents to the smoking area, put on the aprons, and handed them a cigarette and lit the cigarette for the resident. RN #2 said residents were not allowed to save the cigarette if they did not finish it and they were not given the lighter to light the cigarette themselves. He said Resident #13 was a supervised smoker. He said sometimes it was noted the family would come by and go outside to the smoking area to smoke with her. He said it was during one of those times that the family gave the resident the lighter. He said the smoking assessments were completed by social services. He said the smoking supplies were locked up in the medication room. CNA #3 was interviewed on 4/17/24 at 8:45 a.m. CNA #3 said she was new to the facility. She said she knew Resident #13 had a burn from an accident and knew she was a supervised smoker. She said she used a vape pen, not cigarettes. She said she had received education on smoking safety recently but could not recall the date. She said the smoking supplies were kept locked in the medication room and only the nurse could get them for the designated smoke breaks. CNA #4 was interviewed on 4/17/24 at 8:50 a.m. CNA #4 said she had not seen Resident #13's family visit since her room change. She said she knew there was an accident with a lighter and now she used a vape pen instead of a cigarette. She said right after the accident the facility did training on smoking and the use of lighters with supervised smokers and how the supervised smokers were not allowed to have a lighter. She said all the smoking supplies were locked in the medication room and only the nurse could get the smoking supplies. Licensed practical nurse (LPN) #2 was interviewed on 4/17/24 at 8:52 a.m. LPN #2 said since Resident #13 had moved to the new room, the family had not been over for a visit while she was there. She said she knew Resident #13 had an accident and now she used a vape pen instead of a cigarette during the scheduled smoke breaks. She said the facility completed training on smoking safety right after the incident. She said supervised smokers were not allowed to have a lighter, and if one was discovered with a supervised smoker, the charge nurse was to be notified immediately and to ask the individual if they could give it up, but not to fight with them. CNA #7 was interviewed on 4/17/24 at 9:10 a.m. CNA #7 said at the smoking times, the residents all lined up to go out. On their way outside, an apron was put on them. She said she would light the cigarettes and watch all of them to make sure they did not burn themselves. She said if they did not finish the cigarette, it was thrown away and the resident was not allowed to save it for the next break. She said residents were not allowed to light their own cigarettes. She said all the smoking supplies were locked at the nurses station in the medication room and only accessed by the nurse on duty. She said all staff were told if a lighter was found with a supervised smoker, to take it and report immediately to the charge nurse. On 4/17/24 at 10:30 a.m. wound care was completed with the wound care nurse practitioner (WCNP). She said the burn was a partial thickness burn (second degree) and it had improved from first treatment. CNA #1 was interviewed on 4/17/24 at 1:02 p.m. CNA #1 said seven to eight months ago a lighter was discovered with Resident #13. He said he reported it to the charge nurse who was no longer at the facility. He said she went and talked to Resident #13 and was able to retrieve the lighter. He said he did not know if the charge nurse told anyone. LPN #1 was interviewed on 4/17/24 at 1:02 p.m. LPN #1 said Resident #13 was found to have a lighter seven to eight months ago. He said he reported it to the charge nurse. He said the charge nurse had a good relationship with Resident #13. He said she talked to Resident #13 and was able to retrieve the lighter and educate the resident. He said he did not know if it was reported to the DON or not. The DON was interviewed on 4/17/24 at 1:30 p.m. She said Resident #13 was trying to burn off a stray thread and lit the bandage around her leg on fire. She said the staff put out the fire with a towel and then water. She said the RN cut off the bandage and called the provider and an ambulance. She said the resident went out to the hospital and returned with first and second degree burns. She said immediately the staff did a search of the supervised smokers for lighters and none were found. She said that day (3/29/24), the SSA started reinforcing the training on smoking safety with the staff, starting with the staff who were present. She said the facility determined all supervised smokers would use an apron going forward. She said Resident #13 was moved to another unit. She said during the care conference on 4/2/24 with the family, it was the family who said they had provided Resident #13 with the lighter. She said the facility and the family, after a lengthy conversation, mutually agreed to have supervised visits with the family during visits if smoking was involved. The facility provided education to the family about smoking and supervised smoking. The facility and family also agreed to use a vape pen for Resident #13. The facility determined the vape pen would be kept with the smoking materials and given during the smoking breaks and returned at the end of the break. The DON said education was immediately started with the staff and a sweep was completed of all the supervised smokers to ensure no other lighters were found for the safety of all the residents. She said the housekeeping staff were to do visual inspection of supervised smokers rooms keeping a lookout for lighters going forward. The DON said she had never been notified before the accident that the resident had ever had a lighter in her possession.
Plan of correction
The state did not require a plan of correction for this citation.
0695Respiratory/Tracheostomy Care and SuctioningS/S D
Findings
Based on observations, record review and interviews, the facility failed to ensure one (#40) of three residents out of 28 sample residents who required respiratory care were provided such care and services consistent with professional standards of practice. Specifically, the facility failed to ensure Resident #40's supplemental oxygen was on the correct ordered liter flow per the physician's order. Findings include I. Facility policy and procedure The Oxygen administration policy, revised October 2010, was received from the director of nursing (DON) on 4/18/24 at 11:40 a.m. It read in pertinent part, "The purpose of this procedure is to provide guidelines for safe oxygen administration. Verify there is a physician order for this procedure. "Documentation in medical records includes: rate of oxygen flow, route, frequency, and duration. "Notify the supervisor if the resident refuses the procedure. Report other information in accordance with facility policy and professional standards of practice" II. Resident #40 A. Resident status Resident #40, under the age of 65, was admitted on 4/20/21. According to the April 2024 computerized physician orders (CPO), diagnoses included type I diabetes mellitus, low vision, chronic obstructive pulmonary disease (COPD), end stage renal disease, and chronic respiratory failure with hypoxia (low levels of oxygen in your body tissues). The 3/13/24 minimum data set (MDS) assessment revealed the resident had moderate cognitive impairment with a brief interview for mental status (BIMS) score of 12 out of 15. He required supervision with personal hygiene, dressing, bed mobility, transfers, toilet use, and set-up assistance with eating. The assessment documented the resident required continuous oxygen therapy. B. Observations and resident interview Resident #40 was interviewed on 4/15/24 at 11:13 a.m. He was on 3 liters per minute (LPM) of oxygen. He said the physician had ordered continuous oxygen at all times at 2 LPM. Resident #40 was observed on 4/16/24 at 12:31 p.m. on 3 LPM of oxygen via nasal cannula. The resident was observed on 4/17/24 at 2:05 p.m. on 3 LPM of oxygen via nasal cannula. The resident was observed on 4/18/24 at 9:30 a.m. in his room on 3 LPM via nasal cannula. C. Record review The April 2024 CPO revealed a physician's order dated 3/7/24 for 2 LPM of oxygen via a nasal cannula. The oxygen care plan, revised 5/6/21, revealed the resident had oxygen therapy related to ineffective gas exchange due to chronic obstructive pulmonary disease (COPD). The care plan indicated the resident was on continuous 3 LPM of oxygen. -The resident' s comprehensive care plan did not match the physician' s order of 2 LPM.D. Staff interviews Registered nurse (RN) #1 was interviewed on 4/18/24 at 9:40 a.m. RN #1 said Resident #40 received supplemental oxygen via nasal cannula at 2 LPM. RN #1 reviewed Resident #40's physician orders and said the physician' s order indicated for the resident to receive 2 LPM via nasal cannula.. RN #1 verified the resident' s oxygen concentrator was at 3 LPM and adjusted the liter flow per minute to 2 LPM as the physician' s order specified. RN #1 took his finger pulse oximetry (a tool used to check the oxygen levels in the blood) to ensure he had an oxygen saturation (oxygen blood level) above 90%. Resident #40's pulse oximetry level was 92% on 2 LPM. The DON was interviewed on 4/18/24 at 10:51 a.m. The DON said residents receiving oxygen should have a physician's order in place. She said the orders should include the rate of oxygen, routes like a nasal cannula or mask and frequency of intermittent or continuous. She said staff should be monitoring the resident's pulse oximetry to ensure they were maintaining oxygen saturation above 90%. The DON said oxygen use should be included on the resident' s comprehensive care plan according to the physician' s order. The DON said failure to follow the physician' s order could result in oxygen toxicity which could cause a variety of health complications leading to death. The DON said she would re-educate the nursing staff to monitor and ensure they were following the physician' s order for oxygen therapy and ensuring the care plan and the physician' s order for oxygen matched. E. Facility Follow-upThe DON provided an updated care plan for Resident #40 on 4/18/24 at 1:45 p.m. The care plan update reflected the right amount of oxygen as indicated on the physician' s order. It documented the resident would sometimes titrate his oxygen concentrator and the facility had notified the physician.
Plan of correction
The state did not require a plan of correction for this citation.
0730Nurse Aide Peform Review-12 hr/yr In-ServiceS/S E
Findings
Based on record review and interviews, the facility failed to complete a performance review of every nurse aide at least once every 12 months and provide regular in-service education based on the outcome of these reviews for five of five staff reviewed. Specifically, the facility had not completed annual performance reviews and/or provided regular in-service education based on the outcome of the reviews for certified nurse aide (CNA) #9, CNA #11, CNA #12, CNA #13 and CNA #14. Findings include:I. Record reviewCNA #9 (hired on 3/13/18), CNA #11 (hired on 7/1/16), CNA #12 (hired on 4/22/22), CNA #13 (hired on 5/7/21) and CNA #14 (hired on 7/1/16) did not have an annual performance review completed. The CNAs did not have an in-service education plan based on the outcome of the review. II. Staff interviewThe director of nursing (DON) was interviewed on 4/16/24 at 2:23 p.m. The DON said she was not aware the performance reviews needed to include a regular in-service plan based on the outcome of these reviews. She said going forward she would ensure the performance reviews were completed annually to ensure best care was being delivered to the residents.
Plan of correction
The state did not require a plan of correction for this citation.
0761Label/Store Drugs and BiologicalsS/S D
Findings
Based on observations, interviews and record review, the facility failed to ensure drugs and biologicals were labeled and stored in accordance with accepted professional standards, in two of two medication carts. Specifically, the facility failed to:-Discard an expired Anoro inhaler;-Date an Anoro inhaler when opened; and,-Date a Lantus insulin pen when opened. Findings include:I. Professional referenceAccording to the Anoro inhaler manufacturer's guidelines, retrieved on 4/22/24 from https://gskpro.com/content/dam/global/hcpportal/en_US/Prescribing_Information/Anoro_Ellipta/pdf/ANORO-ELLIPTA-PI-PIL-IFU.PDF, "Discard Anoro Ellipta 6 (six) weeks after opening the foil tray or when the counter reads '0', whichever comes first."According to the Lantus insulin pen manufacturer's guidelines, retrieved on 4/22/24 from https://products.sanofi.us/lantus/lantus.html#section-15, "Storage conditions for the 3 ml (milliliter) single patient use solostar pen in-use (opened) 28 days room temperature only."II. Observations and interviewsOn 4/16/24 at 3:30 p.m. the west medication cart was observed with registered nurse (RN) #2. The medication cart contained two Anoro inhalers. One inhaler was expired with an open date of 3/1/24 and one inhaler was not dated with the date it was opened. RN #2 said he did not know the Anoro inhaler was expired and the second inhaler belonged to a resident who had just moved rooms to his hall. He said it was important to date the inhalers when they were opened to ensure the medication was effective and safe. On 4/18/24 at 11:10 a.m. the south medication cart was observed with licensed practical nurse (LPN) #2. The medication cart contained an open Lantus solostar pen with no open date labeled on it. LPN #2 said she was not aware the insulin pen did not have an open date. She said it was important to date the insulin when it was opened to make sure it was safe to administer to the resident. III. Additional interviewThe director of nursing (DON) was interviewed on 4/18/24 at 11:40 a.m. The DON said it was important for all medications to be dated when opened and discarded when expired to ensure the medication was safe for the residents who received them.
Plan of correction
The state did not require a plan of correction for this citation.
0812Food Procurement,Store/Prepare/Serve-SanitaryS/S F
Findings
Based on observations and interviews, the facility failed to store, prepare, distribute and serve food in a sanitary manner in the main kitchen. Specifically, the facility failed to:-Ensure the kitchen was clean and sanitary; and,-Ensure food was held at appropriate temperatures. Findings include:I. Ensure kitchen staff prepared and served food in a sanitary environment in the main kitchen. A. Facility policy and procedure The Sanitation policy, revised November 2022, was provided by the dietary supervisor (DS) on 4/18/24 at 11:45 a.m. It read in pertinent part, "The food service area is maintained in a clean and sanitary manner. "All kitchens, kitchen areas, and dining areas will be kept clean, free from garbage and debris. "All equipment, food contact surfaces, and utensils are cleaned and sanitized using heat or chemical sanitizing solutions. "All utensils, counters, shelves, and equipment are kept clean, maintained in good repair, and are free from breaks, corrosions, open seams, cracks, and chipped areas that may affect their use." B. Observations During the initial tour of the kitchen on 4/15/24, beginning at 8:30 a.m. and ending at 9:15 a.m., the following was observed:-There was chipped paint and there was dust on the surface on the shelf below the three compartment sink.-There was dust and debris buildup on the exposed plumbing pipes, around the hand-washing sink and on top of the dishwashing machine.-The outside of the kitchen steamer was covered with dark greasy substances.-There was dirt and grime build up on the wall under and around the hand-washing sink located at the left side of the cooking area. On a follow-up visit to the kitchen on 4/17/24 at 11:30 a.m. the following was observed;-There was the same chipped paint and the shelf below the three compartment sink with items on it were covered in dust.-There was dust and debris build up on the exposed plumbing pipes, around the hand-washing sink, and on top of the dishwashing machine.-The outside of the kitchen steamer was covered with dark greasy substances.-There was dirt and grime build up under and around the hand-washing sink located at the left side of the cooking area. C. Staff interviews The dietary supervisor (DS) was interviewed on 4/17/24 at 2:34 p.m. The DS said there were areas in the kitchen where the facility could do better cleaning. He said it was important to maintain a clean food preparation area to avoid any foodborne illness. The DS said without a clean and sanitary kitchen environment the facility was at risk for contamination of food and food preparation surfaces. II. Food temperatures of cold and hot food items were not held at the proper temperature A. Tray line observation During a continuous observation on 4/17/9/24, beginning from 12:05 p.m. and ending at 2:00 p.m. the lunch meal service was observed from the tray line on the secured unit. Dietary aide (DA) #1 took the initial holding temperatures of the hot foods on the steam table and the cold foods were in a plastic bowl with ice cubes underneath the bowl in the serving area. DA #1 took food temperatures again at the end of the lunch service. The food holding temperatures did not hold to safe levels throughout the lunch service. The temperatures of the foods at the end of the service revealed: -The country fried steak was 116 degrees fahrenheit (F); -The mechanical soft country fry steak was 82 degrees F;-The puree vegetables were 96 degrees F;-The puree steak was of 90 degrees F;-The chocolate pudding was 67 degrees F.-The potato salad was 48 degrees F.-The temperatures taken at the end of service were outside the correct safe temperature zone to prevent foodborne illness. B. Staff interviewDA #1 was interviewed on 4/17/24 at approximately 1:45 p.m. DA #1 said the food should be held on the steam table at 165 degrees F for hot foods and cold foods should be below 41 degrees F. He said he did not think the steam table was functioning properly. DA #1 said it was important to ensure the food items being served remained in the safe temperature zone to avoid contamination and the growth of harmful bacteria which could get the residents sick. The DS was interviewed on 4/17/24 at 2:34 p.m. The DS said he would complete a maintenance work order for maintenance to work on the steam table on the locked unit. He said it was important to ensure food items remained in the safe temperature zone to avoid harmful bacteria growth which could cause illness and serious health issues for the residents. The DS said he would ensure lids were utilized to help keep the food warm.
Plan of correction
The state did not require a plan of correction for this citation.
4/8/2024Focused Infection Control, Other-Fed Survey · ID 8E9C111 deficiency
0884Reporting - National Health Safety NetworkS/S F
Findings
Based on record review, the facility failed to report complete information about COVID-19 to the Centers for Disease Control and Prevention's (CDC) National Healthcare Safety Network (NHSN) during a seven-day period that reporting was required by regulation. The CDC submitted data from the NHSN to the Centers for Medicare and Medicaid Services (CMS). Based on review of that data, CMS determined that between 04/01/2024 and 04/07/2024, the facility did not report complete information to NHSN about COVID-19 in the standardized format and frequency as specified by CMS and the CDC. This failure to report has the potential to cause more than minimal harm to all residents residing in the facility.
Plan of correction
The state did not require a plan of correction for this citation.
1/22/2024Revisit: Complaint Survey · ID 5D2W12No deficiencies
0000INITIAL COMMENTSSurveyor note
Findings
A revisit survey was completed on 1/22/24 for all previous deficiencies cited on 11/13/23. The facility is in compliance with all regulations surveyed.
Plan of correction
The state did not require a plan of correction for this citation.
1/2/2024Focused Infection Control, Other-Fed Survey · ID MY8G111 deficiency
0884Reporting - National Health Safety NetworkS/S F
Findings
Based on record review, the facility failed to report complete information about COVID-19 to the Centers for Disease Control and Prevention's (CDC) National Healthcare Safety Network (NHSN) during a seven-day period that reporting was required by regulation. The CDC submitted data from the NHSN to the Centers for Medicare and Medicaid Services (CMS). Based on review of that data, CMS determined that between 12/25/2023 and 12/31/2023, the facility did not report complete information to NHSN about COVID-19 in the standardized format and frequency as specified by CMS and the CDC. This failure to report has the potential to cause more than minimal harm to all residents residing in the facility.
