cms_WV: 199
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 199 | MADISON PARK HEALTHCARE | 515021 | 700 MADISON AVENUE | HUNTINGTON | WV | 25704 | 2017-04-19 | 157 | E | 0 | 1 | HZCX11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review, staff interview, responsible party interview, and resident interview, the facility failed to notify the responsible party/resident of changes in the residents medications and treatments for three (3) of four (4) residents reviewed for the care area of notification of change during Stage 2 of the Quality Indicator Survey (QIS). This was true for Resident #49, #44 and #8. Resident Identifiers: #49, #44 and #8. Facility Census: 39. Findings Include: a) Resident #49 A review of Resident #49's medical record, at 8:58 a.m. on 04/18/17, found Resident #49 was declared incapacitated by her attending physician on 12/29/16. Also contained in the record was the residents appointment of a Power of Attorney (POA) which was completed on 01/28/11. This POA included medical decision making power. Further review of the record found the following physician orders: --Order dated 01/18/17 for Vitamin D level every 12 months --Order dated 03/24/17 got Physical Therapy five (5) times a week for two (2) weeks --Order dated 03/30/17 for [MEDICATION NAME] 20 milligrams one time a day, KCL 10 meq one time a day, and Basic Metabolic Panel in one week due to pedal [MEDICAL CONDITION] The medical record contained no evidence the POA was notified of these medication/treatment changes. An interview with the Director of Nursing, at 9:57 a.m. on 04/19/17, confirmed the medical record contained no evidence Resident #49's POA was notified of the medication/treatment orders. b) Resident #44. Record review found the resident was admitted to the facility on [DATE]. During Stage 1 of the Quality Indicator Survey (QIS), on 04/17/17 at 12:21 p.m., the resident said she is not included in changes about her medication and care at the facility. She said, They tell my daughter, I guess. They must think I am senile. Review of the resident's most recent annual, minimum data set (MDS) with an assessment reference date (ARD) of 03/13/17, found the resident's brief interview for mental status (BIMS). The resident scored a 15 on her BIMS. A score of 15 is the highest score obtainable and indicates the resident is cognitively intact. The MDS noted the resident was able to understand others and make herself understood. The resident had appointed her daughter as her medical power of attorney (MPOA) on 07/06/15. The facility physician determined the resident lacked capacity to make medical decisions on 03/02/17, due to a [DIAGNOSES REDACTED]. On 03/16/17, the physician wrote an order to discontinue her [MEDICATION NAME], current dose, (current dose was 3 mg daily) and change to [MEDICATION NAME] 1 mg daily. A second order, dated 03/16/17, noted to discontinue [MEDICATION NAME] 20 mg and start [MEDICATION NAME] 20 mg every other day in the morning, for 2 weeks, then 20 mg's on Monday and Thursday for 2 weeks, then 20 mg's on Monday for 1 week - then stop the medication. On 04/06/17, the physician started [MEDICATION NAME], 20 mg daily. At 4:09 p.m. on 04/18/17, Employee #43, a Registered Nurse (RN), chief nursing officer, was asked if the changes in medications had been discussed with the resident and/or her daughter, the MPOA? At 8:11 a.m. on 04/19/17, RN #43 provided a consent for use of psychoactive medications, signed by the daughter on 03/15/17. The consent noted the resident is currently receiving [MEDICATION NAME] 1 mg daily. However, the physician's orders [REDACTED]. RN #43 said the facility knew the physician was going to reduce the [MEDICATION NAME] on 03/15/17, so the daughter was advised of the change on 03/16/17. On 04/05/17, the [MEDICATION NAME] was reduced to 0.5 mg daily. On 04/13/17 the Resperdal was again reduced to 0.25 mg daily, with an end date of 04/20/17. At the close of the survey at 11:45 a.m. on 04/19/17, the facility provided no evidence the daughter/resident had been made aware of the gradual dose reductions (GDR) on [MEDICATION NAME] on 04/05/17 and 04/13/17and [MEDICATION NAME] on 03/16/17. There was no evidence of notification the [MEDICATION NAME] was re-started on 04/06/17. c) Resident #8 Resident #8 was admitted to the facility on [DATE]. The resident is her own responsible party. A review of Resident #8's Annual Minimum Data Set (MDS), with an Assessment Reference Date (ARD) of 02/10/17, was conducted on 04/18/17 at 9:00 a.m. Section C-Cognitive Patterns of the assessment revealed the resident scored a 15 out of 15 on the Brief Interview for Mental Status (BIMS) assessment. A score of 15 indicated the resident was cognitively intact at the time of the assessment. An interview with Resident #8, on 04/18/17 at 9:30 a.m., revealed the facility does not notify her when physician's orders [REDACTED]. A review of Resident #8's medical record, on 04/18/17 at 9:45 a.m., revealed the following orders with no resident notification: --physician's orders [REDACTED]. No documentation of resident notification in the medical record. --physician's orders [REDACTED]. Give Tylenol 325 mg at midnight. No documentation of resident notification in the medical record. --physician's orders [REDACTED]. [MEDICATION NAME] 7.5 mg-325 mg 1 tablet po four times a day for pain. No documentation of resident notification in the medical record. An interview with the Administrator on 04/18/17 at 10:05 a.m. revealed she could not provide any documentation the resident was notified of the medication changes. | 2020-09-01 |