cms_ID: 62
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 |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
62 | WEISER CARE OF CASCADIA | 135010 | 331 EAST PARK STREET | WEISER | ID | 83672 | 2016-10-21 | 309 | D | 0 | 1 | 224111 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, staff interview, and record review it was determined the facility failed to ensure a) a resident received rapid acting insulin at the correct time, and that the amount of insulin administered was based on accurate blood sugar levels and b) physician orders [REDACTED]. This was true for 1 of 5 (Resident #2) residents observed during medication administration. This placed Resident #2 at risk of [MEDICAL CONDITION] when he was administered rapid acting insulin greater than one hour after the lunch meal. Findings include: Resident #2 was admitted to the facility with multiple [DIAGNOSES REDACTED]. Resident #2's physician orders, dated 10/10/16, included [MEDICATION NAME] solution 100 units/ml - Inject as per sliding scale subcutaneously before meals and at bedtime for diabetes mellitus. The sliding scale was as follows: 0-149 = 0 units 150-200 = 3 units 201-250 = 6 units 251-300 = 9 units 301-350 = 12 units 351-400 = 15 units 401-450 = 18 units For blood sugar greater than 450 give 21 units and notify the medical doctor. The FDA's specifications for use state [MEDICATION NAME] subcutaneous injections should, generally be given immediately (within 5-10 minutes) prior to the start of a meal. On 10/18/16 at 11:50 am, Resident #2's blood sugar reading was 219 mg/dl, indicating he should receive 6 units of [MEDICATION NAME] per the sliding scale. LN #6 told Resident #2 she would administer his sliding scale insulin after lunch. On 10/18/16 at 1:00 pm, LN #6 was observed to administer 6 units of [MEDICATION NAME] to Resident #2. LN #6 stated she routinely administered Resident #2's sliding scale insulin after meals. When asked if she checked Resident #2's blood sugar after lunch prior to administering the sliding scale insulin, LN #6 stated she did not and gave the sliding scale insulin based on what Resident #2's blood sugar was prior to lunch. LN #6 stated Resident #2's physician was not aware she had been holding the sliding scale insulin until after meals. LN #6 then reviewed the physician's orders [REDACTED]. | 2020-09-01 |