cms_GA: 4172
Data source: Big Local News · About: big-local-datasette
| rowid | facility_name | facility_id | address | city | state | zip | inspection_date | deficiency_tag | scope_severity | complaint | standard | eventid | inspection_text | filedate |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 4172 | ANDERSON MILL HEALTH AND REHABILITATION CENTER | 115145 | 2130 ANDERSON MILL RD | AUSTELL | GA | 30106 | 2017-02-03 | 225 | D | 1 | 0 | KWE811 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** > Based on clinical record review, review of the facility's Abuse and Neglect Prohibition Policy and resident and staff interview, the facility failed to report to the State Survey Agency (SSA) an allegation of abuse for one resident (R#8) from a sample of (3) residents reviewed. The Census was 135 residents. Findings include: Review of the facility's Abuse and Neglect Prohibition Guidelines noted: Facility supervisors will immediately correct and intervene in reported or identified situations in which abuse, neglect, injuries of unknown origin, or misappropriation or resident property are at risk of occurring. The facility will conduct an investigation of any alleged abuse/neglect, exploitation, mistreatment, injuries of unknown origin or misappropriation of resident property in accordance with state law. The facility will report such allegations to the state within 24 hours Review of the facility's Reporting and Response section of their Abuse and Neglect Prohibition Guidelines noted. The facility will report all investigation findings to the state within five (5) calendar days. The facility will report all allegations and substantiated occurrences of abuse, neglect, injuries of unknown origin, and misappropriation of property to the state agency and law enforcement officials within twenty-four (24) hours of identification. The facility will complete an incident/accident report in accordance with OP2 0401.02 incident/accident reporting for residents Review of the clinical record for R#8 revealed that she had [DIAGNOSES REDACTED]. Review of her Quarterly Minimum Data Set ((MDS) dated [DATE] revealed that she had a Brief Interview for Mental Status (BIMS) score of 13 indicating she is cognitively intact. During interview with R#8 on 2/1/17 at 2:30 p.m., she was noted to speak slowly but clearly. R#8 indicated during interview that about a week prior to the interview, a nurse came into her room to give her medication about 9:30 p.m. or 10:00 p.m. R#8 further indicated that she told the nurse the potassium pill needed to be dissolved and the nurse got huffy, left the room and returned with a spoonful that contained the dissolved pill in applesauce. R#8 further indicated the nurse jammed and forced the spoon into R#8s mouth. R#8 revealed she was not physically injured but it caused her to be angry and upset. When asked if she had told anyone R#8 responded yes and indicated that on the following morning, she told the Activities person who comes by the room to check on each day and the Activities person put in a report about the incident. R#8 added, she only feels safe now when she knows the person taking care of her because she had never seen the accused nurse before that night. R#8 then indicated no one had talked to her about the incident since she reported it. R#8 further indicated she had not seen the accused nurse since the incident. During interview with the Activities Assistant AA on 2/1/17 at 3:02 p.m., revealed that she is the Ambassador to R#8 and stated She did tell me about the nurse jamming the spoon in her mouth. I went and told the Administrator and that the Administrator was going to go and talk to her. Activity Assistant AA further revealed she did not write a grievance regarding the incident involving the spoon and R#8 because she told the Administrator directly. Activity Assistant AA further indicated she did not know who the accused nurse is. When asked why she did not complete a written report of the abuse complaint, Activity Assistant AA revealed, I should have written it. During interview with the Administrator on 2/1/17 at 3:56 p.m., she denied knowing anything about the incident reported by R#8. The Administrator indicated the Ambassador is to go around to residents and find out what has happened. We discuss it in morning meeting and allegations are investigated beginning that day. The nurse would have been suspended pending the outcome of the investigation. When asked what her expectation is regarding staff reporting allegations of abuse, the Administrator indicated she expects abuse allegations to be written up and brought to her. During interview with the Activities Director (AD) on 2/2/17 at 10:15 a.m., he indicated that Activity Assistant AA did not report the incident with R#8 because she thought it was just an attitude issue. AD further indicated he would have told the Activity Assistant AA to follow-up to make sure the issue she reported was addressed. AD stated to me, the resident presented it as the resident was just saying the nurse was being a smart ass. AD further indicated, he did not consider the incident abuse so he would not have considered it an official grievance and it should not have been written up as one. AD went on the say For me, no matter what your perceptions are, even the smallest thing should be written down as a grievance. During an interview with the Interim Director of Nursing (DON) on 2/2/17 at 10:30 a.m. she revealed that she was not employed with the facility at the time of the incident and could not speak to the incident specifically. | 2020-02-01 |