Accel At Longmont Health And Rehab, Llc
ACCEL AT LONGMONT HEALTH AND REHAB, LLC in LONGMONT, CO — inspection on August 29, 2024.
Found 2 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
According to the Basic Nursing third edition, Treas, L.S., [NAME], K.L., & [NAME], M.H. (2022), page 1214, Healthy people regularly shift position to maintain comfort.
However, many patients are unable to move without assistance.
They require a change of position at least every two hours to prevent skin breakdown, muscle discomfort, damage to superficial nerves and blood vessels, and contractures.
III.
Facility policy
065429
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 065429 B.
Wing 08/29/2024
NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE
Accel at Longmont Health and Rehab, LLC 1960 S Fordham St Longmont, CO 80503
F-F867 (Quality Assurance and Performance Improvement).
RESIDENT #85
Resident #85, who had a diagnosis of diabetes, kidney disease, and generalized muscle weakness, was admitted to the facility on [DATE] for rehabilitation and strengthening. Resident #85 was assessed on admission with intact skin of the lower extremities, feet, and heels, and a stage 2 pressure injury to her coccyx/sacrum.
She was evaluated at moderate risk of developing pressure injuries due to a history of previous pressure injury and stroke.
On 11/16/23, nine days after admission, a weekly skin assessment documented bilateral heel discoloration.
However, the resident's primary care physician (PCP) did not become aware of the resident's skin condition until 11/20/23. In a note that day, the PCP documented the resident had deep tissue injury (DTI) changes to both heels and right lower extremity cellulitis (skin infection), ascending on the right calf.
The resident was sent to the hospital where she was diagnosed with cellulitis and sepsis from cellulitis, as well as a trauma injury to the right big toe, a stage 3 pressure injury on her coccyx/sacrum, and unstageable pressure injuries to her right and left heel.
She was treated with intravenous (IV) antibiotics and spent a week in the hospital, including one day in the intensive care unit (ICU).
Record review revealed the facility failed to provide the resident with timely and necessary services to prevent the development of the resident's heel wounds and to promote the healing of her coccyx/sacral wound.
Specifically:
-While an 11/16/23 assessment revealed discoloration to bilateral heels and a nursing note the same day documented the physician was notified of the resident's DTI injuries, a change of condition assessment was not completed, and a PCP note on 11/20/24, four days later, indicated the physician was unaware of the heel wounds, citing new wounds on feet have not been seen before.
-While the resident's care plan for skin integrity was initiated on 11/7/23, and included interventions to assist the resident in turning and repositioning frequently and to off-load heels, there was insufficient evidence these interventions were implemented.
Further, the discovery of bilateral heel discoloration on 11/16/23 did not trigger the facility to consider new interventions to prevent further skin breakdown despite being noted as a problem on the care plan.
-While a review of the medication and treatment administration records (MAR and TAR) revealed orders for the resident's coccyx/sacral wound, there was no treatment order for the resident's heels in November 2023.
065429
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 065429 B.
Wing 08/29/2024
NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE
Accel at Longmont Health and Rehab, LLC 1960 S Fordham St Longmont, CO 80503