cms_WV: 3889
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 3889 | MERCER NURSING AND REHABILITATION CENTER | 515052 | 1275 SOUTHVIEW DRIVE | BLUEFIELD | WV | 24701 | 2016-08-19 | 282 | E | 0 | 1 | 5Q6I11 | Based on record review and staff interview, the facility failed to ensure implementation of his care plan in regards to his risk for dehydration. This was true for one (1) of three (3) residents reviewed for the care area of hydration during Stage 2 of the Quality Indicator Survey. Resident Identifier: #24. Facility Census: 75. Findings include: a) Resident #24 A review of Resident #24's medical record at 8:25 a.m. on 08/18/16 found a care plan focus initiated 12/04/15 of, (typed as written) (Resident #24's Name) has potential dehydration or potential fluid deficit r/t (related to) Diuretic use. The goal associated with this care plan was, (typed as written) Patient will be free of symptoms of dehydration and maintain moist mucous membranes, good skin turgor through review period. This goal, last reviewed on 08/12/16, had no changes made to it since first initiated on 04/01/15. The interventions related to this focus statement and goal included, (typed as written) Monitor and notify physician of acute symptoms leading to or indicative of dehydration, including persistent symptoms of diarrhea; nausea/vomiting unresolved past 48 hours; persistent output exceeding intake past 48 hours; abnormal labs (laboratory). Further review of his medical record found the resident's intakes and outputs were recorded on a daily basis. Review of the intake and output records found the following: --On 05/11/16 - his output was 75 cubic centimeters (cc) greater than his intake. --On 05/12/16 - his output was 1750 cc greater than his intake. --On 05/13/16 - his output was 930 cc greater than his intake. --On 05/25/16 - his output was 1390 cc greater than his intake. --On 05/26/16 - his output was 170 cc greater than his intake. --On 05/27/16 - his output was 1140 cc greater than his intake. --On 05/28/16 - his output was 1470 cc greater than his intake. --On 06/17/16 - his output was 1940 cc greater than his intake. --On 06/18/16 - his output was 1180 cc greater than his intake. --On 06/19/16 - his output was 250 cc greater than his intake. --On 06/20/16 - his output was 1860 cc greater than his intake. --On 06/29/16 - his output was 260 cc greater than his intake. --On 06/30/16 - his output was 560 cc greater than his intake. --On 07/01/16 - his output was 1900 cc greater than his intake. --On 07/02/16 - his output was 1990 cc greater than his intake. --On 07/03/16 - his output was 1440 cc greater than his intake. --On 07/04/16 - his output was 520 cc greater than his intake. --On 07/05/16 - his output was 1680 cc greater than his intake. --On 07/11/16 - his output was 2640 cc greater than his intake. --On 07/12/16 - his output was 1770 cc greater than his intake. --On 07/13/16 - his output was 1840 cc greater than his intake. --On 07/14/16 - his output was 120 cc greater than his intake. --On 07/15/16 - his output was 50 cc greater than his intake. --On 07/16/16 - his output was 180 cc greater than his intake. --On 07/17/16 - his output was 780 cc greater than his intake. --On 07/18/16 - his output was 780 cc greater than his intake. --On 07/23/16 - his output was 720 cc greater than his intake. --On 07/24/16 - his output was 940 cc greater than his intake. --On 07/25/16 - his output was 1560 cc greater than his intake. --On 07/26/16 - his output was 170 cc greater than his intake. --On 07/27/16 - his output was 2380 cc greater than his intake. --On 07/28/16 - his output was 1220 cc greater than his intake. --On 08/09/16 - his output was 1820 cc greater than his intake. --On 08/10/16 - his output was 280 cc greater than his intake. --On 08/11/16 - his output was 255 cc greater than his intake. Although the resident's output exceed his intake from, - 05/11/16 through 05/13/16, - 05/25/16 through 05/28/16, - 06/17/16 through 06/20/16, - 06/29/16 through 07/05/16, - 07/11/16 through 07/18/16, - 07/23/16 through 07/28/16, and - 08/09/16 through 08/11/16, there was no evidence in the medical record of his attending physician being notified as directed by the resident's care plan. An interview with Clinical Care Supervisor #95 at 9:19 a.m. on 08/18/16 confirmed that according to the care plan the attending physician should have been notified of these instances when his output exceeded his intake for greater than 48 hours. She said she would have to review his medical record to see whether the physician was notified or not. During an additional interview at 10:36 a.m. on 08/18/16, Clinical Care Supervisor #95 reported she could find no evidence his attending physician was notified of the instances when the resident's output exceeded his intake for greater than 48 hours. She agreed they did not implement his dehydration care plan, but made mention that they would need to look at the care plan for possible revision because due to his diuretic use it was an expectation that his output would exceed his intake. | 2020-04-01 |