Country Lane Manor

In the surveyor’s words

From the most serious findings on record at Country Lane Manor, in the surveyor’s own words.

• Actual harm, isolatedF684May 2, 2024

  Based on clinical record review, policy review, resident interview and staff interviews, the facility failed to carry out assessments and interventions for 2 of 5 residents reviewed for a change in condition (Resident #10, and #209). The facility failed to carry out assessments/interventions for a resident with a low blood sugar (#10), and failed to carry out interventions after a resident did not have a bowel movement for multiple days (#209). The facility reported a census of 58 residents. Findings include: 1. The MDS assessment dated [DATE] revealed Resident #10 scored a 14 out of 15 on the BIMS exam, which indicated cognition intact. […]

• Actual harm, isolatedF686May 2, 2024

  Based on observations, staff interviews, resident interview, provider interview and clinical record review, the facility failed to implement timely interventions for residents identified at high risk for pressure ulcer development and to prevent worsening of wounds, perform thorough and consistent assessment which included wound measurements and wound description, and coordinate which staff from the clinical team staged and measured wounds for two of three residents reviewed for pressure ulcers (Resident #20, Resident #208). […]

• Actual harm, isolatedF689May 2, 2024

  Based on observations, clinical record review, policy review, and staff interviews, the facility failed to ensure an environment free of accidents and hazards for 4 of 6 residents reviewed for supervision. The facility failed to provide adequate supervision to prevent falls for Residents #42 and #18, and #19, and failed to utilize both foot pedals during wheelchair locomotion for Resident #211. The facility reported a census of 58 residents. Findings include: 1. The Minimum Data Set (MDS) assessment tool, dated 10/27/23, listed diagnoses for Resident #42 which included fracture of the right femur (leg bone), non-Alzheimer's dementia, and heart failure. The MDS documented the resident had a Brief Interview for Mental Status (BIMS) score of 6 out of 15 indicating impaired cognition. […]

• Actual harm, isolatedF692May 2, 2024

  Based on observations, clinical record review, policy review, staff interviews, family interview and resident interviews, the facility failed to develop and implement interventions to prevent/treat weight loss for 2 of 5 residents reviewed for nutrition (Residents #13 and #52) and failed to provide ordered supplements for 2 of 5 residents reviewed for nutrition (Residents #18 and #34). The facility reported a census of 58 residents. Findings include: 1. The Minimum Data Set (MDS) assessment tool, dated 3/27/24, listed diagnoses for Resident #52 which included dementia, adult failure to thrive, and muscle weakness. […]

• Actual harm, isolatedF689Aug 2, 2023

  Based on observation, clinical record review and staff interviews, the facility failed to safely provide cares when turning a resident in bed which led to a fall with facial fractures for 1 of 4 residents reviewed for supervision. (Resident #1) The facility reported census was 53. Findings include: According to the Quarterly Minimum Data Set (MDS) with an assessment reference date of 5/17/23, Resident #1 had long- and short-term memory deficits and a severely impaired cognitive status. Resident #1 required extensive to total dependence of two staff with mobility, transfers, dressing, toilet use and personal hygiene needs and a diagnosis, which included Non-Alzheimer's Dementia. In an interview on on 7/25/23 at 8:17 a.m. […]