Plan of correction
The state did not require a plan of correction for this citation.
12/26/2023Focused Infection Control, Other-Fed Survey · ID MMJ9111 deficiency
0884Reporting - National Health Safety NetworkS/S F
Findings
Based on record review, the facility failed to report complete information about COVID-19 to the Centers for Disease Control and Prevention's (CDC) National Healthcare Safety Network (NHSN) during a seven-day period that reporting was required by regulation. The CDC submitted data from the NHSN to the Centers for Medicare and Medicaid Services (CMS). Based on review of that data, CMS determined that between 12/18/2023 and 12/24/2023, the facility did not report complete information to NHSN about COVID-19 in the standardized format and frequency as specified by CMS and the CDC. This failure to report has the potential to cause more than minimal harm to all residents residing in the facility.
Plan of correction
The state did not require a plan of correction for this citation.
11/13/2023Complaint Survey · ID 5D2W111 deficiency
0000INITIAL COMMENTSSurveyor note
Findings
A complaint survey, prompted by #CO34130 and Incident #31002, #31826 and #32381 was conducted on 11/13/23. One deficiency was cited.
Plan of correction
The state did not require a plan of correction for this citation.
0600Free from Abuse and NeglectS/S E
Findings
Based on interviews and record review, the facility failed to ensure three (#2, #3 and #5) out of nine residents reviewed for abuse were kept free from abuse out of nine sample residents. Specifically, the facility failed to:-Prevent a resident-to-resident altercations between Resident #1 and #2; -Prevent a resident-to-resident altercation between Resident #3 and #4; and,-Prevent a resident-to-resident altercation between Resident #5 and #6. Findings include:I. Resident #1A. Resident status Resident #1, age under 65, was admitted on 11/17/22 and discharged 4/20/23. According to the April 2023 computerized physicians orders (CPO), diagnoses included delusional disorder, anxiety disorder and paranoid schizophrenia. The 2/15/23 minimum data set (MDS) assessment revealed the resident's mental status was cognitively intact with a brief interview for mental status (BIMS) score of 15 out of 15. Physical and verbal behaviors were noted daily on the assessment. B. Record reviewThe care plan, initiated 12/29/22 and revised on 2/17/23, identified the resident was a serious danger to self or others. Interventions included to attempt to redirect resident to another area of the unit when increased agitation was noted. The care plan, initiated 3/2/23, identified the resident suffered from schizophrenia with occasional physical aggression. Interventions included to redirect him to music with personal earbuds. II. Resident #2A, Resident statusResident #1, age under 65, was admitted on 9/1/22 and passed away on 3/16/23. According to the March 2023 CPO, diagnoses included paranoid schizophrenia, obsessive compulsive disorder and depressive episodes. The 1/24/23 MDS assessment revealed the resident's mental status was cognitively intact with a BIMS score of 14 out of 15. No behaviors were noted on the assessment. III. Altercation on 2/15/23The facility investigation included:On 2/15/23 staff reported Resident #1 told Resident #2 he owed Resident #1 $5.00. Resident #2 told Resident #1 he did not because he did not have $5.00. Resident #1 then hit Resident #2 on top of his head. No injuries noted and no reports of Resident #2 being afraid of Resident #1. The staff statement included, "At about 11:40 a.m. after passing drinks, certified nurse aide (CNA) #3 went to the nurses station and could hear Resident #1 talk to Resident #2. As she walked into the dining room she heard Resident #1 ask Resident #2 about paying Resident #1 back his $5.00. Resident #2 said he did not have any money. When she turned the corner she saw Resident #1 make contact with an open hand on Resident #2's head."The residents were separated. Resident #2 had a staff member stay with him until he calmed down and was assisted back to his room to watch television per his request. Frequent rounding was completed. Resident #1 was provided resident focused activities by the activity aide who assisted him until transportation could arrive to transfer Resident #1 out to the hospital. The conclusion of the facility investigation substantiated Resident #1 hit Resident #2. IV. Resident #4A. Resident statusResident #4, age under 65, was admitted on 8/23/17. According to the November 2023 CPO, diagnoses included post traumatic stress disorder, psychoactive substance abuse and dementia. The 10/26/23 MDS assessment revealed the resident's mental status was cognitively intact with a BIMS score of 15 out of 15. No behaviors were noted on the assessment. B. Record reviewThe care plan, initiated 8/4/17 and revised 2/19/23, identified the resident had a history of making sexually inappropriate comments/gestures toward staff and other residents. Interventions included:-Deter him from touching other's clothing for his safety as well as others.-Educate him on limits of keeping hands to himself as needed.-Staff are to provide close supervision when he was out of the room for meals, activities, or in hallways. The care plan, initiated 8/22/17 and revised on 2/17/23, identified the resident had a history of sexually inappropriate behavior of touching other males' penises. Interventions included:-Educate him on limits of keeping his hands to himself as needed.-Educate Resident #4 on respecting others boundaries and personal space.-Give generous, positive reinforcement for appropriate behavior. V. Resident #3A. Resident statusResident #3, age 80, was admitted on 2/16/23 and discharged on 11/10/23. According to the November 2023 CPO, diagnoses included dementia, vascular dementia and transient ischemic attack (TIA). The 8/21/23 MDS assessment revealed the resident's mental status was severely cognitively impaired with a BIMS score of three out of 15. No behaviors were noted on the assessment. VI. Altercation on 4/14/23The facility investigation included:Resident #3 reported to the CNA of being touched inappropriately, on his private part over his clothes by another male resident (Resident #4). When Resident #4 was interviewed he stated he did touch Resident #3's crotch area. The facility conclusion to the investigation was that contact was made. VII. Resident #6A. Resident statusResident 6, age under 65, was admitted on 11/11/17 and readmitted on 12/12/22. According to the November 2023 CPO, diagnoses included dementia, schizophrenia and aphasia (difficulty with speech from brain damage). The 11/1/23MDS assessment revealed the resident's mental status was severely cognitively impaired and a BIMS was not completed. No behaviors were noted on the assessment. B. Record reviewThe care plan, initiated 11/14/19 and revised on 6/4/21, identified the resident used psychotropic medications for schizophrenia with anxiety and dementia with behaviors. Interventions included to evaluate and document occurance of target behaviors symptoms and document. The care plan, initiated 10/3/22 and revised on 4/20/23, identified behaviors due to schizophrenia of verbal aggression. Interventions included to offer one to one activities daily. The care plan, initiated 4/17/23 and revised 7/10/23, identified the resident had the potential to be physically aggressive. Interventions included to document observed behavior and attempted interventions in behavior log, and observe, document, report as needed signs and symptoms of the resident posing a danger to self and others. VIII. Resident #5A. Resident statusResident #5, age under 65, was admitted on 6/26/18 and readmitted on 3/23/22. According to the November 2023 CPO, diagnoses included schizoaffective disorder bipolar type, Tourette's disorder (involves repetitive movements or unwanted sounds) and transient cerebral ischemic attack (TIA). The 8/31/23 MDS assessment revealed the resident's mental status was cognitively intact with a BIMS score of 14 out of 15. No behaviors were noted on the assessment. IX. Altercation on 5/16/23The facility investigation included:CNA #4's witness statement included seeing Resident #6 walking up to Resident #5 really quick and hit him with a closed fist in his upper arm then took off quickly down the hall. Resident #5 denied any fear or pain. The facility found no injuries. The facility investigation conclusion documented there was no fear or harm intended. X. InterviewsThe director of nursing (DON) and the nursing home administrator (NHA) were interviewed on 11/13/23 at 2:35 p.m. The NHA said the altercations did happen and the facility had been working diligently to prevent any further abuse. She said it was important for all the residents to feel safe in their own home. She said the facility had increased staffing recently to include more activities staff, care coordinators and an additional social services staff. She said the facility had improved the behavior tracking and had an overall improvement with residents. She said all staff were encouraged to participate in care planning and meetings to help provide the best home for all the residents.
Plan of correction · submitted by the facility
Preparation and execution of this response and plan of correction does not constitute an admission or agreement by the provider of the truth of the facts alleged or conclusions set forth in the statement of deficiencies. The plan of correction is prepared and/or executed solely because it is required by the provisions of federal and state law. For the purposes of any allegation that the facility is not in substantial compliance with federal requirements of participation. This response and plan of correction constitutes the facility’s allegation of compliance in accordance with section 42. C.F.R. §488.18 and section 7317A of the State Operations Manual. F600 Free from Abuse, Neglect and Exploitation Correction: Resident #1 was discharged from the facility on 4/30/2023. Resident #2 was discharged from the facility on 3/16/2023. Resident #3 currently resides in the south unit of the facility and has not been involved in any other altercations since then. Resident #4 currently resides in the south unit of the facility and has been involved in a physical altercation over a dispute of a TV remote control, which was reported to the state portal on 9/14/2023. Immediate interventions were put into place and an investigation was completed and care plan was updated. No other occurrences of a sexual nature have occurred. Resident #5 currently resides in the south unit of the facility and has not been involved in any other altercations since then. Resident #6 currently resides in the south unit of the facility and has been involved in one occurrence, which was reported to the state portal on 9/14/2023, in which he was the recipient of physical abuse. Immediate interventions were put into place, an investigation was completed and care plan was updated. Identification: All 22 residents currently residing on the South Unit of the facility, which is a locked unit, have the potential to be affected by this deficient practice, and have been reviewed by the inter-disciplinary team. Systemic: Since these occurrences in February 2023, April 2023 and May 2023, a new investigation form for occurrences which the facility has been utilizing since August 2023. Inservice scheduled with CCO and lead clinical, social services and administration team on 11/30/2023 to cover up to and including abuse training, abuse investigation, abuse reporting and abuse interventions. The facility has identified varying scopes of interventions to implement up to and including: person-centered care information books for all units identifying residents’ current known behavior triggers and known de-escalation tips for staff to utilize at their convenience; staffing has been increased on the South Unit with the addition of a dedicated full-time Social Service Director; hiring activities aide to start in the middle of December that will specialize in providing person-centered activities to residents specifically on the South Unit in the evening times to aide in resident psycho-social well-being varying types of activities based on current preferences. The IDT has reviewed the residents’ diagnoses, non-pharmacological interventions and care plans to ensure that triggers are identified and that appropriate interventions are in place. Abuse training is to continue to be completed with all staff upon hire, annually, as needed. All staff re-in-servicing on abuse training to be completed by 12/11/2023. Monitoring: Social Services Director or designee will complete a weekly audit of abuse training of new staff for 3 months in coordination with Human Resources and direct supervisor. Nursing Home Administrator or designee will monitor weekly for 3 months that all new abuse occurrences will have a new intervention assigned and updated in care plan. Social Services Director or designee will review weekly with inter-disciplinary team all new abuse occurrences, interventions, care plans and monitoring sheets for 3 months. Nursing Home Administrator or designee will bringall monitoring to QAPI to submit to inter-disciplinary team for review for 3 months. Date of Compliance: 12/11/2023
10/17/2023Focused Infection Control, Other-Fed Survey · ID 47G3111 deficiency
0884Reporting - National Health Safety NetworkS/S F
Findings
Based on record review, the facility failed to report complete information about COVID-19 to the Centers for Disease Control and Prevention's (CDC) National Healthcare Safety Network (NHSN) during a seven-day period that reporting was required by regulation. The CDC submitted data from the NHSN to the Centers for Medicare and Medicaid Services (CMS). Based on review of that data, CMS determined that between 10/09/2023 and 10/15/2023, the facility did not report complete information to NHSN about COVID-19 in the standardized format and frequency as specified by CMS and the CDC. This failure to report has the potential to cause more than minimal harm to all residents residing in the facility.
Plan of correction
The state did not require a plan of correction for this citation.
8/7/2023Focused Infection Control, Other-Fed Survey · ID P55H111 deficiency
0884Reporting - National Health Safety NetworkS/S F
Findings
Based on record review, the facility failed to report complete information about COVID-19 to the Centers for Disease Control and Prevention's (CDC) National Healthcare Safety Network (NHSN) during a seven-day period that reporting was required by regulation. The CDC submitted data from the NHSN to the Centers for Medicare and Medicaid Services (CMS). Based on review of that data, CMS determined that between 07/31/2023 and 08/06/2023, the facility did not report complete information to NHSN about COVID-19 in the standardized format and frequency as specified by CMS and the CDC. This failure to report has the potential to cause more than minimal harm to all residents residing in the facility.
Plan of correction
The state did not require a plan of correction for this citation.
7/17/2023Focused Infection Control, Other-Fed Survey · ID Y92W111 deficiency
0884Reporting - National Health Safety NetworkS/S F
Findings
Based on record review, the facility failed to report complete information about COVID-19 to the Centers for Disease Control and Prevention's (CDC) National Healthcare Safety Network (NHSN) during a seven-day period that reporting was required by regulation. The CDC submitted data from the NHSN to the Centers for Medicare and Medicaid Services (CMS). Based on review of that data, CMS determined that between 07/10/2023 and 07/16/2023, the facility did not report complete information to NHSN about COVID-19 in the standardized format and frequency as specified by CMS and the CDC. This failure to report has the potential to cause more than minimal harm to all residents residing in the facility.
Plan of correction
The state did not require a plan of correction for this citation.
6/1/2023Complaint, Focused Infection Control, Other-Fed Survey · ID RK4211No deficiencies
0000Initial CommentsSurveyor note2 building records
Findings · record 1 of 2
A focused infection control survey with complaint #CO32265 was conducted 5/31/23 to 6/1/23. No deficiencies were cited.
Findings · record 2 of 2
An Emergency Preparedness focused infection control survey was conducted 5/31/23 to 6/1/23. No deficiencies were cited.
Plan of correction
The state did not require a plan of correction for this citation.
5/23/2023Focused Infection Control, Other-Fed Survey · ID R1D7111 deficiency
0884Reporting - National Health Safety NetworkS/S F
Findings
Based on record review, the facility failed to report complete information about COVID-19 to the Centers for Disease Control and Prevention's (CDC) National Healthcare Safety Network (NHSN) during a seven-day period that reporting was required by regulation. The CDC submitted data from the NHSN to the Centers for Medicare and Medicaid Services (CMS). Based on review of that data, CMS determined that between 05/15/2023 and 05/21/2023, the facility did not report complete information to NHSN about COVID-19 in the standardized format and frequency as specified by CMS and the CDC. This failure to report has the potential to cause more than minimal harm to all residents residing in the facility.
Plan of correction
The state did not require a plan of correction for this citation.
5/15/2023Focused Infection Control, Other-Fed Survey · ID GUGH111 deficiency
0884Reporting - National Health Safety NetworkS/S F
Findings
Based on record review, the facility failed to report complete information about COVID-19 to the Centers for Disease Control and Prevention's (CDC) National Healthcare Safety Network (NHSN) during a seven-day period that reporting was required by regulation. The CDC submitted data from the NHSN to the Centers for Medicare and Medicaid Services (CMS). Based on review of that data, CMS determined that between 05/08/2023 and 05/14/2023, the facility did not report complete information to NHSN about COVID-19 in the standardized format and frequency as specified by CMS and the CDC. This failure to report has the potential to cause more than minimal harm to all residents residing in the facility.
Plan of correction
The state did not require a plan of correction for this citation.
3/22/2023Revisit: Recertification Survey · ID FHW312No deficiencies
0000Initial CommentsSurveyor note
Findings
A revisit to the 12/29/2022 was completed on 3/22/2023. The facility was in compliance with the regulations surveyed.
Plan of correction
The state did not require a plan of correction for this citation.
3/22/2023Revisit: State Licensure Survey · ID G8KZ12No deficiencies
0000Initial CommentsSurveyor note
Findings
A revisit to the 12/29/2022 was completed on 03/22/2023. The facility was in compliance with the regulations surveyed.
Plan of correction
The state did not require a plan of correction for this citation.
2/28/2023Focused Infection Control, Other-Fed Survey · ID 71UV111 deficiency
0884Reporting - National Health Safety NetworkS/S F
Findings
Based on record review, the facility failed to report complete information about COVID-19 to the Centers for Disease Control and Prevention's (CDC) National Healthcare Safety Network (NHSN) during a seven-day period that reporting was required by regulation. The CDC submitted data from the NHSN to the Centers for Medicare and Medicaid Services (CMS). Based on review of that data, CMS determined that between 02/20/2023 and 02/26/2023, the facility did not report complete information to NHSN about COVID-19 in the standardized format and frequency as specified by CMS and the CDC. This failure to report has the potential to cause more than minimal harm to all residents residing in the facility.
Plan of correction
The state did not require a plan of correction for this citation.
2/21/2023Focused Infection Control, Other-Fed Survey · ID WVTK111 deficiency
0884Reporting - National Health Safety NetworkS/S F
Findings
Based on record review, the facility failed to report complete information about COVID-19 to the Centers for Disease Control and Prevention's (CDC) National Healthcare Safety Network (NHSN) during a seven-day period that reporting was required by regulation. The CDC submitted data from the NHSN to the Centers for Medicare and Medicaid Services (CMS). Based on review of that data, CMS determined that between 02/13/2023 and 02/19/2023, the facility did not report complete information to NHSN about COVID-19 in the standardized format and frequency as specified by CMS and the CDC. This failure to report has the potential to cause more than minimal harm to all residents residing in the facility.
Plan of correction
The state did not require a plan of correction for this citation.
2/15/2023Revisit: Recertification Survey · ID FHW322No deficiencies
0000INITIAL COMMENTSSurveyor note
Findings
A document revisit was completed with all deficiencies being corrected. No other deficiencies were cited and no response is needed.
Plan of correction
The state did not require a plan of correction for this citation.
