Inspection Results » Sidney Care and Rehabilitation Center, LLC

Health Inspection on March 6, 2018 ^[1]

1. Pattern: Actual harm that is not immediate jeopardy

   • Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. (Corrected 2018-04-20)
   • Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. (Corrected 2018-04-20)
   • Provide safe, appropriate pain management for a resident who requires such services. (Corrected 2018-04-20)
   • Have a plan that describes the process for conducting QAPI and QAA activities. (Corrected 2018-04-20)
   • Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action. (Corrected 2018-04-20)
   • Administer the facility in a manner that enables it to use its resources effectively and efficiently. (Corrected 2018-04-20)

2. Widespread: No actual harm with potential for more than minimal harm that is not immediate jeopardy

   • Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. (Corrected 2018-04-20)
   • Provide and implement an infection prevention and control program. (Corrected 2018-04-20)
   • Designate a physician to serve as medical director responsible for implementation of resident care policies and coordination of medical care in the facility. (Corrected 2018-04-20)
   • Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. (Corrected 2018-04-20)
   • Establish a governing body that is legally responsible for establishing and implementing policies for managing and operating the facility and appoints a properly licensed administrator responsible for managing the facility. (Corrected 2018-04-20)
   • Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis. (Corrected 2018-04-20)

3. Pattern: No actual harm with potential for more than minimal harm that is not immediate jeopardy

   • Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. (Corrected 2018-04-20)
   • Ensure medication error rates are not 5 percent or greater. (Corrected 2018-04-20)
   • Ensure services provided by the nursing facility meet professional standards of quality. (Corrected 2018-04-20)
   • Provide activities to meet all resident's needs. (Corrected 2018-04-20)
   • Ensure each resident receives an accurate assessment. (Corrected 2018-04-20)
   • Provide medically-related social services to help each resident achieve the highest possible quality of life. (Corrected 2018-04-20)
   • Provide appropriate treatment and care according to orders, residentÂ’s preferences and goals. (Corrected 2018-04-20)
   • Ensure meals and snacks are served at times in accordance with residentÂ’s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of schedu (Corrected 2018-04-20)
   • Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted (Corrected 2018-04-20)
   • Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. (Corrected 2018-04-20)
   • Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice. (Corrected 2018-04-20)

4. Isolated: No actual harm with potential for more than minimal harm that is not immediate jeopardy

   • Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason. (Corrected 2018-04-20)
   • Ensure each residentÂ’s drug regimen must be free from unnecessary drugs. (Corrected 2018-04-20)
   • Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. (Corrected 2018-04-20)
   • Provide appropriate pressure ulcer care and prevent new ulcers from developing. (Corrected 2018-04-20)
   • Assess the resident when there is a significant change in condition (Corrected 2018-04-20)
   • Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. (Corrected 2018-04-20)
   • Provide enough food/fluids to maintain a resident's health. (Corrected 2018-04-20)
   • Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. (Corrected 2018-04-20)
   • Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge. (Corrected 2018-04-20)
   • Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. (Corrected 2018-04-20)

5. Widespread: No actual harm with potential for minimal harm

   • Post nurse staffing information every day. (Corrected 2018-04-20)