Wapello Specialty Care

In the surveyor’s words

From the most serious findings on record at Wapello Specialty Care, in the surveyor’s own words.

• Immediate jeopardy, isolatedF689Jun 6, 2022

  Based on clinical record review, staff interviews, facility investigation review, and observation, the facility failed to provide adequate supervision for 1 of 3 residents sampled for elopement (Resident #1). The facility failed to ensure all exit door alarms audible throughout the facility and failed to respond promptly to a door alarm when Resident #1 eloped. Resident #1 transferred to the hospital and returned to the facility two days later. Resident #1 required 14 stitches for a forehead laceration as well as a cervical collar for fractures of C1 and C2. The failure resulted in Immediate Jeopardy to the health, safety, and security of the residents. The facility reported 8 residents as independently mobile with cognitive impairment. […]

• Actual harm, isolatedF686Sep 21, 2023

  Based on observation, interview, record review, and the facility policy review the facility failed to implement interventions to prevent worsening of a Stage II pressure ulcer on the right heel for 1 of 3 residents reviewed for pressure ulcers (Resident #17). The facility reported a census of 38. Findings include: The Discharge Return Anticipated Minimum Data Set (MDS) dated [DATE] revealed Resident #17 with diagnoses of medically complex conditions and multiple sclerosis; three Stage 4 pressure ulcers present on admission and no unstageable pressure ulcers present. The Annual MDS assessment dated [DATE] revealed Resident #17 scored 15 out of 15 on a Brief Interview for Mental Status (BIMS) exam, which indicated cognition intact. […]

• Actual harm, isolatedF689Sep 21, 2023

  Based on interviews, observations and record review the facility failed to transport a Resident safely in the shower chair and failed to determine the root cause analysis for two recent falls for 2 of 3 residents reviewed for accidents. (Resident #13 and Resident #34). The deficient practice resulted in a fractured fibula, increased pain and hospitalization . The facility reported a census of 38. Findings include: 1. The Quarterly Minimum Data Set (MDS) assessment for Resident #13 dated 08/18/2023 documented Resident #13 scored 15 out of 15 on a Brief Interview for Mental Status (BIMS) exam, which indicated cognitively intact. […]

• Actual harm, isolatedF690Sep 21, 2023

  Based on observation, interview, and record review, the facility failed to ensure prompt follow up on urinalysis and culture and sensitivity results, failed to document effectiveness of antibiotics, failed to ensure a catheter drainage bag remained positioned off of the floor, and failed to promptly address decreased urinary output for a resident who had a Foley catheter for three of four residents reviewed for catheter and/urinary tract infections (Resident #19, Resident #93, Resident #143). The facility reported a census of 38 residents. Findings include: 1. The Quarterly Minimum Data Set (MDS) assessment for Resident #143 dated 9/21/22 revealed the resident scored 15 out of 15 on a Brief Interview for Mental Status (BIMS) exam, which indicated intact cognition. […]

• Actual harm, isolatedF773Sep 20, 2021

  Based on clinical record review, hospital record review, staff interview and Nurse Practitioner interview, the facility failed to follow-up on a urinalysis (test to check urine for infection) which delayed timely treatment of [MEDICAL RECORD OR PHYSICIAN ORDER] . The resident transferred to the hospital with a primary diagnosis [MEDICAL RECORD OR PHYSICIAN ORDER] . The facility reported a census of 44 residents. Findings include: The Minimum Data Set (MDS) dated [DATE] documented Resident #4 had short and long term memory impairments and diagnoses [MEDICAL RECORD OR PHYSICIAN ORDER] . […]