cms_WV: 100
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| rowid | facility_name | facility_id | address | city | state | zip | inspection_date | deficiency_tag | scope_severity | complaint | standard | eventid | inspection_text | filedate |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 100 | HUNTINGTON HEALTH AND REHABILITATION CENTER | 515007 | 1720 17TH STREET | HUNTINGTON | WV | 25701 | 2018-08-23 | 679 | D | 0 | 1 | TKSO11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review, staff interviews, observations and review of policy and procedure for activities, the facility failed to invite and provide activities of interests for two of three residents reviewed for activities. Resident identifiers: #74 and #80. Facility census: 176. Findings included: a) Resident #74 1. Resident #74's medical record was reviewed on 08/22/18 at 09:46 AM. The resident was admitted on [DATE]. The Admission Minimum Data Set (MDS) assessment Section I revealed the resident had [DIAGNOSES REDACTED]. Section G0110, required extensive assistance of two with transfers. Section F0500, Interview for Activity Preferences, responses from the resident were reviewed and revealed that is was very important to have books, newspaper or magazines to read, music, news, group activities, favorite activities, religion and fresh air. The resident's activities care plan, dated 05/15/18, was reviewed on 08/22/18 at 10:18 AM. The care plan revealed the resident had an anticipated short stay and had interventions that included the following: ensure that the activities the resident attend are compatible with known interests, invite the resident to activities, provide a program of activities that is of interest, provide activity calendars, review resident activation needs, staff will informally visit on a regular basis to ensure leisure needs are being met, the resident needs assistance/escort to activity functions, attending church services, when resident chooses not to participate in organized activities, the resident prefers to spend time in room listening to music or reading. Observations were made of the resident on 08/20/18 at 03:35 PM of the resident in bed and awake. The television that was in front of the bed was not on. On 08/21/18 at 12:12 PM the resident was observed lying in bed asleep. On 08/22/18 at 08:57 AM the resident was observed in bed and had just finished breakfast, at 10:58 AM the resident was asleep in bed. On 08/23/18 at 9:24 AM the resident was observed in bed in room awake, the television was not on and there was no music on. On 08/22/18 at 10:34 AM the Individual Activity Participation Records for May, June, (MONTH) and (MONTH) (YEAR) were reviewed. The documentation revealed in the past four months that Resident #74 only participated in music one time, cards/other games one time and received mail twice. The resident refused glamour nails once. There were no other refusals documented on the participation records. On 08/22/18 at 11:00 AM, Activity Assistant (AA)#21 was interviewed. AA #21 stated that she used to be the Activity Director but stepped down and was an Activity Assistant. AA #21 was asked if she invited Resident #74 to the group activities and she stated she had not invited the resident any this month. She stated she did not invite her to come to activities, realized she should and that was a mistake. She stated she made informal visits to Resident #74's room, but nothing specific based on her activity preferences. On 08/23/18 at 11:06 AM, Activity Assistant (AA) #22 was interviewed. AA #22 stated she provided activities on the unit. AA #22 stated she did not invite Resident #74 to come to activities when the resident was in bed. On 08/23/18 at 11:07 AM, Activity Director (AD) #80 was interviewed regarding Resident #74. AD #80 verified the staff did not provide invitations for the resident to attend scheduled activities based on the resident's individual activity preferences and should have. b) Resident #80 2. Resident #80's record review was reviewed on 08/21/18 at 03:51 PM. The Annual Minimum Data Set (MDS), dated [DATE], Section I had [DIAGNOSES REDACTED]. Section G0110 revealed the resident required extensive assistance of two for transfers and revealed in Section F0500, Interview for Activity Preferences, responses from the resident were as follows: very important to have music, news, pets, group activities, fresh air, favorite activities and religious activities. The Resident #80's care plan, dated 7/31/18, was reviewed on 08/21/18 at 04:03 PM. The care plan revealed the resident was dependent on staff for meeting emotional, intellectual, physical, and social needs. The care plan interventions included: ensure that the activities the resident attend are compatible with known interests and preferences, compatible with individual needs and abilities, introduce the resident to residents with similar background and interests, invite the resident to scheduled activities, provide a program of activities that is of interest, provide activity