CENTRAL REGION

Facility: Riverdell Care Center

Boonville, MO

60-Bed Skilled Nursing Facility

Date of Notice: January 2009

Owner: Riverdell Real Estate LLC

Operator: Boonville No. 2, Inc.

Registered Agent: Clifton L. Shirrell

Legal Action: Class I Notice of Noncompliance

In a letter from DHSS: On 1/16/2009, SLCR staff completed a revisit at the facility and determined that the Class I deficiency could be lowered to a Class II.

Description: Facility staff failed to provide adequate supervision and assistive devices to prevent accidents. Facility staff failed to provide monitoring and supervision for one resident (Resident #1) in accordance with the resident’s plan of care. Facility staff failed to ensure a bed alarm device remained in the on position to alert them of the resident’s attempts to get out of bed unassisted. Staff found the resident with his/her head between the bedrail and the mattress and his/her body resting on the floor. Staff assessed the resident had expired.

Facility: Eldercare RCF

Sedalia, MO

12-Bed Residential Care Facility

Date of Notice: January 2009

Owner: Reeves, Joyce A.

Operator: Eldercare, LLC

Registered Agent: Al Kroeger

Legal Action: Uncorrected Class II Notice of Noncompliance

Description:  At the fifth revisit of 01/15/2009, the facility was still noncompliant in the following areas: Fire Safety Standards: The facility failed to remove accumulated trash and combustible debris from the premises to prevent fire hazards and public health nuisance. Physical Plant Requirements: The facility failed to maintain residents’ furniture and facility equipments including chairs, mattresses and tables in good condition and repair. Dietary Requirements: The facility failed to ensure a qualified individual reviewed and documented the diet, food preparation and service for one resident who had a physician ordered modified diet. General Sanitation Requirements: The facility failed to ensure floors were maintained clean and in good repair. The kitchen flooring had accumulated black, brown, and tan stains, multiple cracks and missing linoleum tiles. The wood floor in one resident room showed dirt, debris, a cigarette on the floor and rodent feces along the dresser and behind a chair. Another resident’s room showed multiple dark stains and scuff marks and dried feline feces on the floor. The facility failed to use effective measures to minimize the presence of rodents. Bagged stuffing mix in the dry food pantry had several small holes and bread crumbs were on the shelf. A bag of candy on top of the dresser in one resident room had holes in the bag and there were rodent feces on top of the dresser; there were also rodent feces on the floor of the resident room. One resident said he/she had seen a mouse in the kitchen. Another resident said he/she caught a mouse in a mouse trap and had also seen a dead mouse in his/her bathroom. In addition, a new Class II violation was found in the area of Physical Plant Requirements. The facility failed to ensure floors were maintained clean and i good repair. Staff failed to provide routine maintenance to ensure the soffit, fascia board, and guttering around the exterior of the building were structurally maintained in good repair. Staff failed to ensure the ceiling in the Activity room and wall in at least one resident room (#5) were structurally maintained and in good repair. 

Facility: Parkside Manor

Columbia, MO

120-Bed Skilled Nursing Facility

Date of Notice: February 2009

Owner: Columbia Ventures, LLC

Operator: N & R of Columbia, LLC

Registered Agent: Charlotte Stutts

Legal Action: Class I Notice of Noncompliance

Description: Facility staff failed to: Ensure exits are readily accessible at all times. Four of four designated exit doors which had delayed-egress locks did not comply with the Life Safety Code (LSC) requirements for special locking arrangements. One of one courtyard gates did not contain a handle to release the latch which prevented evacuation for 12 residents that live on the Special Care Unit in the event of an emergency. Note: At the time of the exit conference of 02/05/2009 staff ensured the Special Care Unit exit doors were unobstructed, the magnets on the door that leads from the unit into the facility was dismantled, and the courtyard gates were opened, abating the immediate jeopardy. The facility had not completed inservice education of all staff regarding emergency evacuation procedures and the grid placement was lowered to a Class II violation. Provide a properly installed, tested and maintained fire alarm system. NOTE: At the time of the exit conference of 02/05/2009 staff ensured a Fire Alarm Technician replaced the batteries, tested the system in emergency battery backup mode, and completed the state Fire Alarm Inspection form certifying the system was properly functioning and abating the immediate jeopardy. Staff had not completed inservice education of Maintenance staff to ensure routine assessment and maintenance of the Fire Alarm system were ongoing and the grid placement was lowered to an F.

Facility: Ashley Manor Care Center

Boonville, MO

52-Bed Skilled Nursing Facility

Date of Notice: April 2009

Owner: Ashley Manor, Inc.

Operator: Same

Registered Agent: Hal Juckette

Legal Action: Uncorrected Class II Notice of Noncompliance

Description: At the revisit, the facility failed to provide a properly tested and maintained fire alarm system. The facility census was 38.

Facility: Lake Ozark Retirement Center

Osage Beach, MO

40-Bed Residential Care Facility

Date of Notice: April 2009

Owner: Lierman Family Co.

Operator: Carl Lang

Registered Agent: Not Listed

Legal Action: Class II Notice of Noncompliance

Description: The facility failed to maintain the smoke detectors interconnected to the complete fire alarm system.

