| 11253 |
AINSWORTH CARE CENTER, LLC |
285142 |
143 NORTH FULLERTON STREET |
AINSWORTH |
NE |
69210 |
2013-11-13 |
312 |
E |
0 |
1 |
320W11 |
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** LICENSURE REFERENCE NUMBER 175 NAC 12-006.09D1c Based on observations, record review, staff and resident interview; the facility failed to provide toileting and bathing assistance for Residents 9, 13 and 24 who required assistance with activities of daily living. Facility census was 27. Findings are: A. Resident 9 stated during interview on 11/6/13 at 8:58 AM that "...bath supposedly set up for once a week. Haven't had a bath for nearly 2 weeks now. Maybe they forgot about me." Review of Resident 9's Minimum Data Set (MDS-a federally mandated comprehensive assessment tool used for care planning) dated 10/24/13 revealed the resident required physical help with personal hygiene and part of bathing activity. Review of Resident 9's Shower/Bath record (a form used to record provision of each resident ' s shower/bath) revealed the resident received a bath on 10/11/13 and 10/18/13. Documentation indicated the resident did not receive another bath until 11/1/13 (14 days later). A confidential staff interview stated, "When we are short on the floor they pull the bath aide to the floor and the baths don't get done." The DON verified during interview on 11/13/13 at 7:30 AM that there was no evidence to indicate Resident 9 received a bath between 10/18/13 and 11/1/13. B. Review of Resident 24's MDS dated [DATE] revealed [DIAGNOSES REDACTED]. The same assessment indicated the resident required total staff assistance with bed mobility and transfers and extensive staff assistance with toileting and that the resident was frequently incontinent of bladder and occasionally incontinent of bowel. Review of Resident 24's Care Plan dated 9/10/13 indicated the resident did not always wait for staff to provide assistance with toileting and was at risk for falls. Interventions included the following: -Staff to assist with toileting, may use the sit- to-stand mechanical lift as needed -Answer the resident's call light promptly -Report signs and symptoms of urinary tract infection -Ask and assist resident with toileting upon arising, whenever in room, before and after meals, before going to bed and as needed. Observations of Resident 24 on 11/7/13 revealed the following: -at 6:25 AM, NA-G assisted resident out of room and into Dining Room for breakfast. -at 9:14 AM, NA-G propelled resident in wheelchair out of the Dining Room and back to the resident's room. NA-G immediately left the room and did not offer the resident the opportunity to use the bathroom. -at 9:31 AM, NA-H asked the resident to go to the group exercise program and propelled the resident in a wheelchair to the Activity Room. The resident was not offered an opportunity to use the bathroom before leaving the room. -at 10:05 AM, Resident 24 remained in wheelchair in the Activity Room for Bible Study. -at 10:25 AM, a volunteer assisted the resident from the Activity Room back to the resident's room. -at 12:00 PM, the resident was assisted back to the dining room for the noon meal by NA-H. Resident 24 was still not offered an opportunity to use the bathroom. During an interview on 11/12/13 from 1:50 PM to 2:00 PM, NA-G indicated Resident 24 was toileted on 11/7/13 after lunch stating "it was probably about 1:30 PM and the resident was incontinent". NA- G further indicated the resident was usually incontinent of urine; however Resident 24 was on a bladder management program and should have been taken to the bathroom at least every 2 hours. B. Review of Resident 13's MDS dated [DATE] revealed [DIAGNOSES REDACTED]. The same MDS indicated the resident required extensive staff assistance with bed mobility, transfers and toileting. Review of Resident 13 ' s Care Plan dated 7/18/13 indicated the resident did not always wait for assistance from staff with toileting. The resident had impaired mobility and was at risk for bladder incontinence due to inability to transfer self to the bathroom. Interventions included the following: -Report signs and symptoms of urinary tract infection -Provide with extensive assist with toileting -Use of incontinent pads as needed for clothing protection and dignity -Provide incontinence care after each incontinent episode Observations of Resident 13 on 11/7/13 revealed the following: -at 6:53 AM, resident was seated in a wheelchair in the Dining Room -at 8:30 AM, Resident 13 self- propelled wheelchair to the resident ' s room -from 9:05 AM to 9:30 AM, Resident 13 remained seated in wheelchair in room. During this time, none of the facility staff offered to assist the resident with using the bathroom. -at 9:31 AM, NA-H asked the resident to attend the group exercise program in the Activity Room and then assisted the resident to the Activity Room. -at 9:56 AM, Resident 13 requested to return to room to use the bathroom and NA-H told the resident that Bible Study was next and the resident could not leave until after Bible Study was finished. -at 10:24 AM, a volunteer assisted the resident back to the resident's room -at 10:25 AM, resident 13 had turned on the bathroom call light and had wheelchair positioned in the doorway of the bathroom calling out for assistance -at 10:26 AM, the volunteer was in the hallway looking for staff to assist Resident 13 with using the bathroom. -at 10:27 am the Director of Nursing entered Resident 13's and assisted the resident with using the bathroom. During an interview with Resident 13 on 11/7/13 at 10:45 AM the resident stated, "I really needed to go to the bathroom and they didn't want me to go, no one would take me when I asked and I know I am supposed to wait for help." |
2015-07-01 |