Stanford Court Skilled Nursing & Rehab Center
STANFORD COURT SKILLED NURSING & REHAB CENTER in SANTEE, CA — inspection on August 2, 2024.
Found 4 citations. Severity: Standard violations.
Health inspections identify deficiencies that facilities must correct within required timeframes. Violations range from minor documentation issues to serious safety concerns and are subject to follow-up verification.
Inspection Findings
During an observation and interview on 7/30/24, at 8:42 A.M. with Resident 177, Resident 177 was sitting on a wheelchair and showed a tube with an accordion bulb connected to a drainage bag. Resident 177 stated the drain was due to an abscess and the staff did not properly took care of it. Resident 177 stated it has been two days that the accordion bulb was not squeezed (squeezed - to apply suction to drain the fluid).
The accordion bulb was observed with small amount of brown fluid, and the accordion bulb was not squeezed.
On 7/31/24, at 12:27 P.M. Resident 177 was sitting up in the wheelchair.
The drainage tube was observed hanging on Resident 177's left side with accordion bulb which was not squeezed.
During a review of physician's orders (POS) for Resident 177, the POS with start date of 7/24/24 indicated, . IR Drain insertion site Site: Left buttocks monitor for drainage, pain and s/sx (signs and symptoms) of infection until healed .
During an interview on 8/1/24, at 10:32 A.M. with licensed nurse (LN) 14, LN 14 stated Resident 177 had a drain on the left buttock due to diverticulitis (small and inflamed pouches that forms in the wall of the large intestine), and the treatment nurse provided care of the drainage tube.
During an interview on 8/1/24, at 1:34 P.M. with the treatment nurse (TN), the TN stated she changed Resident 177's drainage tube site dressing, then squeezed the accordion bulb for fluid to drain.
The TN further stated the accordion bulb must be squeezed to create suction and drain fluid.
On 8/1/24, at 1:41 P.M. an interview was conducted with LN 11. LN 11 stated she covered for the TN when TN was off. LN 11 stated she flushed Resident 177's drainage tube and covered the site with a dressing. LN 11 stated the drain worked by gravity and the accordion bulb did not have to be squeezed. LN 11 further stated the accordion bulb was squeezed only upon emptying of the drainage bag.
555290
Form Approved OMB
STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A.
Building 555290 B.
Wing 08/02/2024
NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE
Stanford Court Skilled Nursing & Rehab Center 8778 Cuyamaca Street Santee, CA 92071
Findings
Review of Resident 15's clinical record indicated Resident 15 was readmitted on [DATE] with diagnoses which included a history of hemiplegia (one sided muscle weakness) and hemiparesis (inability to move one side of the body) following cerebral infarction affecting left dominant side (a brain attack known as a stroke that stops blood flow to the brain causing left sided weakness and movement to the body) per the facility's Admission Record.
A record review of Resident 15's minimum data set (MDS: a nursing assessment tool) dated 7/18/24 indicated a Brief Interview for Mental Status (BIMS- developed by reviewing the resident's mental status during the prior seven-day period) score of 15 points out of 15 possible points which indicated Resident 15 had no cognitive (pertaining to memory, judgement, and reasoning ability) deficits.
A record review of Resident 15's MDS dated [DATE], indicated that Resident 15's functional abilities status with personal hygiene (the ability to maintain personal hygiene, including combing hair, shaving, applying makeup, washing/drying face and hands) was dependent.
On 7/31/24 at 10:39 A.M., an observation and interview was conducted with Resident 15, in Resident 15's room. Resident 15 was seen lying in bed resting with a left-hand contracture without a hand splint. Resident 15's fingernails on both hands were long, thick, yellowish brown with brown dirt-like debris (accumulation of waste and/or dead skin) underneath her nailbeds with old chipped brownish red nail polish on the tip of the fingernails. Resident 15 stated that the staff puts on her hand splint only when they thought of doing so. Resident 15 stated she did not remember the last time they put on the hand splint or provided nail care.
On 8/1/24 at 8:53 A.M., an observation and interview was conducted with Resident 15, in Resident 15's room. Resident 15 was observed with a hand splint to her left contracted hand. Resident 15's fingernails on both hands were long, thick, yellowish brown with brown dirt-like debris underneath her nailbeds and old chipped brownish red nail polish on the tip of the fingernails. Resident 15 stated the nursing staff did not provide nail care for her.
