cms_DC: 15
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 |
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15 | WASHINGTON CTR FOR AGING SVCS | 95014 | 2601 18TH STREET NE | WASHINGTON | DC | 20018 | 2019-07-30 | 693 | D | 0 | 1 | BMNI11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, medical record review and staff interview for one (1) of 56 sampled residents facility staff failed to provide evidence of providing care for one (1) resident's percutaneous endoscopic gastrostomy (PEG) site. Resident #155. Findings included . Resident #155 was admitted to the facility on [DATE] with [DIAGNOSES REDACTED]. Review of the Quarterly Minimum Data Set ((MDS) dated [DATE] showed resident Brief Interview for Mental Status (BIMS) is coded as 6 to indicate moderately impaired cognition. Further review of the MDS showed Section K (Swallowing/Nutritional Status) Nutrition Approach resident is coded as having a feeding tube. Percutaneous Endoscopic Gastrostomy (PEG) is a medical procedure in whch a tube is passed into a patient's stomach to provide a means of feeding when oral intake is not adequate. Review of the nurses note on 6/28/19 showed resident went to the emergency room via non-emergency ambulance for evaluation. Review of (Hospital name) transfer summary dated 7/3/19 showed the patient was found to have skin excoriation and some pus discharge around the PEG tube site on admission. Further review of the transfer summary showed discharge plan please continue the PEG care at the nursing home, clean the area around the PEG tube. Observation on 7/26/19 at 11:30 AM of Resident #155 PEG site showed PEG tube insertion site without a dressing in place or evidence the site was cleaned. During an interview on 7/26/19, at 11:30 AM Employee #13 was asked if nurses were providing PEG site care? Employee #13, I did not see this on the transfer summary, I will let the doctor know right away. Review of the medical record showed no documented evidence facility staff are cleaning around the PEG site. Facility staff failed to provide evidence of providing skin care to PEG site to maintain infection control practices. During a face-to-face interview on 7/26/19 at 11:30 AM, Employee #13 acknowleged the finding. | 2020-09-01 |