Brickyard Healthcare - Fountainview Care Center

In the surveyor’s words

From the most serious findings on record at Brickyard Healthcare - Fountainview Care Center, in the surveyor’s own words.

• Actual harm, isolatedF689Mar 15, 2023

  Based on observation, record review, and interview, the facility failed to provide a safe mechanically lifted transfer to prevent a major injury (Resident C), and safe activities of daily living (ADL) during a bed bath requiring bed mobility to prevent injury (Resident B) for 2 of 3 residents reviewed for accidents. Findings include: 1. A clinical record review was completed on 3/13/2023 at 11:18 A.M. Diagnoses included, but were not limited to: necrotizing fasciitis, left lower extremity below the knee amputation, sepsis, anemia, and chronic kidney disease. An Admission Minimum Data Set (MDS) Assessment reviewed on 1/16/2023, indicated Resident C had moderate cognitive impairment. She required extensive assistance with two or more staff members for bed mobility, transfers, and toileting. […]

• Actual harm, isolatedF684Feb 6, 2023

  A. Based on interview and record review, the facility failed to ensure physician orders were carried out in a timely manner for a resident who was admitted to the facility after ventral hernia repair surgery as a result the resident required hospitalization for debridement and IV therapy for 1 of 3 Residents reviwed (Resident G) B. Based on record review and interview, the facility failed to ensure admission orders for surgical treatment and timely physician follow up appointment for a resident with fracture of neck of left femur, and surgical treatment for a resident with a left below the knee amputation for 3 of 3 charts reviewed for physician orders. (Resident E, F, G) Findings include: 1. The clinical record review for Resident G was conducted on 2/1/2023 at 9:00 A.M. […]

• Actual harm, isolatedF804Feb 6, 2023

  Based on record review and interview the facility failed to prevent burns from hot liquids by serving it at an inappropriate temperature resulting in a partial thickness to full thickness burn.(Resident D). Finding includes: An Incident Report, dated 1/20/23, indicated .Description added: Resident was in room and yelled. Staff responded and noted resident had spilt her hot tea .Action Taken: Resident assessed, NP [Nurse Practitioner] notified with new orders .Type of injury: Belly area has a 48 cm [centimeter] by 22 cm open blister area with redness noted by nurse During an interview, with Resident D, on 2/1/23 at 9:55 A.M., Resident D indicated she was sitting in her wheelchair with the overbed table across her lap, she was served hot tea in a Styrofoam cup that did not have a lid. […]

• Actual harm, isolatedF689Aug 24, 2021

  Based on interview and record review, the facility failed to develop and implement a complete and adequate policy regarding falls/accidents which addressed post fall assessments. The facility also failed to follow up with changes of condition for a resident after a witnessed fall. This deficient practice resulted in the resident experiencing a right [CONDITION(S)] for 1 of 3 residents reviewed for falls. (Resident B) Finding includes: On 8/23/21 at 10:50 A.M., a review of the clinical record for Resident B was conducted. The record indicated the resident was admitted on [DATE], with a re-admission on 8/14/21, after a hospital stay for a fractured hip. […]

• No harm, potential for more than minimal, patternF628May 27, 2025

  Based on interview and record review, the facility failed to notify the Long Term Care (LTC) Ombudsman in a timely manner of resident discharges for 3 of 5 residents reviewed for discharges. (Residents 32, 75 and 76) Findings include: 1. On 4/17/2025 Resident 75 was discharged to home after completing therapy and meeting goals. On 5/23/2025 at 1:42 P.M. a list of LTC Ombudsman discharge notifications for February, March and April 2025 were requested from the ED. During an interview on 5/27/2025 at 9:11 A.M. the ED indicated she received an email from the LTC Ombudsman with the discharges for February and March 2025 but not April. The email indicated the LTC Ombudsman had not received any documentation of discharges for April 2025. […]