BLUE HILLS REST HOME, INC.

“The administrator shall develop and implement a safe and effective system of medication control and use, which assures that all residents ' medications are administered by personnel at least eighteen (18) years of age, in accordance with physicians ' instructions using acceptable nursing techniques. The facility shall employ a licensed nurse eight (8) hours per week for every thirty (30) residents to monitor each resident ' s condition and medication. Administration of medication shall mean delivering to a resident his or her prescription medication either in the original pharmacy container, or for internal medication, removing an individual dose from the pharmacy container and placing it in a small cup container or liquid medium for the resident to remove from the container and self-administer. External prescription medication may be applied by facility personnel if the resident is unable to do so and the resident ' s physician so authorizes. All individuals who administer medication shall be trained in medication administration and, if not a physician or a licensed nurse, shall be a certified medication technician or level I medication aide. I/II”

This is the rule that was cited, not the inspector’s specific finding. The detailed Statement of Deficiencies is in the official report below.

“Based on observation and interview on 9/27/23 the facility failed to provide a proper oxygen storage room in accordance with NFPA 99, 1999 Edition. | The facility census was sixty (60). This potentially affected sixty (60) of sixty (60) residents. Observation on 9/27/23 at 1:32 P.M. showed the oxygen storage being kept in an open hallway by the first-floor offices. During an interview on 9/27/23 at 2:42 P.M. the maintenance supervisor said he/she could use the old mop sink closet, install a positive ventilation fan and put an oxygen storage sign on the door to properly store the oxygen tanks. . -, - PLAN OF CORRECTION Provider/Supplier Name: Blue Hills Rest Home City, Zip: 2207 N Blue Mills Rd. Independence, MO 6458 Date of Survey: PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER ID PREFIX TAG PROVIDER'S PLAN OF CORRECTION: (EACH CORRECTIVE ACTION SHOULD BE CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) Oxygen cylinders on 9-27-23 consisted of 3 M-6 (B), 6 M-9 (C) & 7 M24(E) equaling 304.50 Volume. COMPLETION DATE Maintenance Supervisor, F. Dingman will move the oxygen Storage from the 3-wall hallway inlet to a closet. The oxygen tanks shall continue to be placed in the oxygen rack to secure the cylinders. Mechanical ventilation shall be installed to maintain continuous ventilation for a negative pressure in the closet. Oxygen signage shall be relocated to the oxygen storage closet and entrance doors. Empty oxygen containers shall remain in the current location. Staff training of the new oxygen location provided by Sarah White, LNHA on October 19, 2023 -———— innneieisieiiieidiniiieaial SS SSS a —— The Administrator signing and dating the first page of the CMS-2567/State Form is indicating their approval of the plan of correction being submitted on this form.”