Nursing Home News — Page 985

The facility's medical provider ordered a venous doppler study, a diagnostic ultrasound procedure used to detect blood clots in veins.

The electronic medication administration records from June 4-17 revealed an extensive pattern of medication refusals.

## Inadequate Pain Management Protocols Inspectors identified concerning gaps in pain management for a resident experiencing chronic, severe pain.

The incident occurred when a Certified Nursing Assistant (CNA) was turning and repositioning the resident, who grabbed onto the facility's bed remote control.

Within days of admission, staff documented that the resident had an unsteady gait, poor balance, and was at risk for falls.

A second resident with a history of heart disease, ischemic cardiomyopathy, and previous myocardial infarction received only partial pneumococcal vaccination.

One resident reported lying in a urine-soaked brief for hours while waiting for staff assistance.

One resident recovering from COVID-19 in isolation received breakfast in a foam tray containing fried eggs, toast, and cream of wheat.

The inability to provide documentation represented more than an administrative oversight.

The facility incorporated this intervention into the resident's care plan for preventing skin breakdown, acknowledging the importance of this measure.

An immediate jeopardy designation indicates conditions exist that could cause serious injury, harm, impairment, or death to residents at any time.

The inspection revealed gaps in the facility's assessment process for restraint use.