Las Palomas Center
Las Palomas Center in Albuquerque, NM — inspection on April 3, 2025.
Found 4 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
Based on record reviews and interviews, an Immediate Jeopardy (IJ) was identified.
The facility Administrator was notified on 03/05/25 at 3:21 pm.
The facility took corrective action by providing an acceptable Plan of Removal (POR).
The Plan of Removal was approved on 03/06/25 at 12:10 pm.
Plan of Removal
All residents have the potential to be affected by this alleged deficient practice.
- A whole house audit of heated electrical devices, completed on 02/27/25.
- A whole house skin sweep audit to identify any undocumented wounds, completed on 12/30/25.
- A second whole house skin sweep was conducted to identify undocumented wounds, completed on 02/03/25.
- Direct care staff were educated on wound documentation, starting 01/08/25.
- CNAs were educated on the Stop and Watch Process, from 01/21/25 through 01/27/25.
- Nurses and CNAs were educated on prohibiting on the use of electrical appliances, completed 02/27/25.
- Center Nurses were re-educated on skin assessments weekly per schedule, starting on 03/05/25.
325036
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 325036 B.
Wing 04/03/2025
NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE
Las Palomas Center 8100 Palomas Avenue NE Albuquerque, NM 87109
Based on record review and interview, the facility failed to ensure the discharge Minimum Data Set (MDS; a federally mandated assessment instrument completed by facility staff) was accurate for 1 (R #6) out of 1 (R #6) residents. If staff do not accurately reflect a resident's status in the MDS, then residents are at risk of not receiving the necessary care to maintain or improve their conditions.
The findings are:
A.
Record review of R #6's admission MDS, dated [DATE], revealed the following:
- admitted [DATE] from hospital.
- Brief Interview of Mental Status (BIMS; a screening for cognitive impairment) score of 15, cognitively intact.
- Diagnoses of end stage renal disease (ESRD; chronic irreversible kidney failure), dependence on renal dialysis renal dialysis (the process of removing extra fluid and waste products from the blood when the kidneys are not able to function properly), and depression.
- The resident was at risk of developing pressure ulcers (PU; an injury to skin and underlying tissue resulting from prolonged pressure on the skin.)
- The resident had two Stage 1 pressure ulcers (intact skin over a bony prominence with a reddened, painful area of skin that does not turn white when pressed.)
- The resident had one Stage 4 pressure ulcer (full thickness tissue loss with exposed bone, tendon, or muscle) present on admission.
- The resident had a skin tear (a type of injury where the skin is torn from the body.)
- Staff did not document any other skin issues, ulcers, or wounds.
B.
Record review of R #6's Wound Evaluations, dated 12/04/24, revealed the following:
- Unstageable pressure ulcer [a wound that has full thickness tissue loss but is covered with slough (dead tissue) or eschar (dark scab or falling away of dead skin) so that the true depth of the wound cannot be determined] to right lateral heel (Documented as a Stage 1 pressure ulcer on admission.)
- Stage 4 pressure ulcer to right medial ankle.
- Unstageable pressure ulcer to left heel (Documented as a Stage 1 pressure ulcer on admission.)
- Stage 1 pressure ulcer to rear left ankle.
325036
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 325036 B.
Wing 04/03/2025
NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE
Las Palomas Center 8100 Palomas Avenue NE Albuquerque, NM 87109
Review of Centers for Medicare and Medicaid Services' (CMS') Enhanced Barrier Precautions in Nursing Homes to Prevent Spread of Multidrug-resistant Organisms (MDROs), dated 03/20/24, revealed the following:
- MDRO transmission is common in long term care (LTC) facilities.
- Enhance Barrier Precautions (EBP) refer to an infection control intervention designed to reduce transmission of MDRO that employs targeted gown and glove use during high contact resident care activities.
- EBP are indicated for residents with wounds, even if the resident is not known to be infected or colonized with a MDRO.
B.
Record review of R #4's medical record revealed the following:
- admitted [DATE].
- Stage 3 pressure ulcer (full thickness skin loss that extends into deeper tissue and fat but not into muscle, tendon, or bone) to right heel.
- Treatment order, dated 12/25/24, for right heel.
Cleanse with Vashe (wound cleanser) solution, pat dry, place calcium alginate and apply Optifoam bordered gauze (wound dressing.) Cover with elastic tubular bandage.
C. On 03/06/25 at 1:27 pm, during an observation of wound care, the Skin Health Team Lead (SHTL) provided wound care to R #4.
The SHTL used hand sanitizer and donned (put on) gloves, but the SHTL did not don a gown before providing wound care to the resident's heel.
D.
Record review of R #5's medical record revealed the following:
- admitted [DATE].
- Arterial wound (caused by decreased blood circulation) to left ankle amputation site.
- Treatment order, dated 03/05/25, for left ankle amputation site.
Cleanse wound with Vashe.
Pat dry.
Apply hydrogel cover (wound dressing designed to provide a moist environment for wound healing) with collagen pad (wound dressing made from collagen to stimulate new tissue growth.) Cover with ABD pad (large wound dressing) and kerlix (bandage roll.)
325036
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 325036 B.
Wing 04/03/2025
NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE
Las Palomas Center 8100 Palomas Avenue NE Albuquerque, NM 87109
F-F880.
Z.
Record review of R #6's admission Minimum Data Set (MDS; a federally mandated assessment instrument completed by facility staff), dated 11/19/24, revealed the following:
- admitted [DATE] from hospital.
- Brief Interview of Mental Status (BIMS; a screening for cognitive impairment) score of 15, cognitively intact.
325036
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 325036 B.
Wing 04/03/2025
NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE
Las Palomas Center 8100 Palomas Avenue NE Albuquerque, NM 87109