OAKS RETIREMENT COMMUNITY,THE.

Missouri Department of Health and Senior Services STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA AND PLAN OF CORRECTION IDENTIFICATION NUMBER: 27358N NAME OF PROVIDER OR SUPPLIER OAKS RETIREMENT COMMUNITY, THE {X4) ID SUMMARY STATEMENT OF DEFICIENCIES PREFIX (EACH DEFICIENCY MUST BE PRECEDED BY FULL TAG REGULATORY OR LSC IDENTIFYING INFORMATION) 19 CSR 30-86.047(19) TB Screen Residents & Staff The facility shall screen residents and staff for tuberculosis as required for long-term care facilities by 19 CSR 20-20.100. I! This regulation is not met as evidenced by: Based on interview and record review, the facility failed to ensure the required two-step tuberculosis (TB- a potentially serious airborne bacterial infection affecting the lungs that spreads through the air when a person with TB coughs, sneezes, or talks) screening test was completed upon hire for one staff member (Level One Medication Aide (LIMA) A). The facility census was nine. Review of 19 CSR 20-20.100 General Requirements for Tuberculosis Testing in Long-Term Care Facilities showed the following: -Long-term care facilities shall screen their staff for tuberculosis using the Mantoux method Purified protein derivative (PPD - a skin test for tuberculosis) two-step tuberculin test within one month prior to starting employment; -If the initial test is zero to nine millimeters (mm), the second test should be given as soon as possible, within three weeks after employment begins, untess documentation is provided indicating a Mantoux PPD test in the past and at least one subsequent annual test within the past two years; -Each facility shall be responsible for ensuring that all test results are completed and documentation is maintained. Review of the facility's policy titled "Communicable Disease," showed the facility will comply with the department's regulations Missouri Department of Health and Senior Services LABORA RY DIRECTOR, STATE FORM B. WING (X2) MULTIPLE CONSTRUCTION A. BUILDING: PREFIX TAG PRINTED: 09/21/2023 FORM APPROVED (X3) DATE SURVEY COMPLETED Cc 09/14/2023 STREET ADDRESS, CITY, STATE, ZIP CODE 127 HAMLET ROAD BRANSON, MO 65616 PROVIDER'S PLAN OF CORRECTION _(X5) {EAGH CORRECTIVE ACTICN SHOULD BE COMPLETE CROSS-REFERENCED TO THE APPROPRIATE DATE DEFICIENCY} This deficient practice as stated in A4724 will be corrected by: Upon hiring of new staff they will not start their new position until the DON has performed a PPD 1% step/Current employees and residents will receive a 2-step Mantoux PPD withing the first month of hire, second to be completed within 3 weeks after employment begins, and annually each year after employment and admission to the facility by DON. Administrator and DON will review new employee records prior to start dates to ensure substantial compliance. TITLE (X6) DATE G{28{ 2023 If continuation sheet 1 of 2 PRINTED: 09/21/2023 a FORM APPROVED Missouri Department of Health and Senior Services STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA . (X2) MULTIPLE CONSTRUCTION {X3) DATE SURVEY | AND PLAN OF CORRECTION IDENTIFICATION NUMBER: A. BUILDING: COMPLETED Cc 27358N B. WING 09/14/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE 127 HAMLET ROAD OAKS RETIREMENT COMMUNITY, THE BRANSON, MO 65616 (X4) ID SUMMARY STATEMENT OF DEFICIENCIES PROVIDER'S PLAN OF CORRECTION (x5) PREFIX {EACH DEFIGIENCY MUST BE PRECEDED BY FULL (EACH CORRECTIVE ACTION SHOULD BE COMPLETE TAG REGULATORY OR LSC IDENTIFYING INFORMATION) CROSS-REFERENCED TO THE APPROPRIATE DATE DEFICIENCY) Continued From page 1 pertaining to communicable disease, specifically 19 CSR 30-86.042 (18) and 19 CSR 20-20.100 (2)(3). 1. Review of LIMAA's personnel file showed the following: -Hire date of 09/08/23; -Start date of 09/12/23; -Staff did not document administration of the required initial two-step TB screening test upon hire. During an interview on 09/14/23, at 2:17 P.M., the Administrator said the following: -He/She does not believe LIMAA had a two-step TB test upon hire; -He/She failed to ensure TB screening requirements were completed according to the facility's policy. Missouri Department of Health and Senior Services STATE FORM 8898 YP8L11 \f continuation sheet 2 of 2