cms_GA: 5860
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 5860 | GOODWILL HEALTH AND REHAB | 115486 | 4373 HOUSTON AVE. | MACON | GA | 31206 | 2015-10-15 | 248 | E | 1 | 0 | 7J0Y12 | Based on observation, interview and record review the facility failed to provide an ongoing meaningful program of meaningful activities to meet the interests, physical, mental and psychosocial well-being of the residents on the secure unit (Faith Two). This failure affected nineteen (19) residents (#1, # 4, #5,#23, #24, #44, #47, #48, #49, #50, #51, #52,#53, #54, #55, #56, #57, #58, #59) that remain in the secured unit to attend activities of the twenty-nine (29) residents who reside on the secured unit. Findings include: Review of the daily census provided on 12/07/2015 revealed twenty-nine (29) residents reside on the secured unit (Faith II). Observation on 12/07/2015 at 9:55 a.m. of activity calendar revealed exercise activity being offered. Observation on the secured unit revealed eleven (11) random residents in the day room/dining room with the television (TV) on. Staff members present were sitting with the residents. Other residents were moving about in the hallway and in their rooms. Observation revealed no other activity being offered on the secured unit at that time. Observation on 12/07/2015 at 11:00 a.m. of the activity calendar revealed crossword puzzles activity. Revealed random residents in dining room with TV on and two staff members present sitting with the residents. Observation revealed no other activity being offered on the secured unit at that time. Observation on 12/07/2015 at 11:45 a.m. of a random female resident attempting to push another random sampled female resident, in the wheelchair, who was objecting loudly. Staff intervened to disengage resident from pushing the wheelchair and the resident continued walking in the hallway but did not re-approach the wheelchair. No other activity was offered to the either resident. Observation on 12/07/2015 at 12:00 p.m. of a random sampled resident in the hallway who had a firm grip on the doors at the entrance to the unit. Staff attempting to disengage resident from the doors but the resident was not easily redirected. Two other staff members were able to get resident to let go of the door. One of those staff members walked up the hall with the resident. Observation on 12/08/2015 at 8:55 a.m. of random sampled residents who were up in the dining room for an activity of watching a movie. Staff were present sitting with the residents. One resident was agitated and yelling out occasionally with staff redirecting the resident. Interview on 12/08/2015 at 10:40 a.m. with Certified Nursing Assistant (CNA) EE revealed the staff tried to keep the residents occupied with activities such as movies, singing, playing games and throwing balls on the unit. The CNA revealed that the residents that were not wanderers would go off the unit for activities. The residents that could not go off the unit to attend activities stayed on the unit. The CNA went on to reveal there were two activity directors. The activity directors brought snacks to the unit. The staff on the unit tried to keep the wanderers occupied and monitor their movement on the unit to keep them out of other resident's rooms and belongings. Residents were removed from other rooms as needed. Observation 12/08/2015 at 11:30 a.m. revealed residents in the day room/dining room on the unit with music on and staff present. Observation on 12/08/2015 at 1:30 p.m. revealed random sampled residents in the day room/dining room with TV on and staff present sitting with the residents. One random observed CNA was ambulating in hallway with two residents. Observation on 12/08/2015 at 1:30 p.m. of the Activity Calendar on the unit revealed (on large board on wall across from the nurses station): On December at 7th at 9:30 a.m. GW News, 10:00 a.m. exercise, 11:00 a.m. Crossword Puzzles, 2:00 p.m. One to One activity room visits, 2:45 p.m. snack cart, 4:00 p.m. playing cards, On December 8th at 9:30 a.m. GW news, 10:00 a.m. Exercise, 11:00 a.m. Arts and Crafts, 2:00 p.m. Shopping List,6:00 p.m. Gentlemen's Hour Interview on 12/08/2015 at 1:35 p.m. with the Care Now Licensed Clinical Social Worker (LCSW) revealed she made recommendations to the staff regarding activities residents might benefit doing, including R #3, from sensory stimulation such as movies to sing-a-longs. Interview on 12/08/2015 at 1:55 p.m. with CNA VV regarding activities on the unit revealed the residents who were able to went off the unit for activities in the main part of the facility. The other residents on the unit would watch TV or listen to music. The CNA further revealed she was not aware of any staff coming onto the unit to do activities with the residents. The CNA also denied having supplies for activities on the unit such as balls, balloons or coloring pages. Observation on 12/08/2015 at 2:15 p.m. of an activity in main dining room off the unit revealed a group singing (activity not listed on activity calendar). Residents from the secured unit were being asked regarding attending the activity and being escorted to the activity. Random sampled residents were observed to remain on the secured unit in the day/dining room with the TV on. Residents were also observed in their rooms and ambulating in the halls. Observation revealed no other activities being offered on the secured unit at that time. Interview on 12/08/2015 at 2:15 p.m. with the Activity Director (AD) revealed she had been employed as the AD for approximately eight (8) to nine (9) weeks. Her background included nine (9) years in memory care as an AD but this was her first experience in long term care (LTC). She was aware of the need for an activity program on the unit and was working on a memory care calendar, however right now she was still trying to learn the paper work and processes associated with LTC. She continued to state regarding activities on the locked unit (Faith Two) unit were conducted by the staff on the unit. If a special group came in to the facility she let them go to the secured unit if they would - such as those groups that would walk through the facility interacting with the residents. She stated that about eleven residents come off the unit for activities. The activity department also provided one on one (1:1) activities three (3) times a week and a snack cart three times a week. Music was provided randomly - not on a schedule. The staff could be providing sensory activities such as massaging hands and nail care. There is a part time activity director who helps with activities on the unit who will sing to them and read Bible stories to them. The AD stated she would need supplies - baskets and laundry items - to train staff on providing the low level activities such as sorting and folding but right now there is no budget for them. She had made a request of supplies