Touchmark On South Hill Nursing
TOUCHMARK ON SOUTH HILL NURSING in SPOKANE, WA — inspection on August 22, 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
Findings included .
The website Dermnet.org - in which derm refers to dermatology (medical field that focuses on conditions that affect skin) - with regard to structure of normal skin showed the layers of the skin from top to bottom, consist of 3 layers: epidermis, dermis, and subcutis Epidermis is the uppermost or epithelial layer of skin. It acts as a physical barrier, preventing loss of water from the body, and preventing entry of substances and organisms into the body.
Its thickness varies according to the body site Dermis is the fibrous connective tissue or supportive layer of the skin Subcutis is the fat layer immediately below the dermis and epidermis. It is also called subcutaneous tissue.
The subcutis mainly consist of fat cells (adipocytes), nerves and blood vessels.
The website nih.gov - in which nih refers to national institute of health- with regard to the revised National Pressure Ulcer Advisory Panel pressure injury staging system showed a pressure injury is localized damage to the skin and underlying soft tissues usually over a bony prominence or related to a medical or other device.
The injury can present as intact skin or an open ulcer and may be painful.
The injury occurs as a result of intense and/or prolonged pressure or pressure in combination with shear.
The tolerance of soft tissue for pressure and shear may also be affected by microclimate, nutrition, perfusion [flow of fluid or blood to cells and tissues], comorbid condition [medical conditions that coexist and affect health and treatment], and condition of the soft tissue .
Stage 1 pressure injury: intact skin with a localized area of non-blanching erythema [redness that does not disappear when pressure is applied to the area] .
Stage 2 pressure injury: partial thickness [involving epidermis and/or dermis] loss of skin with exposed dermis.
The wound bed is viable, pink or red, moist, and may also present as an intact or ruptured serum-filled blister Stage 3 pressure injury: full thickness [wound that extends below the epidermis and dermis into the subcutaneous tissue or deeper] skin loss, in which adipose (fat) or granulation [new connective tissue] tissue is visible in the ulcer Stage 4 pressure injury: full thickness skin and tissue loss with exposed or directly palpable fascia [connective tissue], muscle, tendon [strong cords of tissue that connect muscle to bones], ligament [bands that connect bones and joints], cartilage [tough, flexible connective tissue that protects bones and joints, and provides structure to the nose and ears], or bone in the ulcer . unstageable pressure injury: full thickness skin and tissue loss in which the extent of the tissue damage within the ulcer cannot be confirmed because it is obscured by slough [dead skin or tissue that can appear in a wound] or eschar [dead tissue that forms over healthy skin and eventually falls off] .
Deep Tissue Pressure Injury [DTPI]: intact or nonintact skin with localized area of persistent non-blanchable deep red, maroon, purple discoloration, or epidermal separation reveling a dark wound bed or blood filled blister It is essential that the intended staging or classification system be used for each type of injury to ensure appropriate treatment.
505498
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 505498 B.
Wing 08/22/2024
NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE
Touchmark on South Hill Nursing 2929 South Waterford Drive Spokane, WA 99203
Findings included .
Reivew of the undated facility policy titled, Personal Property Policy showed residents were encouraged to bring personal belongings to provide familiarity and a homey atmosphere.
The policy showed the facility would not ask a resident to waive their rights including the right to collect payment for lost or stolen articles.
The policy showed a personal inventory sheet would be completed and updated whenever items were brought into or removed from a resident's possession.
Reimbursement for missing items may depend upon verification of the presence of the item.
The policy further showed it would not be reasonable or prudent for a resident to maintain cash in their possession; the resident is vulnerable to theft of cash and there was little to spend money on inside the community.
For an item to be considered for replacement, missing items must be promptly reported, a search would be conducted, if the loss was deemed to be the responsibility of the community, the community would replace the item.
Review of the undated facility policy titled, Grievance Policy showed a grievance was a formal or informal written or verbal complaint made by a resident, their representative, family member, or staff member about quality of care, treatment, or concerns related to the facility.