Facility: Seville Care Center

Salem, MO

90-Bed Residential Care Facility

Date of Notice: May 2009

Owner: BJB Industries, Inc.

Operator: Community Care Center of Salem, Inc.

Registered Agent: James Giardina

Legal Action: Class I Notice of Noncompliance

In a letter from DHSS: On 05/11/2009, SLCR staff completed a revisit at the facility and determined that the Class I deficiency could be lowered to a Class II.

Description: The facility staff failed to transport one dependent resident in a safe manner in accordance with his/her needs. Staff failed to apply wheelchair footrests to the resident’s wheelchair prior to transporting him/her to the local hospital about 1/8 of a mile from the facility. Staff did not put shoes on the dependent resident’s feet, and failed to ensure the resident’s feet did not make contact with the asphalt during the transport, resulting in the loss of skin and underlying tissue on seven of the resident’s toes and exposing the bone on at least two toes.

Facility: Eldercare RCF

Sedalia, MO

12-Bed Residential Care Facility

Date of Notice: May 2009

Owner: Reeves, Joyce A.

Operator: Eldercare, LLC

Registered Agent: Alexander Kroeger

Legal Action: Uncorrected Class II Notice of Noncompliance

Description: At the sixth revisit, the facility failed to correct the following violations. The facility census was 11. General Sanitation requirements: Throughout the facility, staff failed to use effective measures to minimize the presence of rodents and insects and failed to ensure floors were maintained clean and in good repair. Physical Plant requirements: The facility failed to maintain residents’ furniture and facility equipment including chairs and mattresses clean and in good condition and repair; failed to ensure floors were maintained clean and in good repair and failed to provide routine maintenance to ensure the fascia board and guttering around the exterior of the building were structurally maintained in good repair.

Facility: Lee House, LLC

Eldon, MO

53-Bed Residential Care Facility

Date of Notice: June 2009

Owner: Blue Spring Creek Properties, LLC

Operator: Lee House, LLC

Registered Agent: Gale Carlson

Legal Action: Class I Notice of Noncompliance

Description: The facility staff failed to implement measures to ensure one confused resident with a history of wandering was safe. The resident exhibited increased confusion and wandering and left the facility without staff knowledge. At 5:15 a.m., a community member found the resident walking in the road toward oncoming traffic and returned the resident to the facility. The facility census was 27.

Facility: Victorian Estates

Belle, MO

30-Bed Residential Care Facility

Date of Notice: July 2009

Owner: Vaughan, Lisa & Clint

Operator: Victorian Residential Care, LLC

Registered Agent: Lisa Watson

Legal Action: Uncorrected Class II Notice of Noncompliance

Description: At the revisit, the facility failed to correct the following Fire Safety Standards: The facility failed to install a range hood extinguishing system in the kitchen. The facility failed to ensure the fire alarm system would automatically transmit to the fire department, dispatching agency or central monitoring company upon activation of the system.

Facility: Eldercare RCF

Sedalia, MO

12-Bed Residential Care Facility

Date of Notice: July 2009

Owner: Reeves, Joyce A.

Operator: Alexander Kroeger

Registered Agent: N/A

Legal Action: Uncorrected Class II Notice of Noncompliance

Description: A licensure inspection was completed on 03/16/2009. The facility was not in substantial compliance with participation requirements. A revisit was completed on 07/08/2009. The facility failed to take corrective action in the following areas: Install fire alarm components in accordance with State Statute and National Fire Protection Association (NFPA) 72. The facility failed to ensure the fire alarm pull boxes were installed and accessible by staff. Install heat and smoke detectors interconnected to the complete fire alarm system in all accessible spaces. To properly install the gas fired water heater.

Facility: Melody House

Jefferson City, MO

15-Bed Residential Care Facility

Date of Notice: July 2009

Owner: W. B. Price, Inc.

Operator: New Horizons Community Support

Registered Agent: Not Listed

Legal Action: Uncorrected Class II Notice of Noncompliance

Description: The facility failed to provide smoke stop partitions.

Facility: Ridgeway Residential Care

Sullivan, MO

20-Bed Residential Care Facility

Date of Notice: August 2009

Owner: Turner, Deborah J.

Operator: Deborah Turner

Registered Agent: Not Listed

Legal Action: Uncorrected Class II Notice of Noncompliance

Description: The facility failed to provide required fire extinguishers. The facility failed to provide a complete fire alarm system. The facility failed to have fire rated or treated drapes. The facility failed to provide two smoke sections in the building.

Facility: Ridgeway Residential Care

Sullivan, MO

20-Bed Residential Care Facility

Date of Notice: August 2009

Owner: Turner, Deborah J.

Operator: Deborah Turner

Registered Agent: Not Listed

Legal Action: Uncorrected Class II Notice of Noncompliance

Description: The facility failed to complete community based assessments as required for three residents. In addition, the facility failed to ensure the staff member responsible for completing the assessments was appropriately trained. The facility census was 18.

