| 82 |
ST JOHN'S LUTHERAN HOME |
275024 |
3940 RIMROCK RD |
BILLINGS |
MT |
59102 |
2019-03-08 |
656 |
D |
0 |
1 |
SJ2F11 |
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to complete a person centered care plan that included interventions for the personal safety of 1 (#76); and failed to develop a comprehensive, person centered activity care , for 1 (#125) of 34 sampled residents. Findings include: 1. During an interview on 3/7/19 at 9:53 a.m., staff member B stated, He is able to go out on the bus independently. He had cigarettes in his pocket when the bus driver picked him up. I know that, because my husband is the driver. She further stated resident #76 had an order for [REDACTED].#76, and had reminded him of the no smoking policy. During an interview on 3/7/19 at 11:00 a.m., staff member L stated when she met with the families she let them know about the no smoking policy. She stated, If I feel that there is a concern identified with regards to smoking, then I would include a Tobacco Free flyer. She stated when resident #76 was admitted , he did sign something acknowledging the no smoking policy. During an interview on 3/7/19 at 1:24 p.m., resident #76 stated he was aware of the no smoking policy in the facility when he was admitted . He stated I don't know why I did that. Review of resident #76's physician progress notes [REDACTED].#76 had recently been caught smoking in his room. The resident had severe [MEDICAL CONDITION] and used oxygen. The progress note showed, He says he smoked because he was stressed about the move to new unit. Review of resident #76's Significant Change MDS, dated [DATE], Section C, showed a BIMS of 15; cognitively intact. Review of the facility document, titled Resident and Service Agreement, dated 6/1/18, and signed by resident #76, showed, under section XII, Miscellaneous, Subsection D, Smoke Free Policy, Resident acknowledges and agrees to comply with Facility's 'Smoke Free' policy as defined in Appendix D. Failure to comply with said policy constitutes Material non-compliance with Agreement. Review of resident #76's Non Fall Incident Report, dated 2/16/19, showed, under #7 Incident type: Smoking in bathroom, with a description of Nurse found elder had been smoking in bathroom and confiscated items after explaining policy. Notified Security. Review of a facility email, dated 2/18/19, from the DON to Administrator, showed resident #76 had been spoken to regarding the seriousness of smoking in the bathroom. The email showed resident #76 understood the concerns, and what the DON and Administrator has spoke to him about. Review of resident #76's care plan, dated 11/18, showed no problem areas, goals, or interventions that addressed the safety concerns regarding the resident smoking in the bathroom. 2. During an interview on 3/8/19 at 12:15 p.m., staff member K said she completed the Resident History and Preferences LTC Form for all the residents on the TCN. The staff member said the information in this form was added, by her, to section F of the comprehensive MDS. Staff member K said she would write an activities care plan for TCN residents if indicated. Staff member K said if residents needed reading material or something similar, she would get it for them. Staff member K said no directed activity program was provided on the TCN. Staff member K said she had not written an activity care plan for resident #125 because concerns with activities had not triggered on Section V of the Admission MDS. Review of resident #125's The Resident History and Preferences LTC Form, dated 2/1/19, showed it was very important for the resident to participate in group activities, and somewhat important to do favorite activities. Review of resident #125's Admission MDS, with an ARD of 2/8/19, Section F, F0500, Interview for Activity Preferences, showed it was somewhat important for the resident to participate in group activities and very important for her to do her favorite activities. This information did not coincide with the 2/8/19 Admission assessment. Review of resident #125's comprehensive care plan failed to address the resident's need for an activities program, although the resident felt it was important to participate in group and favorite activities. |
2020-09-01 |