The Knolls

In the surveyor’s words

From the most serious findings on record at The Knolls, in the surveyor’s own words.

• No harm, potential for more than minimal, patternF812Jul 6, 2021

  Based on observation, interview and record review conducted during a recertification survey, the facility did not ensure proper storage of food in accordance with professional standards for food safety. Specifically, 1) perishable foods were not labeled and dated, 2) foods were not discarded by use by date, and 3) dry goods were not stored in closed containers. .A facility policy and procedure titled Labeling and Dating, dated [DATE] and last revised on [DATE], included but was not limited to: All food items must be labeled with either a manufacturers label or handwritten label. […]

• No harm, potential for more than minimal, isolatedF657Jul 6, 2021

  Based on observation, interview, and record review conducted during a recertification survey, the facility did not ensure that comprehensive person-centered care plans with measurable goals and interventions were reviewed and revised for 1 of 5 Residents (Resident #63) reviewed for unnecessary medications. Specifically, (1) A Pharmacy Drug Review was conducted for Resident #63 and revealed a drug-drug interaction of concurrent use of Aspirin and [MEDICATION(S)] medication may increase the risk of bleeding and to monitor the resident; (2) There was no documented evidence the residents' care plans were reviewed and revised to reflect the drug-drug interactions as identified by the Pharmacist; (3) There was no evidence these changes were communicated among the nursing staff for ongoing… […]

• No harm, potential for more than minimal, isolatedF684Jul 6, 2021

  Based on interview and observation conducted during a recertification survey, it could not be ensured that the facility provided care and treatment in accordance with professional standards of practice. Specifically, the facility did not ensure that a change in skin condition was reported and treated timely for 1 of 1 resident (Resident #7) reviewed for skin conditions (non-pressure). The finding is: The facility policy and procedure titled Skin Care/Personal Grooming, dated 1/15/2002 and revised 12/2014 documented: Certified Nursimg Assistant (CNA) responsibility during AM bed bath, shower, or tub bath, inspects resident's skin for any redness, dryness, cracking, etc. Report any finding to Nurse. […]

• No harm, potential for more than minimal, isolatedF692Jul 6, 2021

  Based on observation, interview and record review conducted during a recertification survey, the facility did not ensure that facility staff accurately measured a resident's fluid intake to maintain proper hydration and health. Specifically,fluid restriction related to abnormal lab values was not followed for one of one resident (Resident #64) reviewed for hydration. Facility staff members did not accurately measure the resident's fluid intake during a recent lunch observation. The findings are: Resident #64 was admitted to the facility on [DATE] with diagnoses [MEDICAL RECORD OR PHYSICIAN ORDER] . […]

• No harm, potential for more than minimal, isolatedF756Jul 6, 2021

  Based on record review and interviews conducted during the Recertification survey, the facility did not ensure that the irregularities identified by the Pharmacist were communicated to the resident's primary medical doctor and acted upon. Specifically, monitoring of the Resident's blood levels of [MEDICATION(S)] did not occur in accordance with the physician's orders. This was evident for 1 (Resident #7) out of 5 residents reviewed for Unnecessary Medications. The finding is: An undated facility policy and procedure titled Drug Regimen Review revealed: The consultant pharmacist reviews the physician's orders, lab test result, nurse's notes, physician's notes, and resident's background in performing drug regimen reviews of each resident on a monthly basis; identifies a possible… […]