Ascension Oaks Nursing & Rehabilitation Center
Inspection Findings
F-Tag F726
F-F726.
In an interview on 06/25/2024 at 8:55 a.m., S7Housekeeping/Laundry Supervisor indicated after the Vander-Lift slings were washed, they were placed in the facility dryer. S7Housekeeping/Laundry Supervisor further indicated the facility's dryer did not have a delicate cycle. S7Housekeeping/Laundry Supervisor further indicated she was unaware of the manufacture's guidelines for drying Vander-Lift slings.
FORM CMS-2567 (02/99) Event ID: Facility ID: If continuation sheet Previous Versions Obsolete Page 13 of 25 195401 Department of Health & Human Services Printed: 09/22/2025 Form Approved OMB Centers for Medicare & Medicaid Services No. 0938-0391
STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A. Building 195401 B. Wing 06/26/2024
NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE
Ascension Oaks Nursing & Rehabilitation Center 711 W. Cornerview Road Gonzales, LA 70737
For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency.
(X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)
F 0835 In an interview on 06/25/2024 at 10:45 a.m., S14Regional Director of Operations indicated the facility's staff should be following the manufacturer's guidelines for laundering the [NAME]- Lift slings. Level of Harm - Immediate jeopardy to resident health or In an interview on 06/25/2024 at 10:52 a.m., S1Administrator indicated the facility's staff should be following safety the manufacturer's guidelines for Vander-Lift sling care. S1Administrator offered no explanation or comment related to the above mentioned deficient practice. Residents Affected - Some
In an interview on 06/25/2024 at 2:00 p.m., S13CNA Supervisor, indicated staff were to visually check the entire Vander-Lift sling for any rips, holes, and/or loose threads prior to the Vander-Lift slings being used to transfer residents. S13CNA Supervisor further indicated, if a Vander-Lift sling was already under a resident prior to transfer, the staff should move the resident, and do a full visual inspection of the Vander-Lift sling.
In an interview on 06/25/2024 at 2:58 p.m., S1Administrator indicated the facility's staff should transfer the facility's residents according to the manufacturer's instructions. S1Administrator further indicated he was aware the Vander-Lift's caster breaks should not be locked when a resident was raised with the lift.
In an interview on 06/25/2024 at 3:40 p.m., S13CNA Supervisor indicated the facility was unable to produce any documented evidence S8CNA was evaluated and deemed competent to transfer a resident with a Vander-Lift.
FORM CMS-2567 (02/99) Event ID: Facility ID: If continuation sheet Previous Versions Obsolete Page 14 of 25 195401 Department of Health & Human Services Printed: 09/22/2025 Form Approved OMB Centers for Medicare & Medicaid Services No. 0938-0391
STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A. Building 195401 B. Wing 06/26/2024
NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE
Ascension Oaks Nursing & Rehabilitation Center 711 W. Cornerview Road Gonzales, LA 70737
For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency.
(X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)
F 0838 Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations (including nights and weekends) and emergencies. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** 30587
Residents Affected - Many Based on record review and interview, the facility failed to have a facility-wide assessment which addressed all components.
Findings:
Review of the Facility assessment dated [DATE REDACTED] and reviewed 06/14/2024 revealed the following sections were not addressed in the facility-wide assessment:
1. Staff competencies;
2. The physical environment and equipment;
3. Any ethnic, cultural, or religious factors; and,
4. The facility's resources.
In an interview on 06/26/2024 at 12:47p.m., S14Regional Director of Operations indicated as of today (06/26/2024), the facility had not completed Section 3 of the facility-wide assessment.
In an interview on 06/26/2024 at 1:27 p.m., S14Regional Director of Operations indicated there was a part 3 which covered the remaining sections of competencies, staff needs, equipment, and contracts that the facility missed; therefore, the facility-wide assessment did not contain the following required components: staff competencies, the physical environment and equipment, any ethnic, cultural, or religious factors, and the facility's resources.
FORM CMS-2567 (02/99) Event ID: Facility ID: If continuation sheet Previous Versions Obsolete Page 15 of 25 195401 Department of Health & Human Services Printed: 09/22/2025 Form Approved OMB Centers for Medicare & Medicaid Services No. 0938-0391
STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A. Building 195401 B. Wing 06/26/2024
NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE
Ascension Oaks Nursing & Rehabilitation Center 711 W. Cornerview Road Gonzales, LA 70737
For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency.
