The Center at Val Vista, LLC

Violation cited

Violation cited

Based on observations, clinical record review, staff and family interviews and facility policy review, the facility failed to ensure reasonable care for the protection of the resident's medical assistive property from loss or theft for one resident (#219). The deficient practice could result in resident not provided with a homelike environment. Findings include: Resident #219 was admitted on December 21, 2023 with diagnoses of laceration without foreign body of other part of head, hypo-osmolality and hyponatremia, syndrome of inappropriate secretion of antidiuretic hormone, muscle weakness, difficulty in walking, essential (primary) hypertension, dysphagia, oropharyngeal phase, cognitive communication deficit, hypokalemia, long term (current) use of anticoagulants, encounter for surgical aftercare following surgery on the circulatory system, personal history of transient ischemic attack, and cerebral infarction without residual deficits. Observation and resident interview conducted on December 26, 2023 at 10:03 AM the resident stated, "My hearing aids were lost when I got here, both sides are missing, I just had them adjusted and they can take up to two weeks to get new ones. I could cry! I had them when I came in. I told the nurses and all they say is, oh dear how terrible." Observed the resident's hearing aid case with no hearing aids but a package of batteries was found in the residents hearing aid case. Observed the resident in having difficulty hearing and resulted in nearly shouting to resident in order to hear questions. Observed the resident tearfully distraught in describing her missing hearing aids. The Resident Dashboard (December 24, 2023) reports a BIMS (Brief Interview for Mental Status) score of 8 indicating the resident had moderately impaired cognition. Review of Nursing Comprehensive Admission Data Collection V8 document (December 21, 2023) and revealed that a Licensed Practical Nurse (staff #60) annotated the resident to use hearing aids on admission. Review of resident Care Plan and revealed the Focus statement (December 26, 2023), "Patient's is hard of hearing Patient has hearing aid in both ears". The Goal states, "Patient's needs will be met every shift X 90 days." The Interventions states, "Eliminate distractions or background noise. Give clear & simple directions. Staff to adjust tone and volume of voice as needed." The resident Care Plan was initiated 12/26/2023 and created by a Registed Nurse (staff #421), MDS Coordinator and revised on 12/27/2023 by (staff #421), MDS Coordinator. Review of Case Management Progress Note (December 21, 2023 at 4:24 PM) and revealed admission was conducted with the resident expressing verbal understanding and all questions were answered at this time. Note Text: Suzann arrived safely to the facility via stretcher with AZ Patient Transport. This writer welcomed & greeted patient upon her arrival to the facility and provided the room number she will be going into. This writer spoke with the r

Based on observations, resident and staff interviews, and facility documentation, the facility failed to ensure that one resident (#42) was free from the accident hazard of self-administering medications not ordered by the physician. This deficient practice could result in resident taking medications with contraindications. Findings include: Resident #42 admitted to the facility on November 18, 2023 with a hip fracture, Deep Venous Thrombosis Prophylaxis, and history of breast cancer. She had a physician's order for an injection of the anticoagulant Enoxaparin 40 mg (milligram) one time a day dated 11/19/23, and supplement which included two 500mg Ascorbic Acid Tablets ordered 11/18/2023 and two tablets of Cholecalciferol Oral Tablet 25 micrograms ordered 11/18/2023. Review of the Medication Administration Record for December 2023 showed she received all the above medications as ordered. According to the Minimum Data Set assessment conducted on 11/21/23 she scored a 10 on the Brief Interview for Mental Status, which indicates moderate cognitive impairment. In the care plan initiated on 11/18/2023, Resident #42 has a goal for not having any complications due to not receiving cancer treatment during her stay at the facility. Resident #42 is also care planned for anticoagulant use. Interventions for these goals includes administer medications per physician orders and monitor frequently. On 12/26/23 at 10:01 AM, surveyor observed a pill box with medication on Resident #42's bedside table. On another counter in her room were medications including Triphala 1000 mg capsules, Vitamin D3, Vitamin K, and 800 mg calcium supplement. On a second observation on 12/26/23 at 2:22 PM, surveyor observed Registered Nurse (RN) Staff #210 inside Resident #42's room passing medication. On 12/26/23 at 2:27 PM surveyor entered the room to interview Resident #42 privately. Her husband was present. Resident #42 stated she did not recall doing a self-administration of medications assessment. She confirmed she does take the medications and the doctor is aware and had told her he is okay with it. Husband stated the pill box still had some days with pills in it and expressed upset that his wife had not been taking them as she should have been. In an interview with RN Staff #210 on 12/26/23 at 2:32 PM when asked how residents are assessed for whether they can self-administer medications or not, she stated the nurse will determine if the patient is eligible and if so, let the provider know so that they can input an order for self-administration of medications. If approved for self-administration of medications, then the resident will keep their medications in their room in the bedside drawer. When asked specifically about the medications in Resident #42's room, Staff #210 stated she would need to check in the EHR (electronic health record) for the orders and if she could self-administer medications. In a follow up interview with staff #210 on the same day at 3:01 PM, she clarif

