A CLOSER LOOK: COVID-19 nursing home inspection report shows 8 violations

A Closer Look

The survey of Mitchell's Nursing Home was completed July 24, 2020

ARKANSAS (KNWA/KFTA) — Arkansas’ Office of Long Term Care (OLTC) did a COVID-19 Focused Infection Control Survey at Mitchell’s Nursing Home on July 24. The 20-page investigative report showed eight serious violations.

VIOLATIONS

F 550: Resident Rights: At least a half dozen times the proper usage of catheter drainage bags for residents did not meet state standards because it was not in a privacy bag.

F 558: Reasonable Accommodations Needs: Based on record reviews and interviews, 21 residents had issues with accessing a “call light.” “This failed practice had the potential to affect 82 residents who resided in the facility,” the report states. In one instance, the resident was sitting up in a recliner and the call light was on the floor behind the chair. A Certified Nursing Assistant was asked to show the surveyor where the resident’s call light was located. She looked around the room, and stated, “Oh, her call light is on the floor.” She picked up the call light and placed it in the resident’s lap, according to the report.

F 636: Comprehensive Assessments & Timing: The facility failed to ensure comprehensive Minimum Data Set (MDS) assessments were completed when required. Lack of completing the MDS could have impacted six residents. One resident was receiving oxygen at 3 liters per minute through her nose — she was sitting in a recliner giving the breathing treatment to herself. No staff was in the room with her. A few minutes later, the surveyor asked a Licensed Practical Nurse (LPN), “does the resident have an assessment for self-administration of medication?” The LPN said, “I am not sure. I will have to look,” the report states.

F 688: Increase/Prevent Decrease Range of Motion: A resident seated in a wheelchair was resting his contracted hand on a tray that was attached to the wheelchair. He could not open his hand and was asked about his splint. “I used to [have one], but they took it away from me,” he said. The surveyor asked the CNA about the splint. “Therapy puts it on him when they come around,” she said, “I’m not sure if they still come or not.” The CNA had worked with the resident for six weeks, and could not remember him wearing a splint. The Director of Nursing was asked for the policy on Range of Motion. “We don’t have one,” she said, according to the report.

F 695: Respiratory/Tracheostomy Care: During four visits (July 20, 21, 22, 23) a surveyor observed a resident sitting in a recliner getting oxygen through his nose at an incorrect flow rate. The report states, at times it was 1.5 or 3 liters per minute (LPM). The doctor’s order (July 2020) called for oxygen to flow at 2 LPMs as needed for shortness of breath related to COVID-19.

F 812: Food Procurement, Store/Prepare/Serve-Sanitary: The facility failed to ensure food items stored in the refrigerator and freezer were sealed and dated, and dented cans were removed to prevent potential foodborne illness for residents who received meals from the kitchen. This had the potential to affect 75 residents.

F 814: Dispose Garbage and Refuse Properly: The facility
failed to ensure trash was properly contained within 2 of 2 dumpsters, to minimize the presence of foul odors and decrease the potential for pest infestation. The failed practice had the potential to affect 75 residents.

F 925: Maintains Effective Pest Control Program: The kitchen area was not free of pests, according to the surveyor’s report. Flies were on a steam table, other flies were drawling on the stove’s vent-a-hood, flies were on top of foil covering lunch rolls. A Dietary Employee was about to reach for the tray that had the fly on it, and was asked, “What do you see on that
tray?” She stated, “A fly.” She placed the empty tray on top of the steam table.

The facility has been sent a copy of the “Statement of Deficiencies” and is asked to sign and return it. “When deficiencies are cited they are asked to submit a Plan of Correction in regard to how they will address the deficiencies,” said Department of Health Services Deputy Chief of Communications Marci Manley. “OLTC is available to assist in helping them address those deficiencies to ensure the health and safety of residents are met.”

Facilities may appeal the findings, or go through an informal dispute resolution process if they want to raise questions about the deficiencies, according to DHS.

11 DEATHS

In mid-July Mitchell’s Nursing home was on an upward trend with COVID-19 related deaths among residents. Seven deaths happened in less than a week, according to the Arkansas Department of Health’s nursing home report. Overall, 11 residents have died, and an employee, who had been with Mitchell’s for about 40 years, died on July 20th.

In July, owner Robert Mitchell said, “I am doing public daily service announcements with the families of the residents to let them know what is going on. All the families are very well informed.”

Mitchell’s Nursing Home is located in the city of Danville, in Yell County. It is privately owned by Robert Mitchell. The facility has 105 licensed beds and it’s classified as a skilled nursing facility. The latest inspection report, April 18, 2019, indicated some deficiencies mainly in the kitchen area.

A CLOSER LOOK: a story about a COVID-19 Yell County funeral

17 additional nursing home death in Arkansas — COVID-19 related

14 nursing home deaths in less than a week; COVID-19 related

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