(X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)
F 0842 Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. Level of Harm - Minimal harm or potential for actual harm 47487
Residents Affected - Some Based on record reviews and interview, the facility failed to ensure a resident had an accurate blood glucose
record for 1 (Resident #32) of 21 (Resident #1, Resident #8, Resident #13, Resident #15, Resident #16, Resident #22, Resident #27, Resident #28, Resident #32, Resident #38, Resident #46, Resident #47, Resident #49, Resident #52, Resident #55, Resident #61, Resident #69, Resident #76, Resident #86, Resident #94 and Resident #96) sampled residents reviewed for accurate record documentation.
Findings:
Review of Resident #32's June 2024 physician's orders revealed, in part, an order dated 08/19/2024 to administer Resident #32's Novolog (a medication used to treat diabetes) 100 Units (u)/Milliliter (ml) injection per sliding scale.
Review of Resident #32's June 2024 electronic Medication Administration Record (eMAR) revealed, in part, Resident #32 was administered 3 units of Novolog 100 u/ml on 06/17/2024 for a blood glucose level of 173, 0 units of Novolog 100 u/ml administered with blood glucose documented as high, and no documentation of
the blood glucose levels were documented on 06/09/2024.
In an interview on 06/26/2025 at 12:27 p.m., S2Assistant Director of Nursing indicated Resident #32's above mentioned eMAR documentation on 06/17/2024 was inaccurate. S2Assistant Director of Nursing further indicated the facility's nurses should be documenting the actual blood glucose levels instead of documenting high to ensure an accurate record of Resident #32's blood glucose levels was being conducted.
FORM CMS-2567 (02/99) Event ID: Facility ID: If continuation sheet Previous Versions Obsolete Page 16 of 25 195401 Department of Health & Human Services Printed: 09/22/2025 Form Approved OMB Centers for Medicare & Medicaid Services No. 0938-0391
STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A. Building 195401 B. Wing 06/26/2024
NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE
Ascension Oaks Nursing & Rehabilitation Center 711 W. Cornerview Road Gonzales, LA 70737
For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency.
(X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)
F 0880 Provide and implement an infection prevention and control program.
Level of Harm - Minimal harm or 47487 potential for actual harm Based on observation and interviews, the facility failed to ensure soiled linen was bagged or contained in Residents Affected - Few sanitary manner at the location where it was collected.
This deficient practice was identified for 1 (Resident #94) of 21 (Resident #1, Resident #8, Resident #13, Resident #15, Resident #16, Resident #22, Resident #27, Resident #28, Resident #32, Resident #38, Resident #46, Resident #47, Resident #49, Resident #52, Resident #55, Resident #61, Resident #69, Resident #76, Resident #86, Resident #94 and Resident #96) sampled residents reviewed for soiled linens in their environment.
Findings:
Observation on 06/23/2024 at 9:18 a.m., reveled soiled linens were seen on Resident #94's floor and a urine odor was present in Resident #94's room.
In an interview on 06/23/2024 at 9:18 a.m., Resident #94 indicated she did not want the soiled linen on the floor, and stated someone needed to come pick them up.
In an interview on 06/23/2024 at 9:20 a.m., S23Certified Nursing Assistant (CNA) indicated the soiled linen should not be on the floor of Resident #94's room.
In an interview on 06/24/2024 at 2:40 p.m., S1Administrator indicated he was happy with S23CNA's response. S1Administrator would provide no further explanation related to the above mentioned deficient practice.
FORM CMS-2567 (02/99) Event ID: Facility ID: If continuation sheet Previous Versions Obsolete Page 17 of 25 195401 Department of Health & Human Services Printed: 09/22/2025 Form Approved OMB Centers for Medicare & Medicaid Services No. 0938-0391
STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A. Building 195401 B. Wing 06/26/2024
NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE
Ascension Oaks Nursing & Rehabilitation Center 711 W. Cornerview Road Gonzales, LA 70737
For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency.
(X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)
F 0942 Ensure that staff members are educated on resident rights and facility responsibilities to properly care for its residents. Level of Harm - Minimal harm or potential for actual harm 48855
Residents Affected - Many Based on interview and record reviews, the provider failed to ensure Certified Nursing Assistant (CNA) staff received the required training on resident rights and facility responsibility for 7 (S4CNA, S5CNA, S8CNA, S10CNA, S11CNA, S12CNA, S13CNA Supervisor of 7 (S4CNA, S5CNA, S8CNA, S10CNA, S11CNA, S12CNA, S13CNA Supervisor) personnel records reviewed.
