Green Hills Health Care Center

In the surveyor’s words

From the most serious findings on record at Green Hills Health Care Center, in the surveyor’s own words.

• No harm, potential for more than minimal, patternF550Nov 21, 2024

  Based on observation, clinical record review, resident and staff interviews, and policy review, the facility failed to maintain dignity in dining for 2 of 4 residents (Resident #10 and #23) reviewed. The facility reported a census of 44 residents. Findings include: 1. The Minimum Data Set (MDS) dated [DATE] identified Resident #10 having BIMS (Brief Interview for Mental Status) of 10, indicating moderate cognitive impairment and had the following diagnoses: Alzheimer ' s Disease, Non-Alzheimer ' s Dementia, and history of stroke. The MDS also identified Resident #10 needing partial to moderate assistance with eating and no impairment of upper extremities. […]

• No harm, potential for more than minimal, patternF812Nov 21, 2024

  Based on observation, policy review, and staff interview, staff failed to serve food under sanitary conditions, in order to reduce the risk of contamination and foodborne illness. The facility reported a census of 44 residents. Findings include: On 11/20/24 with meal service starting at 11:10 AM, Staff A, Food & Beverage Coordinator put on a glove, with the gloved hand opened a drawer, and with the same gloved hand touched tater tots, placed tater tots on a pan and into the oven. While preparing residents' plates, Staff A frequently leaned over the plates sitting on the shelf of the steam table with his apron touching the top surface side of the plates where food was placed. […]

• No harm, potential for more than minimal, isolatedF655Nov 21, 2024

  Based on resident record review, staff interview, and facility policy review the facility failed to develop and implement a base line care plan to include a resident's use of a high-risk medication for 1 resident (Resident #35) of 5 residents reviewed for base line care plans. The facility reported a census of 44 residents. Findings include: The Minimum Data Set (MDS) for Resident #35, dated 11/8/24, included diagnoses of transient cerebral ischemic attack (stroke) long term use of anticoagulants (blood thinner medication). The MDS documented the resident was receiving an anticoagulant. […]

• No harm, potential for more than minimal, isolatedF656Nov 21, 2024

  Based on resident record review, staff interview, and facility policy review the facility failed to develop and implement a comprehensive person-centered care plan to include a resident's pressure ulcer and treatment for 1 resident (Resident #22) of 12 residents reviewed for care plans. The facility reported a census of 44 residents. Findings include: The Minimum Data Set (MDS) for Resident #22, dated 10/8/24, included diagnoses of stroke and Parkinson's. The MDS documented the resident had a Stage 2 (partial-thickness skin loss with exposed dermis) and Stage 3 (full-thickness skin loss) pressure ulcer. […]

• No harm, potential for more than minimal, isolatedF658Nov 21, 2024

  Based on observation, resident record review, resident and staff interview, and facility policy review the facility failed to followed a physician's order for 1 resident (Resident #22) of 12 residents reviewed. The facility reported a census of 44 residents. Findings include: The Minimum Data Set (MDS) for Resident #22, dated 10/8/24, included diagnoses of stroke and Parkinson's. The MDS documented the resident had a Stage 2 (partial-thickness skin loss with exposed dermis) and Stage 3 (full-thickness skin loss) pressure ulcer. […]