Parkwood Skilled Nursing And Rehabilitation Center

F 0554 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

FORM CMS-2567 (02/99) Previous Versions Obsolete

after a traumatic injury);-No physician order to keep medications at bedside and self-administer.

Observation on 11/25/25, showed at 7:55 A.M., a tube of diclofenac sodium 1% on an over bed table. There was a second over bed table closer to the bed with a Breztri inhaler on it. At 9:41 A.M., the medications remained in the same spot. During an interview on 11/25/25 at 11:45 A.M., the resident said he/she used

the inhaler as needed and he/she applied the diclofenac topical gel to his/her knees as needed. During an

interview on 11/25/25 at 12:58 P.M., Licensed Practical Nurse (LPN) B said if a resident wanted to keep their medications at bedside and self-administer, they would assess the resident by having the resident do

a return demonstration and they would need to obtain a physician order. During an interview on 11/25/25 at 12:19 P.M. and 1:46 P.M. LPN A said if a resident wanted to self-administer their medications, they would need to assess the resident for alertness. To keep medications at bedside and self-administer them required a physician order. Currently there were no residents who had medications at their bedside or who could self-administer their own medications. LPN A went into the resident's room and the medications were

in the same place. LPN A said he/she would need to check to see if the resident could have the medications at his/her bedside. During an interview on 11/25/25 at 1:46 P.M., LPN C said the resident did not have an order for self-administration because of his/her vision. LPN C had staff remove the medications from the resident's room. During an interview on 11/25/25 at 2:26 P.M., the Administrator said he would expect medications to be stored on the medication cart and he would expect staff to follow the facility's policies and procedures. 2676769

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Printed: 04/13/2026 Form Approved OMB No. 0938-0391

Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION

(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:

(X2) MULTIPLE CONSTRUCTION

B. Wing

A. Building

(X3) DATE SURVEY COMPLETED

11/25/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Parkwood Skilled Nursing and Rehabilitation Center

3201 Parkwood Lane Maryland Heights, MO 63043

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 0658

Ensure services provided by the nursing facility meet professional standards of quality.

Level of Harm - Minimal harm or potential for actual harm

Based on observation, interview and record review, the facility failed to meet professional standards when staff failed to follow physician orders when staff provided wound care for one resident (Resident #5). The sample was 7. The census was 86. Review of the facility's Physician Orders policy, dated revised October 2023, showed when a Physician gives orders on any resident, nursing staff will have the orders written in

the Medication Administration Record (MAR) and/or Treatment Administration Record (TAR) of the medical

record of the resident. Nursing staff will follow through with any order(s) that were provided by the physician

in the time frame given by the physician. 1. Review of Resident #5's medical record, showed:-Diagnoses included: high blood pressure, diabetes and heart failure;-A physician order summary dated 11/15/25 through 11/25/25, showed a physician order to cleanse one time per day, bilateral (both) lower extremities with Vashe (wound cleanser), soak 3-5 minutes; apply silver wound gel (antimicrobial wound gel designed to provide a moist healing environment) to wound bed. Apply mepitel (a soft, flexible silicone dressing) cover with abdominal (ABD, gauze dressing that absorbs fluid from large or heavily draining wound) pad and wrap with kerlix (gauze) and ace wrap daily. Observation and interview on 11/24/25 at 9:55 A.M., showed the resident lay in bed, he/she had gauze dressing on his/her lower legs. The resident said his/her dressings are not changed daily, last week they were changed three-four times. No ace wrap was in place.

Observation on 11/24/25 at 10:35 A.M., showed the resident lay in bed. Licensed Practical Nurse (LPN) D put gloves on and removed the dressing from both lower legs. The right lower leg had two small open areas and one closed area. The left lower leg had several small open areas. LPN D changed his/her gloves, cleaned the wounds with Vashe, applied silver 1% sulfadiazine cream (used to prevent and treat wound infections), applied an ABD pad and wrapped both legs with gauze. No soak was done, no silver wound gel or mepitel was applied to the wounds. The ace wraps were not applied. Observation on 11/25/25 at 1:40 P.M., showed the resident lay in bed, he/she had slipper socks on over the dressings. No ace wraps were in place. The resident said he/she only had ace wraps applied once when he/she was in the hospital. During

an interview on 11/25/25 at 12:19 A.M. and 1:46 P.M., Licensed Practical Nurse (LPN) A said silver wound gel and sulfadiazine cream are not the same. LPN A checked the treatment cart, and he/she did not see silver wound gel on the cart. During an interview on 11/25/25 at 2:26 P.M., the Administrator said he would expect for staff to follow physician orders and the facility's policies and procedures. 26720742675750

Residents Affected - Few

FORM CMS-2567 (02/99) Previous Versions Obsolete

Event ID:

Facility ID:

If continuation sheet