Saint Therese At Oxbow Lake

During observation and interview on 8/6/24 at 10:53 a.m., R3 sat in her w/c. R3's w/c was without adaptive devices and a soft-touched call light was near her.

Her bedroom and bathroom environment lacked such devices as a Reacher to assist with picking up things from the floor which would help her obtain things from her closet. In addition, the environment lacked CALL TO NOT FALL sign(s).

During observation and interview on 8/6/24 at 10:41 a.m., R2 sat in his wheelchair. R2's w/c had anti-lock and anti-tip devices. R2's environment was observed which lacked fall mitigation signs and/or devices.

When interviewed via telephone on 8/6/24 at 11:55 a.m., R1, R2, and R3's medical provider (MD) stated individualized fall interventions should be implemented upon admission, if considered a fall risk, and then right after the first fall these should be reviewed and adjusted.

After further discussion of R1, R2, and R3 care plan interventions, MD indicated he would have thought staff would have initiated more specific interventions, adding, That is someone's job to put those precautions in place.

245619

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 245619 B.

Wing 08/07/2024

NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE

Saint Therese at Oxbow Lake 9751 Regent Avenue North Brooklyn Park, MN 55443