Grandview Post Acute

In the surveyor’s words

From the most serious findings on record at Grandview Post Acute, in the surveyor’s own words.

• Immediate jeopardy, isolatedF600May 27, 2021

  Based on Facility policy review, medical record review and interview, the facility failed to provide treatment and services as care planned to prevent constipation and fecal impaction for Resident #2 placing the Resident in Immediate Jeopardy (a situation in which the provider's noncompliance with one or more requirements of participation has caused or is likely to cause serious injury, harm, impairment, or death to a resident). On [DATE] Resident #2 was diagnosed with severe fecal impaction after being transferred to a local emergency room after vomiting what the facility staff described as black slime. Resident #2 expired shortly after admission to the hospital on [DATE]. […]

• Immediate jeopardy, isolatedF690May 27, 2021

  Based on policy review, medical record review, and interview the facility failed to administer treatment and services to restore normal bowel function for 2 Residents (#2 and #7) of 7 Residents reviewed for bowel protocol placing both Residents in Immediate Jeopardy (a situation in which the provider's noncompliance with one or more requirements of participation has caused or is likely to cause serious injury, harm, impairment, or death to a Resident). On [DATE] Resident #2 was diagnosed with severe fecal impaction after being transferred to a local emergency room after vomiting what the facility staff described as black slime. Resident #2 expired shortly after arrival to the hospital. […]

• No harm, potential for more than minimal, widespreadF908May 6, 2025

  Based on facility policy review, observations, and interviews, the facility failed to ensure kitchen equipment of 1 gas cook top oven and 1 deep fryer was maintained in good working condition. The findings include: Review of the facility's Nutritional Services policy titled, Cleaning & Sanitization, dated 9/2/2020, revealed .The Director of Food and Nutrition Services will develop, implement, and monitor schedules for cleaning, sanitizing and maintenance . Review of facility documentation titled, Instructions .Facility Inspection: Inspect kitchen small appliances, undated, revealed .Conduct safety and operation inspections .Visually inspect all appliances for damage .Test functionality of appliances and proper operation of all controls .Inspect all tethered gas fed appliances . […]

• No harm, potential for more than minimal, widespreadF583Mar 31, 2022

  Based on facility policy review, medical record review, observation, and interview, the facility failed to maintain patient confidentiality related to 3 computer screens open with resident health information visualized with no staff attendance. The findings include: Review of the facility policy titled, Patient Confidentiality, dated 2/2021, revealed, .Confidentiality is defined as safeguarding the content of information .or other computer stored information from unauthorized disclosure without the consent of the resident and/or representative .all efforts will be made to protect the confidentiality/privacy of the resident and their health information .this includes medical records .the electronic record is equipped with security features that allow only those with a password to retrieve… […]

• No harm, potential for more than minimal, widespreadF725Mar 31, 2022

  Based on facility policy review, facility documentation review, medical record review, observations, and interviews, the facility failed to maintain adequate staffing levels to meet the care needs of 5 of 44 sampled residents (Resident #19, #27, #31, #34, #37, and #51) residing on 3 of 5 hallways having the potential to affect the entire facility related to receiving showers/baths, passing meal trays, and turning and repositioning residents every 2 hours. The findings include: Review of the facility's policy titled, Nurse Staffing Posting Information, dated 11/2017 and revised 11/2018, revealed, .It is the policy of this facility to have sufficient staff to provide nursing services to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident… […]