Washington Veteran Home-Retsil

In the surveyor’s words

From the most serious findings on record at Washington Veteran Home-Retsil, in the surveyor’s own words.

• Actual harm, isolatedF689Jul 2, 2025

  Based on observation, interview, and record review, the facility failed to follow manufacturer's guidelines during the use of a mechanical lift and the lift sling for 2 of 3 residents (Residents 1, 5) reviewed for falls. The facility failed to assess, evaluate the root cause, and implement fall prevention interventions specific to resident needs for 4 of 6 sampled residents (Residents 1, 2, 3, and 4) reviewed for accidents. In addition, the facility failed to follow manufacturer instructions for routine, documented inspection of the mechanical lift slings. Resident 1 experienced harm when they sustained a hip fracture when transferred with a mechanical lift and sling in a manner inconsistent with the manufacturer instructions. […]

• Actual harm, isolatedF689Jan 30, 2023

  Based on interview and record review, facility failed to ensure the care plan for safe transfers with a mechanical lift was followed for one of three residents (Resident 1) and failed to ensure one of three residents (Resident 2) was assessed for safe transfer with a mechanical lift after sustaining a head injury during a fall. Failure to follow the care plan for safe transfers caused harm to Resident 1 when he fell and fractured his lower leg during a transfer performed without the use of the mechanical lift. […]

• Actual harm, isolatedF689May 12, 2022

  Based on interview and record review, facility failed to ensure care planned interventions to prevent falls for one of three sampled residents (Resident 1) reviewed for avoidable falls were implemented and failed to ensure staff were oriented to facility policy regarding use of transfer gait belts (belts used around resident's waist for support during a transfer from one surface to another). Failure to follow care planned interventions and orient staff for transferring resident with a gait belt resulted in harm to Resident 1 who sustained a femur (thigh bone) fracture and endured severe pain. Facility Policy, Equipment- Transfer/Gait Belt, dated 09/17/2008, documented staff were to use a gait belt for resident transfers that did not involve the use of a mechanical lift. […]

• No harm, potential for more than minimal, widespreadF725Apr 22, 2024

  Based on observation, interview, and record review, the facility failed to ensure sufficient qualified nursing staff were available to provide care and services as evidenced by information provided in Resident/Surveyor interviews for 7 residents (Residents 84, 389, 14, 6, 41, 184 & 67) interviewed, and 9 staff (Staff Q, R, J, K, L, M, N, O & P) interviewed. The facility had insufficient staff to ensure residents received assistance with restorative services, meal tray delivery times, and Activities of Daily Living (ADLs) including showers and shaving. […]

• No harm, potential for more than minimal, widespreadF882Mar 25, 2022

  Based on staff interviews and facility policy review, the facility failed to ensure they employed a designated Infection Preventionist (IP) with specialized training. This failure had the potential to affect all the residents residing in the facility. Findings included . Review of the facility's policy regarding the employment of a dedicated IP were requested. The survey team was provided with the Long-term Care Guidance to Surveyors F-Tag F882 (Infection Preventionist) document which read, in pertinent part, The facility must designate one or more individuals as the infection preventionist(s) (IP)(s) who are responsible for the facility's IPCP. The IP must: Completed specialized training in infection prevention and control. […]