Dove Healthcare - Spooner

In the surveyor’s words

From the most serious findings on record at Dove Healthcare - Spooner, in the surveyor’s own words.

• Actual harm, isolatedF684May 23, 2024

  Based on observations, interviews and record reviews, the facility did not provide diabetic care and treatment by professional standards of practice to maintain a resident's highest practicable level of physical well-being for 1 of 14 residents (R32) reviewed. Staff did not follow diabetic protocol to manage R32's type 1 diabetic hypoglycemia episodes by not providing glucagon when blood sugars were below 70 and re-checking low blood glucose (BG) levels within 15 minutes after intervention. Staff did not notify R32's physician when hypoglycemic and hyperglycemic episodes were occurring to change treatment. Staff did not monitor R32's vital signs, monitor and documenting signs and symptoms. […]

• Actual harm, isolatedF760May 23, 2024

  Based on observation, record review and interview, the facility did not ensure that residents are free of significant medication errors for 1 of 14 residents (R32) reviewed for medication errors. R32 has a type 1 diabetes mellitus diagnosis. Facility staff administered glucagon three times with no documentation and reasoning for giving glucagon outside of blood glucose parameters. Facility staff did not administer glucagon when R32's blood glucose levels were 30 to 54. Facility staff did not follow physician orders when insulin was held and administered insulin as R32 requested. The facility did not have a physician order to allow R32 direct the amount of insulin administered. Findings include: Surveyor reviewed the policy titled, Management of Hypoglycemia which stated in part, #2. […]

• Actual harm, isolatedF686Sep 28, 2022

  Based on interviews and record reviews, the facility did not update the care plan with nor provide new interventions to promote the healing of pressure injuries according to current standards of practice for 1 of 1 residents (R) reviewed for pressure injuries (R4.) On 08/12/22, R4 had a significant change in condition due to a broken arm resulting in needing additional assistance with cares and mobility. The facility did not implement new interventions for R4's decreased mobility. After discovering R4's pressure injury on 08/22/22, the facility did not implement new repositioning interventions to promote the healing of the pressure injury. This is evidenced by: R4 was admitted to the facility on [DATE]. diagnoses [MEDICAL RECORD OR PHYSICIAN ORDER] . […]

• No harm, potential for more than minimal, widespreadF812Jul 23, 2025

  Based on observation, interview and record review, the facility did not ensure proper sanitation practices to prevent the outbreak of foodborne illness which had the potential to affect all 45 residents.-The facility did not ensure dishes were dried appropriately.-The facility did not ensure proper cleaning of portable steam tables before replacing clean covers.Findings include:The facility policy entitled, Dishwashing, (no date) reads in part: All items are air dried in racks before storing.The facility policy regarding steam tables (no date, no title), reads in part: Wash top of steam table with warm soapy water and cloth. Spray sanitizing solution.empty water.wash all covers after each meal. On 07/22/25 at 9:20 AM, Surveyor entered the kitchen to observe dish washing. […]

• No harm, potential for more than minimal, widespreadF880Jul 23, 2025

  Based on interview and record review, the facility failed to ensure it maintained an infection prevention and control program designed to help prevent the development and transmission of communicable disease and infections such as COVID-19. This had the potential to affect all 45 residents. -The facility did not test staff or residents with symptoms of COVID-19. -Staff did not use a barrier under the graduate when emptying the catheter for R3.-The facility did not ensure proper infection control measures were conducted when providing a shower and during catheter care for R3 who is on Enhanced Barrier Precautions (EBP). […]