Nicholasville Nursing and Rehabilitation

In the surveyor’s words

From the most serious findings on record at Nicholasville Nursing and Rehabilitation, in the surveyor’s own words.

• Immediate jeopardy, isolatedF711Feb 2, 2021

  Based on interview, record review, review of the facility's Job Description, and review of the facility's policies, it was determined the facility failed to ensure the resident's Advanced Practice Registered Nurse (APRN) #1 reviewed the resident's total program of care, including medications and treatments at each visit for one (1) of four (4) sampled residents (Resident #1). On [DATE] at approximately 2:30 PM, the facility admitted Resident #1 from an acute care facility with diagnoses [MEDICAL RECORD OR PHYSICIAN ORDER] . The hospital's Infectious Disease (ID) Specialist ordered the resident to have the antibiotic [MEDICATION(S)], six hundred (600) milligrams (mg) every twelve (12) hours to treat the infection, and continue it through [DATE]. […]

• Actual harm, isolatedF656May 5, 2023

  Based on interview, record review, and review of the Resident Assessment Instrument Manual, Version 3 it was determined the facility failed to develop and implement care plan interventions for three (3) of sixteen (16) sampled residents (Residents #3, #5, and #2). Residents #3 and #5's care plan interventions were not developed and implemented to prevent escalation of aggressive behaviors, resulting in resident-to-resident abuse. Resident #2 fell at home and was in the hospital prior to transfer to the facility on [DATE]. Resident #2 had a fall on the day of admission to the facility, 02/22/2022, which resulted in a fractured wrist. On 04/07/2022, the resident had a fall without injury. On 05/13/2022, the resident had a third fall which resulted in a fractured hip. […]

• Actual harm, isolatedF689May 5, 2023

  Based on observation, interview, record review, review of the facility's investigative reports, and review of the facility's policy, it was determined the facility failed to have an effective system in place to ensure residents received supervision to prevent accidents for one (1) of six (6) sampled residents (Resident #2). The facility admitted Resident #2 with a history of falls. Resident #2 had a fall at home and in the hospital before his/her admission to the facility. Resident #2 had a fall on 02/22/2022, the day of admission to the facility, when staff left him/her alone in his/her room. This fall resulted in a fractured wrist. On 04/07/2022, the resident had a fall without injury. On 05/13/2022, the resident had a third fall which resulted in a fractured hip. […]

• No harm, potential for more than minimal, widespreadF755Sep 12, 2024

  Based on observation, interview, record review, and review of the facility's policy, the facility failed to maintain correct recordkeeping of all controlled drugs, which ensured an accurate inventory of medications by accounting for controlled medicines the facility received, dispensed, and administered. A review of narcotic count sheets revealed staff failed to sign inventory sheets for controlled narcotics and sign narcotic count sheets at the change of shift, for four of four medication carts. […]

• No harm, potential for more than minimal, widespreadF761Sep 12, 2024

  Based on observation, interview, record review, and review of the facility's policy, the facility failed to ensure all drugs used in the facility were labeled in accordance with professional standards for four of four medication carts. Undated opened medications were found in all medication carts. The findings include: Record review of the facility's policy titles, Administration Procedures for All Medications, effective date 09/2018, revised date 08/2020, revealed the facility staff was to check the expiration date on the package/container before administering any medication. The policy stated when opening a multi-dose container, place the date on the container. […]