cms_GA: 2974
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2974 | PRUITTHEALTH - FITZGERALD | 115617 | 185 BOWEN'S MILL HIGHWAY | FITZGERALD | GA | 31750 | 2019-07-03 | 688 | D | 1 | 0 | KWBX11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** > Based on interviews and record review, the facility failed to ensure that restorative nursing services were consistently provided for one of four residents (B) reviewed for restorative nursing. Findings include: The facility had a Lippincott Procedure for a Restorative Nursing Program. The procedure noted that it was the policy of the facility to provide restorative nursing which focuses on achieving and maintaining optimal physical, mental and psychosocial functioning of the resident. The restorative nursing program is under the supervision of a licensed nurse and provided by restorative nursing assistants or certified nursing assistants or any other qualified staff. The procedure also documented if it is determined that the resident would benefit from a Restorative Nursing Program, the nurse should arrange for such a minimum of six days a week, unless otherwise noted. During an interview on 6/24/19 at 12:35 p.m., the Assistant Director of Health Services (ADHS) stated that she oversaw the restorative program and restorative certified nursing assistant (CNA) BBB provided the restorative nursing services. The ADHS also stated that restorative services are usually set up to be provided three to five times per week or as tolerated. She added that currently restorative CNA BBB had been out of the facility, since last week, on leave, and that a list of all residents who received restorative nursing services would be given to the CNA's assigned to the residents that day (6/24/19). Resident (R) B had [DIAGNOSES REDACTED]. She received skilled physical therapy services from 2/19/19 through 4/30/19 and was discharged to a Restorative Nursing Program on 5/1/19. Care plan problems were developed on 4/30/19 for requiring restorative assistance to maintain goals and for being at an increased risk for falls with interventions to complete passive range of motion (PROM) exercises and ambulate as able with a bariatric walker for 15 to 80 feet, with staff to follow close behind with a wheelchair. A review of the quarterly Minimum Data Set (MDS) assessment, dated 5/18/19, revealed that the resident was cognitively intact with a Brief Interview for Mental Status (BIMS) score of 15. The MDS assessment also documented that the resident was provided with extensive assistance from staff for transfers and supervision and set up assistance for ambulation. The Restorative Therapy Referral form, with an effective date of 5/1/19, included the approaches of 15 to 30 repetitions of therapeutic exercises to the bilateral lower extremities and ambulation with a bariatric walker for 15 to 80 feet as able. The goal of the program was to maintain range of motion and strength to the bilateral lower extremities and maintain ambulation. A review of the Restorative Log, Restorative I CNA Role, Restorative II CNA Role, and Restorative Nursing Flow Record forms from 5/1/19 through 7/1/19 revealed that range of motion services were provided 21 times in May, only six times in (MONTH) and once in July. Restorative ambulation services were provided 21 times in (MONTH) and only four times in June. There was no additional evidence that restorative services were consistently provided, as care planned after (MONTH) 2019. Although restorative documentation indicated that restorative services were being provided, during an interview on 6/24/19 at 10:24 a.m. and 6/26/19 at 3:20 p.m., RB stated that she had only been assisted by nursing staff to walk one time, since being discharged from physical therapy (4/30/19) and being placed on restorative nursing services. She further stated that she performed range of motion exercises herself, like physical therapist (PT) CCC showed her. During an interview on 6/24/19 at 12:20 p.m., PT CCC indicated that she did not think RB was receiving restorative nursing services. She had observed the resident ambulating with restorative only once, maybe twice. She stated that she did not feel like it was being provided based on what she was told by RB, who would ask her repeatedly, where restorative nursing staff was, and when restorative nursing staff was coming to ambulate with her. PT CCC did state that she, herself, was not at the facility all the time because she went to other buildings also. However, she thought that if restorative nursing services were being provided, RB would not have repeatedly asked her about it. PT CCC added that she used to go by the resident's room almost daily, going down her hall, and RB would call out to her, but she had not been down that hall and talked to her as much in the past month. PT CCC stated that she could not remember the last time that the resident complained to her about not getting walked with restorative. PT CCC stated that she had brought up her concerns to management in the past, and they had attempted to resolve the issue several times. PT CCC stated that RB was safe to ambulate but needed supervision to follow her with a wheelchair, obtain her walker for her, and manage her oxygen. During an interview on 7/3/19 at 10:30 a.m., the Director of Health Services (DHS) stated that she had not received any complaints regarding RB not being provided with restorative services and had observed her ambulating with three to four staff members once the previous week or two. | 2020-09-01 |