The grievance officer was responsible for overseeing the grievance process, documenting and tracking grievances, conducting investigations, and maintaining confidentiality.
The policy showed a praise, concern, suggestion form may be used if a concern was NOT an allegation of abuse or neglect, those concerns were to be reported to the director of nursing or administrator immediately. If a grievance involved potential abuse, neglect, or exploitation, the policy instructed staff to follow mandatory reporting procedures.
Review of the facility policy titled, Abuse Policy dated 2023, showed abuse was prohibited and must be reported in a timely manner to allow for proper investigation and implementation of measures to prevent recurrence or retaliation.
The policy defined an allegation as a statement, or a gesture made by someone (regardless of capacity or decision-making ability) that indicated abuse, neglect, exploitation, or misappropriation of resident property may have occurred and required a thorough investigation.
Abuse included sexual abuse, mental abuse, physical abuse, and exploitation.
The policy defined financial exploitation as illegal or improper use of the property, income, resources, or trust funds of the vulnerable adult by any person for any person's profit or advantage.
The policy further showed all alleged violations of abuse, neglect, mistreatment, and/or exploitation must be reported to the administrator, director of nursing or their designee and reported to the State Survey Agency hotline.
The policy showed staff were mandatory reporters, trained to identify and report allegations including disappearance or misappropriation of resident's personal property, and expected to understand individual responsibilities as a mandatory reporters.
505498
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 505498 B.
Wing 08/22/2024
NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE
Touchmark on South Hill Nursing 2929 South Waterford Drive Spokane, WA 99203
F-F641 for additional information
505498
Findings included .
Review of the facility policy titled, Prevention of Skin Breakdown dated 2023, defined skin breakdown as skin damage that could result in ulcers, sores, or wounds, often due to pressure, friction, or shear forces.
The policy instructed staff to complete a comprehensive skin risk assessment upon admission and regularly thereafter, use assessment tools to evaluate a resident's risk level, and develop individualized care plan with interventions based on the risk assessment outcomes.
The policy further showed all skin assessment, interventions, and resident responses were to be documented in the electronic health record accurately and promptly.
Skin assessments were to be completed weekly with any changes in skin condition or care needs communicated promptly to the interdisciplinary team.
Review of the facility policy titled, Skin Program dated 2023, showed nursing staff would complete weekly skin check documenting wound measurements, wound site, wound type, wound status, drainage, status of surrounding tissue, signs of infection, pain identified, and document findings into the electronic health record.
The policy instructed staff to contact the wound care specialist if a resident had an acute or chronic wound. If a wound was found to have developed in the facility staff were instructed to assess/investigate to identify potential causes, determine what interventions were in place prior to wound development, wound identification, and identify new potential interventions to prevent further skin breakdown and/or complications. A nutrition committee regularly reviewed skin conditions, risk factors, skin assessment notes, care plans and interventions to ensure proper treatments were in place.
The policy further showed all identified pressure areas would be assessed weekly to identify progress, and identify new treatments needed.
All residents in the facility would have routine preventative skin care such as turning and positioning, application of pressure relieving devices, good skin care, adequate nutrition and hydration.
The website Dermnet.org - in which derm refers to dermatology (medical field that focuses on conditions that affect skin) - with regard to structure of normal skin showed the layers of the skin from top to bottom, consist of 3 layers: epidermis, dermis, and subcutis Epidermis is the uppermost or epithelial layer of skin. It acts as a physical barrier, preventing loss of water from the body, and preventing entry of substances and organisms into the body.
Its thickness varies according to the body site Dermis is the fibrous connective tissue or supportive layer of the skin Subcutis is the fat layer immediately below the dermis and epidermis. It is also called subcutaneous tissue.
The subcutis mainly consist of fat cells (adipocytes), nerves and blood vessels.
505498
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 505498 B.
Wing 08/22/2024
NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE
Touchmark on South Hill Nursing 2929 South Waterford Drive Spokane, WA 99203