2/13/2023Focused Infection Control, Other-Fed Survey · ID 7EYI111 deficiency
0884Reporting - National Health Safety NetworkS/S F
Findings
Based on record review, the facility failed to report complete information about COVID-19 to the Centers for Disease Control and Prevention's (CDC) National Healthcare Safety Network (NHSN) during a seven-day period that reporting was required by regulation. The CDC submitted data from the NHSN to the Centers for Medicare and Medicaid Services (CMS). Based on review of that data, CMS determined that between 02/06/2023 and 02/12/2023, the facility did not report complete information to NHSN about COVID-19 in the standardized format and frequency as specified by CMS and the CDC. This failure to report has the potential to cause more than minimal harm to all residents residing in the facility.
Plan of correction
The state did not require a plan of correction for this citation.
2/6/2023Focused Infection Control, Other-Fed Survey · ID 4D3F111 deficiency
0884Reporting - National Health Safety NetworkS/S F
Findings
Based on record review, the facility failed to report complete information about COVID-19 to the Centers for Disease Control and Prevention's (CDC) National Healthcare Safety Network (NHSN) during a seven-day period that reporting was required by regulation. The CDC submitted data from the NHSN to the Centers for Medicare and Medicaid Services (CMS). Based on review of that data, CMS determined that between 01/30/2023 and 02/05/2023, the facility did not report complete information to NHSN about COVID-19 in the standardized format and frequency as specified by CMS and the CDC. This failure to report has the potential to cause more than minimal harm to all residents residing in the facility.
Plan of correction
The state did not require a plan of correction for this citation.
1/11/2023Recertification Survey · ID FHW3215 deficiencies
0000INITIAL COMMENTSSurveyor note
Findings
INITIAL COMENTS (ID Prefix Tag #K000) are informational only and a representation of the facility's general characteristics. This survey was conducted in accordance with the Federal Register at Section 42 CFR 483.70(a). This facility licensed for 101 beds and consist of two structures. This re-certification survey conducted on January 11, 2023 was for compliance with the National Fire Protection Association, (NFPA 101) Life Safety Code (2012) Chapter 19, "Existing Health Care Occupancies". The deficiencies cited were discussed with the Regional Director and Maintenance Director staff during the exit conference conducted at the end on-site survey. As previously mention, the facility consists of two buildings, which are known as the South Building and the North Building. The buildings are connected by a below-grade tunnel with a two-hour, fire rated separation at the tunnel entrance to the North Building. South Building: The South Building is a one-story Type II (200) structure with a basement. It was originally constructed in 1954 as a hospital. The South Building is protected throughout by a National Fire Protection Association (NFPA) 13 automatic fire suppression systems and is classified as Fully Sprinklered. North Building: The North Building is a one-story building Type V (111) structure with a partial basement. Constructed in two phases separated by a ten-year span of time. The original western portion of the building was constructed 1964, with eastern portion of the building constructed in 1974. The North Building is also protected throughout by a National Fire Protection Association (NFPA) 13 automatic fire suppression systems and is classified as Fully Sprinklered. The basement of both buildings, neither of which are accessible to the residents, are used for support services only.
Plan of correction
The state did not require a plan of correction for this citation.
0321Hazardous Areas - EnclosureS/S F
Findings
STANDARD is not met as evidenced by: Based on observation and staff interview during the survey, it was determined that the facility failed to maintain sprinkler protected hazardous areas in accordance with Life Safety Section 19.3.2.1. This deficient practice could affect all residents and staff in the main smoke compartment including the beauty shop should there be smoke and heat transfer between the hazardous area and other portions of the building. This was evidence by the following. Laundry room door self-closing device was removed from door. Life Safety Code Section 19.3.2.1 requires that sprinkler protected hazardous areas be separated from other spaces by smoke-resisting construction. Doors installed to protect hazardous areas must be self-closing or automatic closing. The Regional Director acknowledged the hazardous area enclosures and door condition during a tour of the facility.
Plan of correction · submitted by the facility
This alleged deficiency was determined that the facility is not met as evidenced by: Based on observation and staff interview during the survey, it was determined that the facility failed to maintain sprinkler protected hazardous areas in accordance with Life Safety Section 19.3.2.1. This deficient practice could affect all residents and staff in the main smoke compartment including the beauty shop should there be smoke and heat transfer between the hazardous area and other portions of the building. This was evidence by the following. The laundry room door self-closing device was removed from door. An audit of the entire building to find any other hazardous areas with non-functional self-closing doors was completed on 1/11/23. The repair of laundry room door was performed by director of plant operations and was completed on 1/26/23 to meet the compliance date of 2/9/23. Measures that were put into place to keep this alleged deficiency from happening again is education was provided for the Director of Plant Operations and maintenance staff on the proper hardware, and functionality of hazardous doors containing self-closing hardware on 1/19/23. The Director of Plant operations or Designee will perform weekly audits on the hazardous doors for 3 weeks, and then will be placed on a monthly audit x 3 months. The audits will be reviewed during the monthly QA and Safety Committee for 3 months.
0345Fire Alarm System - Testing and MaintenanceS/S F2 building records
Findings · record 1 of 2
STANDARD is not met as evidenced by: Based review of the records and discussion during the survey, it was determined the facility failed to inspect and test the fire alarm system per NFPA 101, Chapter 9 (Section 9.6 Paragraph 9.6.1.4) and NFPA 72, (Chapter 7, Paragraph 7-1.2.2). Failure to maintain and test the fire alarm system has the potential to harm all occupants, staff and visitor in the build if the fire alarm system failed to operate if a fire was to occur. 1) During the review of the records, with the Director of Maintenance, documentation was not available to verify the sensitivity testing of the smoke detectors per NFPA 101 2012 Edition 19.3.4.1, 9.6.1.3, NFPA 72 7-3 and 7-3.2.1.2012 Life Safety Code 101 section 7-3.2.1*Detector sensitivity shall be checked within 1 year after installation and every alternate year thereafter. After the second required calibration test, if sensitivity tests indicate that the detector has remained within its listed and marked sensitivity range (or 4 percent obscuration light gray smoke, if not marked), the length of time between calibration tests shall be permitted to be extended to a maximum of 5 years. If the frequency is extended, records of detector-caused nuisance alarms and subsequent trends of these alarms shall be maintained. In zones or in areas where nuisance alarms show any increase over the previous year, calibration tests shall be performed. To ensure that each smoke detector is within its listed and marked sensitivity range.it shall be tested using any of the following methods: 2) The 2022 Annual Fire Alarm Testing did not included testing of magnetic door holders, heat or duct detectors. 2012 Life Safety Code 101 section 9.6.1.5* To ensure operational integrity, the fire alarm system shall have an approved maintenance and testing program complying with the applicable requirements of NFPA 70, National Electrical Code, and NFPA 72, National Fire Alarm and Signaling Code. The Regional Director acknowledged the condition of testing the fire alarm system during the record review.
Findings · record 2 of 2
STANDARD is not met as evidenced by: Based review of the records and discussion during the survey, it was determined the facility failed to inspect and test the fire alarm system per NFPA 101, Chapter 9 (Section 9.6 Paragraph 9.6.1.4) and NFPA 72, (Chapter 7, Paragraph 7-1.2.2). Failure to maintain and test the fire alarm system has the potential to harm all occupants, staff and visitor in the build if the fire alarm system failed to operate if a fire was to occur. 1) During the review of the records, with the Maintenance Director, documentation was not available to verify the sensitivity testing of the smoke detectors per NFPA 101 2012 Edition 19.3.4.1, 9.6.1.3, NFPA 72 7-3 and 7-3.2.1.2012 Life Safety Code 101 section 7-3.2.1*Detector sensitivity shall be checked within 1 year after installation and every alternate year thereafter. After the second required calibration test, if sensitivity tests indicate that the detector has remained within its listed and marked sensitivity range (or 4 percent obscuration light gray smoke, if not marked), the length of time between calibration tests shall be permitted to be extended to a maximum of 5 years. If the frequency is extended, records of detector-caused nuisance alarms and subsequent trends of these alarms shall be maintained. In zones or in areas where nuisance alarms show any increase over the previous year, calibration tests shall be performed. To ensure that each smoke detector is within its listed and marked sensitivity range.it shall be tested using any of the following methods: 2) The 2022 Annual Fire Alarm Testing did not included testing of magnetic door holders, heat or duct detectors. 2012 Life Safety Code 101 section 9.6.1.5* To ensure operational integrity, the fire alarm system shall have an approved maintenance and testing program complying with the applicable requirements of NFPA 70, National Electrical Code, and NFPA 72, National Fire Alarm and Signaling Code. The Regional Director acknowledged the condition of testing the fire alarm system during the record review.
Plan of correction · submitted by the facility
This alleged deficiency was determined that the facility is not met as evidenced by: Based review of the records and discussion during the survey, it was determined the facility failed to inspect and test the fire alarm system per NFPA 101, Chapter 9 (Section 9.6 Paragraph 9.6.1.4) and NFPA 72, (Chapter 7, Paragraph 7-1.2.2). Failure to maintain and test the fire alarm system has the potential to harm all occupants, staff and visitor in the build if the fire alarm system failed to operate if a fire was to occur. 1) During the review of the records, with the Director of Maintenance, documentation was not available to verify the sensitivity testing of the smoke detectors per NFPA 101 2012 Edition 19.3.4.1, 9.6.1.3, NFPA 72 7-3 and 7-3.2.1. The 2022 Annual Fire Alarm Testing did not included testing of magnetic door holders, heat or duct detectors. An audit of the documentation concerning smoke detector sensitivity testing, magnetic door holders, heat detectors, or duct detectors was completed on 1/11/23 The sensitivity testing, magnetic door holders, was performed by dignity fire and was completed on 1/31/23 to meet the compliance date of 2/9/23. The facility does not have heat or duct detectors at this time. Measures that were put into place to keep this alleged deficiency from happening again is education was provided for the Director of Plant Operations and maintenance staff on the proper documentation of sensitivity testing and magnetic door holders on 1/19/23 The Director of Plant operations or Designee will perform weekly audits on the hazardous doors for 3 weeks, and then will be placed on a monthly audit x 3 months. The audits will be reviewed during the monthly QA and Safety Committee for 3 months.
0353Sprinkler System - Maintenance and TestingS/S F2 building records
Findings · record 1 of 2
STANDARD is not met as evidenced by: Based on observation and staff interview, it was determined that the facility failed to maintain the automatic sprinkler system in accordance with National Fire Protection Association (NFPA) Standard 13 and Standard 25. This deficient practice could affect all residents, staff and visitors should the automatic sprinkler system fail to operate in a timely and effective manner due to non-code compliant maintenance. This was evidence by the following. 1) Antifreeze Systems was not inspected during the Annual Fire Suppression System Testing during 2022.2011 NFPA 25 section 5.3.4* Antifreeze Systems. The freezing point of solutions in antifreeze shall be tested annually by measuring the specific gravity with a hydrometer or refractometer and adjusting the solutions if necessary. 2) Pendent sprinkler heads located in the walk-in cooler and freeze observed to be older than 5 years old and shall be replaced. NFPA 25, 2010 section 5.3.1.1.2* Where sprinklers are subjected to harsh environments, including corrosive atmospheres and corrosive water supplies, on a 5-year basis, either sprinklers shall be replaced or representative sprinkler samples shall be tested. The Regional Director acknowledge the lack of maintenance of the automatic sprinkler system deficiency during record review of the facility.
Findings · record 2 of 2
STANDARD is not met as evidenced by: Based on observation and staff interview, it was determined that the facility failed to maintain the automatic sprinkler system in accordance with National Fire Protection Association (NFPA) Standard 13 and Standard 25. This deficient practice could affect all residents, staff and visitors should the automatic sprinkler system fail to operate in a timely and effective manner due to non-code compliant maintenance. This was evidence by the following. 1) Antifreeze Systems was not inspected during the Annual Fire Suppression System Testing during 2022.2011 NFPA 25 section 5.3.4* Antifreeze Systems. The freezing point of solutions in antifreeze shall be tested annually by measuring the specific gravity with a hydrometer or refractometer and adjusting the solutions if necessary. 2) Fire Sprinkler Raiser room, two gauges contained the manufacture date of 2016, gauges shall be calibrated or replace every five years. NFPA 25 section 5.3.2.1 Gauges shall be replaced every 5 years or tested every 5 years by comparison with a calibrated gauge. The Regional Director acknowledge the lack of maintenance of the automatic sprinkler system deficiency during record review of the facility.
Plan of correction · submitted by the facility
This alleged deficiency was determined that the facility is not met as evidenced by: Based on observation and staff interview, it was determined that the facility failed to maintain the automatic sprinkler system in accordance with National Fire Protection Association (NFPA) Standard 13 and Standard 25. This deficient practice could affect all residents, staff and visitors should the automatic sprinkler system fail to operate in a timely and effective manner due to non-code compliant maintenance. This wasevidence by the following. 1) Antifreeze Systems was not inspected during the Annual Fire Suppression System Testing during 2022. 2) Fire Sprinkler Raiser room, two gauges contained the manufacture date of 2016, gauges shall be calibrated or replace every five years. NFPA 25 section 5.3.2.1 Gauges shall be replaced every 5 years or tested every 5 years by comparison with a calibrated gauge. Pendent sprinkler heads located in the walk-in cooler and freeze observed to be older than 5 years old and shall be replaced An audit of the documentation concerning Antifreeze Systems and Gauges, and pendent sprinkler heads needing to be replaced was completed on 1/11/23 The Antifreeze System test documentation, Gauges and pendent head replacement was performed by Dignity Fire and was completed on 1/31/23 to meet the compliance date of 2/9/23. Measures that were put into place to keep this alleged deficiency from happening again is education was provided for the Director of Plant Operations and maintenance staff on the proper documentation of Antifreeze System test and Gauges replacement on 1/19/23. The Director of Plant operations or Designee will perform weekly audits on the documentation and repairs for 3 weeks, and then will be placed on a monthly audit x 3 months. The audits will be reviewed during the monthly QA and Safety Committee for 3 months.
0712Fire DrillsS/S F
Findings
STANDARD is not met as evidenced by: Based on record review during the survey, it was determined that the facility failed to conduct fire drills in accordance with the Life Safety Code, Section 19.7.1.2 and 4.7. This deficient practice could affect residents when staff are not trained in the emergency actions required during unusual condition that can occur in an actual emergency. This was evidenced by the following: Fire drills are required to be conducted on each shift quarterly, the facility failed to conduct a fire drill on the second shift on the first and third quarter of 2022. Life Safety Code, Section 19.7.1.2 requires, in part, that fire drills be conducted quarterly on each shift to familiarize personnel (nurses, interns, maintenance engineers, and administrative staff) with the signals and emergency action required under varied conditions. When drills are conducted between 9:00 pm and 6:00 am, a coded announcement shall be permitted to be used instead of audible alarms. Section 4.7.5 requires that drills be held unexpected times and under varying conditions to simulate the unusual conditions that can occur in an actual emergency. The Regional Director acknowledge the conditions of fire drills deficiency during record review of the facility.
Plan of correction · submitted by the facility
This alleged deficiency was determined that the facility is not met as evidenced by: Based on Basedon record review during the survey, it was determined that the facility failed to conduct fire drills in accordance with the Life Safety Code, Section 19.7.1.2 and 4.7. This deficient practice could affect residents when staff are not trained in the emergency actions required during unusual condition that can occur in an actual emergency. This was evidenced by the following: Fire drills are required to be conducted on each shift quarterly, the facility failed to conduct a fire drill on the second shift on the first and third quarter of 2022. An audit of the documentation concerning Fire Drills, was completed on 1/11/23 Fire drills documentation review was performed by DPO and was completed on 1/31/23 to meet the compliance date of 2/9/23 Measures that were put into place to keep this alleged deficiency from happening again is education was provided for the Director of Plant Operations and maintenance staff on the proper fire drill procedure on 1/19/23 The Director of Plant operations or Designee will perform weekly audits on the documentation of fire drills for 3 weeks, and then will be placed on a monthly audit x 3 months. The audits will be reviewed during the monthly QA and Safety Committee for 3 months.
0918Electrical Systems - Essential Electric SysteS/S F
Findings
STANDARD is not met as evidenced by: Based on record review during the course testing the transfer switch on the generator it was determined that the facility failed to maintain emergency power systems in accordance with section 19.2.9.1 of the Life Safety Code and the referenced NFPA 110, Standard for Emergency and Standby Power Systems Chapter 6 This deficient practice has the potential to affect all residents, staff and visitors in the event of power loss. This was evidenced by the following. No records were available to verify testing and recording of the EPSS Loads L1, L2 and L3 after transfer. NFPA 110, Section 6-4.1 Level I and Level EPSSs, including all appurtenant components, shall be inspected and shall be exercised under load at least monthly. The emergency power supply system deficiency item was discussed with the Regional Director during the survey.
Plan of correction · submitted by the facility
This alleged deficiency was determined that the facility is not met as evidenced by: Based on record review during the course testing the transfer switch on the generator it was determined that the facility failed to maintain emergency power systems in accordance with section 19.2.9.1 of the Life Safety Code and the referenced NFPA 110, Standard for Emergency and Standby Power Systems Chapter 6 This deficient practice has the potential to affect all residents, staff and visitors in the event of power loss. This was evidenced by the following. No records were available to verify testing and recording of the EPSS Loads L1, L2 and L3 after transfer. NFPA 110, Section 6-4.1 Level I and Level EPSSs, including all appurtenant components, shall be inspected and shall be exercised under load at least monthly. An audit of the documentation concerning generator load testing after transfer, was completed on 1/11/23 Load testing documentation review was performed by DPO and was completed on 2/3/23 to meet the compliance date of 2/9/23 Measures that were put into place to keep this alleged deficiency from happening again is education was provided for the Director of Plant Operations and maintenance staff on the proper load testing documentation procedure on 1/19/23 The Director of Plant operations or Designee will perform weekly audits on the documentation of load testing documentation for 3 weeks, and then will be placed on a monthly audit x 3 months. The audits will be reviewed during the monthly QA and Safety Committee for 3 months.

