of F497 citations were written at actual harm or above. The mark is the share across all tags, 5.4%.
The harm level
How severely F497 is cited
0.0% of citations found actual harm or worse (level G and above).
Citations by CMS scope and severity. Rows are harm level, columns are how widespread the finding was.
Severity
Isolated
Pattern
Widespread
Immediate jeopardy
J—
K—
L—
Actual harm
G—
H—
I—
No harm, potential for more than minimal
D1100.0%
E—
F—
No harm, potential for minimal
A—
B—
C—
Every recorded F497 citation, by the harm level and scope the surveyor assigned.
In the surveyor’s words
What an F497 citation says
One finding from each severity level, most serious first.
Severity is as the surveyor wrote it. Some findings had already been corrected before the survey.
G · Actual harm, isolatedApril 27, 2011
Based on observation, staff interview and record review for one (1) resident, it was determined that Employee #1, a Certified Nurse Aide (CNA) failed to apply interventions necessary to meet the resident ' s needs.
Resident #1 was born on November 5, 1928 and was admitted to the facility on [DATE]. According to the quarterly Minimum Data Set assessment completed on January 27, 2011, Resident #1 was assessed as being in a persistent vegetative state with no response to verbal or tactile stimuli in Section C (Cognitive Patterns). He/she was assessed as being totally dependent for all Activities of Daily Living (ADL) in Section G (Functional Status). His/her weight was recorded as 221 pounds in Section K (Swallowing/ Nutritional Status). Disease [DIAGNOSES REDACTED]. …
E · No harm, potential for more than minimal, patternFebruary 5, 2018
Based on interview and record review the facility failed to ensure Certified Nursing Assistants (CNAs) were evaluated annually, during their 30/60/90 day probationary periods, and that they received training in the areas of needed improvement to ensure all residents' plans of care were being implemented when:
1. CNA 30 had many performance issues identified and training was not provided based on evaluation.
2. CNA 23 had no 30/60/90 day probationary period evaluations found in her record.
3. CNA 19 had performance issues identified and training was not provided based on evaluation.
4. NA (Nurse Assistant, in training and not certified) 5 had no 30/60/90 day probationary evaluations found in his record.
This resulted in abuse and injuries of unknown origin. Refer to F 223 and F 226. …
C · No harm, potential for minimal, widespreadOctober 24, 2017
Based on interview and document review, the facility failed to ensure an annual performance review was completed for 3 of 8 staff (NA-J, NA-C, NA-K) reviewed for annual performance review. This had the potential to affect all 52 residents residing in the facility.
Findings include:
On 10/24/17, a review of personnel records indicated the following:
Nursing assistant (NA)-J was hired on 5/17/82. The personnel record indicated NA-J's last annual performance review was done on 6/17/15.
NA-C was hired on 6/26/07. The personnel record indicated NA-C's last annual performance review was done on 7/6/15.
NA-K was hired on 8/16/16. NA-K's personnel record lacked evidence of an annual performance review.
On 10/24/17, at 4:00 p.m. …
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