Kimball Farms Nursing Care Center

In the surveyor’s words

From the most serious findings on record at Kimball Farms Nursing Care Center, in the surveyor’s own words.

• No harm, potential for more than minimal, widespreadF638May 22, 2023

  Based on record review and interview, the facility failed to ensure its staff completed Quarterly Minimum Data Set (MDS) Assessments within the required timeframe for 12 Residents (#10, #17, #23, #26, #29, #41, #43, #50, #53, #61, #66 and #73 out of 14 sampled residents. Findings include: Review of the Centers for Medicare and Medicaid Services (CMS) Resident Assessment Instrument (RAI) version 3.0 Manual, dated October 2019, indicated the Quarterly MDS Assessment must be completed no later than 14 calendar days after the Assessment Reference Date (ARD- refers to the last day of the observation period that the assessment covers for the resident). 1. Resident #10 was admitted to the facility in January 2021. […]

• No harm, potential for more than minimal, patternF880Dec 9, 2025

  Based on observations, record reviews, and interviews, the facility failed to adhere to infection control standards of practice to prevent contamination and the spread of infections for six Residents (#43, #25, #5, #8, #3, and #40) out of a total sample of 17 residents, and on two units (Windemere and [NAME]) out of a total of three units. Specifically, the facility failed to ensure that:1) for Resident's #43, #25, #5, #8 and #3, who resided on the Windemere unit, the facility staff used the correct Personal Protective Equipment (PPE: items such as gowns, masks, eye protection or gloves that are used to prevent the spread of infection) for residents who were on Contact/Droplet Isolation for COVID-19 infection placing other residents and staff at risk of cross contamination and infection. […]

• No harm, potential for more than minimal, patternF640May 22, 2023

  Based on record review and interview, the facility failed to ensure its staff completed Discharge Minimum Data Set (MDS) Assessments for three Residents (#19, #70 and #73) out of 14 sampled Residents. Findings include: Review of the Centers for Medicare and Medicaid Services (CMS) Resident Assessment Instrument (RAI) version 3.0 Manual, dated October 2019, indicated the Discharge MDS Assessment must be completed no later than 14 calendar days after the date of discharge from the facility. 1. Resident #19 was admitted to the facility in December 2022. Review of the medical record indicated the Resident was discharged from the facility on 4/19/23. Further review of the medical record indicated no Discharge MDS Assessment was completed. 2. […]

• No harm, potential for more than minimal, patternF641May 22, 2023

  Based on record review and interview the facility failed to ensure its staff accurately completed Minimum Data Set (MDS) Assessments for three Resident's (#44, #60, and #25) out of a total of 18 residents sampled. Specifically, the facility staff failed to accurately code an MDS Assessment relative to falls for Resident #44, mood assessment for Resident #60, and use of an antidepressant for Resident #25. Findings include: 1. Resident #44 was admitted to the facility in April 2023. Review of a nurses note dated 5/3/23 indicated Resident #44 fell on this date and was subsequently transferred to the hospital to be evaluated. Review of MDS Assessment with a target date of 5/5/23 indicated that the Resident had no falls since admission/entry, re-entry, or the prior assessment. […]

• No harm, potential for more than minimal, patternF761Aug 19, 2021

  Based on observations and interviews, the facility failed to A.) ensure a medication cart was clean and sanitary, on one of three units, and B.) failed to ensure stored narcotics were properly labeled, on two of three units. Findings include: A.) During an observation on [DATE] at 7:46 A.M. of the [NAME] Unit Medication Cart #3 with Nurse #3, the third medication drawer was found to be very sticky with a brown substance spilled onto the floor of the drawer. There were other bottles in the same drawer that were sticking to the floor of the drawer and they could not be easily removed from the drawer for usage. […]