Reportable Occurrences

69 records
6/8/2026Physical Abuse · ID 26020256008Reported on time: Yes
Occurrence summary
SUMMARY OF FINDINGS:On 6/8/26, the healthcare entity investigated a reportable event. The facility acted appropriately to protect their clients by taking immediate protective actions, investigating the event, and implementing a plan to help prevent a future recurrence. The healthcare entity reported physical abuse of a client. Staff witnessed client(B) make physical contact with client (A). During the course of the investigation, the healthcare entity separated the clients prior to notifying law enforcement, assessed the client, conducted interviews, and initiated increased safety monitoring. Client (A) sustained two scratches on their forearm. Client (B) was not able to recall the event due to cognitive impairment. Staff witnesses indicated client (B) became aggressive with client (A) in an attempt to protect staff, as client (B) thought client (A) was being verbally aggressive with staff. The facility implemented a room change, provided client (B) with a less stimulatory dining environment, and educated staff regarding environmental triggers and redirection. The event was substantiated. Client (B) was identified in another physical abuse occurrence, please see case ID 26020256007 for additional information. This public occurrence summary was provided in accordance with 25-1-124, C.R.S., and was based on the report and investigation provided by the licensed healthcare entity. Department investigation of this occurrence was conducted off-site. The healthcare entity occurrence report was submitted within the required timeframe.
Publication
Sent to facility 7/30/2026 · released to the public 8/6/2026.
5/14/2026Physical Abuse · ID 26020256007Reported on time: Yes
Occurrence summary
SUMMARY OF FINDINGS:On 5/14/26, the healthcare entity investigated a reportable event. The facility acted appropriately to protect their clients by taking immediate protective actions, investigating the event, and implementing a plan to help prevent a future recurrence. The healthcare entity reported physical abuse of a client. Reportedly, client (B) hit client (A) in the back of the head with a closed fist after a verbal altercation. During the course of the investigation, the healthcare entity separated the clients prior to notifying law enforcement, assessed the clients, conducted interviews, and started increased safety monitoring. Client (A) did not sustain any visible injuries. Client (B) did not recall the event due to cognitive impairment. The facility initiated a plan for increased supervision during meals and in common areas, initiated behavior monitoring, adjusted staffing assignments to support ongoing supervision needs, and educated staff regarding increased monitoring requirements. The event was substantiated. This is the second physical abuse occurrence involving these two clients, please see case ID 25020256015f for additional information. Client (A) was identified in two additional physical abuse occurrences, please see case IDs 26020256003 and 25020256024 for additional information. This public occurrence summary was provided in accordance with 25-1-124, C.R.S., and was based on the report and investigation provided by the licensed healthcare entity. Department investigation of this occurrence was conducted off-site. The healthcare entity occurrence report was submitted within the required timeframe.
Publication
Sent to facility 7/17/2026 · released to the public 7/24/2026.
4/10/2026Death · ID 26020256006Reported on time: Yes
Occurrence summary
SUMMARY OF FINDINGS:On 4/10/26, the healthcare entity investigated a reportable event. The facility acted appropriately to protect their clients by taking immediate protective actions, investigating the event, and implementing a plan to help prevent a future recurrence. The healthcare entity reported the death of a client. The client choked during a meal, received life saving measures, and ultimately died. During the course of the investigation, the healthcare entity conducted interviews and reviewed records. Interviews indicated the client choked, staff responded immediately and performed multiple life saving measures and called emergency services. Record review showed the client had no dietary restrictions and an inspection of the food indicated proper consistency and size. The facility determined the event was a sudden and unforeseen choking incident despite appropriate care planning, diet management, and staff response. The facility completed an audit of all diet orders, reviewed all food preparation procedures, and educated staff. The event was substantiated. This public occurrence summary was provided in accordance with 25-1-124, C.R.S., and was based on the report and investigation provided by the licensed healthcare entity. Department investigation of this occurrence was conducted off-site. The healthcare entity occurrence report was submitted within the required timeframe.
Publication
Sent to facility 4/28/2026 · released to the public 5/5/2026.
4/5/2026Physical Abuse · ID 26020256005Reported on time: Yes
Occurrence summary
SUMMARY OF FINDINGS:On 4/5/26, the healthcare entity investigated a reportable event. The facility acted appropriately to protect their clients by taking immediate protective actions, investigating the event, and implementing a plan to help prevent a future recurrence. The healthcare entity reported physical abuse of a client. Staff witnessed client (B) hit client (A), their roommate, in the chest with an open hand after a verbal altercation. During the course of the investigation, the healthcare entity separated the clients prior to notifying law enforcement, assessed the client, conducted interviews, and reviewed records. Client (B) denied the allegations. Client (A) did have any visible injuries and declined to discuss the event. Staff indicated the two clients had multiple verbal altercations throughout the day requiring client (B) to be redirected multiple times. The facility implemented a room change, supervised visits, completed a medication review and adjustment, and increased monitoring. The event was substantiated. This public occurrence summary was provided in accordance with 25-1-124, C.R.S., and was based on the report and investigation provided by the licensed healthcare entity. Department investigation of this occurrence was conducted off-site. The healthcare entity occurrence report was submitted within the required timeframe.
Publication
Sent to facility 6/26/2026 · released to the public 7/3/2026.
4/3/2026Physical Abuse · ID 26020256004Reported on time: Yes
Occurrence summary
SUMMARY OF FINDINGS:On 4/3/26, the healthcare entity investigated a reportable event. The facility acted appropriately to protect their clients by taking immediate protective actions, investigating the event, and implementing a plan to help prevent a future recurrence. The healthcare entity reported physical abuse of a client. Reportedly, staff was rough when providing care. During the course of the investigation, the healthcare entity notified law enforcement, suspended staff, assessed the client, and conducted interviews. The client did not sustain any visible injuries. Staff reported they were specifically requested by the client and provided care several times during their shift with no issues. Record review showed the client had a history of similar unsubstantiated allegations. The facility relocated staff to a different work area, continued the existing two person care model, and educated the client on the importance of the two person care model. The event was not substantiated. This public occurrence summary was provided in accordance with 25-1-124, C.R.S., and was based on the report and investigation provided by the licensed healthcare entity. Department investigation of this occurrence was conducted off-site. The healthcare entity occurrence report was submitted within the required timeframe.
Publication
Sent to facility 6/29/2026 · released to the public 7/6/2026.
3/10/2026Physical Abuse · ID 26020256003Reported on time: Yes
Occurrence summary
SUMMARY OF FINDINGS:On 3/10/26, the healthcare entity investigated a reportable event. The facility acted appropriately to protect their clients by taking immediate protective actions, investigating the event, and implementing a plan to help prevent a future recurrence. The healthcare entity reported physical abuse of a client. Reportedly, staff #1 used their foot to push the client’s foot onto the lift device during a negative interaction with the client. During the course of the investigation, the healthcare entity notified law enforcement, suspended staff, conducted interviews, and assessed the client. The client did not have any visible injuries. The client reported staff #1 was mean and pushed their leg but denied being harmed and was unable to describe specific instances of the staff being mean. Staff #1 denied the allegations and reported a normal care routine. Staff witness indicated the interaction with the client caused the client to be upset. The facility determined staff #1’s actions did not meet facility expectations for appropriate caregiving practices related to technique and professionalism but did not result in physical abuse. The facility terminated staff #1’s employment, educated all staff, and implemented increased supervisory observation of staff-to-client interactions. The event was not substantiated. This public occurrence summary was provided in accordance with 25-1-124, C.R.S., and was based on the report and investigation provided by the licensed healthcare entity. Department investigation of this occurrence was conducted off-site. The healthcare entity occurrence report was submitted within the required timeframe.
Publication
Sent to facility 6/12/2026 · released to the public 6/19/2026.
1/24/2026Physical Abuse · ID 26020256002Reported on time: Yes
Occurrence summary
SUMMARY OF FINDINGS:On 1/24/26, the healthcare entity investigated a reportable event. The facility acted appropriately to protect their clients by taking immediate protective actions, investigating the event, and implementing a plan to help prevent a future recurrence. The healthcare entity reported physical abuse of a client. Staff witnessed two clients have a verbal altercation culminating in physical contact between the clients. During the course of the investigation, the healthcare entity separated the clients prior to notifying law enforcement, assessed the clients, conducted interviews, and reviewed records. Client (A) reported being hit in the face and chest area and was found to have a bruise on their finger. The facility determined both clients have significant cognitive impairment and triggers related to loud noises which seemed to cause the altercation. The facility implemented increased safety monitoring, requested a psychiatric evaluation, made environmental changes to reduce triggers, and completed referrals for alternative placement. The event was substantiated. This public occurrence summary was provided in accordance with 25-1-124, C.R.S., and was based on the report and investigation provided by the licensed healthcare entity. Department investigation of this occurrence was conducted off-site. The healthcare entity occurrence report was submitted within the required timeframe.
Publication
Sent to facility 5/14/2026 · released to the public 5/21/2026.
10/4/2025Physical Abuse · ID 25020256024Reported on time: Yes
Occurrence summary
SUMMARY OF FINDINGS:On 10/4/25, the healthcare entity investigated a reportable event. The facility acted appropriately to protect their clients by taking immediate protective actions, investigating the event, and implementing a plan to help prevent a future recurrence. The healthcare entity reported physical abuse of a client. Staff witnessed a physical altercation between two clients resulting in one client being scratched on the arm and neck. During the course of the investigation, the healthcare entity separated the clients prior to notifying law enforcement, conducted interviews, and started increased safety monitoring. The facility determined staff heard a verbal altercation between the clients and ultimately did not act fast enough to intervene and suspended the staff member. The facility educated staff and updated care plans to include increased safety monitoring. The event was substantiated. This public occurrence summary was provided in accordance with 25-1-124, C.R.S., and was based on the report and investigation provided by the licensed healthcare entity. Department investigation of this occurrence was conducted off-site. The healthcare entity occurrence report was submitted within the required timeframe.
Publication
Sent to facility 1/12/2026 · released to the public 1/22/2026.
9/26/2025Neglect · ID 25020256023Reported on time: No
Occurrence summary
SUMMARY OF FINDINGS:On 9/26/25, the healthcare entity investigated a reportable event. The facility acted appropriately to protect their clients by taking immediate protective actions, investigating the event, and implementing a plan to help prevent a future recurrence. The healthcare entity reported neglect of a client. The client alleged staff left them without access to their call light and did not answer their call light for over 30 minutes. During the course of the investigation, the healthcare entity provided additional staffing to the unit, conducted interviews, reviewed records, and completed a call light audit. The client, who has a history of unsubstantiated allegations and aggressive behaviors towards staff, did not sustain any injuries. Record review revealed the client had access to their call light, response times were appropriate, and the client received appropriate care as outlined in the care plan. The facility scheduled an intake appointment with behavioral therapy services and continued to provide behavioral interventions. The event was not substantiated. This public occurrence summary was provided in accordance with 25-1-124, C.R.S., and was based on the report and investigation provided by the licensed healthcare entity. Department investigation of this occurrence was conducted off-site. The healthcare entity occurrence report was not submitted within the required timeframe.
Publication
Sent to facility 1/20/2026 · released to the public 1/27/2026.
9/8/2025Brain Injury · ID 25020256022Reported on time: Yes
Occurrence summary
SUMMARY OF FINDINGS:On 9/8/25, the healthcare entity investigated a reportable event. The facility acted appropriately to protect their clients by taking immediate protective actions, investigating the event, and implementing a plan to help prevent a future recurrence. The healthcare entity reported a brain injury of a client. The client attempted to go to the bathroom without assistance, had an unwitnessed fall, experienced a change of condition, and was later diagnosed with a brain injury. During the course of the investigation, the healthcare entity assessed the client, conducted interviews, and reviewed records. The client had several fall interventions in place at the time, all of which were implemented appropriately. The facility reviewed and revised the care plan, educated staff, and encouraged the client to use their call light. The event was substantiated. This public occurrence summary was provided in accordance with 25-1-124, C.R.S., and was based on the report and investigation provided by the licensed healthcare entity. Department investigation of this occurrence was conducted off-site. The healthcare entity occurrence report was submitted within the required timeframe.
Publication
Sent to facility 3/31/2026 · released to the public 4/13/2026.
8/8/2025Physical Abuse · ID 25020256018Reported on time: Yes
Occurrence summary
SUMMARY OF FINDINGS:On 8/8/25, the healthcare entity investigated a reportable event. The facility acted appropriately to protect their clients by taking immediate protective actions, investigating the event, and implementing a plan to help prevent a future recurrence. The healthcare entity reported physical abuse of a client. Staff witnessed a physical altercation between client (A) and their roommate client (B), resulting in client (A) hitting client (B) with their cane. During the course of the investigation, the healthcare entity separated the clients prior to notifying law enforcement, started increased safety monitoring, and conducted interviews. Client (B) sustained a scratch and swelling to their upper lip. Due to cognitive impairment, neither client could provide details surrounding the event. The facility completed a room change, completed a referral for therapeutic services, and started line of sight monitoring for client (A) when in common areas. The event was substantiated. This public occurrence summary was provided in accordance with 25-1-124, C.R.S., and was based on the report and investigation provided by the licensed healthcare entity. Department investigation of this occurrence was conducted off-site. The healthcare entity occurrence report was submitted within the required timeframe.
Publication
Sent to facility 11/20/2025 · released to the public 11/28/2025.
8/3/2025Physical Abuse · ID 25020256017Reported on time: Yes
Occurrence summary
SUMMARY OF FINDINGS:On 8/3/25, the healthcare entity investigated a reportable event. The facility acted appropriately to protect their clients by taking immediate protective actions, investigating the event, and implementing a plan to help prevent a future recurrence. The healthcare entity reported physical abuse of a client. Staff witnessed a visitor become frustrated and make physical contact with the client’s head after they interrupted the visitor’s conversation. During the course of the investigation, the healthcare entity escorted the visitor out of the facility, notified law enforcement, and conducted an assessment and interviews. The client did not sustain any visible injuries. The visitor reported they were trying to push the client’s chair from the back to maintain the privacy of their conversation and accidentally made contact with the client. The facility made arrangements for the visitor to use a room in an administration building for future visits and will no longer be allowed in the residential areas of the facility. The event was not substantiated. This public occurrence summary was provided in accordance with 25-1-124, C.R.S., and was based on the report and investigation provided by the licensed healthcare entity. Department investigation of this occurrence was conducted off-site. The healthcare entity occurrence report was submitted within the required timeframe.
Publication
Sent to facility 11/20/2025 · released to the public 11/28/2025.
6/26/2025Physical Abuse · ID 25020256016Reported on time: Yes
Occurrence summary
SUMMARY OF FINDINGS:On 6/26/25, the healthcare entity investigated a reportable event. The facility acted appropriately to protect their clients by taking immediate protective actions, investigating the event, and implementing a plan to help prevent a future recurrence. The healthcare entity reported physical abuse of a client. Two clients became involved in a verbal altercation and both alleged the other person initiated physical contact, one client also became physically aggressive with staff. During the course of the investigation, the healthcare entity notified law enforcement, separated the clients, and conducted interviews. Neither client sustained visible injuries as the result of the other person. Client (A) was immediately discharged from the facility upon law enforcement notifying the facility of outstanding warrants. The event was substantiated. This public occurrence summary was provided in accordance with 25-1-124, C.R.S., and was based on the report and investigation provided by the licensed healthcare entity. Department investigation of this occurrence was conducted off-site. The healthcare entity occurrence report was submitted within the required timeframe.
Publication
Sent to facility 9/30/2025 · released to the public 10/8/2025.
6/7/2025Physical Abuse · ID 25020256015Reported on time: Yes
Occurrence summary
SUMMARY OF FINDINGS:On 6/7/25, the healthcare entity investigated a reportable event. The facility acted appropriately to protect their clients by taking immediate protective actions, investigating the event, and implementing a plan to help prevent a future recurrence. The healthcare entity reported physical abuse of a client. Staff witnessed physical contact occur between two clients. During the course of the investigation, the healthcare entity separated the clients, notified law enforcement, and conducted interviews. Neither client sustained visible injuries. The facility determined that both clients may have been overstimulated by things happening in the environment. The facility increased supervision in common areas, educated staff, added signage to both clients rooms, and rearranged client (A)’s room to decrease stimulation. The event was not substantiated. This is the second occurrence involving these two clients, please see case ID 25020256010 for additional information. This public occurrence summary was provided in accordance with 25-1-124, C.R.S., and was based on the report and investigation provided by the licensed healthcare entity. Department investigation of this occurrence was conducted off-site. The healthcare entity occurrence report was submitted within the required timeframe.
Publication
Sent to facility 9/18/2025 · released to the public 9/25/2025.