555290
Form Approved OMB
STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A.
Building 555290 B.
Wing 08/02/2024
NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE
Stanford Court Skilled Nursing & Rehab Center 8778 Cuyamaca Street Santee, CA 92071
Findings
Review of Resident 58's Admission Record indicated Resident 58 was admitted to the facility on [DATE] with diagnoses that included Malignant Neoplasm of Endometrium (cancer of uterus).
On 7/30/24 at 9:20 A.M., an observation of Resident 58's room was conducted. Resident 58's door had signage which indicated Resident 58 was on neutropenic precautions.
On 7/30/24 at 9:25 A.M., an interview with Resident 58's roommate (Resident 59) was conducted. Resident 59's bedside table had a basket of raw fruits which consisted of apples and oranges. Resident 59 stated her daughter brought in the basket of fruits few weeks ago and left them on her bedside table. Resident 59 stated a supervisor from the facility took them out yesterday after the State saw the basket of raw fruits. Resident 59 stated she did not realize the raw fruits were not allowed in the room.
On 8/2/24 at 9:30 A.M., an interview with Certified Nursing Assistant (CNA) 23 was conducted. CNA 23 stated Resident 58 was on neutropenic precautions to protect her from outside germs brought in by staff and visitors since Resident 58 was prone to infection. CNA 23 stated staff must gown up before entering Resident 58 's room and do hand hygiene. CNA 23 stated flowers were allowed in Resident 58's room, same with fruits and vegetables if they have been washed. CNA 23 stated visitors must gown up too but often they did not.
On 8/2/24 at 9:57 A.M., an interview with licensed nurse (LN) 21 was conducted. LN 21 stated staff needed to wear mask, gown and gloves when entering Resident 58's room. LN 21 stated the facility does laboratory work to monitor Resident 58's white blood cell to ensure Resident 58 was protected from infection.
On 8/2/24 at 10:02 A.M., an interview with LN 22 was conducted. LN 22 stated Resident 58 was on neutropenic isolation due a low white blood cell count. LN 22 stated staff needed to gown up and wear mask prior to entering Resident 58's room. LN 22 stated that was done to protect Resident 58 from infection. LN 22 stated there should be no fresh or raw fruits, vegetables, or flowers in Resident 58's room. LN 22 stated Resident 58's visitors were advised to gown up and are not allowed to bring fruits, vegetables, and flowers of any kind.
555290
Form Approved OMB
STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A.
Building 555290 B.
Wing 08/02/2024
NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE
Stanford Court Skilled Nursing & Rehab Center 8778 Cuyamaca Street Santee, CA 92071
Review of Resident 59's clinical record indicated Resident 59 was readmitted on [DATE] with diagnoses which included a history of hemiplegia (one sided muscle weakness) and hemiparesis (inability to move one side of the body) following cerebral infarction affecting left non-dominant side (a brain attack known as a stroke that stops blood flow to the brain causing left sided weakness and movement to the body).
A record review of Resident 59's minimum data set (MDS: a nursing assessment tool) dated 6/3/24, indicated a Brief Interview for Mental Status (BIMS- developed by reviewing the resident's mental status during the prior seven-day period) score of 15 points out of 15 possible points which indicated Resident 47 had no cognitive (pertaining to memory, judgement, and reasoning ability) deficits.
On 7/30/24 at 9:26 A.M., an observation and interview was conducted with Resident 59. Resident 59 had a mesh bag that contained oranges and apples in a clear plastic bag beside fresh flowers on the nightstand to her right. Resident 59 stated she liked fruits and that her daughter had brought over the oranges and apples about a week ago and had been placed there for easy access for when she craved them.
On 8/1/24 at 9:34 A.M., an observation and interview was conducted with Resident 59. Resident 59 stated that the facility had removed her oranges and apples because, They have State here [the facility] and was told by the nursing staff to keep the oranges and apples in the closet. Resident 59 stated that the nursing staff had placed her oranges and apples in her closet so that it was not left out in the open.
555290
Form Approved OMB
STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A.
Building 555290 B.
Wing 08/02/2024
NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE
Stanford Court Skilled Nursing & Rehab Center 8778 Cuyamaca Street Santee, CA 92071