Accura Healthcare Of Cresco

Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on clinical record review, staff interview, and policy review the facility failed to develop a Care Plan that addressed risk factors and interventions related to having a Peripherally Inserted Central Catheter (PICC) for 2 of 2 residents reviewed (Resident #4 and #5).

The facility reported a census of 29 residents.

Findings Include: 1. Resident #4's Minimum Data Set (MDS) assessment dated [DATE] documented a Brief Interview of Mental Status (BIMS) score of 0 out of 15 indicating severely impaired cognition.

The MDS included diagnoses of heart failure, anemia and hypertension (high blood pressure).

The MDS documented Resident #4 had a central line (PICC) and received IV (intravenous) medications through the PICC while in the facility. Resident #4's Care Plan lacked documentation of having a PICC line, the risk factors and things to monitor for. On 11/17/25 at 12:20 PM the Director of Nursing acknowledged the Care Plans lacked addressing the PICC line and reported it should be on the Care Plan.

The Comprehensive Care Plans Policy updated April 2025 documened the facility will develop and implement a comprehensive person-centered care plan for each resident, consistent with resident rights, that includes measurable objectives and timeframes to meet a resident's medical, nursing, and mental and psychosocial needs and ALL services that are identified in the resident's comprehensive assessment and meet professional standards of quality. 2. Resident #5's MDS assessment dated [DATE] documented a BIMS score of 14 out of 15, indicating intact cognition.

The MDS included diagnoses of osteomyelitis , pneumonia and hypertension.

The MDS documented Resident #4 had a peripheral line and received IV medications while in the facility.

Per the MDS, Resident #5 entered the facility on 10/27/25 from the hospital.

Review of the resident's After Visit Summary from the hospital dated 10/2/25 to 10/27/25 revealed [Resident #5] was being discharged with a PICC Line. Resident #5's Care Plan lacked documentation of having a PICC line, the risk factors and things to monitor for.

Facility ID:

IDENTIFICATION NUMBER:

A.

Building

COMPLETED

11/17/2025

STREET ADDRESS, CITY, STATE, ZIP CODE

Accura Healthcare of Cresco

701 Vernon Road SW Cresco, IA 52136

SUMMARY STATEMENT OF DEFICIENCIES

Review of Resident #4's Discharge Summary from transfer to hospital on 7/27/25, date of service 7/28/25, revealed the central line was removed due to it being occluded.On 12/20/25 at 12:20 PM the Director of Nursing reported the nurses were to assess the site when administering the medication.

She reported the nurses did not measure the catheter for the PICC to ensure it had not moved out of place.

She reported there was no documentation to prove the PICC site was assessed.

The Facility Policy for IV peripheral and PICC lines updated 7/31/23 directed nurses to monitor dressing, line, and resident every shift for signs of infection, malposition and/or occlusion, notify physicians as appropriate and document in the medical record. 2. Resident #5's MDS assessment dated [DATE] documented a BIMS score of 14 out of 15 indicating intact cognition.

The MDS included diagnoses of osteomyelitis , pneumonia and hypertension.

The MDS documented Resident #4 had a peripheral line and received IV medications while in the facility. Resident #5's After Visit Summary admission orders from the hospital dated 10/27/25 documented the resident had a PICC line on admission. Resident #5 EHR lacked documentation of assessing the PICC site, location and length at any point while having the PICC line in the facility. Resident #5's Assessment Assessment lacked documentation of the resident having a PICC line.

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