Findings:
Review of S4CNA's personnel record revealed, in part, S4CNA was hired on 06/06/2022.
There was no documented evidence and the facility did not present any documented evidence that S4CNA received the required training on resident rights and facility responsibility for caring of residents.
Review of S5CNA's personnel record revealed, in part, S5CNA was hired on 02/20/2016.
There was no documented evidence and the facility did not present any documented evidence that S5CNA received the required training on resident rights and facility responsibility for caring of residents.
Review of S8CNA's personnel record revealed, in part, S8CNA was hired on 07/26/2023.
There was no documented evidence and the facility did not present any documented evidence that S8CNA received the required training on resident rights and facility responsibility for caring of residents.
Review of S10CNA's personnel record revealed, in part, S10CNA was hired on 07/16/2019.
There was no documented evidence and the facility did not present any documented evidence that S10CNA received the required training on resident rights and facility responsibility for caring of residents.
Review of S11CNA's personnel record revealed, in part, S11CNA was hired on 06/21/2023.
There was no documented evidence and the facility did not present any documented evidence that S11CNA received the required training on resident rights and facility responsibility for caring of residents.
Review of S12CNA's personnel record revealed, in part, S12CNA was hired on 05/04/2021.
There was no documented evidence and the facility did not present any documented evidence that S12CNA received the required training on resident rights and facility responsibility for caring of residents.
FORM CMS-2567 (02/99) Event ID: Facility ID: If continuation sheet Previous Versions Obsolete Page 18 of 25 195401 Department of Health & Human Services Printed: 09/22/2025 Form Approved OMB Centers for Medicare & Medicaid Services No. 0938-0391
STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A. Building 195401 B. Wing 06/26/2024
NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE
Ascension Oaks Nursing & Rehabilitation Center 711 W. Cornerview Road Gonzales, LA 70737
For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency.
(X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)
F 0942 Review of S13CNA Supervisor's personnel record revealed, in part, S13CNA was hired on 07/15/2014.
Level of Harm - Minimal harm or There was no documented evidence and the facility did not present any documented evidence that S13CNA potential for actual harm Supervisor received the required training on resident rights and facility responsibility for caring of residents.
Residents Affected - Many In an interview on 06/26/2024 at 2:45 p.m., S1Administrator indicated he could not produce documented evidence of the above mentioned required training for the above mentioned facility staff was completed as required.
FORM CMS-2567 (02/99) Event ID: Facility ID: If continuation sheet Previous Versions Obsolete Page 19 of 25 195401 Department of Health & Human Services Printed: 09/22/2025 Form Approved OMB Centers for Medicare & Medicaid Services No. 0938-0391
STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A. Building 195401 B. Wing 06/26/2024
NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE
Ascension Oaks Nursing & Rehabilitation Center 711 W. Cornerview Road Gonzales, LA 70737
For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency.
(X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)
F 0944 Conduct mandatory training, for all staff, on the facility’s Quality Assurance and Performance Improvement Program. Level of Harm - Minimal harm or potential for actual harm 48855
Residents Affected - Some Based on interview and record reviews, the provider failed to ensure Certified Nursing Assistant (CNA) staff were trained on the requirements for Quality Assurance Performance Improvement (QAPI) for 7 (S4CNA, S5CNA, S8CNA, S10CNA, S11CNA, S12CNA, S13CNA Supervisor of 7 (S4CNA, S5CNA, S8CNA, S10CNA, S11CNA, S12CNA, S13CNA Supervisor) personnel records reviewed.
Findings:
Review of S4CNA's personnel record revealed, in part, S4CNA was hired on 06/06/2022.
There was no documented evidence and the facility did not present any documented evidence that S4CNA received the required training on the elements and goals of the facility's QAPI program.
Review of S5CNA's personnel record revealed, in part, S5CNA was hired on 02/20/2016.
There was no documented evidence and the facility did not present any documented evidence that S5CNA received the required training on the elements and goals of the facility's QAPI program.
Review of S8CNA's personnel record revealed, in part, S8CNA was hired on 07/26/2023.
There was no documented evidence and the facility did not present any documented evidence that S8CNA received the required training on the elements and goals of the facility's QAPI program.
Review of S10CNA's personnel record revealed, in part, S10CNA was hired on 07/16/2019.
There was no documented evidence and the facility did not present any documented evidence that S10CNA received the required training on the elements and goals of the facility's QAPI program.