6/2/2025Physical Abuse · ID 25020256014Reported on time: Yes
Occurrence summary
SUMMARY OF FINDINGS: On 6/2/25, the healthcare entity investigated a reportable event of physical abuse of a client. Staff witnessed physical contact between two clients when client (B) wandered towards the room of client (A), resulting in a scratch on client (A)’s arm. During the course of the investigation, the healthcare entity separated the clients prior to notifying law enforcement, started increased safety monitoring, and conducted interviews. The facility placed a stop sign on client (A)’s door, implemented line of sight for client (B) when outside of their room, and educated staff. The event was substantiated. This public occurrence summary was provided in accordance with 25-1-124, C.R.S., and was based on the report and investigation provided by the licensed healthcare entity. The department review of the occurrence investigation was conducted off-site. The healthcare entity occurrence report was submitted within the required timeframe. Client (A) has been involved in occurrence events prior to this one, please see case ID 25020256003 and 25020256007 for more information. In addition, this event has been identified for further investigation by the Department. An onsite investigation was conducted by a representative from the State agency. For results of that on-site investigation, please reference https://cdphe.colorado.gov/find-and-compare-facilities, specifically the inspection dated 9/11/25, Event ID VP6Z11.
Publication
Sent to facility 9/29/2025 · released to the public 10/6/2025.
3/22/2025Physical Abuse · ID 25020256010Reported on time: Yes
Occurrence summary
SUMMARY OF FINDINGS: On 3/22/25, the healthcare entity investigated a reportable event. The facility acted appropriately to protect their clients by taking immediate protective actions, investigating the event, and implementing a plan to prevent a future recurrence. The healthcare entity reported physical abuse of client (A) by client (B). During the course of the investigation, the healthcare entity separated the clients, and took client (B) to his/her room to keep them away from other clients, conducted interviews, and notified police and psychiatrist. Both clients were assessed with no injuries or psycho-social distress. Client (A) stated client (B) hit him/her in the head with their hand. Client (B) could not recall the incident. The event was not substantiated. This public occurrence summary was provided in accordance with 25-1-124, C.R.S., and was based on the report and investigation provided by the licensed healthcare entity. Department investigation of this occurrence was conducted off-site. The healthcare entity occurrence report was submitted within the required timeframe.
Publication
Sent to facility 7/1/2025 · released to the public 7/8/2025.
2/16/2025Physical Abuse · ID 25020256007Reported on time: Yes
Occurrence summary
SUMMARY OF FINDINGS:On 2/16/25, the healthcare entity investigated a reportable event of physical abuse of client (A) by client (B). This occurrence has been identified for further investigation by the Department. An onsite investigation was conducted by a representative from the State agency. For results of that on-site investigation, please reference https://cdphe.colorado.gov/find-and-compare-facilities, specifically the inspection dated 3/4/25, Event ID X04K11. Client (B) had a history of being involved in several physical abuse occurrences as the alleged assailant. This public occurrence summary was provided in accordance with 25-1-124, C.R.S., and was based on the report and investigation provided by the licensed healthcare entity. The department investigation of this occurrence was also conducted offsite. The healthcare entity occurrence report was submitted within the required timeframe.
Publication
Sent to facility 5/29/2025 · released to the public 6/5/2025.
2/9/2025Physical Abuse · ID 25020256006Reported on time: Yes
Occurrence summary
SUMMARY OF FINDINGS: On 2/11/25, the healthcare entity investigated a reportable event. The facility acted appropriately to protect their clients by taking immediate protective actions, investigating the event, and implementing a plan to prevent a future recurrence. The healthcare entity reported physical abuse of client (A) by client (B) who were roommates. During the course of the investigation, the healthcare entity conducted interviews, moved client (B) to another room, and assessed client (A) with no injuries. Client (B) admitted to hitting client (A) on the top of the head playfully without intention to hurt him/her. Client (A) reported fear if s/he continued to be roommates with client (B). Client (B) was educated to not hit others, and the event was substantiated. This public occurrence summary was provided in accordance with 25-1-124, C.R.S., and was based on the report and investigation provided by the licensed healthcare entity. Department investigation of this occurrence was conducted off-site. The healthcare entity occurrence report was submitted within the required timeframe.
Publication
Sent to facility 5/22/2025 · released to the public 5/29/2025.
2/8/2025Physical Abuse · ID 25020256005Reported on time: Yes
Occurrence summary
SUMMARY OF FINDINGS:On 2/8/25, the healthcare entity investigated a reportable event of physical abuse. This occurrence has been identified for further investigation by the Department. An onsite investigation was conducted by a representative from the State agency. For results of that on-site investigation, please reference https://cdphe.colorado.gov/find-and-compare-facilities, specifically the inspection dated 3/4/25, Event ID X04K11. This public occurrence summary was provided in accordance with 25-1-124, C.R.S., and was based on the report and investigation provided by the licensed healthcare entity. The department investigation of this occurrence was also conducted offsite. The healthcare entity occurrence report was submitted within the required timeframe.
Publication
Sent to facility 6/26/2025 · released to the public 7/3/2025.
2/1/2025Verbal Abuse · ID 25020256004Reported on time: Yes
Occurrence summary
SUMMARY OF FINDINGS: On 2/1/25, the healthcare entity investigated a reportable event. The facility acted appropriately to protect their clients by taking immediate protective actions, investigating the event, and implementing a plan to prevent a future recurrence. The healthcare entity reported verbal abuse of four clients by client (A). During the course of the investigation, the healthcare entity called the police who placed client (A) on a mental health hold, and transported him/her to a local hospital. Client (B) was witnessed by staff and the clients screaming obscenities and threatening to harm them. Clients (B), (C), (D) and (E) reported being fearful of client (A) if s/he was allowed to return to the facility. The staff sent client (A) involuntary discharge paperwork and s/he did not return to the facility. The event was substantiated. This public occurrence summary was provided in accordance with 25-1-124, C.R.S., and was based on the report and investigation provided by the licensed healthcare entity. Department investigation of this occurrence was conducted off-site. The healthcare entity occurrence report was submitted within the required timeframe.
Publication
Sent to facility 5/9/2025 · released to the public 5/16/2025.
1/14/2025Physical Abuse · ID 25020256003Reported on time: No
Occurrence summary
SUMMARY OF FINDINGS:On 1/14/25, the healthcare entity investigated a reportable event of physical abuse of client (A) by client (B). During the course of the investigation, the healthcare entity separated the clients and completed frequent checks on both clients. Client (B) received line of sight monitoring and increased focused activities. Client (A) was assessed and found to be uninjured. The event was substantiated. This public occurrence summary was provided in accordance with 25-1-124, C.R.S., and was based on the report and investigation provided by the licensed healthcare entity. The department review of the occurrence investigation was conducted off-site. The healthcare entity occurrence report was not submitted within the required timeframe. In addition, this event has been identified for further investigation by the Department. An onsite investigation was conducted by a representative from the State agency. For results of that on-site investigation, please reference https://cdphe.colorado.gov/find-and-compare-facilities, specifically the inspection dated 1/29/25, Event ID F4U311.
Publication
Sent to facility 5/28/2025 · released to the public 6/4/2025.
11/9/2024Physical Abuse · ID 24020256035Reported on time: Yes
Occurrence summary
SUMMARY OF FINDINGS:On 11/9/24, the healthcare entity investigated a reportable event. The facility acted appropriately to protect their clients by taking immediate protective actions, investigating the event, and implementing a plan to help prevent a future recurrence. The healthcare entity reported physical abuse of a client. Staff witnessed client (A) push client (B) to the floor. During the course of the investigation, the healthcare entity separated the clients, notified law enforcement, conducted an assessment and interviews. Due to cognitive impairment, client (B) did not recall the event. Client (A) reported that they thought the other client stole someone’s money and intervened by pushing them. The facility provided education to client (A). Although there were no visible injuries to client (B), intentional physical contact occurred between the clients. The event was substantiated. Client (A) has been involved in another event prior to this one, please see case ID 24020256012 for more information. This public occurrence summary was provided in accordance with 25-1-124, C.R.S., and was based on the report and investigation provided by the licensed healthcare entity. Department investigation of this occurrence was conducted off-site. The healthcare entity occurrence report was submitted within the required timeframe.
Publication
Sent to facility 7/16/2025 · released to the public 7/23/2025.
11/6/2024Physical Abuse · ID 24020256033Reported on time: Yes
Occurrence summary
SUMMARY OF FINDINGS: On 11/6/24, the healthcare entity investigated a reportable event. The facility acted appropriately to protect their clients by taking immediate protective actions, investigating the event, and implementing a plan to help prevent a future recurrence. The healthcare entity reported physical abuse of a client. Staff witnessed client (A) hit client (B) on the head. During the course of the investigation, the healthcare entity notified law enforcement, separated the clients, completed an assessment, and conducted interviews. Client (A) would not participate in an interview and was sent to the hospital for evaluation, as this event had been preceded by increased verbal aggression. Client (B) confirmed that physical contact occurred but denied injury or pain. Client (A) did not return to the facility. The event was not substantiated. This public occurrence summary was provided in accordance with 25-1-124, C.R.S., and was based on the report and investigation provided by the licensed healthcare entity. Department investigation of this occurrence was conducted off-site. The healthcare entity occurrence report was submitted within the required timeframe.
Publication
Sent to facility 6/26/2025 · released to the public 7/4/2025.
10/31/2024Physical Abuse · ID 24020256032Reported on time: Yes
Occurrence summary
SUMMARY OF FINDINGS: On 10/31/24, the healthcare entity investigated a reportable event. The facility acted appropriately to protect their clients by taking immediate protective actions, investigating the event, and implementing a plan to prevent a future recurrence. The healthcare entity reported physical abuse of a client. During the course of the investigation, the healthcare entity completed an assessment, conducted interviews, and increased safety monitoring. Client (B) reported that client (A) hit them on the head, causing a laceration to the scalp. Client (B) was sent to the hospital for treatment and returned to the facility. Client (A) did not recall the event and was sent to the local hospital for psychological and medication evaluations, resulting in a medication adjustment. The event was substantiated. This public occurrence summary was provided in accordance with 25-1-124, C.R.S., and was based on the report and investigation provided by the licensed healthcare entity. Department investigation of this occurrence was conducted off-site. The healthcare entity occurrence report was submitted within the required timeframe.
Publication
Sent to facility 6/15/2025 · released to the public 6/22/2025.
10/11/2024Physical Abuse · ID 24020256030Reported on time: Yes
Occurrence summary
SUMMARY OF FINDINGS: On 10/11/24, the healthcare entity investigated a reportable event. The facility acted appropriately to protect their clients by taking immediate protective actions, investigating the event, and implementing a plan to prevent a future recurrence. The healthcare entity reported physical abuse of a client. During the course of the investigation, the healthcare entity notified the police, family, physician, the ombudsman, and Adult Protective Services (APS). The clients were immediately separated. Assessments were completed and neurological checks were initiated on client 1 (victim). Client 1 also had redness to the face. Client 2 (assailant) was kept in the staff’s line of sight, then was transferred to the local hospital for a psych evaluation and medication review. Staff and clients were interviewed, and documentation was reviewed. Client 2 was discharged to the hospital to ensure the safety of self and others. The event was substantiated. This public occurrence summary was provided in accordance with 25-1-124, C.R.S., and was based on the report and investigation provided by the licensed healthcare entity. Department investigation of this occurrence was conducted off-site. The healthcare entity’s occurrence report was submitted within the required timeframe.
Publication
Sent to facility 6/18/2025 · released to the public 6/25/2025.
9/23/2024Brain Injury · ID 24020256028Reported on time: Yes
Occurrence summary
SUMMARY OF FINDINGS:On 9/23/24, the healthcare entity investigated a reportable event. The facility acted appropriately to protect their clients by taking immediate protective actions, investigating the event, and implementing a plan to prevent a future recurrence. The healthcare entity reported a brain injury of a client. The client fell and was immediately assisted and assessed. One day after the fall, the client exhibited a change in condition and was sent to the hospital. During the course of the investigation, the healthcare entity completed assessments and conducted neurological evaluations. The client was admitted and due to advancing medical conditions placed on hospice. Subsequently the client passed away. The event was substantiated. This public occurrence summary was provided in accordance with 25-1-124, C.R.S., and was based on the report and investigation provided by the licensed healthcare entity. Department investigation of this occurrence was conducted off-site. The healthcare entity occurrence report was submitted within the required timeframe.
Publication
Sent to facility 5/29/2025 · released to the public 6/5/2025.
8/12/2024Physical Abuse · ID 24020256023Reported on time: Yes
Occurrence summary
SUMMARY OF FINDINGS: On 8/12/24, the healthcare entity investigated a reportable event. The facility acted appropriately to protect their clients by taking immediate protective actions, investigating the event, and implementing a plan to prevent a future recurrence. The healthcare entity reported a physical abuse event. Reportedly, male client (A) slapped female client (B) on the face. During the course of the investigation, the healthcare entity separated the clients, conducted an assessment and interviews, and started frequent safety checks in the smoking area. Client (B) was unable to state what provoked client (A)’s physical contact. No visible injury was observed with client (B), and one staff witness reported it was a soft slap. As there was no visible injury, the facility concluded the abuse event was not substantiated. This public occurrence summary was provided in accordance with 25-1-124, C.R.S., and was based on the report and investigation provided by the licensed healthcare entity. Department investigation of this occurrence was conducted off-site. The healthcare entity occurrence report was submitted within the required timeframe.
Publication
Sent to facility 4/23/2025 · released to the public 4/30/2025.
8/5/2024Physical Abuse · ID 24020256020Reported on time: Yes
Occurrence summary
SUMMARY OF FINDINGS: On 8/5/24, the healthcare entity investigated a reportable event. The facility acted appropriately to protect their clients by taking immediate protective actions, investigating the event, and implementing a plan to prevent a future recurrence. The healthcare entity reported a physical abuse event. Reportedly, male client (A) slapped female client (B) on the face. During the course of the investigation, the healthcare entity separated the clients, conducted an assessment and interviews, and started safety checks. Client (A) said he lightly tapped client (B) on the cheek after she allegedly flipped him off. Client (B) reported he slapped her and walked away. No visible injury was observed. The report showed neither the witness nor client (B) corroborated client (A)’s version of the event. Education was provided to client (A) not to touch others. Client (B) was moved to a new unit, and staff was asked to monitor her behaviors. The facility concluded the event happened but due to conflicting reports regarding the force of touch and without a visible injury, the abuse event was not substantiated. This public occurrence summary was provided in accordance with 25-1-124, C.R.S., and was based on the report and investigation provided by the licensed healthcare entity. Department investigation of this occurrence was conducted off-site. The healthcare entity occurrence report was submitted within the required timeframe.
Publication
Sent to facility 4/23/2025 · released to the public 4/30/2025.
8/5/2024Verbal Abuse · ID 24020256021Reported on time: Yes
Occurrence summary
SUMMARY OF FINDINGS: On 8/6/24, the healthcare entity investigated a reportable event. The facility acted appropriately to protect their clients by taking immediate protective actions, investigating the event, and implementing a plan to prevent a future recurrence. The healthcare entity reported a verbal abuse event. Reportedly, staff heard client (A) verbally threaten client (B) if she would not give him money. Client (B) gave him money. During the course of the investigation, the healthcare entity kept the clients separated, conducted interviews and provided education to client (A) regarding his actions. Client (A) reported client (B) gave him money out of fear. Staff directed him to return the money. Through further interviews, the facility determined client (A)’s comment was not a threat of harm, as he was experiencing a mental health episode. Staff continued to monitor the clients to help redirect them when needed. The event was not substantiated. This public occurrence summary was provided in accordance with 25-1-124, C.R.S., and was based on the report and investigation provided by the licensed healthcare entity. Department investigation of this occurrence was conducted off-site. The healthcare entity occurrence report was submitted within the required timeframe.
Publication
Sent to facility 5/7/2025 · released to the public 5/14/2025.
8/4/2024Neglect · ID 24020256019Reported on time: Yes
Occurrence summary
SUMMARY OF FINDINGS: On 8/4/24, the healthcare entity investigated a reportable event. The facility acted appropriately to protect their clients by taking immediate protective actions, investigating the event, and implementing a plan to prevent a future recurrence. The healthcare entity reported neglect of a client. During the course of the investigation, the healthcare entity removed the staff member from the schedule after the client alleged he was shut inside his room without the ability to leave. Interviews were performed with other staff and clients without evidence to support the allegation. The staff member was allowed to return to work and staff received education on client rights. The event was not substantiated. This public occurrence summary was provided in accordance with 25-1-124, C.R.S., and was based on the report and investigation provided by the licensed healthcare entity. Department investigation of this occurrence was conducted off-site. The healthcare entity occurrence report was not submitted within the required timeframe.
Publication
Sent to facility 3/5/2025 · released to the public 3/12/2025.
7/20/2024Physical Abuse · ID 24020256018Reported on time: Yes
Occurrence summary
SUMMARY OF FINDINGS: On 7/16/24, the healthcare entity investigated a reportable event. The facility acted appropriately to protect their clients by taking immediate protective actions, investigating the event, and implementing a plan to prevent a future recurrence. The healthcare entity reported physical abuse of a client. During the course of the investigation, the healthcare entity determined the client admitted to laughing at his peer; his peer retaliated by kicking and punching the client. Staff separated the clients and placed them on increased monitoring after the event. A staff member witnessed and confirmed the client was laughing at his peer for laying on the ground when his peer hit the client. The event was substantiated. This public occurrence summary was provided in accordance with 25-1-124, C.R.S., and was based on the report and investigation provided by the licensed healthcare entity. Department investigation of this occurrence was conducted off-site. The healthcare entity occurrence report was submitted within the required timeframe. The client’s peer was involved in an occurrence prior to this event. Please refer to Occurrence ID: 24020256015 for more information.
Publication
Sent to facility 3/13/2025 · released to the public 3/20/2025.
