Maunalani Nursing And Rehabilitation Center

Review of the facility’s policy and procedure “Hoyer Lift Safe Use Policy” dated 07/28/25, documented “A minimum of two trained staff members is required for all mechanical lift transfers.” On 08/13/25 at 03:15 PM, an interview with CNA Supervisor, CNA57 was done. CNA57 was not able to provide documentation that NA23 was trained to use the mechanical lift to meet the facility’s policy requiring a minimum of two trained staff.

The facility uses a checklist that the CNA or NA orientee signs after a trainer goes over what is included in the checklist and CNA57 confirmed NA23 did not sign it. 2) R1 is an [AGE] year-old female admitted to the facility on [DATE] for short-term rehabilitation.

Her admitting diagnoses include, but are not limited to, a history of stroke, gastrostomy (a surgical opening into the stomach for the introduction of nutrition and/or medication), and dysphagia (difficulty swallowing foods or liquids).

On 08/11/25 at 11:47 AM, observations were made at the bedside of R1. R1 was lying in bed sleeping connected to oxygen via nasal cannula (indicating respiratory issues), with a suction machine at the bedside without any suction tubing, suction canister, or yankauer (rigid, curved, suction tip connected to suction tubing).

On 08/11/25 at 11:51 AM, an interview was done with Registered Nurse (RN) 3. RN3 validated that due to R1’s dysphagia, she is to have nothing by mouth, however the suction machine is kept at the bedside “just in case it is needed.” RN3 agreed that the suction machine at the bedside was no good without the suction canister, suction tubing, and yankauer, stating, it should definitely be there.

During a concurrent review of R1’s physician orders, the following order was revealed: Suction PRN [as needed] for oral secretions.

When asked why it was important to have the suction machine set-up and ready to use at any time, RN3 answered “to prevent an accident.”

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