Follow-up·July 5, 2024

On 7/5/2024, LPA Johnson arrived unannounced to follow-up on a request for an exception for a prohibited Health Condition. The facility has retained a Resident (R1) with a prohibited health condition unstageable pressure injury to the right heel. Home Health agency has been working with R1 from 5/6/2024 to present the facility has third party notes for home health service that have been in place to address a pressure injury to the lower back or tailbone area, right heel and arms. The facility does have orders from the doctor for the 5/6/2024 initial home health services and has recently received notification from the home health RN on 7/2/2024 that R1 has an unstageable pressure injury to the heel and service will be discontinued. R1 was sent out by the facility to have the injury on the right heel assessed on 6/30/2024. R1 was returned to the facility with no orders to continue home health services for nursing. The injury on the right heel is unstageable and treatment is not viable. Continued On 7/3/20204, The facility requested skilled nursing from R1's primary physician. Also noted during the inspection of documents was information about R1's development of a blood blister on the right heel (large hard eschar approximately 1 to 2 inches) about a month ago according to the discharge papers dated 6/30/2024, R1 was prescribed some medication but R1's daughter cannot recall what kind of medication it was. The facility has no record of medication for R1 for treatment of the blood blister. R1 is a self medication administer. The facility did not have the self-medication evaluation form for R1. The preplacement appraisal dated 4/30 2024, does not include information about treatment plans for the pressure injuries noted on the plan of care from home health dated 5/6/2024. The facility has requested a exception for R1 dated 7/3/2024.