7/16/2024Physical Abuse · ID 24020256017Reported on time: Yes
Occurrence summary
SUMMARY OF FINDINGS: On 7/16/24, the healthcare entity investigated a reportable event. The facility acted appropriately to protect their clients by taking immediate protective actions, investigating the event, and implementing a plan to prevent a future recurrence. The healthcare entity reported physical abuse of a client. During the course of the investigation, the healthcare entity gathered information and determined the client was exiting the dining room when his peer was trying to enter. The clients startled one another and words were exchanged before the client’s peer hit the client. The clients were separated and treated for injuries. Since the clients were roommates, the facility initiated a room move and increased monitoring after the event for their safety. Neither client was able to recall the altercation when interviewed due to cognitive deficits. Although unwanted physical contact was made, the event was not substantiated because the facility determined there was no intent to harm the client. This public occurrence summary was provided in accordance with 25-1-124, C.R.S., and was based on the report and investigation provided by the licensed healthcare entity. Department investigation of this occurrence was conducted off-site. The healthcare entity occurrence report was submitted within the required timeframe.
Publication
Sent to facility 3/13/2025 · released to the public 3/20/2025.
7/15/2024Physical Abuse · ID 24020256016Reported on time: Yes
Occurrence summary
SUMMARY OF FINDINGS: On 7/15/24, the healthcare entity investigated a reportable event. The facility acted appropriately to protect their clients by taking immediate protective actions, investigating the event, and implementing a plan to prevent a future recurrence. The healthcare entity reported physical abuse of a client. During the course of the investigation, the healthcare entity determined two clients were arguing over personal items made during an activity when a peer pushed the client causing the client to fall and injure her arm. The client was sent to the hospital for treatment and she returned on the same day with an arm sling. The event was witnessed by staff. The event was substantiated. This public occurrence summary was provided in accordance with 25-1-124, C.R.S., and was based on the report and investigation provided by the licensed healthcare entity. Department investigation of this occurrence was conducted off-site. The healthcare entity occurrence report was submitted within the required timeframe.
Publication
Sent to facility 3/13/2025 · released to the public 3/20/2025.
7/10/2024Physical Abuse · ID 24020256015Reported on time: Yes
Occurrence summary
SUMMARY OF FINDINGS: On 7/10/24, the healthcare entity investigated a reportable event. The facility acted appropriately to protect their clients by taking immediate protective actions, investigating the event, and implementing a plan to prevent a future recurrence. The healthcare entity reported physical abuse of a client. During the course of the investigation, the healthcare entity gathered information and determined two clients were in the smoking area yelling at each other. The client alleged his peer kicked him. Staff separated the clients and neither reported fear or injury. There were no other clients in the area who witnessed the event. The facility determined the incident likely occurred however, no injuries resulted. The event was substantiated. This public occurrence summary was provided in accordance with 25-1-124, C.R.S., and was based on the report and investigation provided by the licensed healthcare entity. Department investigation of this occurrence was conducted off-site. The healthcare entity occurrence report was submitted within the required timeframe.
Publication
Sent to facility 3/5/2025 · released to the public 3/12/2025.
7/9/2024Sexual Abuse · ID 24020256014Reported on time: Yes
Occurrence summary
SUMMARY OF FINDINGS: On 7/9/24, the healthcare entity investigated a reportable event. The facility acted appropriately to protect their clients by taking immediate protective actions, investigating the event, and implementing a plan to prevent a future recurrence. The healthcare entity reported sexual abuse of a client. During the course of the investigation, the healthcare entity suspended a staff member after an allegation was made that she assaulted a client. The client said she was upset after the staff member woke her up to take her medications and the client requested to take them later. The staff member said she tapped the client’s toe to wake her for her medication administration. She said no other contact was made. Interviews with additional clients failed to show any concern for the staff member and care she provided to others. The event was not substantiated and the client’s care plan was updated to reflect how to approach the client for medication administration when she’s not awake. The client was involved in an occurrence prior to this event. Please refer to Occurrence ID: 24020256013 for more information. This public occurrence summary was provided in accordance with 25-1-124, C.R.S., and was based on the report and investigation provided by the licensed healthcare entity. Department investigation of this occurrence was conducted off-site. The healthcare entity occurrence report was submitted within the required timeframe.
Publication
Sent to facility 2/20/2025 · released to the public 2/27/2025.
6/20/2024Physical Abuse · ID 24020256013Reported on time: Yes
Occurrence summary
SUMMARY OF FINDINGS: On 6/27/24, the healthcare entity investigated a reportable event. The facility acted appropriately to protect their clients by taking immediate protective actions, investigating the event, and implementing a plan to prevent a future recurrence. The healthcare entity reported physical abuse of a client. During the course of the investigation, the healthcare entity separated the clients in the event and assessed the client for injury with none identified. The facility placed a sign outside the client’s door to keep other clients from accessing her room. The event was not substantiated. This public occurrence summary was provided in accordance with 25-1-124, C.R.S., and was based on the report and investigation provided by the licensed healthcare entity. Department investigation of this occurrence was conducted off-site. The healthcare entity occurrence report was submitted within the required timeframe.
Publication
Sent to facility 2/20/2025 · released to the public 2/27/2025.
5/26/2024Physical Abuse · ID 24020256012Reported on time: Yes
Occurrence summary
SUMMARY OF FINDINGS:On 5/26/24, the healthcare entity investigated a reportable event. The facility acted appropriately to protect their clients by taking immediate protective actions, investigating the event, and implementing a plan to prevent a future recurrence. The healthcare entity reported physical abuse of a client. During the course of the investigation, the healthcare entity determined the client’s roommate assaulted the client. Staff intervened and the client was assessed for injuries. The client’s roommate was placed on a one to one support program and moved to a room closer to the nurse’s station. The event was substantiated. This is the second event for the client's roommate. Please refer to Occurrence ID: 23020256050 for more information. This public occurrence summary was provided in accordance with 25-1-124, C.R.S., and was based on the report and investigation provided by the licensed healthcare entity. Department investigation of this occurrence was conducted off-site. The healthcare entity occurrence report was submitted within the required timeframe.
Publication
Sent to facility 2/6/2025 · released to the public 2/13/2025.
5/25/2024Physical Abuse · ID 24020256011Reported on time: Yes
Occurrence summary
SUMMARY OF FINDINGS:On 5/31/24, the healthcare entity investigated a reportable event. The facility acted appropriately to protect their clients by taking immediate protective actions, investigating the event, and implementing a plan to prevent a future recurrence. The healthcare entity reported physical abuse of a client. During the course of the investigation, the healthcare entity determined the client admitted to making vulgar statements directed at his peer when his peer hit him in the head and walked away into his room. The nurse assessed the client with no injuries. The clients remain separated. The event was substantiated. This public occurrence summary was provided in accordance with 25-1-124, C.R.S., and was based on the report and investigation provided by the licensed healthcare entity. Department investigation of this occurrence was conducted off-site. The healthcare entity occurrence report was submitted within the required timeframe.
Publication
Sent to facility 2/5/2025 · released to the public 2/12/2025.
5/12/2024Neglect · ID 24020256010Reported on time: Yes
Occurrence summary
SUMMARY OF FINDINGS: On 5/12/24, the healthcare entity investigated a reportable event. The facility acted appropriately to protect their clients by taking immediate protective actions, investigating the event, and implementing a plan to prevent a future recurrence. The healthcare entity reported a neglect event. During the course of the investigation, the healthcare entity reported client (A) reported staff did not provide timely incontinence care since the start of shift. He also complained of bed bugs, which were not observed. Care was provided, and he was moved to a different room. Management suspended the staff member, conducted an assessment, and ensured all client needs were addressed. Skin integrity issues were identified on his buttocks. Staff reported he refuses care and repositioning at times. No other clients reported having concerns of staff neglect. Documentation showed care was offered that morning, but he declined. From the findings, the facility could not corroborate client (A)’s version of staff neglect. Education was provided to the client on accepting care offers and staff implemented care in pairs. The event was not substantiated. This public occurrence summary was provided in accordance with 25-1-124, C.R.S., and was based on the report and investigation provided by the licensed healthcare entity. Department investigation of this occurrence was conducted off-site. The healthcare entity occurrence report was submitted within the required timeframe.
Publication
Sent to facility 3/3/2025 · released to the public 3/10/2025.
5/8/2024Neglect · ID 24020256009Reported on time: Yes
Occurrence summary
SUMMARY OF FINDINGS: On 5/9/24, the healthcare entity investigated a reportable event. The facility acted appropriately to protect their clients by taking immediate protective actions, investigating the event, and implementing a plan to prevent a future recurrence. The healthcare entity reported an alleged neglect event involving client (A). During the course of the investigation, the healthcare entity reported client (A) alleged staff did not provide incontinence care for him for over 12 hours on 5/7. Nursing ensured his care needs were met. An assessment showed no new skin integrity issues. Staff reported they offered care, but the client declined. No other clients reported concerns of unmet needs. Client (A) acknowledged he has declined care and previously asked staff not to disturb him during the night. Staff requested a medication review and offered mental health counseling. Management revised his care plan to address refusals of care and track behaviors. Staff were educated on new interventions when offering care and to provide care in pairs. Due to interviews, the event was not substantiated. This public occurrence summary was provided in accordance with 25-1-124, C.R.S., and was based on the report and investigation provided by the licensed healthcare entity. Department investigation of this occurrence was conducted off-site. The healthcare entity occurrence report was submitted within the required timeframe.
Publication
Sent to facility 2/18/2025 · released to the public 2/25/2025.
4/15/2024Misappropriation of Property · ID 24020256008Reported on time: Yes
Occurrence summary
SUMMARY OF FINDINGS: On 4/15/24 a resident reported they were missing money when they came back from the hospital. Allegedly, the resident said they were missing $130 from atop their dresser in their room. The facility reported they conducted a thorough search of the resident’s room and could not locate the alleged missing money. The resident did not name a known alleged assailant and none was identified through the facility’s investigation. The facility was unable to substantiate the allegation of misappropriation. The resident was educated regarding safe-keeping practices and s/he was offered a lockbox; however, they declined. The resident’s care plan was updated to reflect options offered. The facility implemented frequent checks to ensure residents personal items are safe and secured to help prevent a recurrence. DEPARTMENT FINDINGS: In accordance with Colorado Revised Statute 25-1-124, the Department conducted an off-site review of this reportable event submitted by the facility. This public summary is based on investigative findings provided by the licensed entity to the Occurrence section of the Department. The provider reports the information submitted to the Department is accurate and complete. Prior to the next onsite investigation of the facility, this occurrence event will be reviewed by the State Agency. The occurrence report was submitted within the required timeframe. The facility complied with licensing standards for conducting an internal investigation of this occurrence event and submitting a report of the findings to the Department.
Publication
Sent to facility 11/27/2024 · released to the public 12/4/2024.
12/10/2023Physical Abuse · ID 23020256060Reported on time: Yes
Occurrence summary
Summary of Findings:On 12/10/23, nurse (1) heard loud sounds from resident (B)’s room. Upon responding to the area, nurse (1) observed resident (B) swing at staff (2) while cursing at them. Staff (2) jumped out of the way and then reportedly staff (2) used their hands to put resident (B)’s arms on the bed and held them down while saying, “how do you like that.” Staff (2) then released the residents’ arms, turned and exited the room. Staff (2) was suspended and management notified the police. Nurse (1) assessed resident (B) and no visible injuries were observed. Resident (B) had a severe cognitive impairment and per staff, he indicated he felt safe and had no concerns. The facility reported resident (B) had a history of behaviors and physical aggression, especially while staff provided care. Care plan interventions were in place directing care staff on how best to approach the resident. Staff (2) reported they were trying to change the resident when he was combative and tried to help them understand the situation better. The facility investigation concluded staff (2) restrained resident (B) inappropriately. Management terminated staff (2)’s employment. In-service training was provided to all staff on abuse and care staff was reminded of resident (B)’s care plan. Department Findings:In accordance with Colorado Revised Statute 25-1-124, the Department conducted an off-site review of this reportable event submitted by the agency/facility. This public summary is based on investigative findings provided by the licensed entity to the Occurrence section of the Department. The provider reports the information submitted to the Department is accurate and complete. The occurrence report was submitted within the required timeframe. The facility/agency complied with licensing standards for conducting an internal investigation of this occurrence event and submitting a report of the findings to the Department. Prior to the next onsite investigation of the agency/facility, this occurrence event will be reviewed by the State Agency.
Publication
Sent to facility 10/28/2024 · released to the public 11/4/2024.
11/26/2023Physical Abuse · ID 23020256058Reported on time: Yes
Occurrence summary
DESCRIPTION OF OCCURRENCE:On 11/26/23, a staff member was attempting to get vitals on resident (A), in their 70's, when the resident's roommate, resident (B) in their 80’s, became agitated. Resident (A) left the room with resident (B) following. When resident (A) turned around to come back into the room resident (B) blocked her and grabbed her arm causing a scratch. FACILITY / AGENCY ACTION:The facility conducted an internal investigation and notified the police, physician, family and ombudsman. Staff escorted resident (B) down the hall to de-escalate the situation and has been kept them separated. Resident (B) was placed with a one to one staff member. Resident (A) moved rooms so they are no longer roommates. Resident (A) was assessed and found to have an injury on their left inner forearm. The scratch to skin was washed with soapy water, patted dry, and left open to the air. Resident (A) remained calm and stated they had no pain. Resident (A) stated when walking out of her room, resident (B) grabbed their left arm. Resident (A) stated they were not afraid of resident (B) but just upset that it happened. Documentation review showed both residents have a history of interactions. Resident (B) was a newer resident and was being reviewed by the psychiatrist. Resident (B) was started on medication recently which seemed to be a part of the root cause. The facility concluded the allegation of physical abuse occurred. Residents are no longer roommates and staff were re-educated on letting resident (B) sleep. Also, resident (B’s) medications were changed per their psychiatrist and interdisciplinary team (IDT) discussion DEPARTMENT FINDINGS:In accordance with Colorado Revised Statute 25-1-124, the Department conducted an off-site investigation of this reportable event and investigative findings submitted by the facility. This public summary is based on information provided by the facility to the Occurrence Section of the Department and is accurate and complete at this time. The occurrence report indicated the facility acted appropriately in response to this occurrence by complying with licensing standards of reporting and investigating this occurrence. Prior to the next onsite investigation of the facility, this occurrence will be reviewed.
11/22/2023Misappropriation of Property · ID 23020256056Reported on time: Yes
Occurrence summary
DESCRIPTION OF OCCURRENCE:On 11/23/23, a resident in their 40’s, reported they woke up and were not able to find their phone which was previously plugged in and charging by the bedside since 9pm the night before. The alarm clock on the phone normally goes off at 3:00 am due to the resident's dialysis schedule, but it did not go off that morning. FACILITY / AGENCY ACTION:The facility conducted an internal investigation and notified the police, physician, family, ombudsman, and adult protective services. The resident and three staff members searched the resident’s immediate area without success. The phone was off and not trackable. It was thought the phone fell into the trash can directly under where the phone was placed. Since the resident’s trash had already been taken out that day, the facility went through the trash in the dumpster, but was unsuccessful in locating a phone. The facility moved the resident to another unit. The resident remained in bed next to the phone the entire evening. The resident and roommate were not able to remember anyone coming into the room and removing the phone. Other residents and staff were interviewed which revealed no patterns of missing property or concerns noted. Documentation review showed the resident was care planned for having a lockbox to keep belongings. The facility concluded the allegation of misappropriation of property was inconclusive as they were unable to determine what may have happened to the phone. The facility replaced the phone. The resident was reminded of using the lockbox. DEPARTMENT FINDINGS:In accordance with Colorado Revised Statute 25-1-124, the Department conducted an off-site review of this reportable event submitted by the agency/facility. This public summary is based on investigative findings provided by the licensed entity to the Occurrence section of the Department. The provider reports the information submitted to the Department is accurate and complete. The occurrence report was submitted within the required timeframe. The facility/agency complied with licensing standards for conducting an internal investigation of this occurrence event and submitting a report of the findings to the Department. Prior to the next onsite investigation of the agency/facility, this occurrence event will be reviewed by the State Agency.
11/17/2023Physical Abuse · ID 23020256055Reported on time: Yes
Occurrence summary
DESCRIPTION OF OCCURRENCE:On 11/17/23, resident (B) was walking in the dining room with roommate resident (A) and another resident when resident (B) allegedly kicked resident (A). A staff member in the vicinity witnessed the event and reminded resident (B) to not kick. Resident (B) said [derogatory word] then kicked resident (A) again. FACILITY / AGENCY ACTION:The facility conducted an internal investigation and notified the police, physician, family, adult protective services (APS) and ombudsman. The residents were separated and resident (B) was put on one to one supervision while a room move was completed. Resident (B) was moved to a different unit for monitoring and frequent checks during the investigation. Both residents were assessed following the incident; neither had any injuries. Resident (A) was unable to remember what happened and had no current complaint of pain. Resident (B) refused to speak during the interview but communicated with head nods. Neither resident was able to corroborate what occurred. The staff member who witnessed the event was interviewed. The staff member stated it was a random incident which was "quickly de-escalated and diverted." The facility concluded the allegation of physical abuse was substantiated due to the witness; however, the facility could not prove if malice was involved based on the resident cognition status. Resident (B) will have a trial period on the memory care unit for progression of dementia to see if a more controlled environment with less stimulation was better suited to meet her needs. DEPARTMENT FINDINGS:In accordance with Colorado Revised Statute 25-1-124, the Department conducted an off-site review of this reportable event submitted by the agency/facility. This public summary is based on investigative findings provided by the licensed entity to the Occurrence section of the Department. The provider reports the information submitted to the Department is accurate and complete. The occurrence report was submitted within the required timeframe. The facility/agency complied with licensing standards for conducting an internal investigation of this occurrence event and submitting a report of the findings to the Department. Prior to the next onsite investigation of the agency/facility, this occurrence event will be reviewed by the State Agency.
