Elevate Health And Rehabilitation
Elevate Health and Rehabilitation in Asheville, NC — inspection on August 7, 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.
Inspection Findings
Review of Resident #31's hospital discharge summary dated 6/19/24 revealed he had diagnoses of bilateral diabetic foot ulcers and peripheral arterial disease (PAD).
The discharge summary revealed he had a chronic diabetic ulcer to his right forefoot and a new ulcer to his left lateral heel that required surgical intervention during his hospital stay.
Review of the podiatry office visit note dated 7/2/24 revealed he had a wound located to his right forefoot overlying the 4th metatarsal and a non-pressure chronic ulcer of the left heel and midfoot.
The office note did not mention a wound to his right heel.
Review of the podiatry office visit note dated 7/22/24 stated Resident #31 was being seen for follow up of a wound, located on the right lateral dorsal (top) foot and left medial plantar (bottom of the foot) heel.
Under the section of the note labeled: skin right foot and ankle the note read ulcer, NEW blister on the medial heel.
345174
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 345174 B.
Wing 08/07/2024
NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE
Elevate Health and Rehabilitation 91 Victoria Road Asheville, NC 28801
Review of the care plan dated 08/05/2022 revealed Resident #3 was at risk for respiratory complications secondary to chronic respiratory failure with hypoxia requiring supplemental oxygen.
The interventions included administer oxygen as ordered and observed for signs and symptoms of respiratory complications.
Review of Resident #3's quarterly Minimum Data Set (MDS) dated [DATE] revealed Resident #3 had moderately impaired cognition.
The MDS also indicated Resident #3 was totally dependent for all activities of daily and had respiratory failure with hypoxia.
The MDS did not indicate Resident #3 was receiving oxygen.
Observations of Resident #3 were completed on 07/22/2024 at 10:59 AM, 07/22/2024 at 3:50 PM, 07/23/2024 at 8:15 AM, and 07/23/2024 at 1:30 PM.
During each of the observations Resident #3 was observed in bed with his nasal cannula in his nostrils and the oxygen concentrator set at 2 liter per minute.
Review of the electronic medical record revealed there was no physician order for continuous or PRN (as needed) orders oxygen for Resident #3.
An interview was completed on 07/23/2024 at 1:32 PM with Nurse Aide (NA) #3. NA #3 stated she does not do anything with oxygen settings. NA #3 further stated she did make sure the nasal cannula was in place and applied correctly for resident's receiving oxygen.
An interview was conducted on 07/23/2024 at 1:50 PM with Medication Aide (MA)#2 who was assigned to Resident #3. MA#2 stated she usually checked to make sure the concentrator was set at the correct flow rate, but she had not checked the physician's orders for oxygen for Resident #3. MA#2 stated that she had worked with Resident #3 several times and he had always had oxygen on.
An interview was completed on 07/23/2024 at 2:23 PM with Unit Manager #1.
Unit Manager #1 stated that all residents receiving oxygen should have a physician's order for oxygen which would include the flow rate.
The Unit Manager also stated that she thought Resident #3 went to the hospital recently and returned the same day and the oxygen order must have fallen off Resident #3's order panel.
345174
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 345174 B.
Wing 08/07/2024
NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE
Elevate Health and Rehabilitation 91 Victoria Road Asheville, NC 28801