Alta Skilled Nursing And Rehabilitation Center
ALTA SKILLED NURSING AND REHABILITATION CENTER in RENO, NV — inspection on June 13, 2024.
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
called to see if they still did not have an ultrasound technician and the company confirmed they did
Manager (UM) advised the nurses to call the Physician if the resident's leg became worse.
A Behavior Note, dated 05/06/2024, documented the resident kept yelling and screaming.
A Transfer to Hospital Summary, dated 05/07/2024, documented the resident had an order for an arterial ultrasound of bilateral lower extremities related to swelling and discoloration.
The ultrasound could not be completed in the facility.
The Physician was notified and ordered the resident sent to the hospital.
The resident's representative was notified of the situation.
The resident was sent to the hospital via emergency transport.
On 06/11/2024 at 10:04 AM, the UM verbalized the resident's nurse had reported to the UM on 04/30/2024, the resident had discoloration of the resident's leg and the discoloration did not improve when the leg was elevated.
The UM verbalized the Physician had ordered an ultrasound, but the facility's contracted ultrasound provider did not have an ultrasound technician.
The UM confirmed the family was not notified of changes between 04/30/2024 and 05/07/2024.
On 06/11/2024 at 10:46 AM, the Director of Nursing (DON) verbalized the DON did not see any documentation the Physician had been notified of the lack of an ultrasound technician and the inability to have the ultrasound completed in the facility.
On 06/11/2024 at 10:58 AM, the Physician verbalized the facility had not informed the Physician the resident was declining while awaiting an ultrasound.
The Physician verbalized if the Physician had been notified of the resident's clinical decline and the unavailability of a bedside ultrasound, the Physician would have ordered for the resident to be sent to the hospital with no delay.
The facility policy titled, Change in a Resident's Condition or Status, adopted 02/01/2019, documented, the facility would promptly notify the resident, the healthcare provider, and the resident representative of changes in the resident's medical condition and status.
The nurse would notify the Physician when there was a significant change in the resident's condition, the need to transfer the resident to a hospital, or when there were specific instructions to notify the Physician of changes in the resident's condition. A nurse would notify the resident's representative when there was a significant change in the resident's physical status.
Complaint #NV00071241 Cross reference with tags F-F600 and F-F849
295077 06/13/2024
Alta Skilled Nursing and Rehabilitation Center 555 Hammill Lane Reno, NV 89511
to follow up on the room change.
The resident verbalized to the social worker the resident had slept
On 06/13/2024 at 10:51 AM, the DON confirmed Resident #83 had spit on and thrown a cup of water
to the altercation and the facility had not been able to implement any new interventions due to Resident #83's increased behaviors; Resident #83 was transferred to a behavioral health center for additional services, and Resident #122 was moved to another room.
The facility policy titled, Abuse Prevention Program, adopted 02/01/2019, documented as part of the resident abuse prevention program, the facility would protect residents from abuse by anyone, including other residents.
FRI #NV00070898
295077 06/13/2024
Alta Skilled Nursing and Rehabilitation Center 555 Hammill Lane Reno, NV 89511
Nurses' Station and the Front Entrance, 04/03/2024.
Residents with Dementia were unable to follow complicated directions, 04/03/2024.
On 06/11/2024 at 2:02 PM, the DON explained all staff were trained on elopement annually and with in-services.
The DON communicated the expectation of the staff to be able to distinguish which residents were safe to go outside of the building.
All staff were to ensure residents did not follow the staff out of an exit door and would be expected to re-direct the resident, get the resident to a safe place, and report the situation to a nurse.
The DON confirmed the elopement was preventable.
On 06/11/2024 at 2:45 PM, the Administrator explained Resident #411 was found in the East parking lot by their family member on 04/08/2024, at approximately 2:46 PM.
The Administrator confirmed Resident #411 had followed an employee out of the East exit door and was wearing a Wanderguard device that did not sound the exit alarm.
The Administrator explained the investigation revealed all of the alarmed exits had malfunctioned with the Wanderguard devices and did not alarm when a resident wearing the device walked past.
The Administrator explained Maintenance was responsible to check the alarm device system weekly but had not found the system was malfunctioning at every exit.
The Administrator communicated the exit alarm system was replaced to correct the malfunctioning system.
The facility policy titled, Wandering and Elopements, adopted 02/01/2019, documented the facility would identify residents who were at risk of unsafe wandering and strive to prevent harm while maintaining the least restrictive environment. If an employee observed a resident leave the premises, the employee would: attempt to prevent the resident from leaving in a courteous manner, get help from another staff member in the immediate vicinity, and instruct another staff member to inform the Charge Nurse or Director of Nursing Services that a resident was attempting to leave or has left the premises.
FRI #NV00070899
31739
Resident to Resident Abuse
Resident #83
Resident #83 was admitted to the facility on [DATE], and readmitted [DATE], with diagnoses including schizophrenia, unspecified, and anxiety disorder with irritability and anger.
An Incident Note dated 04/09/2024, documented a nurse had heard Resident #83 screaming and cursing while an aide had witnessed Resident #83 spit on and throw a cup with water at the resident's roommate while the roommate was lying in bed, asleep (Resident #122).
Resident #83's Care Plan dated 05/25/2020, documented the resident had the potential for disruptive behaviors, and to monitor for inappropriate language around other residents and intervene as necessary.
Care Plan dated 06/08/2023, documented the resident had demonstrated verbally aggressive behaviors towards others related to schizophrenia diagnosis and to administer medications as ordered and monitor and document for side effects and effectiveness.
A physician's order dated 04/10/2024, documented Resident #83 may be discharged to behavioral health center today, when bed was available.
Resident #122
Resident #122 was admitted to the facility on [DATE], with diagnoses including epilepsy, unspecified, and dysphagia, oropharyngeal phase.
295077
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 295077 B.
Wing 06/13/2024
NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE
Alta Skilled Nursing and Rehabilitation Center 555 Hammill Lane Reno, NV 89511
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Source: This inspection report was downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases nursing home inspection reports in bulk. The findings reflect what state surveyors documented in the official Form CMS-2567 Statement of Deficiencies on the date of the inspection.
Plan of correction not included: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to their state survey agency and those responses may not appear in CMS public data at the time of release. The absence of a plan of correction in this report does not mean one was not filed. Readers who want information about corrective steps taken by the facility are encouraged to contact the facility or their state survey agency directly.
Corrections may have been made: This report reflects conditions observed on the date of the survey. The facility may have implemented staffing changes, additional training, policy revisions, or other corrective actions since this report was issued. We publish what CMS provides and encourage readers to seek current information from the facility.