Flesher's Fairview Rest Home

The facility failed to maintain the resident's rights by removing a television remote control from Resident #4's room. This action prevented the resident, who has Alzheimer's and dementia, from controlling the volume and caused significant distress. Staff had been instructed by the Administrator to remove the remote at night, which hindered the resident's ability to exercise their rights without hindrance.

The facility failed to maintain the resident's rights by removing a television remote control from Resident #4's room. This action prevented the resident from adjusting the volume and forced the resident to walk to a desk to request the item, hindering their ability to exercise their rights without hindrance.

The facility failed to ensure a medication aide recorded the administration of morning medications immediately after administration and failed to observe a resident actually taking their medications. This was evidenced by a review of Resident #2, where the medication administration record did not reflect proper real-time documentation and observation protocols.

The facility failed to ensure a medication aide recorded the administration of morning medications immediately after administration and failed to observe a resident actually taking the medication. Specifically, medications were left unattended on a resident's bedside table and documented as administered before the resident had even woken up to take them.

The facility failed to ensure physician orders were implemented for a resident requiring CPAP with 4L of oxygen at bedtime. Staff incorrectly believed that adjusting the CPAP pressure dial to 4 was equivalent to providing 4L of oxygen, and no oxygen concentrator or tank was present in the resident's room.

The facility failed to ensure physician orders were implemented for a resident requiring CPAP with 4L of oxygen at bedtime. While documentation showed the treatment was being administered, an observation revealed there was no oxygen concentrator or oxygen tank available in the resident's room to provide the ordered oxygen level.

The facility failed to ensure an administrator or administrator-in-charge was present in the facility or within 500 feet with two-way telecommunication during the third shift. Staffing records and interviews revealed that the third shift was often staffed by only one person and relied on a nearby skilled nursing facility to meet the administrator proximity requirement.

The facility failed to ensure an administrator or administrator-in-charge was in the home or within 500 feet of the home with two-way telecommunication at all times during the third shift. Review of staffing schedules showed only one staff member was scheduled to cover the third shift on 12/20/16 and 12/21/16.