Nursing Home News — Page 591

These regulations ensure facilities maintain minimum standards to protect vulnerable elderly populations.

The violations occurred during both 2023 and 2024 reporting periods.

## Paint Brush Food Preparation Violations The most egregious violation involved kitchen staff using paint brushes to prepare food for residents.

This comparison revealed the significant dosing discrepancy that facility staff had missed during the admission process.

The facility's own policy, revised in November 2023, clearly outlined these requirements.

A resident with severe cognitive impairment and dementia was taking multiple medications that the facility's pharmacist identified as problematic.

The medications were labeled with the resident's name but came from an outside pharmacy, violating facility policies.

The resident had a 7.5 size tracheostomy tube in place, but facility records incorrectly indicated it was a 6.5 size.

Any changes in a resident's condition or oxygen needs should be immediately reported to the attending physician for potential order modifications.

Normal oxygen saturation ranges from 96 to 100 percent.

On August 13, 2024, inspectors observed a registered nurse hanging IV fluids for the resident without wearing the required protective gown.

Within days of admission, staff completed a PHQ-9 depression screening that revealed a score of 17 - indicating moderately severe depression symptoms.