cms_WV: 4800
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 4800 | SALEM CENTER | 515071 | 255 SUNBRIDGE DRIVE | SALEM | WV | 26426 | 2015-11-04 | 248 | D | 0 | 1 | KC5S11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, record reviews, and staff interview, the facility failed to provide an ongoing activities program to meet the interests and needs for three (3) of six (6) Stage 2 residents reviewed for the provision of activities. When the facility discontinued their Alzheimer's unit, all structured daily activities geared to meet the needs of those residents were also discontinued. The available scheduled group activities did not meet the identified individual needs of these residents with dementia, short attention spans, and/or behaviors. Resident identifiers: #73, #99, and #50. Facility census: 87. Findings include: a) Residents #73, #99, and #50 resided on the Solana unit, which was previously a secured Alzheimer's unit. The facility discontinued the Alzehimer's unit, and on 04/20/15, the doors of the secured unit were unlocked. These residents no longer had a confined area to wander, and no longer were provided on-going structured activities based on their assessed needs. 1. Resident #73 Review of the medical record, on 10/28/15 at 2:20 p.m., revealed Resident #73 was admitted to the facility on [DATE]. Her [DIAGNOSES REDACTED]. She was identified at risk for limited meaningful engagement related to her cognitive loss, confusion, and short attention span. The resident was unable to make her needs known, and was at risk for falls. Her behaviors included pacing to the point of exhaustion. The resident's recreational assessment, dated 05/19/15, noted the resident was rarely/never understood. Her favorite activities included music, food, and social events. The accommodations listed related to her cognitive loss included small groups, decreased environmental clutter, verbal prompts, physical prompts (hand over hand), simple noncomplex directions, and sensory focused activities. The summary stated she was confused, had a short attention span, and often wandered. The assessment noted: She needs adapted activities to her cognition, with focus on sensory stimulation. The resident's prior care plan (used before the doors were unlocked), dated 01/21/15, stated the resident loved to dress up and wear boas, beads, and hats. It indicated staff should offer her activity beads during times of restlessness. Daily observations of Resident #73, during the survey, found her actively roaming the facility halls, talking in word salads, and entering other residents' rooms. Occasionally she was found sitting at the nurses' desk eating a snack or looking at a magazine. On one (1) occasion she was sitting at the desk with a stethoscope and a blood pressure cuff. She was never found dressed up or playing with activity beads. 2. Resident #99 Review of the medical record, on 10/29/15 at 9:00 a.m., revealed Resident #99 was admitted to the facility on [DATE]. Her [DIAGNOSES REDACTED]. She was identified at risk for limited meaningful engagement related to cognitive loss, due to her [DIAGNOSES REDACTED]. Her behaviors included wandering, yelling at staff, and paranoia. The resident's recreation assessment, dated 07/16/15, identified her important preferences were snacks between meals, music, and going outside weekly. Her previous activity care plan (used before the doors were unlocked) was last reviewed on 01/28/15, It stated she liked to eat, read adventure and horror books, watch television, and do word searches. Throughout the survey, Resident #99 was observed walking the halls and verbally interacting with staff. She was never seen with a book or word puzzle. The resident was observed only once sitting in the television room with other residents. On 10/27/15, the resident repeatedly asked the surveyor to take her outside for a walk. There was no evidence she was offered a trip outside during the warm fall days. A review of the recreational assessment for Resident #99, with Activity Director (AD) #46 on 11/03/15 at 10:25 a.m., revealed the record was silent regarding the resident being taken outside for walks. 