The Laurels of University Park

In the surveyor’s words

From the most serious findings on record at The Laurels of University Park, in the surveyor’s own words.

• No harm, potential for more than minimal, patternF656Apr 24, 2024

  Based on observations, resident/staff interviews, facility document review and clinical record review, it was determined the facility staff failed to develop/implement the care plan for five of 39 residents in the survey sample, Residents #17, #18, #35, #135 and #189. The findings include: 1.The facility staff failed to develop the comprehensive care plan for anticoagulation therapy for Resident #17. Resident #17 was admitted to the facility on [DATE] with diagnosis that included but were not limited to: CHF (congestive heart failure) and DM (diabetes mellitus). A review of the comprehensive care plan dated 4/18/24, which revealed, FOCUS: Resident is at nutritional and/or dehydration risk related to: edema, CHF and DM. […]

• No harm, potential for more than minimal, patternF684Apr 24, 2024

  Based on staff interview, facility document review and clinical record review, it was determined the facility staff failed to ensure four of 39 residents in the survey sample, received care and services in accordance with professional standards of practice and the comprehensive care plan, Residents #2, #17, #18, and #135. The findings include: 1. For Resident #2, the facility staff failed to follow physician orders for obtaining weights and notifying the provider of a change in weight. The physician order dated, 3/31/2024, documented, Weights in the morning every Mon, Wed, Fri for HF (heart failure). NOTIFY PROVIDED IF WEIGHT GAIN OF 3 LBS (POUNDS) IN 24 HOURS OR 5 LBS IN A WEEK. The MAR (medication administration record) for April 2024, documented the above order. […]

• No harm, potential for more than minimal, patternF695Apr 24, 2024

  Based on observation, resident interview, staff interview, and clinical record review, it was determined that facility staff failed to provide respiratory care and services for four of 39 residents in the survey sample, Resident #s (R) R32, R38, R 35 and R2. The findings include: 1a. For R32, the facility staff failed to store a Bi-PAP mask (1) in a sanitary manner. R32 was admitted to the facility with diagnoses that included but were not limited to obstructive sleep apnea (2) and COPD (chronic obstructive pulmonary disease) (3). […]

• No harm, potential for more than minimal, patternF697Apr 24, 2024

  Based on resident interview, staff interview, clinical record review and facility document review, it was determined that the facility staff failed to implement a complete pain management program for three of 39 residents in the survey sample, Resident #s R97, R38 and R135. The findings include: 1. For R97, the facility staff failed to attempt non-pharmacological interventions prior to the administration of a prn (as needed) pain medications of Oxycodone (1) 5mg (five milligrams). On the most recent MDS (minimum data set), an annual assessment with an ARD (assessment reference date) of 04/04/2024, R97 scored 15 out of 15 on the BIMS (brief interview for mental status), indicating R97 was cognitively intact for making daily decisions. […]

• No harm, potential for more than minimal, patternF812Apr 24, 2024

  Based on observation, staff interview, and facility document review it was determined facility staff failed to store, prepare, and serve food in a sanitary manner in one of one facility kitchens. The findings include: On [DATE] at approximately 11:25 a.m., an inspection of the facility's kitchen was conducted with OSM (other staff member) #4, dietary manager. 1. On [DATE] at approximately 11:35 a.m., an observation of the top shelf inside the walk-in refrigerator revealed five bags of chopped cabbage available for use. Further observation revealed each of the one-gallon zip-loc storage bags had a use-by-date of [DATE]. OSM #4 immediately removed the bags of cabbage from the refrigerator. 2. […]