cms_GA: 8095
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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8095 | COOK SENIOR LIVING CENTER | 115655 | 706 NORTH PARRISH AVE . | ADEL | GA | 31620 | 2013-08-15 | 318 | D | 0 | 1 | FB2I11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, record review and staff interview the facility failed to provide passive range of motion and failed to apply knee and hand splints as ordered by the physician and as outlined in the plan of care for one (1) resident (#40) of 33 residents. Findings include: Review of the clinical record for Resident #40 revealed that he had a current physician's orders [REDACTED]. Record review of the resident's Quarterly Minimum Data Set (MDS) of 7/12/13 revealed impaired function of range in motion of both upper and lower extremities on one side. The resident is assessed as receiving restorative nursing care for both passive and active range of motion seven (7) days per week with no splint assistance. Review of the resident's care plan dated 2/22/13 for impaired mobility and right sided weakness with the following interventions: active assist range of motion (ROM) left upper and left lower extremities daily as tolerated, passive range of motion right upper and lower extremities daily as tolerated, knee splint to be worn three hours on the right knee and then three hours on the left knee daily as tolerated. Place pillow between legs if wearing splint in bed, perform range of motion prior to applying knee splint. Review of the splint instructions dated 1/21/12, signed by the Physical Therapist, for the knee splint revealed the resident to wear the knee splint on the right knee for three (3) hours then on the left knee for three (3) hours. The instructions include special instructions to place a pillow between the resident's legs if wearing the knee splint while in bed and that the resident should receive range of motion prior to splinting. Instructions for use of the hand splint were not available. Review of the restorative nursing care documentation record revealed the resident was to receive active ROM to the upper and lower left and right extremities daily as tolerated and was signed as done daily. The document revealed the resident is to wear the knee splint three (3) hours on the right knee and three (3) hours on the left knee daily as tolerated. Place pillow between legs if wearing splint in bed. Perform ROM prior to applying knee splint. There are no instructions on the Restorative nursing care documentation for the positioning right hand splint. The resident was observed in the bed on 8/13/13 at 2:30 p.m. and 4:00 p.m., on 8/14/13 at 8:30 a.m., 12:00 p.m. and 5:15 p.m. and on 8/15/13 at 8:35 am, and 11:00 a.m. with no splints on the resident's knees or right hand. During an observation of restorative nursing care on 8/15/13 at 12:40 p.m., the restorative aide failed to provide range of motion to the right knee before applying the knee splint. The aide also failed to provide range of motion to the right hand and arm prior to applying the hand splint and there was no range of motion done to the left upper and lower extremities as outlined in the plan of care. An interview with Certified Nursing Assistant (CNA) AA on 8/15/13 at 12:40 p.m. revealed that she that if the resident was in the bed, then the knee splints were not applied and revealed that the splints were only applied if the resident was up in the chair. An interview with the Director of Nursing on 8/15/13 at 2:35 p.m. revealed that she was unsure of the origin of the splint instructions for this resident. | 2016-07-01 |