The Wolfe Living Center at Summit Ridge

In the surveyor’s words

From the most serious findings on record at The Wolfe Living Center at Summit Ridge, in the surveyor’s own words.

• Immediate jeopardy, isolatedF686Apr 29, 2022

  A past noncompliance Immediate Jeopardy situation was determined to exist effective 12/01/20 related to failure to implement weekly wound and skin assessments for a resident who was non weight bearing (left foot) and implement interventions to prevent pressure ulcers for a resident who was at risk for pressure ulcers. Res #3 was admitted with a left trimalleollar fracture with surgical repair and was non weight bearing for 12 weeks. On 12/01/20 the facility identified a wound on Res #3's right heel. There was no wound assessments or measurements conducted until 12/14/20. Res #4 had no pressure reducing interventions implemented prior to aquiring a Stage IV pressure ulcer. […]

• No harm, potential for more than minimal, patternF578Apr 1, 2025

  Based on record review and interview, the facility failed to ensure a resident's POA was included in their clinical record for 1 (#13) of 16 sampled residents reviewed for advance directives. The administrator identified 38 residents resided in the facility. Findings: Resident #13 had diagnoses which included cognitive communication deficit and atrial fibrillation. Resident #13's Advance Directives Acknowledgement form, dated 08/21/23, read in part, I do have an Advance Directive/ Living Will/ Durable Power of Attorney for medical or health care decisions. Resident #13's clinical record did not contain a copy of their POA. […]

• No harm, potential for more than minimal, patternF582Apr 1, 2025

  Based on record review and interview, the facility failed to ensure advance beneficiary notices were provided for 2 (#140 and #141) of 3 sampled residents who were reviewed for beneficiary notices. The Beneficiary Notice - Residents discharged within the Last Six Months form, showed 12 residents who were discharged to home with skilled days remaining in the last six months. Findings: A facility policy titled [NAME] Living Center-Advanced Beneficiary Notices, dated 02/17/22, read in part, It is the policy of this facility to provide timely notices regarding Medicare eligibility and coverage .If services are being terminated and the beneficiary wants to continue receiving care that is no longer considered medically reasonable and necessary, the facility shall issue an ABN prior to furnishing… […]

• No harm, potential for more than minimal, patternF607Apr 1, 2025

  Based on record review and interview, the facility failed to implement their abuse policy by not: a. conducting a complete and thorough investigation; b. establishing coordination with the QAPI program; c. reporting to the OSDH within 2 hours of the allegation of abuse; and d. assess the residents for any sign of injury for 2 (#1 and #23) of 2 sampled residents reviewed for abuse. The administrator identified 38 residents resided in the facility. Findings: A facility policy titled Abuse, Neglect, and Exploitation, dated 01/01/22, read in part, The facility will develop an implement written policies and procedures that: a. Prohibit and prevent abuse, neglect, and exploitation of resident and misappropriation of resident property; b. […]

• No harm, potential for more than minimal, patternF761Oct 13, 2022

  Based on observation and interview, it was determined the facility failed to ensure the removal of expired medications and supplies from the medication storage room and medication cart. This had the potential to affect all 39 residents who resided in the facility. Findings: On 10/12/22 at 9:45 a.m., the medication room was observed. Expired medications and supplies were found in the facility's medication room refrigerator and medication storage room for the following. 1. 9- [MEDICATION(S)] suppositories with an expiration date of 09/2022. 2. 7- [CONDITION(S)] vaccines with an expiration date of 03/01/22. 3. 1- Box [NAME] 20cc syringes with an expiration date of 11/01/21. 4. 14- BD Safety-Lok 3ml syringes with an expiration date of 06/29/21. 5. […]