Bryson Senior Living

The facility failed to administer medications as ordered for 2 of 5 sampled residents. Specifically, a medication aide incorrectly administered an extra dose of ibuprofen to Resident #3 by failing to verify the tablet count in the bubble pack due to being in a hurry.

The facility failed to ensure that medications were administered according to physician orders and instructions.

The facility failed to manage medications found on residents' persons, specifically regarding the requirement for physician orders and assessments for self-administration.

The facility failed to ensure that all medications on the medication cart were appropriately labeled and remained in their original packaging.

The facility failed to ensure that staff were documenting medication administrations under their own assigned eMAR logins and that documentation matched staff schedules.

The facility failed to ensure all employees have the appropriate clinical skills training documented as completed in their personnel files.

The facility failed to prevent staff from removing medications from original packaging or preparing medications for other staff members to administer.

The facility failed to ensure that all employee files contained appropriate documentation for required Tuberculosis testing.

The facility failed to ensure that appropriate staff members maintained valid CPR certification and that the staffing schedule ensured at least one certified employee per shift.

The facility failed to ensure that a Supervisor in Charge was present at the facility at all times.

The facility failed to maintain accurate reconciliation of controlled substances within the narcotic count records.

The facility failed to ensure that one of three sampled medication aides had completed the required training, clinical skills validation, and passed the state written examination. Specifically, Staff B was administering medications, including controlled substances, without documentation of passing the State MA written examination.

The facility failed to properly furnish and review required resident contract information with residents or their authorized representatives upon admission or when changes occurred. This includes failure to ensure the contract specifies all charges, levels of care, and any health needs the facility cannot meet, as well as failure to maintain signed and dated acknowledgments in the resident's record.

The facility failed to provide an amended contract for review or signature following a monthly room rate increase for one of two sampled residents. Specifically, the resident's Power of Attorney was not notified in advance of the change and did not sign any documentation regarding the increase. Additionally, the facility could not provide proof that the required notification letters were mailed to residents.

The facility failed to ensure medications were administered according to physician orders. Specifically, for one resident, furosemide was documented as administered 'as needed' despite a new order dated 09/21/18 changing the administration to a daily scheduled dose.

The facility failed to ensure medications were administered according to physician orders. Specifically, for one resident, medications including furosemide, levothyroxine, and potassium chloride were not administered as prescribed, resulting in significant physical symptoms such as severe leg and abdominal swelling.

The facility failed to ensure therapeutic diets were served as ordered for 2 of 5 residents sampled. Specifically, Resident #3, who was prescribed a no added salt diet, was observed using a salt shaker at the dining table during both lunch and breakfast services. Staff members, including the PCA and Medication Aide, were unaware of the specific dietary restriction, and the Administrator stated that salt shakers remained on tables as a matter of resident right.