cms_GA: 604
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 |
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604 | PRUITTHEALTH - MACON | 115288 | 2255 ANTHONY ROAD | MACON | GA | 31204 | 2019-05-28 | 658 | D | 1 | 0 | F4GX11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** > Based on interviews and record review, review of the Georgia Nurse Practice Act, licensed nursing staff failed exercise competent independent judgement by not verifying the location of one resident (A) to ensure their safety, from a total sample of 19 residents. Findings include: Review of the Rules and Regulations of the State of Georgia, Rule 410-10-.02 Standards of Practice for Licensed Practical Nurse addressed Rule 410-10-.02 (a) Participating in patient assessment activities and the planning, implementation, and evaluation of the delivery of health care services and other specialized tasks when appropriately educated and consistent with board rules and regulations; (b) Providing direct personal patient observation, care, and assistance in hospitals, clinics, nursing homes, or emergency treatment facilities, or health care facilities in area of practice including, but not limited to: coronary care, intensive care, emergency treatment, surgical care and recovery, obstetrics, pediatrics, outpatient services, [MEDICAL TREATMENT], specialty labs, home health care, or other such areas of practice. (f) Performing other specialized tasks as appropriately educated. 2. Responsibility: Each individual is responsible for personal acts of negligence under the law. Licensed practical nurses are liable if the perform functions for which they are not prepared by education and experience and for which supervision is not provided. The facility had a job description for Licensed Practical Nurses (LPN). The job description included an essential supervisory function of exercising independent judgement. The job description acknowledgement was signed by LPN AA on 10/19/15. However, LPN AA failed to exercise competent independent judgement on 5/12/19 by not verifying the location of Resident (R) A, when the resident was not in her room. A 5/13/19 9:09 a.m. Nurse's Note documented that LPN AA was summoned by nursing staff on D hall that RA was lying on the ground in the courtyard. The resident was assisted back to her room and assessed. Review of facility investigation information revealed that the resident was observed on the ground in the courtyard on 5/13/19 at 7:10 a.m. by R#7 from his bedroom window. R#7 alerted nursing staff, who responded and assisted RA back to her room for further assessment and interventions. A further review of the investigation information revealed that it was determined that the RA had been outside, in the courtyard overnight. An interview on 5/20/19 at 10:33 a.m., LPN AA confirmed that she was assigned to RA from 5/12/19 at 7:00 p.m. through 5/13/19 at 7:00 a.m. She stated that she did not see RA during her shift and assumed she was out with her family for Mother's day. LPN AA further stated that she looked at the Leave of Absence (LOA) book to see if the resident had been signed out, and she had not been signed out as leaving the facility. She assumed the resident left with her family without signing the LOA book. However, LPN AA did not call the resident's family to verify her assumption. During an interview on 5/15/19 at 2:55 p.m. the Administrator stated that when LPN AA did not see RA in her room and the LOA book had not been signed out, she should have looked for the resident and if not found, should have called a code pink (missing person code). Cross refer to F689 | 2020-09-01 |