Ardie R Copas State Veterans Nursing Home

In the surveyor’s words

From the most serious findings on record at Ardie R Copas State Veterans Nursing Home, in the surveyor’s own words.

• No harm, potential for more than minimal, isolatedF552Jun 19, 2025

  Based on record review and interview, the facility failed to ensure written consent for psychotropic medications for 1 of 5 sampled residents, Resident #69, which was the facility's method of informing the resident and or representative of the risks and benefits of proposed treatments. The findings included: Review of the record revealed Resident #69 was admitted to the facility on [DATE]. Review of the current Minimum Data Set (MDS) assessment dated [DATE] lacked a Brief Interview for Mental Status (BIMS) score for the resident as he was rarely understood and was rarely able to understand. Review of the current physician orders documented the use of Depakote, being used for the resident's mood disorder, along with an order for Ativan that was being used for an anxiety disorder. […]

• No harm, potential for more than minimal, isolatedF605Jun 19, 2025

  3) Review of the record revealed Resident #69 was admitted to the facility on [DATE] and later admitted to hospice services on 04/08/25. Review of the current physician orders confirmed Resident #69 was admitted to the hospice services on 04/08/25. Another order dated 04/08/25 documented the use of Ativan, a psychotropic medication, every 4 hours as needed for anxiety. Further review of this order revealed it was an open ended order and lacked any stop date or duration of use. […]

• No harm, potential for more than minimal, isolatedF676Jun 19, 2025

  Based on observations, interviews, and record review, the facility failed to provide services to ensure abilities in Activities of Daily Living (ADL) did not diminish for 1 of 3 sampled residents, Resident #27, reviewed for ambulation. The findings included: During an initial interview on 06/16/25 at 2:56 PM, Resident #27 reported that he was concerned about being discharged from Physical Therapy (PT) because he was walking with a hemi walker and since his discharge from PT he has not walked at all and only uses a wheelchair for mobility in the facility. There was a hemi walker located in Resident #27's room during the initial interview. Review of the record revealed that Resident #27 was admitted to the facility on [DATE]. […]

• No harm, potential for more than minimal, isolatedF684Jun 19, 2025

  3) Review of the record revealed Resident #72 was admitted to the facility on [DATE]. Review of the current MDS assessment dated [DATE] documented the resident had a BIMS score of 9, on a 0 to 15 scale, indicating mild cognitive impairment. This MDS also indicated the resident had an infection of the foot. Review of the current physician orders documented as of 06/06/25 wound care to the right foot, to include the application of betadine (an antiseptic used for skin infections), was to be completed daily and as needed for soiling, saturation, or dislodgement. The routine order for the wound care was scheduled during the evening (7 PM to 7 AM) shift. […]

• No harm, potential for more than minimal, isolatedF695Jun 19, 2025

  Based on policy review, observation, record review, and interviews, the facility failed to ensure respiratory care and services for 1 of 1 sampled resident, Resident #312, as evidenced by the failure to monitor and document a respiratory assessment after administration of a nebulizer (breathing) treatment, and failure to obtain a physician order for administration of oxygen for Resident #312. The findings included: Review of a policy titled, Nebulizer Administration of Medications revised on 08/01/2023, documented in part .Post Treatment Evaluation and Documentation: Document the treatment in the EMR (electronic medical record). […]