Cheyenne County Village Inc

In the surveyor’s words

From the most serious findings on record at Cheyenne County Village Inc, in the surveyor’s own words.

• Immediate jeopardy, isolatedF686Apr 3, 2024

  The facility identified a census of 43 residents with three residents reviewed for pressure ulcers. Based on record review and interview, the facility failed to identify, monitor, and provide appropriate treatments and interventions, to prevent pressure ulcers from worsening and prevent infection for Resident (R) 1. R1 admitted to the facility on [DATE] with a Stage 3 pressure ulcer (full thickness pressure injury extending through the skin into the tissue below) on his coccyx (area at the base of the spine). Nursing staff did not perform consistent wound assessments to include measurements and presence of infection. On [DATE], 81 days after admission, R1's wound had worsened and had foul-smelling yellow drainage. […]

• Actual harm, isolatedF697Apr 3, 2024

  The facility identified a census of 43 residents with three residents reviewed for pain. Based on record review and interview, the facility failed to provide Resident (R) 1 with pain relieving measures prior to or after pressure ulcer dressing changes though R1 had documented pain and demonstrated signs of discomfort during dressing change. This deficient practice resulted in untreated pain for R1 and placed him at risk for continued unnecessary pain and altered psychosocial well-being. […]

• No harm, potential for more than minimal, widespreadF812Jun 18, 2025

  The facility had a census of 21 residents. The sample included 12 residents. Based on observation, record review, and interview, the facility failed to store food by professional standards for food service safety in one kitchen. This deficient practice placed the residents who received their meals from the facility's kitchens at risk for foodborne illness. Findings included: - On 06/16/25 at 08:48 AM, observation in the kitchen revealed the following: In the walk-in refrigerator two pans of uncovered Jello. The two-door silver artic refrigerator had an unzipped bag of yellow square cheese and an unzipped bag with five hamburger patties, which left them open to the air. […]

• No harm, potential for more than minimal, widespreadF812Sep 28, 2023

  The facility had a census of 24 residents. The facility identified one main kitchen. Based on observation, record review, and interview the facility failed to prepare, store, and serve food in accordance with professional standards for food service safety for the 24 residents who resided in the facility and received their food from the facility kitchen, when facility failed to ensure clean and sanitary food prep areas. The facility kitchen staff failed to label and date food in the kitchen refrigerator and freezer. This placed the 24 residents, who resided at the facility and received food from the facility kitchen at risk for receiving foodborne illness. […]

• No harm, potential for more than minimal, widespreadF851Sep 28, 2023

  The facility had a census of 24 residents. Based on observation, interview, and record review, the facility failed to submit complete and accurate staffing information through Payroll Based Journaling (PBJ) as required. This deficient practice placed the residents at risk for unidentified and ongoing inadequate nurse staffing. Findings included: - The PBJ report provided by the Centers for Medicare & Medicaid Services (CMS) for Fiscal year (FY) 2022 Quarter 4 and FY 2023 Quarters 1 and 2 indicated the facility did not have licensed nurse coverage 24 hours a day, seven days a week on multiple (51) dates. Review of the facility licensed nurse timeclock data for the dates listed on the PBJ revealed a licensed nurse was on duty for 24 hours a day seven days a week. […]