Central Continuing Care

In the surveyor’s words

From the most serious findings on record at Central Continuing Care, in the surveyor’s own words.

• Immediate jeopardy, isolatedF580Nov 9, 2021

  Based on record reviews and staff, Medical Director (MD) and Nurse Practitioner (NP) interviews the facility failed to inform the Physician of a supratherapeutic (above therapeutic level) Prothrombin Time/International Normalized Ratio (PT/INR) levels for a resident prescribed [MEDICATION(S)] (anticoagulant) when they notified him a severely cognitively impaired resident had an unwitnessed fall (Resident #45). The INR measures how long it takes blood to clot. Supratherapeutic levels above 4.9 are considered critical values and increase the risk of bleeding. The facility further failed to notify the Physician of dark purple bruising to the Resident's right hip at the time it was observed for the same resident. […]

• Immediate jeopardy, isolatedF684Nov 9, 2021

  Based on record review and staff, Medical Director (MD) and Nurse Practitioner (NP) interviews the facility failed to complete and document on-going thorough assessments of a resident's condition who was prescribed [MEDICATION(S)] (anticoagulant) after supratherapeutic (above therapeutic level) International Normalized Ratio (INR) levels were reported beginning on [DATE] and an unwitnessed fall on [DATE]. The INR measures how long it takes blood to clot. A dark purple bruise was observed on Resident #45's right side on [DATE]. Resident #45's INR was 8 on [DATE] and she was observed with dark red bleeding from the mouth and bruising to the abdomen, right flank, and bilateral arms and was sent to the emergency room for an evaluation. […]

• Immediate jeopardy, isolatedF714Nov 9, 2021

  Based on record review, Physician and Nurse Practitioner (NP) interviews the NP failed to communicate and collaborate with the Physician for a resident with supratherapeutic (amounts of a drug that are greater than the therapeutic concentration) [MEDICATION(S)] (an anticoagulant - a medication which prevents blood from clotting) values. This failure affected 1 of 1 resident on [MEDICATION(S)] therapy resulting in hospitalization for [MEDICATION(S)] toxicity (Resident #45). Immediate jeopardy began on [DATE] when the Nurse Practitioner failed to communicate and collaborate with the Physician on supratherapeutic [MEDICATION(S)] values for Resident #45. […]

• Immediate jeopardy, isolatedF757Nov 9, 2021

  Based on record reviews and Medical Director (MD), Nurse Practitioner (NP) and Pharmacist interviews the facility continued to administer [MEDICATION(S)] (anticoagulant) in the presence of supratherapeutic (above therapeutic level) Prothrombin Time/International Normalized Ratio (PT/INR) levels. The INR measures how long it takes blood to clot. Supratherapeutic INR levels above 4.9 are considered critical values and increase the risk of bleeding. On [DATE] Resident #45's INR was 8 and she was observed with dark red bleeding from the mouth and bruising to the abdomen, right flank, and bilateral arms and was sent to the emergency room for an evaluation and admitted and treated for [MEDICAL RECORD OR PHYSICIAN ORDER] . […]

• No harm, potential for more than minimal, patternF695Aug 7, 2024

  Based on observations, record review, and staff interviews the facility failed to post cautionary safety signs that indicated the use of oxygen for 5 of 7 residents reviewed for oxygen use (Resident #47, #30, #48, #19, and #70). The findings included: a. Resident #47 was admitted to the facility on [DATE] with a diagnosis of respiratory failure. A physician's order dated 7/30/2024 revealed Resident #47 was ordered to wear 2 liters per minute of oxygen continuously. An observation was conducted on 8/4/2024 at 9:56 am. Resident #47 was observed with his eyes closed in bed and oxygen being administered at a rate of 2 liters per minute via nasal cannula. There was no oxygen signage outside of Resident #47's room or on the doorframe. […]