Facility: Eldercare RCF I

Sedalia, MO

12-Bed Residential Care Facility

Date of Notice: August 2009

Owner: Reeves, Joyce A.

Operator: Alexander Kroeger

Registered Agent: Not Listed

Legal Action: Uncorrected Class II Notice of Noncompliance

Description: The facility failed to have a complete fire alarm system in accordance with NFPA 101 Section 18.3.4, 2000 edition.

Facility: Villa Marie Skilled Nursing Facility

Jefferson City, MO

120-Bed Skilled Nursing Facility

Date of Notice: September 2009

Owner: Lierman Family Co.

Operator: Eldercare of Mid-Missouri VII, Inc.

Registered Agent: Carl Lang

Legal Action: Class I Notice of Noncompliance

Description: The facility failed to properly assess one resident with an unsteady gait and failed to implement interventions to prevent falls. The resident fell at the facility and sustained a head injury which resulted in the resident’s death.

Facility: Harambee House, Inc.

Columbia, MO

15-Bed Residential Care Facility

Date of Notice: September 2009

Owner: Harambee House, Inc.

Operator: Same

Registered Agent: Not Listed

Legal Action: Uncorrected Class II Notice of Noncompliance

Description: The facility failed to properly install a complete fire alarm system in accordance with NFPA 72 1999 edition. The facility failed to properly maintain electromagnetic hold open devices providing separation between floors.

Facility: Stoney Ridge Village

Sedalia, MO

160-Bed Residential Care Facility

Date of Notice: September 2009

Owner: Sedalia Health Group LLC

Operator: AHG-Stoney Ridge, LLC

Registered Agent: Not Listed

Legal Action: Uncorrected Class II Notice of Noncompliance

Description: The facility failed to install and maintain the range hood extinguishing system. The facility failed to have inspections and written certifications of the complete fire alarm system. The facility failed to properly install and maintain a complete fire alarm system. The facility failed to install smoke detectors interconnected to the fire alarm system. The facility failed to install smoke stop partitions on each floor. The facility failed to maintain smoke barrier separation between floors. The facility failed to install self closing devices on doors providing separation between floors. The facility failed to treat or certify the treatment of curtains and drapes in the facility as flame resistant. The facility failed to maintain the electrical system in good repair.

Facility: Heritage Park Skilled Care

Rolla, MO

120-Bed Skilled Nursing Facility

Date of Notice: October 2009

Owner: CRAVIV, LLC

Operator: Cathedral Rock of Rolla, Inc.

Registered Agent: Anthony Soukenik

Legal Action: Class I Notice of Noncompliance

Description: The facility failed to provide two residents personal attention and nursing care in accordance with his/her condition and consistent with current acceptable nursing practice. Facility staff failed to administer intravenous (IV) fluids and IV antibiotics as ordered for two residents with dehydration and infections. Facility staff further failed to obtain a laboratory blood sample as directed for one of the residents and did not notify the resident’s physician of the failure. Staff failed to administer any medications by mouth (including anti-seizure medication) to one of the residents (who was hospitalized on 09/11 for a seizure) on 09/12 and 09/13 and did not notify the resident’s physician of the failure to administer the medications. The facility census was 101.

Facility: Jefferson City Nursing & Rehabilitation Center, LLC

Jefferson City, MO

120-Bed Skilled Nursing Facility

Date of Notice: November 2009

Owner: HCRI Missouri Properties LLC

Operator: Jefferson City Nursing & Rehab Center, LLC

Registered Agent: CSC - Lawyers Incorporating Service Company

Legal Action: Uncorrected Class II Notice of Noncompliance

Description: The facility staff failed to follow the facility bowel movement (BM) protocol for three dependent residents and the facility staff failed to transfer orders for five of 16 sampled residents.

Facility: Stoney Ridge Village

Sedalia, MO

160-Bed Residential Care Facility

Date of Notice: December 2009

Owner: Sedalia Health Group, LLC

Operator: AGH-Stoney Ridge, LLC

Registered Agent: Not Listed

Legal Action: Uncorrected Class II Notice of Noncompliance

Description: The facility failed to install and maintain electrical wiring in accordance with the requirements of the National Electrical Code, 1999 edition.

Facility: Victorian Estates II

Belle, MO

30-Bed Residential Care Facility

Date of Notice: December 2009

Owner: Watson, Lisa & Vaughan, Clint

Operator: Victorian Residential Care, LLC

Registered Agent: Lisa Watson

Legal Action: Class I and Uncorrected Class II Notice of Noncompliance

Description: The facility failed to correct a problem with the alarm system for at least 12 days after the monitoring company notified facility staff that the monitoring company was not receiving the fire alarm signal. In addition, the facility had the following uncorrected Class II violations. The facility failed: To ensure resident use bathrooms were maintained clean and in good repair. To maintain furniture and equipment clean and in good repair including chairs, pillows and mattresses. To provide routine housekeeping services necessary to maintain resident rooms in a safe, clean and sanitary manner. The Owner/Manager failed to devote sufficient time to the management of the facility to assure compliance with all applicable laws and regulations based on the Class I and uncorrected Class II violations.