Based on observations, resident and staff interviews, and facility documentation, the facility failed to ensure that one resident (#42) was free from the accident hazard of self-administering medications not ordered by the physician. This deficient practice could result in resident taking medications with contraindications. Findings include: Resident #42 admitted to the facility on November 18, 2023 with a hip fracture, Deep Venous Thrombosis Prophylaxis, and history of breast cancer. She had a physician's order for an injection of the anticoagulant Enoxaparin 40 mg (milligram) one time a day dated 11/19/23, and supplement which included two 500mg Ascorbic Acid Tablets ordered 11/18/2023 and two tablets of Cholecalciferol Oral Tablet 25 micrograms ordered 11/18/2023. Review of the Medication Administration Record for December 2023 showed she received all the above medications as ordered. According to the Minimum Data Set assessment conducted on 11/21/23 she scored a 10 on the Brief Interview for Mental Status, which indicates moderate cognitive impairment. In the care plan initiated on 11/18/2023, Resident #42 has a goal for not having any complications due to not receiving cancer treatment during her stay at the facility. Resident #42 is also care planned for anticoagulant use. Interventions for these goals includes administer medications per physician orders and monitor frequently. On 12/26/23 at 10:01 AM, surveyor observed a pill box with medication on Resident #42's bedside table. On another counter in her room were medications including Triphala 1000 mg capsules, Vitamin D3, Vitamin K, and 800 mg calcium supplement. On a second observation on 12/26/23 at 2:22 PM, surveyor observed Registered Nurse (RN) Staff #210 inside Resident #42's room passing medication. On 12/26/23 at 2:27 PM surveyor entered the room to interview Resident #42 privately. Her husband was present. Resident #42 stated she did not recall doing a self-administration of medications assessment. She confirmed she does take the medications and the doctor is aware and had told her he is okay with it. Husband stated the pill box still had some days with pills in it and expressed upset that his wife had not been taking them as she should have been. In an interview with RN Staff #210 on 12/26/23 at 2:32 PM when asked how residents are assessed for whether they can self-administer medications or not, she stated the nurse will determine if the patient is eligible and if so, let the provider know so that they can input an order for self-administration of medications. If approved for self-administration of medications, then the resident will keep their medications in their room in the bedside drawer. When asked specifically about the medications in Resident #42's room, Staff #210 stated she would need to check in the EHR (electronic health record) for the orders and if she could self-administer medications. In a follow up interview with staff #210 on the same day at 3:01 PM, she clarif

Based on observation the facility failed to maintain several special locking exit doors located in the facility. Failing to ensure the correct amount of force needed to release of the exit doors could cause harm to patients and/or staff in an emergency NFPA 101 Life Safety Court, 2012, Chapter 18, Section, 18.2.2.2.4 "Doors within a required means of egress shall not be equipped with a latch or lock that requires the use of a tool or key from the egress side." Exception No. 2 "Delayed-egress locks complying with 7.2.1.6.1 shall be permitted, provided that not more than one such device is located in any egress path. Section 7.2.1.6.1 "Special Locking Arrangements" " (c) An irreversible process shall release the lock within 15 to 30 seconds upon application of a force to the release device required in 7.2.1.5.4 that shall not be required to exceed 15 lbs nor be required to be continuously applied for more than 3 seconds. The initiation of the release process shall activate an audible signal in the vicinity of the door. Once the door lock has been released by the application of force to the releasing device, relocking shall be by manual means only." Findings include: Observations made while on tour on January 3, 2024, revealed the following; 1) the third floor "C" Hall delayed egress door exit door failed to open with a force of less than 15 lbf. The panic bar was pushed and set off the irreversible process at 34 lbf 2) the third floor "B" Hall delayed egress door exit door failed to open with a force of less than 15 lbf. The panic bar was pushed and set off the irreversible process at 25 lbf 3) the third floor "A" Hall delayed egress door exit door failed to open with a force of less than 15 lbf. The panic bar was pushed and set off the irreversible process at 45 lbf 4) the second floor "C" Hall delayed egress door exit door failed to open with a force of less than 15 lbf. The panic bar was pushed and set off the irreversible process at 45 lbf 5) the second floor "B" Hall delayed egress door exit door failed to open with a force of less than 15 lbf. The panic bar was pushed and set off the irreversible process at 35 lbf 6) the second floor "A" Hall delayed egress door exit door failed to open with a force of less than 15 lbf. The panic bar was pushed and set off the irreversible process at 46 lbf During the exit conference on January 3, 2024, the above findings were again acknowledged by the management team.