Sabino Canyon Rehabilitation & Care Center

In the surveyor’s words

From the most serious findings on record at Sabino Canyon Rehabilitation & Care Center, in the surveyor’s own words.

• No harm, potential for more than minimal, patternF584Aug 25, 2023

  Based on observations, review of records, maintenance log, and policy, and staff and resident interviews, the facility failed to provide a safe, clean, comfortable, homelike environment for 21 out of 86 residents sampled and ensure that all areas in the facility are in good repair. The deficient practice could result in accidents and or impact resident health. Findings included: -Resident #225 was admitted on [DATE] with diagnoses including a malignant neoplasm of the right upper lobe of the bronchus or lung, emphysema, chronic obstructive pulmonary disease, asthma muscle weakness and difficulty walking. An MDS (Minimum Data Set) assessment dated [DATE] revealed a BIMS (brief interview of mental status) score of 15, indicating that the resident was cognitively intact. […]

• No harm, potential for more than minimal, patternF689Aug 25, 2023

  Based on resident and staff interviews, review of clinical records and facility policies, and observations of current practice, the facility failed to ensure that one resident (#23) out of 19 sampled, received adequate supervision to prevent medication accidents. The deficient practice could result in the resident sustaining medication accident-related injuries. Findings included: Resident #57 was admitted on [DATE] with diagnoses that included fracture of the sacrum, pneumocystosis, muscle weakness, chronic obstructive pulmonary disease, and depression. A review of the MDS (minimum data set) assessment dated [DATE] revealed a BIMS (brief interview of mental status) score of 15, indicating that the resident is cognitively intact. […]

• No harm, potential for more than minimal, patternF686Jul 28, 2022

  Based on clinical record review, observation, staff interviews, and policy review, the facility failed to ensure one resident (#35) was consistently provided the necessary treatment and services to promote the healing of pressure ulcers. The sample size was 2 residents. The deficient practice could result in delayed healing of pressure ulcers. Findings include: Resident #35 was admitted on [DATE] with diagnoses [MEDICAL RECORD OR PHYSICIAN ORDER] . Review of the care plan initiated on January 12, 2015 revealed the resident had the potential for pressure ulcer development related to immobility and non-adherence to repositioning, and a history of pressure injury to the right and left buttocks. […]

• No harm, potential for more than minimal, patternF880Jul 28, 2022

  Based on observations, staff interviews, manufacturer instructions, and review of policy, the facility failed to ensure appropriate infection control protocol was followed during point-of-care glucose testing. The deficient practice increases the risk for transmission of infectious disease and/or bloodborne pathogens. Findings include: On 07/27/22 at 7:10 a.m., an observation of point-of-care glucose testing was conducted with a Licensed Practical Nurse (LPN/staff #83) on the Transmission Based Precautions unit. Staff #83 obtained a small storage basket which measured approximately 4 inches by 4 inches from the medication cart. Inside the basket approximately 20 packaged alcohol wipes, a container of testing strips, multiple lancets and a glucometer were identified. […]

• No harm, potential for more than minimal, patternF609Oct 25, 2021

  Based on clinical record review, staff interviews, review of facility records, review of the State database and review of facility policies and procedures, the facility failed to ensure that an allegation of neglect for one resident (#1) was reported to the State Agency within required time frame of 2 hours. The deficient practice could result in additional incidents of neglect not being reported as required. Findings include: Resident #1 was admitted [DATE] with diagnoses [MEDICAL RECORD OR PHYSICIAN ORDER] . A quarterly MDS (Minimum Data Set) assessment dated [DATE] included that resident #1 had a BIMS (Brief Interview for Mental Status) score of 15, which indicated that the resident was cognitively intact. […]