cms_MT: 5589
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 |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
5589 | PIONEER MEDICAL CENTER LTC | 275139 | 301 W 7TH AVE | BIG TIMBER | MT | 59011 | 2011-03-17 | 329 | D | 79GP11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and staff interview, the facility increased an anxiolytic medication without adequately monitoring behaviors for one (#5) of 10 sampled residents. Findings include: Resident #5 was admitted to the facility on [DATE]; [DIAGNOSES REDACTED]. On 9/7/10, resident #5's physician reduced her order for [MEDICATION NAME] from .5 mg p.o. TID and at hs to .5 mg po TID. On 11/9/10, in a nursing home visit report, the family nurse practicer (FNP) wrote "Patient had been decreased on her [MEDICATION NAME] dose from qid (four times a day) dosing to tid dosing and the staff reports that patient has had increased combativeness." The FNP's plan was "We are going to bump her [MEDICATION NAME] to .5 mg one p.o. tid and at bedtime for anxiety." The surveyor reviewed resident #5's Interdisciplinary Progress Notes dated 9/7/10 to 11/9/10. On 10/3/10, at 0200 (2 a.m.), the nurse wrote: "Resident did a lot of yelling tonight scream out 'get me to bed' pt was in bed - would tell her this..." Then at 0300 (3 a.m.), the nurse wrote "Resident is resting @ this time no more yelling @ this time." On 10/26/10, at 16:15 (4:15 p.m.), the nurse wrote: "After lunch today she was hollering and hollering - when checked it was noted that her face was red and slightly swollen - Indicated she had pain in her abdomen - medicated c Tylenol 650 mg crushed." During an exit meeting on 3/15/11 at 5:15 p.m., the surveyor asked how the facility monitored behaviors. Staff member A, the DON, said the nurses chart behaviors. Staff member G, the ADON, said behaviors are also monitored on progress note sheets by the CNAs. On 3/16/11 at 9 a.m., the ADON said the CNAs had not documented any behaviors for resident #5. The facility failed to monitor behaviors during the gradual dose reduction of the [MEDICATION NAME]. The dose was increased with two documented incidents of hollering between 9/7/10 and 11/9/10. In one of the documented incidents, the resident was hollering because of pain. | 2014-04-01 |