ALBUQUERQUE, NM- SPANISH TRAILS REHABILITATION SUITES

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

Honor the resident’s right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.

Based on interview and observation, the facility failed to maintain a comfortable water temperature in
resident bathroom showers. This deficient practice is likely to negatively impact resident safety and comfort.

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

Based on observation, record review, and interview the facility failed to develop and implement a
comprehensive person-centered care plan for 1 (R #138) 5 (R #23, ,40, 88, 128, 138) residents. Failure to develop and implement a resident centered care plan may result in staff’s failure to understand and implement the needs and treatments of residents possibly resulting in decline in abilities and a failure to thrive.

Ensure services provided by the nursing facility meet professional standards of quality.

Based on record review and interview, the facility failed to ensure the medical record was accurate for 1 (R #40) of 2 (R #40 and 138) residents reviewed. This deficient practice is likely to result in staff confusion as to the services and treatment to be provided to the resident.

Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason.

Based on observation, record review, and interview, the facility failed to provide restorative physical therapy service devices as ordered by a physician for 3 (R #’s 15, 36, and 72) of 3 (R #’s 15, 36, and 72) residents. This deficient practice is likely to result in residents having pain and a decrease in mobility, causing psychosocial harm and despair.

Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.

Based on observations and interviews, the facility failed to ensure they had sufficient staff to meet the needs of all 123 residents residing in the facility when staff failed to answer call lights timely to meet the needs of the residents. These deficient practices are likely to negatively impact resident safety, comfort, and to impede processes such as timely incontinence care (assisting residents to the bathroom or changing adult briefs), regular turning schedules (moving or turning residents that need assistance and are unable to move on their own), showers, and appropriate assistance with meals.

Ensure therapeutic diets are prescribed by the attending physician and may be delegated to a registered or licensed dietitian, to the extent allowed by State law.

Based on observation, record review, and interview the facility failed to provide a therapeutic diet as ordered by a physician for 2 (R #11 and R #49) of 2 (R #11 and R #49) residents reviewed during random dining observations. If the facility fails to provide a diet as ordered, then residents are likely to experience a decline in weight loss and health.

Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.

Based on record review and interview, the facility failed to:
1. Initiate a gradual dose reduction (GDR; the stepwise tapering of a dose to determine if symptoms, conditions, or risks can be managed by a lower dose or if the medication can be discontinued altogether) for an antipsychotic (used to treat psychotic disorders) medication as recommended by the pharmacist and ordered by the physician for R # 28 reviewed for unnecessary medications.
2. Ensure medications were prescribed for appropriate indication (diagnosis) for R #86.
for 2 (R #28 and R #86) of 5 (R #11,#23, #28, #86, #100 and #112) reviewed for unnecessary medication. If consultant pharmacist recommendations and physicians orders are not implemented in a timely manner, residents are likely to be administered medications they do not need, experience potential unnecessary drug interactions, and adverse side effects.