to the last administrator who said he would get them but never did. She had not asked the current administrator because the current administrator was so new to the facility. Interview on 12/08/2015 at 5:45 p.m. the Administrator revealed there was no policy and procedure for an activity program but she did provide an NBC Requirements paper stating All regulatory requirements, federal and state specific, are followed by NBC activity directors and 7 day a week activity program in place that meets the needs of residents. Weekend activities required. Interview on 12/09/2015 at 8:10 a.m. with CNA XX revealed that one of the activity leaders did the activities on the unit but the staff would occasionally do activities with the residents when the activity staff were unable to. The unit staff could provide activities including ball toss and crossword puzzles that could be obtained from the AD. CNA XX had not had any training in providing activities to the special population on the unit other than what they got from observing the AD, however, they did receive training on care of residents with dementia. Interview on 12/09/2015 at 8:30 a.m. with LPN EE regarding activities on the unit revealed the AD had been coming back and playing movies and passing snacks. Residents who could, went out to activities off the unit. LPN EE also revealed the staff were not responsible for providing activities on the unit. If a resident needed a diversional activity LPN EE would offer a snack. Observation on 12/09/2015 at 7:00 p.m. revealed activity in the main facility dining room, Baptist Ministries, as scheduled on the activity calendar. While this activity was going on in the main facility dining room, residents on the secured unit (Faith Two), were observed in the day/dining room with TV on - eleven (11) residents - and other residents observed walking in halls. Observation revealed no other activity being offered on the secured unit at that time. Interview on 12/09/2015 at 2:15 p.m. with the Director of Clinical Services, Admin, DON, Director of Operations revealed they were not aware of a prior request being made regarding activity supplies for the unit and they would approve any requests made for resident activities; however, The Director of Clinical Services added that she had been made aware of the need for an activity program on the unit and knew what the building needed (did not specify what that was). The directors further revealed that they were hiring for another full time activities person to help on the closed unit. Interview on 12/10/2015 at 8:45 a.m. with the Medical Director (MD) revealed he did not observe meaningful activities on the unit. He recalled that at one time there was an activity person on the unit. He recalled that activities for the unit had been discussed in a Quality Assurance (QA) meeting but he could not recall when. He did remember it was discussed to offer more activities in the evenings when residents could experience increased agitation. He is in the facility on Tuesday mornings so he does not know what happens on the unit when he is not there. Further Review of activity calendar for December revealed: On December 09 at 9:30 a.m. GW News, 10:00 a.m. Exercise, 11:00 a.m. Manicure, 2:00 p.m. One to One room visits, 4:00 p.m. Crosswords, 7:00 p.m. Baptist Ministries On December 10 at 9:30 a.m. GW News, 10:00 a.m. Exercise 11:00 a.m. Baking Class, 12:30 p.m. Christmas Carols by guest 2:00 p.m. Ladies Hour, 3:00 p.m. Devotion Hour, 4:00 p.m. Afternoon Room Visits On December 11 at 9:30 a.m. GW News, 10:00 a.m. Exercise, 2:00 p.m. One to One room visits, 2:45 p.m. Snack Cart 4:00 p.m. Bingo. Interview on 12/10/2015 at 12:20 p.m. the AD clarified the activity calendar and part time activity director revealed GW NEWS was the morning announcements made over the facility public address (PA) system. Shopping list was when the residents met in the main dining room to give her their shopping lists and money, she would then go get items for them. She further revealed she makes her supply requests by writing them down on a piece of paper, no specific form and would turn in to the administrator - she does not make requests to corporate. She has also bought some supplies with her own money and received reimbursement. Regarding the manicure activity on the schedule for yesterday she revealed that the residents who desired had been brought out from the unit to participate; and she had asked for the names of any residents on unit that would like manicures but was not provided with any names. Observation on 12/10/2015 at 12:30 p.m. revealed Christmas Carols by (guest) activity occurring in the main facility dining room. Observations on the secured unit revealed random residents on the day/dining room being assisted with meals by staff, TV on. Other random residents were observed in the independent dining room in the secured unit with staff assisting as needed. Observation revealed no other activities being offered on the secure unit at that time. Interview with on 12/10/2015 at 12:50 p.m. with CNA VV regarding any changes to the activities on the unit. The CNA revealed that there was an activity person who worked with the residents on the unit but she left around the first of the year and things were not the same after that. Then there was another activity assistant who would try to do extra activities with the residents but she went part time a couple of weeks ago. The CNA also revealed she had not received training in providing activities to cognitively impaired residents. Interview on 12/11/2015 at 7:45 a.m. with LPN GG regarding activities. The LPN revealed the residents on the unit did not have an activity schedule. The residents had the TV room, some residents that were more alert would talk with each other, some residents had TVs in their rooms, and some residents who smoked had smoke breaks. The residents who can will go off the unit for activities. Activities that have been offered on the unit have included movies, snacks and popcorn, music, painting and painting nails. Also sometimes churches would come back and sing songs and music. She revealed she had received training in activities appropriate for special populations but could not recall when. Observation on 12/11/2015 at 10:35 a.m. revealed conclusion of the exercise activity in main dining room and one resident sitting at a table with blocks. Observations on the secured unit revealed five (5) random residents in the day/dining room, music playing and one resident engaged in manipulating stems of artificial flowers, no staff observed in the day room. Observation on 12/10/15 at 1:10 p. m. of the Common Day room in the secured unit revealed six (6) random sampled residents sitting in chairs with a staff member supervision. Continued observation revealed that the television was on for the residents to watch no other activity was provided. | 2018-05-01 |