Life Care Center Of Reno

F-F690

FORM CMS-2567 (02/99) Event ID: Facility ID: If continuation sheet Previous Versions Obsolete Page 27 of 29 295050 Department of Health & Human Services Printed: 09/17/2025 Form Approved OMB Centers for Medicare & Medicaid Services No. 0938-0391

STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A. Building 295050 B. Wing 08/01/2024

NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE

Life Care Center of Reno 445 W. Holcomb Lane Reno, NV 89511

For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency.

(X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0880 Provide and implement an infection prevention and control program.

Level of Harm - Minimal harm or **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** 49557 potential for actual harm Based on observation, interview, clinical record review, and document review the facility failed to ensure Residents Affected - Few Enhanced Barrier Precautions (EBP) were implemented for a resident with a chronic wound for 1 of 94 unsampled residents (Resident #26).

Findings include:

Resident #26

Resident #26 was admitted to the facility on [DATE REDACTED], with diagnoses including unspecified open wound of abdominal wall, unspecified quadrant without penetration into peritoneal cavity, subsequent encounter and unspecified open wound, right thigh, subsequent encounter.

On 07/29/2024 at 10:08 AM, Resident #26 verbalized the resident had wounds. The resident recalled having

the wounds for at least seven months and verbalized facility staff were providing wound care. Resident #26's room lacked EBP signage and a Personal Protective Equipment (PPE) cart.

A physician's order dated 07/06/2024, documented wound care: clean right medial thigh wound with Normal Saline (NS), pat dry, apply Xeroform, cover with clean dry dressing (CDD) every Monday, Wednesday, Friday and as needed (PRN).

A physician's order dated 07/06/2024, documented wound care: clean abdominal wound with NS, pat dry, apply Xeroform, cover with CDD every Monday, Wednesday, and Friday.

A Wound Observation Tool dated 07/26/2024, documented Resident #26 had a wound on the resident's right medial thigh. The wound was described as chronic and non-healing.

A Wound Observation Tool dated 07/26/2024, documented Resident #26 had a wound on the resident's abdomen. The wound was described as chronic and non-healing.

On 08/01/2024 at 8:39 AM, the Licensed Practical Nurse (LPN) assigned to Resident #26 confirmed the resident had wounds and was receiving wound care on Mondays, Wednesdays, Fridays and PRN. The LPN confirmed residents with wounds typically had EBP in place. The LPN verbalized the LPN was not sure why Resident #26 did not have EBP in place and would contact the Director of Nursing (DON).

On 08/01/2024 at 8:54 AM, the DON confirmed Resident #26 should have had EBP in place as soon as the resident had orders for wound care.

On 08/01/2024 at 9:36 AM, the Infection Preventionist (IP) explained EBP was used for any resident with extensive wound care or an open wound. The IP confirmed Resident #26 should have had EBP in place. The IP explained EBP was used to prevent the spread of infection.

FORM CMS-2567 (02/99) Event ID: Facility ID: If continuation sheet Previous Versions Obsolete Page 28 of 29 295050 Department of Health & Human Services Printed: 09/17/2025 Form Approved OMB Centers for Medicare & Medicaid Services No. 0938-0391

STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A. Building 295050 B. Wing 08/01/2024

NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE

Life Care Center of Reno 445 W. Holcomb Lane Reno, NV 89511

For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency.

(X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0880 The facility policy titled Enhanced Barrier Precautions, reviewed 06/03/2024, documented EBP was an infection control intervention used to reduce transmission of Multi-Drug Resistant Organisms (MDROs). EBP Level of Harm - Minimal harm or employed gown and glove use during high-contact resident care activities. EBP was to be used for residents potential for actual harm with wounds and/or indwelling medical devices.

Residents Affected - Few

FORM CMS-2567 (02/99) Event ID: Facility ID: If continuation sheet Previous Versions Obsolete Page 29 of 29 295050