Health inspection·May 21, 2024

F 0641 Ensure each resident receives an accurate assessment. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to ensure resident assessments accurately reflect the resident's status for 2 (Resident #1 and #5) of 3 residents reviewed for respiratory care. Residents Affected - Some Findings include: 1.) Review of the admission record documented Resident #1 was admitted to the facility on [DATE] with diagnoses that include COPD (Chronic Obstructive Pulmonary Disease and OSA (Obstructive Sleep Apnea). During an interview on 5/21/24 at 9:59 AM, Resident #1 confirmed it was her CPAP (Continuous Positive Airway Pressure) machine sitting on the nightstand. She stated that she is still using the machine; she just cannot clean it with her SoClean® [CPAP cleaner and sanitizer machine]. Review of Minimum Data Set (MDS) Quarterly assessment dated [DATE] documented Resident #1 is not using a CPAP machine. 2.) Review of the admission record documented Resident #5 was readmitted to the facility on [DATE] with diagnoses including CHF (Congestive Heart Failure), COPD (Chronic Obstructive Pulmonary Disease), and Pulmonary Edema. During an observation on 5/21/24 at 11:40 AM, Resident #5 was observed in his bedroom with a CPAP machine on the nightstand next to the bed. During an interview on 5/21/24 at 11:41 AM, Resident #5 stated, That is my CPAP machine on the table there, indicating the device on the nightstand next to the bed. Review of the care plan dated 7/25/22 for Resident #5's care plan dated 7/25/22 documented at risk for respiratory complications related to dx (diagnosis) of: CHF, COPD, Pulmonary Edema, with interventions that include Monitor use of Bi-Pap (Bilevel Positive Airway Pressure) machine use as ordered. Review of the MDS Quarterly assessment dated [DATE] documented Resident #5 as not using a CPAP machine. During an interview on 5/21/24 at 1:30 PM, the Minimum Data Set Coordinator confirmed Resident #1 and Resident #5's MDS assessments documented that they were not using CPAP machines. Page 1 of 2 105825 105825 05/21/2024 Suwannee Valley Nursing Center 427 15th Avenue Northwest Jasper, FL 32052

F 0695 Provide safe and appropriate respiratory care for a resident when needed. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to ensure an attending practitioner's orders and indication of use for CPAP (Continuous Positive Airway Pressure) or BIPAP (Bi-level Positive Airway Pressure) devices for 1 (Resident #5) of 3 residents reviewed for respiratory care services. Residents Affected - Few Findings include: Review of the admission record documented Resident #5 was readmitted to the facility on [DATE] with diagnoses including CHF (Congestive Heart Failure), COPD (Chronic Obstructive Pulmonary Disease), and Pulmonary Edema. Review of the physician's orders for Resident #5 as of 5/21/24 documented no orders for the use or care of a CPAP or BIPAP machine. During an observation on 5/21/24 at 11:40 AM, Resident #5 was observed in his bedroom with a CPAP machine on the nightstand next to the bed. During an interview on 5/21/24 at 11:41 AM, Resident #5 stated, That is my CPAP machine on the table there, indicating the device on the nightstand next to the bed. Review of the care plan dated 7/25/22 for Resident #5 documented at risk for respiratory complications related to dx (diagnosis) of: CHF, COPD, Pulmonary Edema, with interventions that include Monitor use of Bi-Pap machine use as ordered. During an interview on 5/21/24 at 1:45 PM, the Director of Nursing confirmed the facility did not have any current orders for Resident #5's use of a CPAP or BIPAP machine. A policy on physician's orders was not provided during the survey. 105825 Page 2 of 2