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Based on record review, interview, and policy review, the facility failed to supervise the nursing care of one patient (#4) of nine patients reviewed.

The findings included:

Medical record review revealed patient #4 was admitted to the facility on December 9, 2010, with diagnoses of Pnuemonia. Review of the vital signs documented on December 13, 2010, at 12:57 a.m., revealed the patient's blood pressure was 164/109 (average normal is 120/80). Further review of the medical record revealed no documentation of the physician being notified of the patient's blood pressure.

Interview with the Director of Nursing, and the Quality and Risk Manager on March 1, 2011, at 3:00 p.m., confirmed there was no documentation of the doctor being notified of patient #4's elevated blood pressure on December 13, 2010.

Review of the facility's policy titled, "Vital Signs, Routine" revealed normal blood pressure was considered "B/P below 140/90 and above 80/50" and "Address concerns with physician".

C/O# TN27377





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Based on observations and interviews the facility failed to maintain equipment in a sanitary manner, in one patient room (#122) of three rooms observed.

The findings included:

Observations of patient room #122, on March 1, 2011, at 3:30 p.m. revealed the room was empty and had been cleaned in preparation for a new admission. In the room was one bed side commode which was visibly soiled with dried yellow residue and smelled of urine.

Interview with the Director of Nursing (DON), on March 1, 2011, at 3:30 p.m., in room #122, confirmed this room had been cleaned and prepared for a new admission, and confirmed the bedside commode was soiled. The DON stated it was the facility's practice is to clean bedside commodes when soiled and between admission.

C/O# TN27377


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