Review of S11CNA's personnel record revealed, in part, S11CNA was hired on 06/21/2023.
There was no documented evidence and the facility did not present any documented evidence that S11CNA received the required training on the elements and goals of the facility's QAPI program.
Review of S12CNA's personnel record revealed, in part, S12CNA was hired on 05/04/2021.
There was no documented evidence and the facility did not present any documented evidence that S12CNA received the required training on the elements and goals of the facility's QAPI program.
Review of S13CNA Supervisor's, personnel record revealed, in part, S13CNA Supervisor was hired on 07/15/2014.
There was no documented evidence and the facility did not present any documented evidence that S13CNA Supervisor received the required training on the elements and goals of the facility's QAPI program.
FORM CMS-2567 (02/99) Event ID: Facility ID: If continuation sheet Previous Versions Obsolete Page 20 of 25 195401 Department of Health & Human Services Printed: 09/22/2025 Form Approved OMB Centers for Medicare & Medicaid Services No. 0938-0391
STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A. Building 195401 B. Wing 06/26/2024
NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE
Ascension Oaks Nursing & Rehabilitation Center 711 W. Cornerview Road Gonzales, LA 70737
For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency.
(X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)
F 0944 In an interview on 06/26/2024 at 2:45 p.m., S1Administrator indicated he could not produce documented evidence of the above mentioned required training for QAPI for the above mentioned facility staff. Level of Harm - Minimal harm or potential for actual harm
Residents Affected - Some
FORM CMS-2567 (02/99) Event ID: Facility ID: If continuation sheet Previous Versions Obsolete Page 21 of 25 195401 Department of Health & Human Services Printed: 09/22/2025 Form Approved OMB Centers for Medicare & Medicaid Services No. 0938-0391
STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A. Building 195401 B. Wing 06/26/2024
NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE
Ascension Oaks Nursing & Rehabilitation Center 711 W. Cornerview Road Gonzales, LA 70737
For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency.
(X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)
F 0945 Include as part of its infection prevention and control program, mandatory training that includes written standards, policies, and procedures for the program. Level of Harm - Minimal harm or potential for actual harm 48855
Residents Affected - Some Based on interviews and record reviews, the facility failed to ensure Certified Nursing Assistant (CNA) staff were trained on an infection control system for preventing, identifying, reporting, investigating, and controlling infections and communicable diseases for 7 (S4CNA, S5CNA, S8CNA, S10CNA, S11CNA, S12CNA, S13CNA Supervisor) of 7 (S4CNA, S5CNA, S8CNA, S10CNA, S11CNA, S12CNA, S13CNA Supervisor) personnel records reviewed.
Findings:
Review of S4CNA's personnel record revealed, in part, S4CNA was hired on 06/06/2022.
There was no documented evidence and the facility did not present any documented evidence that S4CNA received training on the requirements for an infection control system for preventing, identifying, reporting, investigating, and controlling infections and communicable diseases.
Review of S5CNA's personnel record revealed, in part, S5CNA was hired on 02/20/2016.
There was no documented evidence and the facility did not present any documented evidence that S5CNA received training on the requirements for an infection control system for preventing, identifying, reporting, investigating, and controlling infections and communicable diseases.
Review of S8CNA's personnel record revealed, in part, S8CNA was hired on 07/26/2023.
There was no documented evidence and the facility did not present any documented evidence that S8CNA received training on the requirements for an infection control system for preventing, identifying, reporting, investigating, and controlling infections and communicable diseases.
Review of S10CNA's personnel record revealed, in part, S10CNA was hired on 07/16/2019.
There was no documented evidence and the facility did not present any documented evidence that S10CNA received training on the requirements for an infection control system for preventing, identifying, reporting, investigating, and controlling infections and communicable diseases.
Review of S11CNA's personnel record revealed, in part, S11CNA was hired on 06/21/2023.
There was no documented evidence and the facility did not present any documented evidence that S11CNA received training on the requirements for an infection control system for preventing, identifying, reporting, investigating, and controlling infections and communicable diseases.
Review of S12CNA's personnel record revealed, in part, S12CNA was hired on 05/04/2021.
There was no documented evidence and the facility did not present any documented evidence that S12CNA received training on the requirements for an infection control system for preventing, identifying, reporting, investigating, and controlling infections and communicable diseases.