3. Resident #50 Review of the medical record, on 10/28/15 at 3:33 p.m., revealed Resident #50 was admitted to the facility on [DATE]. Her [DIAGNOSES REDACTED]. The resident's medical record indicated she needed adaptive activities, had confusion, and had a short attention span. According to the medical record, the resident was often on the go, pacing the halls in her wheel chair. Her behaviors included exit seeking, crying for extended periods, and combative actions (hits, kicks, and grabs staff). The medical record contained evidence of a resident-to-resident altercation on 10/05/15. The resident's previous activity care plan (in place prior to the doors being unlocked) with a review date of 01/28/15, stated she liked cooking, cleaning, socializing, and playing Bingo and cards. It also indicated the resident sometimes carried a baby doll. The resident's recreation assessment, dated 09/01/15, listed her favorite activities as walking or wheeling, music, food activities, church or religious activities. and talking. It indicated she would benefit from accommodations for cognitive loss, including small groups and single step activities. The assessment noted her activity participation was limited, due to her short attention span. Observations throughout the survey found the resident continuously wheeling up and down the halls. At times she was observed repeatedly bending over and picking at unseen objects on the floor. She was never observed with a baby doll. There was no evidence cooking or cleaning activities were offered to her. b) Licensed Practical Nurse (LPN) #54 was interviewed on 10/27/15 at 9:45 a.m. and again on 10/28/15 at 8:35 a.m. She reported the residents with dementia from the Solana unit wandered throughout the facility, now that the unit was no longer locked. She said Residents #73, #99, and #50 were kept busy with activities before the discontinuation of the Alzheimer's unit. LPN #54 said now there were no activities for the residents with dementia, and they just wandered around the facility. She said some of the residents entered other residents' rooms, climbed into their beds, and took their belongings. LPN #54 said the residents were previously kept busy with a long day of activities designed to meet the needs of a resident with dementia and with a short attention span. c) Confidential interviews with nursing assistants on 10/28/15 revealed concerns with no scheduled activities that residents with dementia could attend to meet their needs. They said, It is sad to watch them wander around and enter other peoples' rooms. d) When interviewed on 11/03/15 at 10:25 a.m., AD #46 confirmed there was only one (1) activity calendar for the facility. She confirmed these activities did not meet the needs of residents with Alzheimer's dementia, especially with their short attention spans. She agreed the facility did not offer individualized activity interventions for Residents #73, #99 and #50 after the Alzheimer's unit was closed. AD #46 confirmed these residents wandered, and were not capable of independent stress/relaxation as documented on their recreation activity logs. She confirmed the facility did not provide a space, or environmental cues, to encourage physical exercise, decrease behaviors, and/or reduce extraneous stimulation for these residents who once were provided these services. The facility had a single rocking chair in the office, and bags of therapy beads and lotion for aromatherapy; however, these items were not readily available for the residents to access and were not routinely offered on a daily basis. AD #46 agreed the activity program needed restructured to meet the individual needs of the residents who remained on the Solana unit. e) Review of the Alzheimer's unit daily flow sheets, obtained from the administrator on 11/04/15, revealed the residents who resided on the Alzheimer's unit had scheduled activities from 7:00 a.m. to 8:00 p.m. daily. These activities included activities of daily living, small group socials with coffee and discussing current events, exercise, artistic expression such as painting, gardening, or drawing, cognitive sharpening exercises such as Bingo, puzzles, and mazes, sensor-motor activities which included making popsicles or pudding, spiritual singing, and community story telling. Beginning 04/20/15, the residents who resided on Solana unit, preciously a locked Alzheimer's unit, were only offered the scheduled activities planned for the higher functioning residents in the facility. The planned activities to meet the needs of residents with Alzheimer's dementia were no longer available. In addition, structured activities were no longer available to them from 7:00 a.m. to 8:00 p.m. daily. The (MONTH) activity calendar listed activities from 9:45 a.m. to 4:45 p.m. It included Wifi games, horseshoes, and Bible study. There were also five (5) evening church services and two (2) evening Bingo games, one (1) evening movie, and two (2) resident choice events. f) During the survey, observation revealed residents, who resided on the Solana unit, previously a locked Alzheimer's unit, wandered freely throughout the facility all day long. Observation revealed no planned activities to keep them busy, as they were previously provided when they resided in a setting for residents with dementia. | 2019-07-01 |