Shawnee Senior Living

In the surveyor’s words

From the most serious findings on record at Shawnee Senior Living, in the surveyor’s own words.

• Immediate jeopardy, isolatedF689Aug 29, 2024

  Deficiencies at this level require more than one deficient practice statement. A. Based on interview and record review, the facility failed to ensure residents assessed as being at risk for elopement were supervised and interventions were implemented to prevent elopement for 2 of 3 (R96 and R162) residents reviewed for accidents and supervision in the sample of 51. This failure resulted in R96, who had a history of elopement, and was assessed as being at risk of elopement, exiting the facility when a visitor entered, without staff knowledge, walking half the length of the facility and re-entering through the kitchen door that is located at the end of the facility, and R162 exiting the facility through a window, crossing a busy highway, and walking approximately 1.3 miles without staff… […]

• Immediate jeopardy, isolatedF600Jul 24, 2024

  Failures at this level require more than one Deficient Practice Statement. A. Based on observation, interview, and record review, the facility failed to ensure a resident was free from neglect when they failed to accurately assess, treat, and prevent a significant decline in condition for 1 (R1) of 3 residents reviewed for neglect in the sample of 24. This failure resulted in R1, who has a history of confusion with infections, experiencing altered mental status and refusing overall care after being diagnosed with a urinary tract infection. R1's refusals of care additionally led to R1 developing a Stage 3 pressure ulcer, an unstageable pressure ulcer with sepsis secondary to skin and soft tissue infection, subsequently requiring an 11-day hospitalization for IV antibiotic therapy. […]

• Immediate jeopardy, isolatedF689Jul 24, 2024

  Based on observation, interview, and record review, the facility failed to ensure residents assessed as being at risk for elopement were supervised, interventions to prevent elopement were implemented, and incidents of elopement were thoroughly investigated for 1 of 3 (R16) residents reviewed for accidents and supervision in the sample of 24. This failure resulted in R16, who had a history of elopement and was assessed as being at risk of elopement, exiting the facility and walking approximately two tenths of a mile down a busy road without staff supervision. This failure resulted in an Immediate Jeopardy, which was identified to have begun on 6/13/24 when R16 was identified to be at risk for elopement and the facility did not implement interventions to prevent elopements. […]

• Immediate jeopardy, isolatedF600Jan 17, 2023

  Based on interview and record review, the facility failed to protect the residents right to be free from neglect by failing to accurately assess, treat, document, and report a decline in condition to the physician and seek timely medical treatment for 1 of 5 residents reviewed for neglect in the sample of 25. These failures resulted in an Immediate Jeopardy, which was identified to have begun on 12/26/22, when the facility failed to monitor R2's vital signs and report a decline in condition to R2's physician and/or seek timely medical treatment. […]

• Immediate jeopardy, isolatedF684Jan 17, 2023

  Based on interview and record review, the facility failed to ensure care was provided per current standards of practice when they failed to accurately assess, treat, document, and report a decline in condition to the physician and seek timely medical treatment for 3 of 5 residents (R2, R3, and R5) residents reviewed for quality of care in the sample of 25. These failures resulted in an Immediate Jeopardy, which was identified to have begun on 12/26/22, when the facility failed to monitor R2's vital signs, report a decline in condition to R2's physician, and/or seek timely medical treatment. […]