SEARCY, AR – THE CROSSING AT RIVERSIDE HEALTH AND REHABILITATION

Based on observation, record review and interview, the facility failed to ensure Licensed Nurses were able to demonstrate competency in conducting wound vac dressing changes for 1 (Resident #1) sample mix resident who required wound vac dressing changes. This failed practice had the potential to affect 1 resident who was dependent required wound vac dressing changes. The findings are:

On 12/02/2020 at 9:56 a.m., Resident #1 was in bed watching television. A wound vac was attached to the half bed rail, it was on and running. Resident #1 was asked, Do you have any pressure ulcers or sores? Resident #1 replied, Yes, I have a vac pump on my bottom, and I have a wound on my left hip and my heel and on my stump. Resident #1 was asked, Does the facility change the dressings on a regular basis? Resident #1 replied, No, I just want it changed three times a week. That’s what they promised to do. Resident #1 stated, I have to wait days, and they are not going to heal if they are not properly handled. Resident #1 was asked, Does the facility have a wound treatment nurse? Resident #1 replied, The girl that used to do it all just walked out and quit. Then they had a guy doing it Monday, Wednesday, and Friday and he was good. Resident #1 was asked, What happened to him? Resident #1 replied, He walked out. Resident #1 stated, The agreement we had was for Monday, Wednesday, and Friday and there is no reason why they can’t hold up their end. That’s when they are supposed to change the dressings, all of them. Resident #1 was asked if this surveyor could look at his wounds. Resident #1 agreed to let this surveyor look at his wound dressings. (Photos taken.)

On 12/02/2020 at 10:07 a.m., with the assistance of Certified Nursing Assistant (CNA) #3 and CNA #4. This surveyor observed Residents #1’s dressings. Resident #1’s buttocks / (and or) sacrum area was red and macerated. The drape dressing was brown and rolled on the edges. There was no date or initials on the dressing as to when the dressing/wound vac was changed. (Photo taken.) A dressing on Resident #1’s left heel did not have a date or initials to note when the dressing was changed. CNA #3 and #4 were asked, Is there a date with initials on the dressing? CNA #3 and #4 replied, No. (A photo was taken with Resident #1’s permission). A dressing to Resident #1’s right knee below the amputation did not have a date or initials to note when the dressing was changed. CNA #3 and #4 were asked, Is there a date with initials on the dressing? Both CNA’s replied, No. (Photo taken.) A pressure ulcer to the right hip was red/pink in color and there was no dressing in place. (Photo taken.) Resident #1’s buttocks had a drape dressing with wound vac in place. Resident #1’s buttocks/sacrum area was red and macerated. The drape dressing was brown and rolled on the edges. There was no date or initials on the dressing as to when the dressing/wound vac was changed. Both CNA #3 and #4 were asked, Is there a date with initials on the dressing? CNA #3 and #4 replied, No. (A photo was taken with Resident #1’s permission). When the CNA’s rolled Resident #1 over, Resident #1 stated, They are supposed to date it and initial it. Resident#1 was asked, How do you know they are supposed to date it and initial it? Resident#1 replied, Because that’s what they used to do on the other hall.

On 12/03/2020 at 10:53 a.m., the DON was asked, Have the nurses been in-serviced on wound vac application and use, and when? The DON replied, I have not trained the nurses on a wound vac. I have no in-services.