Springs Village Care Center

In the surveyor’s words

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

• Actual harm, isolatedF550Sep 14, 2023

  Based on record review and interviews, the facility failed to ensure two (#8 and #52) of two out of 47 sample residents had the right to a dignified existence. Specifically, the facility failed to ensure call lights were answered timely for Resident #8 and Resident #52, who were both dependent on staff for assistance. Resident #8 said she felt lonely and ignored when staff took over an hour to answer her call light and Resident #52 said she felt humiliated when her call light was not answered timely resulting in an episode of incontinence. Findings include: I. Facility policy and procedure A. The Answering the Call Light policy and procedure, revised in March 2021, was provided by the nursing home administrator (NHA) on 9//14/23 at 7:25 p.m. […]

• Actual harm, isolatedF689Sep 14, 2023

  Based on record review, observations, and interviews, the facility failed to ensure one (#32) of four out of 47 sample residents received adequate supervision to prevent accidents. Specifically, the facility failed to ensure Resident #32, who had a history of falls, was a high fall risk and was identified by the facility upon admission to be impulsive and not ask for assistance, received the care and services indicated in her comprehensive care plan. The facility failed to ensure Resident #32 received the supervision required to prevent the resident from getting up without assistance. The facility failed to implement the interventions effectively and identify the trend that the resident's falls focused around the resident using the bathroom. […]

• Actual harm, isolatedF697Sep 14, 2023

  Based on observations, interviews, and record review, the facility failed to manage pain in a manner consistent with professional standard of practice, the comprehensive person-centered care plan, and the resident's goals and preferences for one (#3) of three residents reviewed for pain out of 47 sample residents. Resident #3 had a diagnosis of schizophrenia (brain disorder), developmental disorder, anxiety, post-traumatic stress disorder (PTSD), restless leg syndrome, and pain. In an interview on 9/11/23 the resident, holding her left knee and grimacing, said the knee pain had started a couple of months ago. Resident #3 said her pain level had increased on 9/10/23 and progressively gotten worse. […]

• Actual harm, isolatedF550May 18, 2021

  Based on interviews and record review, the facility failed to ensure residents on one out of three units had the right to a dignified existence. Specifically, the facility failed to ensure residents experienced a dignified living experience by answering the call lights timely to include Residents #10, Resident #7, Resident #9 and Resident #8's roommate. The feeling of dehuminization is evidenced by the residents' interviews. Resident #9 dependent on staff said, it made her feel as though she was not importnant. She said it really bothered her to sit in a dirty brief for a long period of time. […]

• No harm, potential for more than minimal, widespreadF812Sep 14, 2023

  Based on observations, interviews and record review the facility failed to store, prepare, distribute and serve food in a sanitary manner in the kitchen. Specifically, the facility failed to: -Ensure food was labeled and dated and disposed of timely in the walk-in refrigerators, dry storage and reach-in refrigerator in the main kitchen and in four nourishment rooms; -Ensure the handwashing sink was only used for handwashing; -Ensure cooked food items were monitored and cooled properly; and, -Ensure proper hand hygiene. Findings include: I. Ensure food was labeled and dated and disposed of timely A. […]