cms_WV: 10337
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 10337 | HEARTLAND OF CLARKSBURG | 515120 | 100 PARKWAY DRIVE | CLARKSBURG | WV | 26301 | 2012-01-31 | 279 | D | 1 | 0 | X6UI11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** . Based on record review, resident interview, staff interview, and family interview, the facility failed to develop an interim care plan upon admission related to anticoagulant use for one (1) of sixteen (16) sampled residents. This resident was known to be on anticoagulants, and was allowed to be shaved by facility staff with a disposable razor. The resident was nicked several times one day while being shaved, yet the care plan was still not developed until two (2) days later when the family requested the resident to be shaved only with an electric razor. Resident identifier. #79. Facility census: 105. Findings include: a) Resident #79 Resident #79 was admitted to the facility, on 01/16/12, with a history of [MEDICAL CONDITION] and embolism, history of old [MEDICAL CONDITION] infarction, and history of a stroke resulting in hemipalegia affecting his non-dominant side. Record review revealed his [DIAGNOSES REDACTED]. During an interview with this resident, on 01/31/12 in the early afternoon, he stated an employee had shaved him with a disposable razor on 01/29/12. The employee had nicked him several times on his face. Observation revealed four (4) small dried scabs on his face. During an interview with a family member, on 01/31/12 in the early afternoon, it was found the family had voiced a complaint to the facility earlier that day about his having been nicked while being shaved on 01/29/12. They requested that a family member come in to shave him on 02/02/12. The family would bring in an electric razor for the resident's use. In an interview, on 01/31/12 in the early afternoon, the director of nursing stated the facility had no policy prohibiting a resident who was on anticoagulant therapy from being shaved by staff with a disposable razor, as long as their PT/INR lab work was normal. However, those residents were not allowed to have disposable razors in their rooms for their own personal use. When asked, she said they had no policy prohibiting aides from trimming the nails of residents who were on anticoagulant therapy. Review of the resident's care plan revealed it was updated on 01/31/12 to include a new focus on anticoagulant therapy for [MEDICATION NAME], and being at risk for adverse effects. A new intervention included nursing staff were not to shave the resident, and the family would obtain an electric shaver for family members to use on him. Another new intervention was to report adverse effects such as blood in the urine or stool, bleeding of the gums or nose, and bruising. Other interventions included to administer (anticoagulant therapy) per physician orders, obtain labs as ordered and notify the physician, obtain vital signs as necessary. Review of the medical record found an abnormal PT blood level on 01/31/12 of 78.4, with the normal reference range being 9.1 - 11.5. The INR was also abnormally elevated at 8.1, with the normal reference range between 0.8 and 1.2. For conventional anticoagulation, the range is between 2.5 and 3.0. For intensive anticoagulation, the range is between 2.5 to 3.5. During interviews with nurses, Employees #12, #52, and #104, in the late afternoon on 01/31/12, they reported the aide (Employee #111) who shaved Resident #79 on 01/29/12, had over [AGE] years experience. They provided a copy of the patient information worksheet the aides used daily, and stated it was updated that day for the resident to not be shaved by staff, and the family would shave him with an electric razor. . | 2015-05-01 |