Inspection Results » Trinity Rehabilitation & Healthcare Center

Health Inspection on November 29, 2018 ^[1]

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

   • Have the Quality Assessment and Assurance group have the required members and meet at least quarterly (Corrected 2018-12-29)
   • Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. (Corrected 2018-12-29)
   • Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. (Corrected 2018-12-29)

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

   • Ensure that nurse aides who have worked more than 4 months, are trained and competent; and nurse aides who have worked less than 4 months are enrolled in appropriate training. (Corrected 2018-12-19)
   • Develop and implement policies and procedures to prevent abuse, neglect, and theft. (Corrected 2018-12-19)
   • Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted (Corrected 2018-12-29)
   • Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. (Corrected 2018-12-29)
   • Verify that a nurse aide has been trained; and if they haven't worked as a nurse aide for 2 years, receive retraining. (Corrected 2018-12-19)
   • Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. (Corrected 2018-12-29)
   • Ensure each resident receives an accurate assessment. (Corrected 2018-12-29)
   • Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. (Corrected 2018-12-29)
   • Ensure medication error rates are not 5 percent or greater. (Corrected 2018-12-29)

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

   • Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. (Corrected 2018-12-19)