Transcendent Healthcare of Boonville

In the surveyor’s words

From the most serious findings on record at Transcendent Healthcare of Boonville, in the surveyor’s own words.

• Immediate jeopardy, isolatedF689Jun 3, 2024

  Based on observation, interview, and record review, the facility failed to ensure adequate supervision was provided to prevent a resident with dementia and a history of elopement from exiting the facility and leaving the property for 1 of 4 residents reviewed for elopement and risk for wandering. This deficient practice resulted in an elopement that occurred during the night of 5/14/24 and early morning hours of 5/15/24, after being last seen by facility staff around 10:00 P.M. on 5/14/24, a resident exited the facility and was not realized to be missing until approximately 1:00 A.M. on 5/15/24. The resident was located by local law enforcement at a previous residence approximately 22 miles from the facility. […]

• Actual harm, isolatedF684Aug 14, 2025

  Based on interview and record review, the facility failed to implement ordered treatment for a rectal fissure for 1 of 3 residents reviewed for skincare. This deficient practice resulted in the resident being hospitalized with severe sepsis and a necrotizing soft tissue infection. (Resident C)Finding includes:During record review on 8/13/25 at 10:00 A.M., Resident C's diagnoses included, but were not limited to, type II diabetes, irritable bowel syndrome with constipation, and overactive bladder. Resident C's most recent annual Minimal Data Set (MDS) assessment, dated 4/29/25, indicated the resident had no cognitive impairment, was always incontinent of bowel and bladder, and required substantial assistance with toileting hygiene. […]

• Actual harm, isolatedF689Mar 27, 2025

  Based on observation, interview, and record review, the facility failed to ensure adequate supervision, and a secure environment was provided to prevent a resident with dementia from exiting the facility and leaving the property for 1 of 3 residents reviewed for elopement risk. This deficient practice resulted in an elopement that occurred during the early morning hours on 3/15/25 after being last seen by facility staff at approximately 2:00 A.M. A resident exited the facility through an unsecured window and was not realized to be missing until approximately 5:00 A.M. The resident was located by local law enforcement at approximately 6:00 A.M. in a field near the facility wet and shivering and required hospitalization . […]

• Actual harm, isolatedF689Oct 15, 2021

  Based on interview and record review, the facility failed to provide supervision to prevent multiple falls, resulting in multiple injuries including a nasal fracture, for 1 of 3 residents reviewed for falls (Resident N). Findings include: The closed clinical record of Resident N was reviewed on 10/13/21 at 11:00 A.M. Diagnoses included, but were not limited to, dementia and Alzheimer's disease. An annual Minimum Data Set (MDS) assessment, dated 7/23/21, indicated Resident N had severely impaired cognition, required supervision for walking in room and corridor. […]

• Actual harm, isolatedF686May 20, 2021

  Based on observation, interview, and record review, the facility failed to prevent the development of pressure areas and/or ensure residents with pressure areas received necessary treatment to promote the healing of pressure areas for 2 of 3 residents reviewed for pressure ulcers. Resident E did not receive catheter care that resulted in the development of an infected unstageable pressure area resulting in a hospital visit and antibiotic treatment given IM (Intramuscular) for 5 days. (Resident E, Resident D) Findings include: 1. During record review on 5/18/21 at 1:45 P.M., Resident E's diagnoses [MEDICAL RECORD OR PHYSICIAN ORDER] . […]