83 |
ST JOHN'S LUTHERAN HOME |
275024 |
3940 RIMROCK RD |
BILLINGS |
MT |
59102 |
2019-03-08 |
679 |
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 provide the residents on the transitional care north (TCN) unit with a meaningful activity program for 2 (#s 100 and 434) of 34 sampled residents. Findings include: During an observation 3/6/19 at 1:10 p.m, no activity calendar was posted on the TCN unit. During an interview on 3/06/19 at 1:27 p.m., staff member J said the TCN did not have a formal activities program. She said most of the residents on the TCN unit have OT, PT, and/or ST (therapy services) several times a day, and by the times the residents are done with all that, they just want to rest. a. During an interview on 3/7/19 at 9:39 a.m., resident #434 said she would like to participate in activities. The resident said she was admitted to the facility on [DATE]. She said a staff member had come by and talked to her about what kind of things the resident was interested in. Resident #434 said no one had asked her if she wanted to participate in any activities. Review of resident #434's baseline care plan, dated 3/4/19, failed to identify any activities for the resident. The baseline care plan did not include an activity care plan. Review of resident #434's The Resident History and Preferences LTC Form, dated 3/5/19, showed it was somewhat important for the resident to participate in group activities, and very important for her to participate in her favorite activities. b. During an interview on 3/8/19 at 10:23 a.m., staff member B said, We don't have activities on TCN. The elders (residents) are here to get well and they don't need activities. They have therapy and doctor appointments. They need to rest when they are not at therapy or at other appointments. Review of resident #100's physician's progress note, dated 1/24/19, showed, At this time, she again reiterates that she is not a person that is used to sitting around and being in the nursing facility is causing boredom and depression. She states she is interested in trialing an antidepressant, and Her family also brought in a coloring book to help keep her mind busy and preoccupied. The physician's progress note also showed [MEDICATION NAME] 25 mg was started for the resident. Review of resident #100's physician's progress note, dated 2/6/19, showed, Discussed with nursing and feels patient is slightly depressed. Explained that she is encouraged to leave her room on occasion. For example to go look at the birds in the main lobby, watch the SuperBowl game this last Sunday, etc. Patient, however, prefers to stay in her room. Does not watch tv. Often seen sleeping. Discussed with patient and she states that her mood is stable, she just isn't used to not being active. She used to be a very active/busy person. She reports the more inactive she is the easier it gets to just sit around. We discussed increasing her [MEDICATION NAME] to 50 mg qhs. She is in agreement with this plan. Will start this tonight. Review of the resident #100's The Resident History and Preferences LTC Form, dated 1/10/19, showed it was very important for the resident to do group activities and to do her favorite activities. Review of resident #100's Admission MDS, with an ARD of 1/17/19, Section F, F0500, Interview for Activity Preferences, showed, it was not very important for the resident to participate in group activities, and it was somewhat important to participate in her favorite activities. The information varied from the assessment completed seven days prior. During an interview on 3/8/19 at 10:32 a.m., staff member A said the TCU was a short stay unit. The usual length of stay was about 20 days. The staff member said social services did a short assessment on admission regarding resident preferences, and we address those as appropriate. Staff member A said the residents were in the TCU for intensive therapy, and they would be too tired to participate in an activities program. Staff member A said, I do not feel it was worth having an activity staff for the TCU, or was it was a good use of resources, for an area (the residents) that would not participate in activities. During an interview on 3/8/19 at 12:15 p.m., staff member K said the facility did not provide directed activities for the TCN unit residents. |
2020-09-01 |