The Living Centre

F-F656 Comprehensive Care Plan), for 1 (#29) of 1 sampled resident for trauma informed care. Findings include:

During an interview on 1/29/25 at 1:33 p.m., resident #29 stated, The work I do is classified by the federal government. I go on scary missions and crawl on my hands and knees in the jungle slitting the throats of the enemy. I don't like to do it, but I don't want them to sneak in and kill us in the night. I served in Vietnam. After I left Vietnam, they bombed all of them, and I think all the guys I worked with got killed. All of those thoughts have left me with bad nightmares, and it is awful. I was stuck out in the jungle looking for the enemy, I had to slit their throats because no one else would do it.

During an interview on 1/28/25 at 3:04 p.m., staff member I stated she would take care of resident #29 when

he would come to the shower. She stated there was an occurrence one time with resident #29, and she could not remember the exact date. Staff member I stated she had another CNA bring her some clothes for resident #29 after she had given him a bath. The other CNA arrived with a red shirt, and resident #29 got very upset. Staff member I stated resident #29 told her the red shirt reminded him of blood, and he would not allow her to put that shirt on him. She said she was aware he had PTSD, but she was not aware of anything that would tell her what things might trigger his PTSD. She stated she would not have tried to put the red shirt on him if she had known it would upset him and trigger his PTSD.

During an interview on 1/29/25 at 10:14 a.m., staff member C stated she did not know if the facility had a trauma informed care assessment. She stated she knew resident #29 had a PTSD diagnosis, and the diagnosis was not new. Staff member C stated she was unaware of how resident #29's PTSD was triggered and stated she did not know who would add that to the resident's care plan. She stated she thought maybe

the activities director would know.

During an interview on 1/29/25 at 10:37 a.m., staff member J stated she would do an initial interview with all residents to find out family history and some other questions for new residents. She stated she did not have

a formal trauma informed care assessment. Staff member J said she would typically ask the residents if they had anything that would make them sad or angry. She said those questions would usually allow her to find out if the resident had anything that would trigger them emotionally. She stated she did not ask the residents directly about past traumatic events.

Review of resident #29's nursing progress note, dated 1/22/25 at 11:51 a.m., showed resident #29 was more confused than normal, and he was hallucinating about his experiences in Vietnam in gruesome detail.

Review of resident #29's comprehensive care plan, printed on 1/29/25, failed to show a focus area reflecting resident #29 had PTSD, or if he had any triggering factors, related to his PTSD.

FORM CMS-2567 (02/99) Event ID: Facility ID: If continuation sheet Previous Versions Obsolete Page 3 of 4 275125 Department of Health & Human Services Printed: 09/10/2025 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 275125 B. Wing 01/30/2025

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

The Living Centre 57 Main St Stevensville, MT 59870

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 0699 Review of a facility policy titled, Trauma-Informed and Culturally Competent Care, revised August 2022, showed: Level of Harm - Minimal harm or potential for actual harm Purpose . To address the needs of trauma survivors by minimizing triggers and/or re-traumatization.

Residents Affected - Few .'Trauma-informed care' is an approach to delivering care that involves understanding, recognizing and responding to the effects of all types of trauma. A trauma-informed approach to care delivery recognizes the widespread impact and signs and symptoms of trauma in residents, and incorporates knowledge about trauma into care plans, policies, procedures and practices to avoid re-traumatization.

.Resident Screening

1. Perform universal screening of residents, which includes a brief, non-specialized identification of exposure to traumatic events.

.Resident Assessment

.2. Resident assessment involves an in-depth process of evaluating the presence of symptoms, their relationship to trauma, as well as the identification of triggers.

Resident Care Planning

1. Develop individualized care plans that address past trauma in collaboration with the resident and family as appropriate.

2. Identify and decrease exposure to triggers that may re-traumatize the resident .

FORM CMS-2567 (02/99) Event ID: Facility ID: If continuation sheet Previous Versions Obsolete Page 4 of 4 275125