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Complaint Investigation

Senatobia Healthcare & Rehab

August 20, 2024 · Senatobia, MS · 402 Getwell Dr
Citations 2
CMS Rating 1/5
Beds 106
Provider ID 255302
Healthcare Facility
Senatobia Healthcare & Rehab
Senatobia, MS  ·  View full profile →
Inspection Summary

SENATOBIA HEALTHCARE & REHAB in SENATOBIA, MS — inspection on August 20, 2024.

Found 2 citations. Severity: Standard violations.

Health inspections identify deficiencies that facilities must correct within required timeframes. Violations range from minor documentation issues to serious safety concerns and are subject to follow-up verification.

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Inspection Findings

FF656
Immediate with resident rights, that includes measurable objectives and timeframes to meet a resident's medical, Few elopement risk. Goal: I will not leave facility unattended through next review date (Target date 10/9/24). affected

During an interview on 8/19/24 at 10:05 AM, the Director of Nursing (DON) confirmed Resident #1 had been sitting unattended on the facility's front porch on 8/15/24, left the facility unsupervised and was located at the local grocery store at approximately 4:45 PM.

She verified video surveillance footage indicated Resident #1 left the facility at 4:05 PM.

She acknowledged a resident who is at risk for wandering/elopement should not have been left unattended and that staff should have been present with her.

During an interview on 8/19/24 at 10:15 AM, Certified Nursing Assistant (CNA) #2 stated Resident #1 wears a Wandergaurd due to her risk of elopement.

She mentioned that Resident #1 frequently sits outside on the porch unattended because she refuses to come back inside.

In an interview on 8/19/24 at 10:20 AM, Licensed Practical Nurse (LPN) #1 also confirmed that Resident #1 is at risk for elopement but often sits unattended on the facility's front porch.

An interview with the Minimum Data Set Nurse (MDS) on 8/19/24 at 12:27 PM, she verified that Resident #1's care plan was not followed when the resident was left on the front porch of the facility unsupervised and subsequently exited the premises unnoticed.

Record review of the Admission Record revealed Resident #1 was admitted to the facility on [DATE] with diagnoses that included Cerebral Vascular Accident.

Record review of Resident #1's Quarterly Minimum Data Set Assessment (MDS) with an Assessment Reference Date (ARD) of 7/15/24 revealed a Brief Interview of Mental Status (BIMS) score of 14 , indicating that the resident is cognitively intact.

Section P-Restrains and Alarms revealed An alarm is any physical or electronic device that monitors resident movement and alerts the staff when movement is detected.

This section was code that an alarm was used daily.

The facility submitted the following removal plan:

On 8/15/24 at approximately 4:15 PM, a passerby notified Certified Nursing Assistant #1 (CNA) at that she observed an individual walking up the hill that she suspected to be a resident of the center. CNA #1 immediately came into the facility and notified the receptionist. A search by staff was initiated.

255302

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 255302 B.

Wing 08/20/2024

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

Senatobia Healthcare & Rehab 402 Getwell Dr Senatobia, MS 38668

During an interview on 8/19/24 at 10:35 AM, Resident #1 recounted that on the afternoon of 8/15/24, she was sitting on the porch thinking about tobacco, which prompted her to walk to the store to buy some.

She stated that she walked through parking lots without going near the street.

She reported no injuries and said that staff eventually picked her up and brought her back to the facility.

On 8/19/24 at 1:30 PM, in an interview with the Front Office Receptionist, the receptionist stated on 8/15/24 at approximately 3:30 PM, she turned off the door alarm to allow Resident #1 to go out and sit on the front porch.

She admitted that no staff accompanied Resident #1 and that in the past, Resident #1 had been allowed to go outside without staff supervision.

She also mentioned that she was not monitoring Resident #1, and no one had asked her to do so.

On 8/19/24 at 1:35 PM, during an interview with the Infection Control Preventionist (ICP) she confirmed that she was working in the front office on 8/15/24 and was unaware that Resident #1 was still outside.

She stated that no one had asked her to monitor Resident #1. At approximately 4:10 PM to 4:15 PM, a CNA informed her that Resident #1's wheelchair was on the porch, but the resident was missing.

She joined other staff in searching for the resident and found Resident #1 standing near a local grocery store, talking to an acquaintance.

The resident was returned to the facility at around 4:25 PM, wearing a t-shirt, black leggings, non-skid socks, and a hair bonnet.

255302

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 255302 B.

Wing 08/20/2024

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

Senatobia Healthcare & Rehab 402 Getwell Dr Senatobia, MS 38668

Frequently Asked Questions

What is an F-tag violation?
F-tags are federal deficiency codes used by CMS to categorize nursing home violations. Each F-tag corresponds to a specific federal regulation (42 CFR Part 483). For example, F607 relates to abuse prevention policies, F880 relates to infection control.
Were these violations corrected?
Facilities must submit plans of correction and implement changes within required timeframes. CMS conducts follow-up inspections to verify corrections. Check the inspection report for specific correction dates and follow-up verification status.
How often do nursing home inspections happen?
CMS conducts unannounced inspections of all Medicare/Medicaid-certified nursing homes at least once per year. Additional inspections may occur based on complaints, facility-reported incidents, or follow-up to verify previous violations were corrected.
What should families do about these violations?
Families should: (1) Review the full inspection report for details, (2) Ask facility administration about specific corrective actions taken, (3) Check if this represents a pattern by reviewing prior inspections, (4) Compare with other facilities in SENATOBIA, MS, (5) Report new concerns to state authorities.
Where can I see the full inspection report?
Complete inspection reports are available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request copies directly from SENATOBIA HEALTHCARE & REHAB or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.


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