The Waters of Shelbyville, LLC

In the surveyor’s words

From the most serious findings on record at The Waters of Shelbyville, LLC, in the surveyor’s own words.

• No harm, potential for more than minimal, isolatedF684Nov 29, 2023

  Based on facility policy review, medical record review, observation, and interview, the facility failed to follow MD (Medical Doctor's) orders for 1 of 17 (Resident #3) residents reviewed. The findings include: Review of the facility policy titled, GUIDELINES FOR PHYSICIAN ORDERS--(FOLLOWING PHYSICIAN ORDERS,) dated 6/18/2023, revealed, .It is the policy of the facility to follow the orders of the physician .All physician orders received pertaining to the resident will be implemented and followed throughout the course of the resident's stay in the facility as the orders are received . Review of the medical record for Resident #3 revealed he was admitted on [DATE] with diagnoses which included Chronic Obstructive Pulmonary Disease and Atrial Fibrillation. […]

• No harm, potential for more than minimal, isolatedF695Nov 29, 2023

  Based on facility procedure review, medical record review, observations, and interviews, the facility failed to ensure that a resident who needs respiratory care is provided such care, consistent with professional standards of practice, for 2 of 2 (Residents #3 and #4) residents reviewed. The findings include: Review of the facility's procedure titled, Oxygen Administration, dated 1/1/2020 revealed, .Change humidifier and tubing per facility procedure .At regular intervals, check and clean oxygen equipment, masks, tubing and cannula . Review of the medical record for Resident #3 was admitted to the facility on [DATE] with diagnoses which included Chronic Obstructive Pulmonary Disease and Atrial Fibrillation. […]

• No harm, potential for more than minimal, isolatedF609Feb 8, 2023

  Based on facility policy review, Facility Reported Investigation (FRI) review, medical record review, and interview, the facility failed to report allegations of abuse within 2 hours for 1 of 3 (Resident #3) sampled residents reviewed for abuse. The findings include: Review of the facility's policy titled, Abuse Prevention Program, dated 1/19/2017, revealed, .It is the policy of this facility to prevent resident abuse, neglect, mistreatment, and misappropriation of resident property. Each resident receives care and services in a person-centered environment in which all individuals are treated as human beings. […]

• No harm, potential for more than minimal, isolatedF559Nov 29, 2021

  An investigation of complaint TN 780 conducted on 11/29/2021 at 9:30 AM. Health deficiencies were cited in relation to the complaint investigation TN 780 under 42 CFR Part 483, Requirements for Long Term Care Facilities. Based on facility policy, medical record review, observations and interviews, the facility failed to notify the responsible party for 1 (Resident #1) of 4 residents reviewed for notification of room change. Review of the facility's undated policy titled, Transfer and Discharge Policy and Procedure revealed, .if the resident is to transfer within the facility, notice of the transfer is given to the resident/responsible party at least 2 days before relocation except when .the safety of individuals would be endangered; the health of individuals in the facility would be… […]

• No harm, potential for more than minimal, isolatedF887Nov 29, 2021

  An investigation of complaint #TN 780 conducted on 11/29/2021 at 9:30 AM . Health deficiencies were citied in relation to the complaint investigation #TN 780 under 42 CFR Part 483, Requirements for Long Term Care Facilities. Based on facility policy, medical record review, observations and interviews, the facility failed to provide a COVID-19 vaccination for 1 (Resident #1) of 4 residents reviewed for COVID-19 vaccinations. Review of the facility policy titled, COVID-19 Vaccine/Booster, revised 9/27/21, revealed, .It is the policy of this facility to offer and to make available, (to the best of their ability considering supply and demand and preferences) and administer a Covid-19 vaccine/booster to the residents who reside in the facility . […]