Groves Center

In the surveyor’s words

From the most serious findings on record at Groves Center, in the surveyor’s own words.

• Immediate jeopardy, widespreadF600Jan 12, 2024

  Based on interviews with residents, staff and administrative staff, and Medical Director, and review of the clinical record, incident log, and policy and procedure, it was determined the facility failed to protect residents' right to be free from physical, verbal, psychological, psychosocial and sexual abuse, and neglect by failing to implement a systematic process to carry out their abuse policy to ensure witnessed or reported abusive interactions, neglect and injuries were fully investigated and addressed for nine residents (#164, #6, #36, #90,#32, #100, #308, #106, #12) of 12 residents sampled. Incidents occurred between residents (#164, #6, #36) and staff members and between a resident (#90) and two other residents (#32, and #100). […]

• Immediate jeopardy, widespreadF610Jan 12, 2024

  Based on observation, interviews with residents, facility staff, resident representatives, the Clinical Manager of a dialysis facility, and the Medical Director, and review of policy and procedures, clinical records, training records and incident logs, it was determined the facility failed to identify, investigate, prevent, and take corrective action for the neglect of two (#308 and #106) of 12 residents reviewed for abuse and neglect. The facility failed to ensure wound care orders were implemented for Resident #308 and #106 resulting in the worsening of the wounds, and failed to investigate the cause of a fracture of unknown origin for one (#12) of 12 residents. […]

• Immediate jeopardy, widespreadF726Jan 12, 2024

  Based on observations, staff interviews, medical record reviews personnel record reviews and training records, the facility failed to have competent staff to identify abuse, protect residents during abuse investigations and investigate abuse allegations to prevent reoccurring abuse; the facility failed to have competent staff to accurately assess residents' medical conditions and to provide care and treatment to prevent worsening of conditions, for pressure ulcers, and significant change in condition after a fall. […]

• Immediate jeopardy, widespreadF835Jan 12, 2024

  Based on interviews, record reviews and review of job descriptions, the facility's administration failed to utilize resources to ensure adequate supervision to effectively implement a systematic process to carry out the facility's abuse policy for seven residents (#32, #90, #100, #6, #36, #12, #164), failed to ensure the facility staff provided care and services to prevent the worsening of wounds for two residents (#308 and #106), failed to ensure hot water temperatures were maintained at a comfortable level for residents on one hallway (Hall 100), and failed to ensure oversight of nurse competency training with the potential to affect a total census of 112 residents. […]

• Immediate jeopardy, widespreadF867Jan 12, 2024

  Based on observations, interviews, and record review, the facility failed to utilize the Quality Assurance and Performance Improvement (QAPI) process to investigate, develop, and implement an effective Performance Improvement Plan (PIP) to ensure the facility was free from abuse and neglect. During a survey conducted on 01/08/24 to 01/12/24 non-compliance was found for 9 of 12 residents reviewed for abuse and neglect. The incidents/allegations included resident to resident physical/sexual abuse (#32, #90, #100), staff to resident physical abuse (#6, #164), staff to resident verbal abuse (#36), and neglect resulting in worsening of wounds (#308, #106), and failure to investigate a fracture of unknown origin (#12). […]