cms_WV: 1144
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1144 | HOLBROOK HEALTHCARE CENTER | 515076 | 183 HOLBROOK ROAD | BUCKHANNON | WV | 26201 | 2019-01-25 | 842 | E | 0 | 1 | K04V11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, staff interview, and policy review, the facility failed to keep residents' medical information confidential and/or maintain complete and accurate medical records. Individual medication packets were disposed in the general trash without attempts to remove or hide the residents' identifiable information. Enteral feeding tube orders lacked caloric counts, the desired fluid volume in a 24 hour period and the amount of flush to be used with each medication administration. Resident identifiers: #63, #79, #47, #76 and #332. Facility census: 84. Findings include: a) Resident #63 and #79 During observations of medication administration on 01/23/19, Licensed Practical Nurse (LPN) #115 discarded medication packs containing Resident (R) #63 and R#79's name, the medication name and dose and the administration date into the trash bag attached to the medication cart. No attempts were made to remove or cover the identifiable information and/or to destroy the medication packets. During an interview on 01/23/19 at 8:45 AM, LPN #115, reported the trash bag with the medication packets is tied up and disposed of with the regular trash in the dumpster. At 9:445 AM, on 01/23/19, the DON reported the individualized medication packets contain the residents' name, the name and description of the medication and the administration date. The DON acknowledged the facility practice of disposing of residents' medication packets without destroying or hiding the identifiable information is a breech of resident confidentiality as defined in the Health Insurance Portability and Accountability Act (HIPAA). b) Resident #47 Review of the medical record on 01/23/19, revealed Resident #47 is in a persistent vegetative state and receives enteral feedings 24 hours a day via a gastric tube (tube inserted into stomach for feeding). The dietary note dated 01/21/19, states Resident (R) #47 receives [MEDICATION NAME] 1.2 39 milliliters (ml)/hour (hr) via Kangaroo Pump and Flush 70 ml per hr. The physician order [REDACTED]. The order lacks information regarding the total caloric intake to be consumed in 24 hours, the total amount of fluid to be consumed in 24 hours, and the amount of flush to be used with each medication pass. The Director of Nursing (DON) reviewed Resident #47's orders during an interview on 01/23/19 at 2:00 PM, and confirmed the enteral feeding orders were incomplete. The orders do not have the total caloric intake to be given in 24 hours, the fluid volume to be consumed in 24 hours, or the amount of flush to be used with each medication administration. The facility policy titled Enteral Feeding - G - Tube with a review date of (MONTH) 2011, states under the procedure: 1. Obtain physician order [REDACTED]. c) Residents #76 and #332 On 01/23/19 at 8:12 AM, Licensed Practical Nurse (LPN) #40 was observed administering medications to Resident #76. The medication tablets to be administered were contained in plastic packets. The resident's name and the medication names were printed on the packets. The LPN opened the packets, poured the medication tablets into a cup for administration to the resident, and then disposed of the plastic packets by placing them into an unlocked trash receptacle on the medication cart. LPN #40 stated the receptacle would be put in a trash bin in the medication room, and then eventually placed in the dumpster. The LPN acknowledged the resident's name and medication information could potentially be accessed by others. Observation of the trash receptacle on the medication cart revealed the receptacle also contained a medication packet for Resident #332 which identified her name and the medication she was receiving. During an interview on 01/23/19 at 10:02 AM, the Director of Nursing stated a small storage bin would be added to a locked drawer in the medication cart. The plastic medication packets would be placed in the storage bin instead of the unlocked trash receptacle on the medication cart. The plastic medication packets would be emptied from the storage bin and placed in a locked bin to be shredded in order to protect the confidential information. | 2020-09-01 |