11/15/2023Misappropriation of Property · ID 23020256054Reported on time: Yes
Occurrence summary
Summary of Findings: On 11/15/23, a resident reported someone took money from her. Per staff, she reported a different amount was missing with each follow up interview and the place where it had been stored varied. No other residents reported having any concerns with missing money. The investigation concluded the allegation of misappropriation of property could not be substantiated. There were no findings to support the resident had money in her possession. Staff reported residents had been talking amongst themselves that if they reported money missing, the facility would reimburse them. Management determined the resident was exhibiting a manipulation tactic and provided behavioral support. Residents are encouraged to safeguard their valuables. Department Findings: In accordance with Colorado Revised Statute 25-1-124, the Department conducted an off-site review of this reportable event submitted by the agency/facility. This public summary is based on investigative findings provided by the licensed entity to the Occurrence section of the Department. The provider reports the information submitted to the Department is accurate and complete. The occurrence report was submitted within the required timeframe. The facility/agency complied with licensing standards for conducting an internal investigation of this occurrence event and submitting a report of the findings to the Department. Prior to the next onsite investigation of the agency/facility, this occurrence event will be reviewed by the State Agency.
Publication
Sent to facility 10/11/2024 · released to the public 10/11/2024.
11/10/2023Misappropriation of Property · ID 23020256053Reported on time: Yes
Occurrence summary
DESCRIPTION OF OCCURRENCE:On 11/10/23, a resident in their 60’s, reported they did not know where their money was and thought it may have been stolen or misplaced. The resident, who had a severe cognitive impairment, stated they were unsure when or where they last saw their money and was unsure how much money they had. FACILITY / AGENCY ACTION:The facility conducted an internal investigation and notified the police, physician, family, adult protective services (APS) and ombudsman. The facility offered the resident a lockbox. The team was able to determine that on 11/9/23 the resident withdrew $30 from their trust fund account. This was the first time the resident had reported money missing. Other residents and staff were interviewed and no concerns were noted. The documentation review revealed the resident will leave "tips" on the tables in the dining rooms and hand out money to other residents to make friends. The facility’s investigation regarding misappropriation was inconclusive. However, the resident was educated to not give money to other residents. They were also encouraged to take out small amounts of money at a time and to look into seeking a financial power of attorney who may be able to help with funds management due to their diagnosis. DEPARTMENT FINDINGS:In accordance with Colorado Revised Statute 25-1-124, the Department conducted an off-site review of this reportable event submitted by the agency/facility. This public summary is based on investigative findings provided by the licensed entity to the Occurrence section of the Department. The provider reports the information submitted to the Department is accurate and complete. The occurrence report was submitted within the required timeframe. The facility/agency complied with licensing standards for conducting an internal investigation of this occurrence event and submitting a report of the findings to the Department. Prior to the next onsite investigation of the agency/facility, this occurrence event will be reviewed by the State Agency.
Publication
Sent to facility 11/1/2024 · released to the public 11/8/2024.
10/16/2023Physical Abuse · ID 23020256050Reported on time: Yes
Occurrence summary
Summary of Findings: On 10/16/23, two residents engaged in a verbal altercation, which led to resident (A) hitting resident (B) with a cane to his left ribs. Staff separated the residents and notified the police. A nurse assessed resident (B) and observed an abrasion on his left rib area along with purple discoloration. Both residents had cognitive impairments and could not state what triggered the altercation. From the facility’s investigation, staff reported resident (B) accidentally got into resident (A)’s bed, which triggered the altercation. Resident (A) displayed territorial tendencies at times. Staff requested a medication review and continued conducting frequent safety checks. Department Findings: In accordance with Colorado Revised Statute 25-1-124, the Department conducted an off-site review of this reportable event submitted by the agency/facility. This public summary is based on investigative findings provided by the licensed entity to the Occurrence section of the Department. The provider reports the information submitted to the Department is accurate and complete. Prior to the next onsite investigation of the agency/facility, this occurrence event will be reviewed by the State Agency. The occurrence report was submitted within the required timeframe. The facility/agency complied with licensing standards for conducting an internal investigation of this occurrence event and submitting a report of the findings to the Department.
Publication
Sent to facility 8/6/2024 · released to the public 8/6/2024.
10/1/2023Physical Abuse · ID 23020256048Reported on time: Yes
Occurrence summary
DESCRIPTION OF OCCURRENCE: On 10/1/23, staff witnessed resident (A), in her 80s, kick and push another resident (B), who was standing next to her. Resident (B), in his 80s, lost his balance and fell to the ground. He suffered a bump on his head and two skin tears. FACILITY / AGENCY ACTION: The facility conducted an internal investigation and notified the police, Adult Protective Services., physician, families/guardians and ombudsman. Staff intervened to separate the residents. Line of sight monitoring was started with resident (A). A nurse assessed resident (B) and reported his neurological status was within normal limits. First aid treatment was provided to clean the skin tears. Both residents had a severe cognitive impairment. Resident (B) was unable to participate in a follow up interview about the event. Resident (A) stated she just stuck her foot out, and he fell down. The staff witness reported s/he heard resident (A) yelling, “get away from him, get away from him” right before she kicked the other resident (B). With resident (A), staff reported she experienced delusions and hallucinations, which caused her to act out sporadically at times. From the findings, management concluded resident (A) appeared to be reacting to her mental delusions and physically reacted towards resident (B) causing injuries. Staff requested a medication review to help with managing resident (A)'s mental state. Staff was tasked to help redirect resident (B) and others away from resident (A). In addition, therapy re-screened resident (A) to develop re-direction and distraction techniques for staff to use when working with the resident (A). DEPARTMENT FINDINGS: In accordance with Colorado Revised Statute 25-1-124, the Department conducted an off-site investigation of this reportable event and investigative findings submitted by the agency/facility. This public summary is based on information provided by the agency/facility to the Occurrence Section of the Department and is accurate and complete at this time. Prior to the next onsite investigation of the agency/facility, this occurrence will be reviewed. The occurrence report indicated the agency/facility acted appropriately in response to this occurrence by complying with licensing standards of reporting and investigating this occurrence.
Publication
Sent to facility 1/4/2024 · released to the public 1/11/2024.
9/24/2023Physical Abuse · ID 23020256047Reported on time: Yes
Occurrence summary
DESCRIPTION OF OCCURRENCE: On 9/24/23, staff observed one resident sitting in a common area with orange liquid dripping down her hair. Resident (A), in her 70s, told staff she got upset with resident (B) over a radio. Resident (B) then got upset and allegedly started hitting resident (A)’s hands. Resident (A) said they “got into it,” and she acknowledged throwing a cup of liquid on resident (B). When separating the residents, staff observed a skin tear on resident (B)’s hand. FACILITY / AGENCY ACTION: The facility conducted an internal investigation and notified the police, physician, families/guardians, Adult Protective Services, and ombudsman. Staff kept the residents separated and provided additional monitoring. A nurse assessed resident (B) and confirmed the presence of a skin tear. The nurse provided first aid treatment. Per the residents' history, staff said both residents had communication problems with expressing their needs in a socially acceptable way. Management concluded the residents started an argument over a radio due to their inability to communicate clearly. Staff requested a medical review for both residents due to their agitation. Additionally, staff continued monitoring the individuals per their plan of care. DEPARTMENT FINDINGS: In accordance with Colorado Revised Statute 25-1-124, the Department conducted an off-site investigation of this reportable event and investigative findings submitted by the agency/facility. This public summary is based on information provided by the agency/facility to the Occurrence Section of the Department and is accurate and complete at this time. Prior to the next onsite investigation of the agency/facility, this occurrence will be reviewed. The occurrence report indicated the agency/facility acted appropriately in response to this occurrence by complying with licensing standards of reporting and investigating this occurrence.
Publication
Sent to facility 1/3/2024 · released to the public 1/10/2024.
8/18/2023Missing Person · ID 23020256041Reported on time: Yes
Occurrence summary
DESCRIPTION OF OCCURRENCE: On 8/18/23, resident (A) in his 70s went on an outing with two groups of residents. Resident (A) was in the second group to return to the facility around 12:30 p.m. Around 12:40 p.m. certified nurse aide (CNA) (1) identified resident (A) could not be located. A search was conducted inside the facility and surrounding area and resident (A) could not be located. FACILITY / AGENCY ACTION: The facility conducted an internal investigation and notified the police, families/guardians, ombudsman, Adult Protective Services and physician. Resident (A) was located several blocks away as he had walked away from the group. He was given water and cooled down for dehydration and heat exhaustion. Paramedics were called to evaluate him and he was taken to the emergency room for evaluation. Resident (A) was treated, cleared and returned to the facility the same day. Resident (A) was missing for 25 minutes. The facility investigation concluded resident (A) did return to the facility with his group but instead of entering the facility, he walked away from the group without staff awareness. There were 14 staff members present with 25 residents. To help prevent a recurrence, internal performance review of policies was done. Management initiated a one-to-one staff to resident ratio for departures of secured residents and two-to-one staff for residents on unsecured units. In-service provided to staff. All residents will be reviewed the day before any outing to clear up any potential conflicts. DEPARTMENT FINDINGS: In accordance with Colorado Revised Statute 25-1-124, the Department conducted an off-site investigation of this reportable event submitted by the agency/facility. This public summary is based on information provided by the agency/facility to the Occurrence section of the Department. The provider reports the information submitted to the Department is accurate and complete. Prior to the next onsite investigation of the agency/facility, this occurrence will be reviewed by the State Agency. The occurrence report was submitted within the required timeframe. The facility/agency complied with licensing standards for conducting an internal investigation of this occurrence event and submitting a report of the findings to the Department.
Publication
Sent to facility 7/26/2024 · released to the public 7/26/2024.
8/16/2023Physical Abuse · ID 23020256040Reported on time: Yes
Occurrence summary
DESCRIPTION OF OCCURRENCE: On 8/16/23, resident (B) threw a soda can in the direction of resident (A). The soda can made contact with resident (A)’s left arm as confirmed by video footage. FACILITY / AGENCY ACTION: The facility conducted an internal investigation and notified the police, family, ombudsman. Adult Protective Services and physician. The residents were separated. Resident (A) had a cognitive impairment and did not know what occurred. No visible injury seen and he was not exhibiting signs of current pain. Resident (B) has a history of aggressive behaviors according to the facility and multiple interventions have been implemented to help redirect when needed. Resident (B) was sent to the hospital for an evaluation of her medications and aggression. The facility investigation concluded there was a pattern of behaviors from resident (B) and this time she hit resident (A) with a soda can. To help prevent a recurrence, resident (B) was discharged to an inpatient psych hospital for medication review and adjustments to keep other residents safe. If she returned, managers would reassess her safety and behavioral plan. DEPARTMENT FINDINGS: In accordance with Colorado Revised Statute 25-1-124, the Department conducted an off-site investigation of this reportable event submitted by the agency/facility. This public summary is based on information provided by the agency/facility to the Occurrence section of the Department. The provider reports the information submitted to the Department is accurate and complete. Prior to the next onsite investigation of the agency/facility, this occurrence will be reviewed by the State Agency. The occurrence report was submitted within the required timeframe. The facility/agency complied with licensing standards for conducting an internal investigation of this occurrence event and submitting a report of the findings to the Department.
Publication
Sent to facility 7/26/2024 · released to the public 7/26/2024.
8/9/2023Sexual Abuse · ID 23020256036Reported on time: Yes
Occurrence summary
DESCRIPTION OF OCCURRENCE: On 8/9/23, resident (A), who suffers with mental health concerns, alleged a male resident raped her a year ago. Resident (A) spelled out the last name of the male resident (B); however, he had a different first name then the one she gave. The name resident (A) provided did not exist as a resident in the facility. FACILITY / AGENCY ACTION: The facility conducted an internal investigation and notified the police, family, ombudsman, Adult Protective Services and physician. The facility reported resident (A) was currently going through a mental health crisis as she reported this allegation. Resident (A) gave a statement and signed it as someone else. Resident (A) was assessed without any findings. Staff reported resident (B) had been accounted for and monitored during the investigation. Documentation revealed resident (A) had reported similar allegations four other times in the past year. No one reported witnessing the allegation. The facility investigation concluded there was no evidence to indicate resident (A) was raped. To help prevent a recurrence, resident (A)'s care plan will continue to have the information about her hallucinations and delusions. Staff will continue to keep resident (A) safe when she is dealing with mental health concerns. Resident (A) will continue to be provided supportive services for her behaviors. DEPARTMENT FINDINGS: In accordance with Colorado Revised Statute 25-1-124, the Department conducted an off-site investigation of this reportable event submitted by the agency/facility. This public summary is based on information provided by the agency/facility to the Occurrence section of the Department. The provider reports the information submitted to the Department is accurate and complete. Prior to the next onsite investigation of the agency/facility, this occurrence will be reviewed by the State Agency. The occurrence report was submitted within the required timeframe. The facility/agency complied with licensing standards for conducting an internal investigation of this occurrence event and submitting a report of the findings to the Department.
Publication
Sent to facility 7/29/2024 · released to the public 7/29/2024.
8/5/2023Physical Abuse · ID 23020256035Reported on time: Yes
Occurrence summary
DESCRIPTION OF OCCURRENCE: On 8/5/23, roommate residents (A) and (B) had a disagreement regarding the air conditioner and the lights. At the end of the argument, resident (B) hit resident (A) in the head with a cane, twice. Resident (A) complained of a headache. FACILITY / AGENCY ACTION: The facility conducted an internal investigation and notified the police, families/guardians, ombudsman, Adult Protective Services and physician. Resident (A) was assessed without any visible injuries but did complain of a headache and was given medication to treat it. Resident (A) stated resident (B) asked her to turn off the air conditioner and the television and then resident (B) hit them with a cane, twice in the head. Resident (B) stated she did not know what happened. Both residents were offered a room change and declined the offer. The facility investigation concluded the allegation of physical abuse was substantiated. To help prevent a recurrence, staff frequently monitored resident (B) and removed resident (B)’s access to the cane. Preferences regarding the room's environment were reviewed and discussed with both residents. DEPARTMENT FINDINGS: In accordance with Colorado Revised Statute 25-1-124, the Department conducted an off-site investigation of this reportable event submitted by the agency/facility. This public summary is based on information provided by the agency/facility to the Occurrence section of the Department. The provider reports the information submitted to the Department is accurate and complete. Prior to the next onsite investigation of the agency/facility, this occurrence will be reviewed by the State Agency. The occurrence report was submitted within the required timeframe. The facility/agency complied with licensing standards for conducting an internal investigation of this occurrence event and submitting a report of the findings to the Department.
Publication
Sent to facility 6/28/2024 · released to the public 7/5/2024.
7/27/2023Misappropriation of Property · ID 23020256034Reported on time: Yes
Occurrence summary
DESCRIPTION OF OCCURRENCE: On 7/27/23, a resident (A) alleged her roommate, resident (B), has been stealing her snacks and sodas. FACILITY / AGENCY ACTION: The facility conducted an internal investigation and notified the police, families/guardians, ombudsman, Adult Protective Services and physician. Resident (B) stated she did not remember taking anything that was not hers. No other residents reported anything missing. Staff reported they have witnessed resident (A) giving out snacks and drinks to other residents willingly. Management was unable to substantiate resident (A)'s claim of theft. Resident (A) was reminded to secure her items in the safe that was present in her room. DEPARTMENT FINDINGS: In accordance with Colorado Revised Statute 25-1-124, the Department conducted an off-site investigation of this reportable event submitted by the agency/facility. This public summary is based on information provided by the agency/facility to the Occurrence section of the Department. The provider reports the information submitted to the Department is accurate and complete. Prior to the next onsite investigation of the agency/facility, this occurrence will be reviewed by the State Agency. The occurrence report was submitted within the required timeframe. The facility/agency complied with licensing standards for conducting an internal investigation of this occurrence event and submitting a report of the findings to the Department.
Publication
Sent to facility 5/31/2024 · released to the public 6/7/2024.
7/17/2023Misappropriation of Property · ID 23020256033Reported on time: Yes
Occurrence summary
DESCRIPTION OF OCCURRENCE: On 5/9/23 a female resident (A) in her 60s reported her remotes were missing and had already ordered a new ones. FACILITY / AGENCY ACTION: The facility conducted an internal investigation and notified the police, families/guardians, ombudsman, Adult Protective Services and physician. Resident (A)’s room was searched and she was not sure where the items went. No other resident reported missing items. Roommate of resident (A) was interviewed and was unaware of the missing items. The facility investigation concluded the resident does have a history of manipulative behaviors and stated the remotes are on way and had no other conclusion. To help prevent a recurrence was offered a lockbox and refused to use it as she already uses a safe. DEPARTMENT FINDINGS: In accordance with Colorado Revised Statute 25-1-124, the Department conducted an off-site investigation of this reportable event and investigative findings submitted by the agency/facility. This public summary is based on information provided by the agency/facility to the Occurrence Section of the Department and is accurate and complete at this time. Prior to the next onsite investigation of the agency/facility, this occurrence will be reviewed. The occurrence report indicated the agency/facility acted appropriately in response to this occurrence by complying with licensing standards of reporting and investigating this occurrence.
Publication
Sent to facility 11/27/2023 · released to the public 12/4/2023.