FORM CMS-2567 (02/99) Event ID: Facility ID: If continuation sheet Previous Versions Obsolete Page 22 of 25 195401 Department of Health & Human Services Printed: 09/22/2025 Form Approved OMB Centers for Medicare & Medicaid Services No. 0938-0391
STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A. Building 195401 B. Wing 06/26/2024
NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE
Ascension Oaks Nursing & Rehabilitation Center 711 W. Cornerview Road Gonzales, LA 70737
For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency.
(X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)
F 0945 Review of S13CNA Supervisor, personnel record revealed, in part, S13CNA Supervisor was hired on 07/15/2014. Level of Harm - Minimal harm or potential for actual harm There was no documented evidence and the facility did not present any documented evidence that S13CNA Supervisor received training on the requirements for an infection control system for preventing, identifying, Residents Affected - Some reporting, investigating, and controlling infections and communicable diseases.
In an interview on 06/26/2024 at 2:45 p.m., S1Administrator indicated he could not produce documented evidence of the above mentioned required training for an infection control system for preventing, identifying, reporting, investigating, and controlling infections and communicable diseases being completed for the above mentioned facility staff.
FORM CMS-2567 (02/99) Event ID: Facility ID: If continuation sheet Previous Versions Obsolete Page 23 of 25 195401 Department of Health & Human Services Printed: 09/22/2025 Form Approved OMB Centers for Medicare & Medicaid Services No. 0938-0391
STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A. Building 195401 B. Wing 06/26/2024
NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE
Ascension Oaks Nursing & Rehabilitation Center 711 W. Cornerview Road Gonzales, LA 70737
For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency.
(X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)
F 0946 Provide training in compliance and ethics.
Level of Harm - Minimal harm or 48855 potential for actual harm Based on interview and record reviews, the facility failed to ensure Certified Nursing Assistant (CNA) staff Residents Affected - Some were trained on the requirements for Compliance and Ethics for 7 (S4CNA, S5CNA, S8CNA, S10CNA, S11CNA, S12CNA, S13CNA Supervisor) of 7 (S4CNA, S5CNA, S8CNA, S10CNA, S11CNA, S12CNA, S13CNA Supervisor) personnel records reviewed.
Findings:
Review of S4CNA's personnel record revealed, in part, S4CNA was hired on 06/06/2022.
There was no documented evidence and the facility did not present any documented evidence S4CNA was trained on the requirements for compliance and ethics program as required.
Review of S5CNA's personnel record revealed, in part, S5CNA was hired on 02/20/2016.
There was no documented evidence and the facility did not present any documented evidence S5CNA was trained on the requirements for compliance and ethics program as required.
Review of S8CNA's personnel record revealed, in part, S8CNA was hired on 07/26/2023.
There was no documented evidence and the facility did not present any documented evidence S8CNA was trained on the requirements for compliance and ethics program as required.
Review of S10CNA's personnel record revealed, in part, S10CNA was hired on 07/16/2019.
There was no documented evidence and the facility did not present any documented evidence S10CNA was trained on the requirements for compliance and ethics program as required.
Review of S11CNA's personnel record revealed, in part, S11CNA was hired on 06/21/2023.
There was no documented evidence and the facility did not present any documented evidence S11CNA was trained on the requirements for compliance and ethics program as required.
Review of S12CNA's personnel record revealed, in part, S12CNA was hired on 05/04/2021.
There was no documented evidence and the facility did not present any documented evidence S12CNA was trained on the requirements for compliance and ethics program as required.
Review of S13CNA Supervisor's, personnel record revealed, in part, S13CNA Supervisor was hired on 07/15/2014.
There was no documented evidence and the facility did not present any documented evidence S13CNA Supervisor was trained on the requirements for compliance and ethics program as required.
FORM CMS-2567 (02/99) Event ID: Facility ID: If continuation sheet Previous Versions Obsolete Page 24 of 25 195401 Department of Health & Human Services Printed: 09/22/2025 Form Approved OMB Centers for Medicare & Medicaid Services No. 0938-0391
STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A. Building 195401 B. Wing 06/26/2024
NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE
Ascension Oaks Nursing & Rehabilitation Center 711 W. Cornerview Road Gonzales, LA 70737
For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency.
(X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)
F 0946 In an interview on 06/26/2024 at 2:45 p.m., S1Administrator indicated he could not produce documented evidence of training for compliance and ethics was completed for the above mentioned facility staff as Level of Harm - Minimal harm or required. potential for actual harm
Residents Affected - Some
FORM CMS-2567 (02/99) Event ID: Facility ID: If continuation sheet Previous Versions Obsolete Page 25 of 25 195401