NHC Healthcare, Smithville

In the surveyor’s words

From the most serious findings on record at NHC Healthcare, Smithville, in the surveyor’s own words.

• Immediate jeopardy, patternF600Apr 11, 2024

  Based on facility policy review, facility investigation review, medical record review, observation, and interview the facility failed to provide an environment free from abuse for 5 of 9 sampled residents (Resident #1, Resident #2, Resident #6, Resident #7 and Resident #8) reviewed for abuse. On [DATE] Resident #2, a vulnerable, severely cognitively impaired, ambulatory female resident wandered into Resident #1's room. Resident #1, an alert male resident with a Brief Interview for Mental Status (BIMS) score of 15 and an extensive psychiatric history, willfully hit Resident #2 multiple times on her head and back. On [DATE] Resident #7, a vulnerable, severely cognitively impaired, female resident in a wheelchair, bumped into Resident #1's wheelchair in the dining room. […]

• Immediate jeopardy, isolatedF689Apr 11, 2024

  Based on facility policy review, medical record review, www.wunderground.com, Electrical Company invoice, observation and interview, the facility failed to provide adequate supervision to prevent an accident for 2 (Resident #5 and Resident #10) of 6 sampled residents reviewed for accidents. The facility failed to ensure adequate supervision to prevent an exit seeking, wandering, cognitively impaired resident (Resident #10) with a Brief Interview for Mental Status (BIMS) score of 9, assessed to be an elopement risk, from leaving a safe environment and exiting the facility to an unsafe environment. Resident #10 (wearing a wander guard bracelet) exited a double door connected to the door alarm/wander guard system that malfunctioned on [DATE] at an unknown time until [DATE] at 2:00 AM. […]

• Actual harm, isolatedF656Apr 11, 2024

  Based on facility policy review, medical record review, observations, and interviews, the facility failed to develop and implement a comprehensive person-centered care plan for 2 of 17 residents sampled (Resident #5 and Resident #7) that resulted in actual harm for Resident #5. The findings include: Review of the policy titled, Documentation Guidelines, dated 6/2023 revealed, .The center will ensure an interdisciplinary and comprehensive approach to the development of the patient's care plan of care. […]

• No harm, potential for more than minimal, isolatedF644Feb 27, 2025

  Based on facility policy review, medical record review, and interview, the facility failed to resubmit a Pre-Admission Screening and Resident Review (PASRR) to include an active mental health condition present upon admission for 1 resident (Resident #74) of 7 residents reviewed for PASRR. The findings include: Review of the facility's policy titled, PRE-ADMISSION SCREENING AND RESIDENT REVIEW (PASRR), revised 11/2016, revealed .all centers to screen patients before admission to determine if they have Mental Illness, Intellectual or Developmental Disability or related condition .It must be determined whether this individual requires the level of services provided by a health care center or whether they need specialized treatment .Center should refer any patient for a Level II resident… […]

• No harm, potential for more than minimal, isolatedF842Feb 27, 2025

  Based on facility policy review, medical record review, and interviews, the facility failed to ensure the medical record was accurate for 1 resident (Resident #37) of 25 residents reviewed for accurate medical records. The findings include: Review of the facility's policy titled, Introduction to Documentation For Inpatient Medical Records, dated 11/2023, revealed .It is the responsibility of each health care center to establish and maintain comprehensive records which accurately reflect all aspects of the organization .Professional Standards of Documentation .Observations .assessments/evaluations .are accurately recorded . […]