Bolivar Medical Center LTC

In the surveyor’s words

From the most serious findings on record at Bolivar Medical Center LTC, in the surveyor’s own words.

• No harm, potential for more than minimal, widespreadF812Jul 31, 2025

  Based on observation, staff interviews, and facility policy review the facility failed to ensure hair restraints were utilized during food preparation to prevent contamination for one (1) of two (2) kitchen tours. Findings include:Review of the facility policy SANITATION AND INFECTION CONTROL with a revision date of 1/2025, revealed that Team members will wear hair restraints regardless of the length of hair or beard at all times in the kitchen. On 7/30/2025 at 11:00 AM during the kitchen tour with the Dietary Manager (DM), an observation was made of Chef #1 preparing food in the kitchen without a hair net in place. […]

• No harm, potential for more than minimal, widespreadF851Jul 31, 2025

  Based on staff interview, record review, and facility policy review, the facility failed to submit accurate staffing data into the Payroll-Based Journal (PBJ) system for one (1) of two (2) quarters reviewed. (2nd Quarter 2025)Findings include: Record review of the facility policy titled, “Electronic Staffing Data Submission Payroll-Based Journal” with a revision date of 6/30/25, revealed, “ .Mandated to submit to CMS (Centers for Medicare and Medicaid Services) complete and accurate direct care staffing information, including information for agency and contract staff, based on payroll and other verifiable and auditable data in a uniform format according to specifications established by CMS. […]

• No harm, potential for more than minimal, isolatedF641Jul 31, 2025

  Based on staff interview, record review, and facility policy review, the facility failed to code the Minimum Data Set (MDS) accurately for a resident with a Mental Illness for one (1) of the 22 sampled residents. Resident #19 Findings include: Review of the facility policy titled “Nursing Assessment and Interdisciplinary Care Plan,” with a revision date of 06/2023, revealed: 2. Long Term Care Facility will conduct a comprehensive, accurate, standardized reproducible assessment upon admission and at regular intervals to ensure that each resident meet his/her highest practicable level of physical, mental, and psycho-social functioning: Physical and mental functional status . […]

• No harm, potential for more than minimal, isolatedF656Oct 12, 2022

  Based on staff interview, resident interview, record review, and facility policy review, the facility failed to implement a comprehensive care plan for Activities of Daily Living (ADL)s for a dependent resident, as evidence of long, rough fingernails, for 1 (one) of 22 residents reviewed for ADL care. Resident #18 Findings include: A review of the facility policy, with an effective date of 03/2021, titled, Nursing Assessment and Interdisciplinary Care Plan under purpose; The purpose is to ensure resident's assessments will be performed by Registered Nurse and that all State and Federal regulations are implemented for MDS+. […]

• No harm, potential for more than minimal, isolatedF677Oct 12, 2022

  Based on observations, staff and resident interviews, and record review, the facility failed to provide nail care for one (1) of 22 residents reviewed for Activities of Daily Living (ADL) care. Resident #18 Findings include: The facility does not have a policy related to nail care. An observation and interview, on 10/10/22 at 11:03 AM of Resident # 18 revealed he had long and jaggad fingernails with a brown substance underneath them on his right hand. An observation of Resident # 18 on 10/11/22 at 9:25 AM revealed the resident had long jagged fingernails with a brown substance under them on his right hand. […]