Mountain View – Stone County Nursing And Rehabilitation Center
Following are some of the deficiencies found during inspections of this nursing home on 1/23/09, 10/23/08, 3/19/08, 1/11/08 and 4/10/07. These reports and others (6/1/07- 6 pp, 11/2/06 - 6 pages, 8/18/06 - 11 pages, 6/16/06 - 22 pages, 10/13/05 - 5 pages and 8/19/05 – 39 pages) can be found at www.arknursinghomeinspectiondeficiencies.com.
Inspection on 1/23/09 (11 pages) 1. PRESSURE SORES: …the facility failed to ensure . . . incontinent care was provided . . . for Resident #3... On 1/21/09 at 10:40 a.m., Resident #3 was incontinent of urine. CNA 9 and CNA 3 removed the resident’s saturated incontinent brief and the fabric incontinent pad that had a dried area of urine approximately 18” in diameter. A clean incontinent brief and gown was provided for the resident who was not cleansed in any areas... The resident’s buttocks and coccyx areas were reddened. Pages 1-4.
Inspection on 10/23/08 (10 pages) 1. ACTIVITIES OF DAILY LIVING: ...The facility failed to ensure urine was cleansed from all areas of the perineum to promote good hygiene for Res. #2 who was incontinent...The CNA then placed the clean and incontinent brief on the resident without cleansing the urine from the perineal area, mons pubis and groin folds. Pages 1-2.
Inspection on 3/19/08 (14 pages) 1. PRESSURE SORES: …The facility failed to ensure pressure ulcers were identified and treatments obtained for Resident #1, pressure relief (off loading of left heel) was provided for Residents #2 and #3, padding for body prominences and turning/repositioning were provided for Resident #3 and the physician was notified and treatments obtained when new pressure ulcers were identified for Residents #2 and #6 and pressure relieving devices were provided in chairs for Resident #3, #5 and #7 with pressure ulcers or at risk for pressure ulcers. The failed practices resulted in a pattern of actual harm for Resident #1… who developed multiple pressure sores that were not promptly responded to...1. Resident #1 was admitted to the facility on 2/26/08… a. The admission nursing assessment dated 2/26/08 at 2:00 p.m. documented: “Small sores to lower extremity” ... The resident was re-admitted to the facility on 3/6/08... d. The resident was sent to [Hospital #1] Emergency Room on 3/9/08 at 9:44 a.m. after becoming non-responsive... e. On 3/9/08 at 4:50 p.m. the resident was admitted to Hospital #3 with a diagnosis of Sepsis. The hospital admission records (pictures) documented the resident had the following skin ulcers... 1) Right heel intact purple wound measures 9 cm x 5.5 cm with 1.5 cm x 2 cm open area. Open area wound bed pink and moist with dry edges surrounding dry and flaky... 2) Left heal wound open area measures 1 cm x 1 cm red base and moist with dry edges purple raised area 1.5 cm x 2 cm all skin dry and flaky. 3) Coccyx wounds measures 5 cm x 3 cm with 2 cm x 2 cm open area. Open wound base red with dry edges surrounding skin dark purple and fragile. 4) Scrotal wounds (numerous) areas red with moderate amount yellow exudates and edema. As of 3/19/08 at 1:00 p.m., the facility could not furnish documentation of the resident’s wounds described above. Pages 1-4.
Inspection on 1/11/08 (39 pages) 1. STAFF TREATMENT OF RESIDENTS:... the facility failed to ensure staff implemented the facility’s policy and procedures regarding misappropriation of resident property as evidenced by staff using the resident’s personal telephones without Resident #2’s permission ... Page 1. 2. ACTIVITIES OF DAILY LIVING: ... the facility failed to ensure that all areas of the perineum and buttocks were cleansed for Resident #4... On 1/8/07 at 2:10 p.m., Training Nursing Assistant (TNA) #1 and CNA#2 assisted Resident #4 to a standing position for incontinent care. The resident’s urine soaked pants were pulled down to his ankles. As the saturated pull-up brief was being pulled down, bowel movement (BM) smeared on the resident’s left lower leg. The CNA and the TNA left the brief down at his ankles with his pants. The CNA wiped the anal area with wet wash cloths two times. There was still BM on the wash cloth after the last wipe. The buttocks, testes, penis or groins were not cleansed. There was a urine soaked cloth bed pad folded in the wheelchair that was under the resident. The CNA turned the pad over and sat the resident down on the pad. The CNA and the TNA then removed the wet pants and pull-up brief from around the ankles and placed the resident’s feet in a clean pull-up and then pants. The TNA wet a washcloth and wiped BM from the left ankle and handed a wet cloth to the CNA who then wiped BM that was on the resident’s left lower leg. The TNA was asked if the cloths were wet with only water and the TNA and CNA both replied, “Yes, water.” The CNA and TNA assisted the resident to standing position again. A moderate amount of BM was smeared on the folded bed pad in the chair. The CNA and TNA both looked behind the resident and observed the BM on the pad and then pulled up the brief and the pants without further cleansing of the anal area. The CNA picked up the urine and BM soiled pad and put them in a bag with the soiled clothing. Pages 16-18.
Inspection on 4/10/07 (96 pages) 1. PRESSURE SORES: . . the facility failed to ensure that skin condition was monitored; the physician was consulted regarding the development or deterioration of pressure sores so that treatment orders were obtained or changed as necessary; increased caloric and protein needs were assessed upon development of pressure sore with interventions developed to promote healing; or pressure relieving devices, incontinent care, or repositioning were provided for residents with pressure sores for Residents #2, #6, #12, #13, #21 and #22... This failed practice... resulted in or could have resulted in serious injury, harm, impairment or death for Resident #13 who developed stage IV pressure sores. The failed practice resulted in actual harm for Residents #13, #12 and #2 who developed multiple pressures sores... Pages 15-16.