6/22/2023Verbal Abuse · ID 23020256029Reported on time: Yes
Occurrence summary
DESCRIPTION OF OCCURRENCE: On 06/22/23 a male resident, in his 60s, alleged someone from the kitchen came up to him with a knife and threatened him. The resident had a diagnosis of mental illness. FACILITY / AGENCY ACTION: The facility conducted an internal investigation and notified the police. The resident was assessed and had no injuries. The resident was interviewed but did not remember making the accusation and denied any current concerns. Other residents and staff were interviewed. No one knew of any such incident. There was a situation two days prior to the resident's allegation when a cook came up with a butter knife to cut a birthday cake. The allegation was not substantiated. The resident's medications were reviewed with his psychiatrist. DEPARTMENT FINDINGS: In accordance with Colorado Revised Statute 25-1-124, the Department conducted an off-site investigation of this reportable event and investigative findings submitted by the agency/facility. This public summary is based on information provided by the agency/facility to the Occurrence Section of the Department and is accurate and complete at this time. Prior to the next onsite investigation of the agency/facility, this occurrence will be reviewed. The occurrence report indicated the agency/facility acted appropriately in response to this occurrence by complying with licensing standards of reporting and investigating this occurrence.
Publication
Sent to facility 7/28/2023 · released to the public 7/28/2023.
6/9/2023Physical Abuse · ID 23020256028Reported on time: Yes
Occurrence summary
DESCRIPTION OF OCCURRENCE: On 06/09/23 male resident (A), in his 70s, pulled female resident (B)'s hair. Resident (B) was also in her 70s. Both residents had diagnoses of mental illness and resident (A) was severely cognitively impaired. FACILITY / AGENCY ACTION: The facility conducted an internal investigation and notified the police, physician, families/guardians, ombudsman and Adult Protective Services. Resident (A) reported resident (B) had pulled her hair. The residents were separated and engaged in one to one activities. Resident (B) was assessed and had no visible injury. Resident (B) said he did not remember pulling anyone's hair. There were no witnesses to the alleged incident. The residents' care plans were updated. DEPARTMENT FINDINGS: In accordance with Colorado Revised Statute 25-1-124, the Department conducted an off-site investigation of this reportable event and investigative findings submitted by the agency/facility. This public summary is based on information provided by the agency/facility to the Occurrence Section of the Department and is accurate and complete at this time. Prior to the next onsite investigation of the agency/facility, this occurrence will be reviewed. The occurrence report indicated the facility/agency acted appropriately in response to this occurrence by complying with licensing standards of reporting and investigating this occurrence.
Publication
Sent to facility 11/10/2023 · released to the public 11/17/2023.
6/2/2023Neglect · ID 23020256027Reported on time: Yes
Occurrence summary
DESCRIPTION OF OCCURRENCE: On 6/02/23, a resident, in his 70s, alleged a staff member did not provide timely incontinence assistance after a bowel movement. He required staff assistance with ADL care. He reported asking a nurse to get a CNA (Certified Nurse Aide) for ADL help. He alleged no one came for two hours. FACILITY / AGENCY ACTION: The facility conducted an internal investigation and notified the physician, family/guardian, ombudsman, and Adult Protective Services. The staff member was identified as an agency employee. Management suspended the staff member. The resident was assessed and had no skin issues. The resident was a new admission to the facility. Staff reported he was trying to acclimate to this new environment. At times, he was confused about timelines. Staff said care was provided once being notified and denied it was a two-hour wait. Other residents reported they had no complaints about excessive wait times for provision of care. The facility was unable to substantiate the resident’s allegation of a two-hour wait. Staff continued providing care per his plan. Management took the opportunity to remind staff on responding to resident needs in a timely manner. The staff member did not return to work in the facility. DEPARTMENT FINDINGS: In accordance with Colorado Revised Statute 25-1-124, the Department conducted an off-site investigation of this reportable event and investigative findings submitted by the agency/facility. This public summary is based on information provided by the agency/facility to the Occurrence Section of the Department and is accurate and complete at this time. Prior to the next onsite investigation of the agency/facility, this occurrence will be reviewed. The occurrence report indicated the agency/facility acted appropriately in response to this occurrence by complying with licensing standards of reporting and investigating this occurrence.
Publication
Sent to facility 12/8/2023 · released to the public 12/15/2023.
5/4/2023Missing Person · ID 23020256023Reported on time: Yes
Occurrence summary
DESCRIPTION OF OCCURRENCE: On 05/04/23 a male resident, in his 50s, signed out to go to a self-scheduled appointment and decided not to return. The resident was not considered to be at risk. FACILITY / AGENCY ACTION: The facility conducted an internal investigation and notified the police, physician, family/guardian, ombudsman and Adult Protective Services. The facility contacted numerous hospitals, jails, businesses and shelters but did not locate the resident. The resident was spotted in a homeless camp by several witnessed and was not interested in returning to the facility or talking with facility staff. The resident had a history of leaving facilities and a history of substance abuse. The resident was discharged. DEPARTMENT FINDINGS: In accordance with Colorado Revised Statute 25-1-124, the Department conducted an off-site investigation of this reportable event and investigative findings submitted by the agency/facility. This public summary is based on information provided by the agency/facility to the Occurrence Section of the Department and is accurate and complete at this time. Prior to the next onsite investigation of the agency/facility, this occurrence will be reviewed. The occurrence report indicated the facility/agency acted appropriately in response to this occurrence by complying with licensing standards of reporting and investigating this occurrence.
Publication
Sent to facility 8/4/2023 · released to the public 8/11/2023.
4/23/2023Physical Abuse · ID 23020256021Reported on time: Yes
Occurrence summary
DESCRIPTION OF OCCURRENCE: On 04/23/23 female resident (B) came to the nurses station and said female resident (A) had scratched her. The residents were roommates and were both in their 70s. Resident (A) was severely cognitively impaired. FACILITY / AGENCY ACTION: The facility conducted an internal investigation and notified the police, physician, families/guardians, ombudsman and Adult Protective Services. Resident (B) said she was trying to more resident (A)'s fan and resident (A) pushed her. Resident (B) said she then reached out and scratched resident (A) who in turn scratched resident (B). Both residents were assessed. Both had a superficial scratch to the top of their hand. Resident (B) refused any treatment as the injury was not bleeding. Resident (A)'s scratch was cleaned and treated. The residents were educated to let staff know if there was a situation happening so they could assist. DEPARTMENT FINDINGS: In accordance with Colorado Revised Statute 25-1-124, the Department conducted an off-site investigation of this reportable event and investigative findings submitted by the agency/facility. This public summary is based on information provided by the agency/facility to the Occurrence Section of the Department and is accurate and complete at this time. Prior to the next onsite investigation of the agency/facility, this occurrence will be reviewed. The occurrence report indicated the agency/facility acted appropriately in response to this occurrence by complying with licensing standards of reporting and investigating this occurrence.
Publication
Sent to facility 7/20/2023 · released to the public 7/20/2023.
4/14/2023Physical Abuse · ID 23020256019Reported on time: Yes
Occurrence summary
DESCRIPTION OF OCCURRENCE: On 04/14/23 male resident (A), in his 60s, pushed male residents (B) and (C). Resident (B) was in his 70s and resident (B) was in his 60s. Residents (B) and (C) were cognitively impaired. Resident (A) was cognitively intact and had a history of aggressive behavior. FACILITY / AGENCY ACTION: The facility conducted an internal investigation and notified the police, physician, families/guardians, ombudsman and Adult Protective Services. The residents were separated and put on increased supervision. Resident (B) was assessed and had a skin tear to his right elbow. The injury was cleaned and treated. Resident (C) was not injured. Resident (A) was sent for a mental health evaluation due to his increased behaviors. No changes were made to the care plans for residents (B) and (C). DEPARTMENT FINDINGS: In accordance with Colorado Revised Statute 25-1-124, the Department conducted an off-site investigation of this reportable event and investigative findings submitted by the agency/facility. This public summary is based on information provided by the agency/facility to the Occurrence Section of the Department and is accurate and complete at this time. Prior to the next onsite investigation of the agency/facility, this occurrence will be reviewed. The occurrence report indicated the agency/facility acted appropriately in response to this occurrence by complying with licensing standards of reporting and investigating this occurrence.
Publication
Sent to facility 7/20/2023 · released to the public 7/20/2023.
4/14/2023Sexual Abuse · ID 23020256018Reported on time: Yes
Occurrence summary
DESCRIPTION OF OCCURRENCE: On 04/14/23 male resident (B), in his 70s, reported he had been inappropriately touched by male resident (A). Resident (A) was in his 30s. Resident (B) was cognitively impaired. FACILITY / AGENCY ACTION: The facility conducted an internal investigation and notified the police, physician, families/guardians, ombudsman and Adult Protective Services. The residents were kept separated and were put on frequent checks. Resident (B) said resident (A) had touched him in his genital area. When staff attempted to re-interview him, he no longer remembered the incident. Resident (A) was interviewed and admitted the inappropriate touching. Resident (A) had a history of inappropriate sexual behavior toward other residents and staff. A behavior plan was implemented for resident (A) to provide goals to work towards small rewards for having little to no behaviors. Resident (B)'s care plan was updated to promote more group interaction/activities to reduce the risk of becoming vulnerable. DEPARTMENT FINDINGS: In accordance with Colorado Revised Statute 25-1-124, the Department conducted an off-site investigation of this reportable event and investigative findings submitted by the agency/facility. This public summary is based on information provided by the agency/facility to the Occurrence Section of the Department and is accurate and complete at this time. Prior to the next onsite investigation of the agency/facility, this occurrence will be reviewed. The occurrence report indicated the agency/facility acted appropriately in response to this occurrence by complying with licensing standards of reporting and investigating this occurrence.
Publication
Sent to facility 8/8/2023 · released to the public 8/15/2023.
3/27/2023Sexual Abuse · ID 23020256013Reported on time: Yes
Occurrence summary
DESCRIPTION OF OCCURRENCE: On 03/27/23 female resident (B) reported having had oral sex with male resident (A) about two months prior to reporting this. The residents were both in their 60s. Resident (B) had a history of mental health issues and of making false sexual allegations. FACILITY / AGENCY ACTION: The facility conducted an internal investigation and notified the police, physician, families/guardians and ombudsman. The residents were both put on frequent checks and kept separated. Resident (A) could not remember any occurrence happening. Resident (B) had make the same allegation about resident (A) in December. She stated that incident had happened two months earlier. That allegation had not been substantiated. Other residents were interviewed and no issues about any abuse were voiced. The facility did not substantiate the allegation. Resident (B)'s psychiatrist was informed about the allegation. The residents were to continue on frequent checks. DEPARTMENT FINDINGS: In accordance with Colorado Revised Statute 25-1-124, the Department conducted an off-site investigation of this reportable event and investigative findings submitted by the agency/facility. This public summary is based on information provided by the agency/facility to the Occurrence Section of the Department and is accurate and complete at this time. Prior to the next onsite investigation of the agency/facility, this occurrence will be reviewed. The occurrence report indicated the agency/facility acted appropriately in response to this occurrence by complying with licensing standards of reporting and investigating this occurrence.
Publication
Sent to facility 8/3/2023 · released to the public 8/3/2023.
2/21/2023Sexual Abuse · ID 23020256009Reported on time: Yes
Occurrence summary
DESCRIPTION OF OCCURRENCE: On 02/21/23 a female resident, in her 60s, alleged she had been raped. The resident was cognitively intact. She had a history of refusing care and making false sexual allegations. FACILITY / AGENCY ACTION: The facility conducted an internal investigation and notified the police, physician, family/guardian, ombudsman and Adult Protective Services. The resident said she had felt hands on her buttocks and something being inserted into her. She could not describe the assailant, could not say if they were a male or female and could not provide a time frame. The resident was put on continuous checks and two person care. The resident refused an assessment. The resident's roommate and unit staff were interviewed and reported no knowledge of any assault. The facility was not able to substantiate the allegation. The resident's plan of care was updated. Continuous checks and two person care were ongoing. DEPARTMENT FINDINGS: In accordance with Colorado Revised Statute 25-1-124, the Department conducted an off-site investigation of this reportable event and investigative findings submitted by the agency/facility. This public summary is based on information provided by the agency/facility to the Occurrence Section of the Department and is accurate and complete at this time. Prior to the next onsite investigation of the agency/facility, this occurrence will be reviewed. The occurrence report indicated the agency/facility acted appropriately in response to this occurrence by complying with licensing standards of reporting and investigating this occurrence.
Publication
Sent to facility 8/3/2023 · released to the public 8/3/2023.
2/16/2023Physical Abuse · ID 23020256008Reported on time: Yes
Occurrence summary
DESCRIPTION OF OCCURRENCE: On 02/16/23 male resident (A), in his 30s, made a sexual advance toward male resident (B). Resident (B) was in his 70s. Resident (B) then pushed resident (A)'s hand away and brushed resident (A)'s head with his forearm. FACILITY / AGENCY ACTION: The facility conducted an internal investigation and notified the police, physician, families/guardians, ombudsman and Adult Protective Services. The residents had a history of consensual sexual contact. Both residents were assessed and had no injury. Resident (A) had asked resident (B) if he wanted to have oral sex. Resident (B) declined. Resident (A) reached for resident (B)'s genitals and resident (B) pushed his hand away. Video footage showed resident (A) did not actually touch resident (B)'s genitals. Both residents denied any altercation had occurred. Staff were educated that when resident (A) was out of his room, staff will assist him to areas that are in view of the nurses station ad still allow him to socialize and participate in activities of choice. Resident (A) was re-educated that any contact must be consensual before it can occur. Frequent rounding on both residents was initiated. DEPARTMENT FINDINGS: In accordance with Colorado Revised Statute 25-1-124, the Department conducted an off-site investigation of this reportable event and investigative findings submitted by the agency/facility. This public summary is based on information provided by the agency/facility to the Occurrence Section of the Department and is accurate and complete at this time. Prior to the next onsite investigation of the agency/facility, this occurrence will be reviewed. The occurrence report indicated the agency/facility acted appropriately in response to this occurrence by complying with licensing standards of reporting and investigating this occurrence.
Publication
Sent to facility 6/7/2023 · released to the public 6/7/2023.
2/14/2023Sexual Abuse · ID 23020256006Reported on time: Yes
Occurrence summary
DESCRIPTION OF OCCURRENCE: On 02/14/23 female resident (B), alleged male resident (A) came to her room, got on top of her and made sexual advances. Resident (B) said her son and daughter in law had to pull him off of her. The residents were both in their 80s and both were severely cognitively impaired. FACILITY / AGENCY ACTION: The facility conducted an internal investigation and notified the police, physician, families/guardians and ombudsman. Resident (B) was assessed and had no physical injuries. Neither resident was able to be interviewed due to their cognitive status. The resident' son was contacted and said he had not been in the facility that night, and reportedly aware of the resident's cognitive status. The facility was not able to substantiate the allegation. A stop sign was put on resident (B)'s door. DEPARTMENT FINDINGS: In accordance with Colorado Revised Statute 25-1-124, the Department conducted an off-site investigation of this reportable event and investigative findings submitted by the agency/facility. This public summary is based on information provided by the agency/facility to the Occurrence Section of the Department and is accurate and complete at this time. Prior to the next onsite investigation of the agency/facility, this occurrence will be reviewed. The occurrence report indicated the agency/facility acted appropriately in response to this occurrence by complying with licensing standards of reporting and investigating this occurrence.
Publication
Sent to facility 8/2/2023 · released to the public 8/3/2023.
1/25/2023Physical Abuse · ID 23020256003Reported on time: Yes
Occurrence summary
DESCRIPTION OF OCCURRENCE: On 01/25/23 male resident (A), in his 50s, hit female resident (B) on her left cheek with an open hand. Resident (B) was in her 80s. Both residents were cognitively impaired. FACILITY / AGENCY ACTION: The facility conducted an internal investigation and notified the police, physician, families/guardians and ombudsman. Both residents were put on frequent checks. Resident (B) was assessed and had no visible injury. Resident (B) did not remember the incident when interviewed. Resident (A) said he hit a woman and apologized. Resident (A)'s care plan was updated to include one to one activities when he becomes agitated. DEPARTMENT FINDINGS: In accordance with Colorado Revised Statute 25-1-124, the Department conducted an off-site investigation of this reportable event and investigative findings submitted by the agency/facility. This public summary is based on information provided by the agency/facility to the Occurrence Section of the Department and is accurate and complete at this time. Prior to the next onsite investigation of the agency/facility, this occurrence will be reviewed. The occurrence report indicated the facility/agency acted appropriately in response to this occurrence by complying with licensing standards of reporting and investigating this occurrence.
Publication
Sent to facility 6/6/2023 · released to the public 6/6/2023.
1/5/2023Diverted Drugs · ID 23020256001Reported on time: Yes
Occurrence summary
DESCRIPTION OF OCCURRENCE: On 01/05/23 it was discovered that a tablet of oxycodone had been replaced with a tablet of carvedilol. The medication had been prescribed for a female resident in her 60s. FACILITY / AGENCY ACTION: The facility conducted an internal investigation and notified the police, physician, family/guardian and ombudsman. The tablet of oxycodone had been removed from a bubble pack and replaced with a tablet of carvedilol and a piece of tape placed over it. The medication was ordered prn (as needed) and the resident had not requested it. An audit of the cart was completed and no other discrepancies were found. All nurses were interviewed and all said they had no knowledge about the missing medication. All nursing staff were drug tested and all tests were negative. The facility was not able to determine who took the narcotic. Audits of all drugs in the medication cart were to be audited randomly. DEPARTMENT FINDINGS: In accordance with Colorado Revised Statute 25-1-124, the Department conducted an off-site investigation of this reportable event and investigative findings submitted by the agency/facility. This public summary is based on information provided by the agency/facility to the Occurrence Section of the Department and is accurate and complete at this time. Prior to the next onsite investigation of the agency/facility, this occurrence will be reviewed. The occurrence report indicated the agency/facility acted appropriately in response to this occurrence by complying with licensing standards of reporting and investigating this occurrence.
Publication
Sent to facility 8/1/2023 · released to the public 8/8/2023.