ABILENE, TX- CORONADO NURSING CENTER

The Department of Health & Human Services conducted an inspection of the facility. The following highlighted decencies listed below were found in a public survey.

Develop and implement a complete care plan that meets all the resident’s needs, with timetables and actions that can be measured.

Based on interviews and record reviews, the facility failed to develop and implement a comprehensive person-centered care plan based on assessed needs with measurable objectives that have the ability to be evaluated or quantified to attain or maintain the resident’s highest practicable physical, mental, and psychosocial well-being for 4 (Resident #5, Resident #30, Resident #54, and Resident #65) of 7 residents reviewed for comprehensive person-centered care plans.

1. The facility failed to develop care plans based on assessed needs with measurable objectives and
timeframes in areas such as bathing, impaired decision making related to insulin dosage, skin breakdown, adverse consequences related to antipsychotic medications, adverse consequences related to antianxiety medication, disruptive behaviors, keeping food and dirty dishes in her room, cognitive loss, compliance with medications and self-care, medication administration time preference, non-participation in activities, communication, elopement risk, PASRR positive status, code status, plan to remain in facility, risk for pressure ulcers, risk for pain, risk for falls, aggressive behaviors, self-care deficit, and tasks documented in the plan of care for Resident #5.

2. The facility failed to develop care plans based on assessed needs with measurable objectives and
timeframes in areas such as behavior management, keeping food and dirty dishes in his room, risk for dehydration and/or malnutrition, communication, facts he would like caregivers to know, managing anxiety, plans to remain in the facility, complications of viral hepatitis, impaired decision making, code status, wandering, fall prevention, resisting care, injury related to diagnosis of epilepsy, and ADL assistance for Resident #30.

3. The facility failed to develop care plans based on assessed needs with measurable objectives and
timeframes in areas such as fall prevention, regular diet, risk for pain, risk for skin breakdown, bladder and bowel incontinence, communication, disruptive behavior management, facts he would like caregivers to know, managing anxiety, cognitive loss, lack of participating in activities, tasks/data recorded in the plan of care, ADL assistance, and code status for Resident #54.

4. The facility failed to develop care plans based on assessed needs with measurable objectives and
timeframes in areas such as fall prevention, risk for adverse effects of antipsychotic medication, cognitive loss, facts he would like caregivers to know, tasks recorded in the plan of care, plan to remain in the facility, need for psychiatric services, at risk for skin breakdown, ADL assistance, boot related to fracture of left lower leg, nutritional status/diet, and code status for Resident #65.

These failures could affect the residents by placing them at risk for not receiving care and services to meet their needs.

Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

Based on interviews and record reviews, the facility failed to make sure that the comprehensive care plan is prepared by a team that included the attending physician and a nurse aide with responsibility for the resident for 16 of 16 residents (Resident #26, #6, #10, #34, # 28, #4, #54, #13, #32, #57, #30, #65, #7, #14, #29, #18) reviewed for care plans.

The facility failed to ensure the attending physicians and nurse aides with responsibility for the residents were invited and attended the resident care plan conferences.

These failures could place the residents at risk for not receiving the care and services to meet their needs.

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.

Based on interview and record review, the facility failed to use the services of a registered nurse for at least 8 consecutive hours a day, seven days a week for 6 of 6 days reviewed for RN Coverage.

The facility failed to provide evidence a Registered Nurse (RN) worked 8 consecutive hours a day, seven days a week for 6 days (08/05/23, 08/06/23,08/19/23, 09/02/23, 09/03/23 and 09/30/23) of the FY Quarter 4 2023 (July1- September 30) out of 4 Quarters.

This failure could place residents at risk for altered physical, mental, and psychological well-being due to decisions that would have required an RN to make in the management of the residents’ healthcare needs and in managing and monitoring the direct care staff.

Provide and implement an infection prevention and control program.

Based on observations, interviews, and record reviews, the facility failed to maintain infection control protocols to prevent infections for 1 of 2 resident (Resident #27) observed for catheter care needs.

The facility failed to ensure CNA A used a peri-care cleaning wipe and cleaned catheter tubing toward the resident and not away toward catheter bag to clean catheter tubing.

These failures place residents at risk for unnecessary infections while in the facility.