Alta Skilled Nursing And Rehabilitation Center
ALTA SKILLED NURSING AND REHABILITATION CENTER in RENO, NV — inspection on June 13, 2024.
Found 3 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
During the interview, the DON reviewed Resident #455's clinical record.
The DON confirmed a physician order dated 06/04/2024, with instruction to start Potassium Chloride ER, was scanned into the documents section of the resident's record.
The DON confirmed Resident #455's clinical record lacked documented evidence the order for Potassium Chloride ER was communicated to the facility's physician, the facility's physician agreed with the order, and the order was entered into the EMR so it would reflect on the Medication Administration Record (MAR) as needing to be administered.
On 06/12/2024 at 12:18 PM, the DON contacted the facility physician via phone.
The facility physician provided a telephone order to start Potassium Chloride ER per the faxed hospice order.
The DON then entered the order into the EMR.
The DON explained the facility did not have one designated hospice coordinator, each unit's manager was responsible for coordinating with hospice.
On 06/12/2024 at 12:21 PM, the UM verbalized an order for Potassium Chloride ER was not in Resident #455's electronic orders and was not on the resident's MAR.
The UM confirmed the Potassium Chloride ER had not been administered as ordered.
The UM verbalized faxes from hospice typically came directly to the nurses' station so staff could review the faxes and enter any new orders in the EMR as appropriate.
The UM verbalized the UM was not going to look in the resident's scanned documents after each hospice visit to determine if new orders had been received.
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
Resident #305
Resident #305 was admitted to the facility on [DATE], and discharged [DATE], with diagnoses including other pulmonary embolism without acute cor pulmonale, other specified peripheral vascular diseases, cognitive communication deficit, and disturbance, psychotic disturbance, mood disturbance, and anxiety.
A Skin/Wound Note, dated 04/30/2024, documented the Nurse noticed bluish discoloration to the resident's right lower extremity.
The affected area was cold and clammy with positive pedal pulses.
The resident was experiencing generalized pain due to contracture of the right leg.
The Nurse called the Physician to relay the condition.
The Physician ordered a bilateral leg arterial ultrasound.
A physician order, dated 04/30/2024, documented bilateral leg arterial ultrasound.
A Weekly Skin Check for Resident #305, dated 05/01/2024, documented the resident had bluish discoloration and cold, clammy skin to the resident's right lower leg and the leg was starting to be painful.
The Physician was notified on 04/30/2024, and a bilateral arterial ultrasound was ordered.
A Nursing Note, dated 05/03/2024, documented the resident was confused and crying out.
The right lower extremity was cool to touch from mid-calf to toes and was tender to touch.
The resident's lower extremity was purplish in color to the pads of the toes.
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
During the interview, the DON reviewed Resident #455's clinical record.
The DON confirmed a physician order dated 06/04/2024, with instruction to start Potassium Chloride ER, was scanned into the documents section of the resident's record.
The DON confirmed Resident #455's clinical record lacked documented evidence the order for Potassium Chloride ER was communicated to the facility's physician, the facility's physician agreed with the order, and the order was entered into the EMR so it would reflect on the Medication Administration Record (MAR) as needing to be administered.
On 06/12/2024 at 12:18 PM, the DON contacted the facility physician via phone.
The facility physician provided a telephone order to start Potassium Chloride ER per the faxed hospice order.
The DON then entered the order into the EMR.
The DON explained the facility did not have one designated hospice coordinator, each unit's manager was responsible for coordinating with hospice.
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