Kyakameena Care Center

In the surveyor’s words

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

• Actual harm, isolatedF689Sep 22, 2023

  Based on observation, interview, and record review, the facility failed to provide supervision and maintain safety to prevent an avoidable accident for one of three sampled residents (Resident 1) when Certified Nurse Assistant (CNA) 1 provided Resident 1 two instant hot packs (a chemically activated disposable pack squeezed to pop an inner fluid bag and shaken to produce heat) without a physician order or protective barrier. Resident 1 placed the hot packs directly on her abdomen and was not supervised or reassessed during the application. This failure caused a second-degree burn (a burn that damages the outer layer [dermis] and second layer [epidermis] of skin) on Resident 1's lower abdomen. […]

• No harm, potential for more than minimal, widespreadF808Jun 10, 2021

  Based on observation, interview, and facility document review, the facility failed to serve two residents (Resident 51 and 49) of 57 sampled residents diets prescribed by a physician. This failure had the potential for two residents, Resident 51 and 49, to receive inadequate calories and/or nutrients contraindicated for a prescribed diet leading to nutritional related health issues. Findings: 1. An observation of trayline food service on 6/8/21, at 12 p.m., showed resident Cook 1 placed a scoop of mashed potatoes on a plate for resident 51's lunch. […]

• No harm, potential for more than minimal, widespreadF813Jun 10, 2021

  Based on observation, interview, and facility record review, the facility failed to store food, brought into the facility by visitors, safely for residents. The facility also failed to have a policy to show food would be stored safely for residents upon request. This failure had the potential for decreased food intake by residents who preferred to eat food brought in from outside sources for 56 residents who were able to eat food by mouth out of a facility census of 57. Findings: Review of the undated facility policy and procedure titled Food For Residents From Outside Sources showed food brought in from outside sources for the resident would first be shown to the charge nurse for approval to ensure the food was within the diet order parameters. […]

• No harm, potential for more than minimal, patternF638Nov 21, 2025

  Based on interview and record review, for four (Resident 1,10, 19, and 27) of five sampled residents, the facility failed to ensure quarterly Minimum Data Set assessments (MDS - a resident assessment instrument used to identify resident care problems to be addressed in an individualized care plan) were completed not less frequently than once every three months according to the regulation. This failure had the potential to result in delayed assessment of residents' needs, goals of care and inability to monitor each residents' progress over time. […]

• No harm, potential for more than minimal, patternF640Nov 21, 2025

  Based on interview and record review, for four (Resident 1,10,19, and 27) of five sampled residents, the facility failed to electronically transmit accurate and complete Minimum Data Set (MDS -a resident assessment instrument used to identify resident care problems to be addressed in an individualized care plan), data to the CMS system within 14 days after completion of resident's assessment.Definition: CMS - The Centers for Medicare & Medicaid Services provides health coverage through Medicare and Medicaid-a government national health insurance program that provided health insurance for adults and children with limited income and resources.These failures had the potential to result in the delay of assessment of residents' needs, goals of care and inability to monitor each resident's… […]