calendars, resident needs assistance/escort to activity functions, when resident chooses not to participate in organized activities the resident prefers to sit up in wheelchair in hall and socialize among peers, watch television for social and sensory stimulation. Observations were made on 08/20/18 at 03:27 PM of the resident lying in bed awake. There was no television on the wall in front of the resident's bed. Only a television wall mount was there and no radio or music was playing. Observations were made on 08/21/18 at 12:11 PM of the resident lying in bed awake. There was no television on the wall mount and there was no radio or music playing. On 08/21/18 at 04:08 PM the Individual Activity Participation Records for June, (MONTH) and (MONTH) (YEAR) were reviewed. The documentation recorded on Individual Activity Participation Records revealed that Resident #80 attended cards/other games and a religious activity one time in (MONTH) (YEAR). Further review of the Individual Activity Participation Records dated June, (MONTH) and (MONTH) (YEAR) revealed documentation that the resident was provided television and visits with family or friends every day in June, (MONTH) and (MONTH) (YEAR). On 08/21/18 at 02:09 PM, Activity Assistant (AA) #160 was interviewed. AA #160 stated she had not invited the resident to any group activities. AA #160 verified the Individual Activity Participation Record for (MONTH) (YEAR) revealed television was provided to the resident every day. AA #160 stated the resident was independent with television and watched it in her room. AA#160 walked with this writer to the resident's room and verified the resident did not have a television in front of her bed that she could operate independently. Observations were made of the resident's roommate with a television, but the cubicle curtain was observed closed. AA #160 stated she didn't invite the resident to activities because she was in bed. AA #160 provided the resident's care plan and stated she goes by the care plan to provide activities to the resident but verified she didn't follow it. On 08/21/18 at 02:20 PM Resident Care Specialist (RCS) #91 was interviewed. RCS #91 stated the activity staff invite the resident to activities. RCS #91 stated Resident #80 couldn't get out of bed on her own and required assistance of two staff to get out of bed. RCS #91 stated the nursing staff or activity staff could assist to take the resident to the activity if the resident wanted to go. On 08/21/18 at 02:50 PM Activity Director (AD) #80 was interviewed. AD #80 verified on the Individual Activity Participation Records for the past three months the resident received visits with family or friends every day and was independent in watching television every day. AD #80 verified there was no television in the Resident #80's room. AD #80 verified there had been no radio in the resident's room until today and that music was listed as a preference of the resident on the care plan. AD #80 was not aware the resident had no visitors and had a caseworker listed as a primary contact person. On 08/21/18 at 03:32 PM Licensed Practical Nurse (LPN) #41 was interviewed. LPN #41 stated had not seen any family or friends visit and the resident's contact person was a caseworker that she had to call if there were concerns regarding the resident. On 08/23/18 at 11:06 AM Activity Assistant (AA) #22 was interviewed. AA #22 stated she provided activities on the unit but does not invite residents to come to group activities when the residents are still in bed. AA #22 verified she did not invite Resident #80 to join the scheduled activities on the unit per the care plan. On 08/23/18 at 11:07 AM, Activity Director (AD) #80 was interviewed regarding both Resident #74 and Resident #80. AD #80 verified that the activity staff failed to invite the resident to scheduled activities, failed to provide a television or music based on individual preferences of the resident. AD #80 also verified for both Resident #74 and #80 that if the residents were not up and out of bed, the Activity Assistants should still ask the resident if they wanted to come to activities. If the residents wanted to come, the Activity Assistants should inform the nursing staff to assist with getting the residents up so they could attend the activity. AD #80 verified if the nursing staff did not get the resident up out of bed when asked, it should be reported to her or nursing staff. AD #80 verified that if the resident did not want to get out of bed to attend a group activity, the activity assistants should provide things to do in their room based on the Individual Activity Preferences on the care plan. If the resident refused, it should be documented on the Individual Activity Participation Records as a refusal. AD #80 verified the staff did not follow the care plan to invite the residents to scheduled activities. AD #80 provided the Policy on Activities Program on 08/23/18 at 11:08 AM. The policy was reviewed and revealed that activities are provided to meet the assessment and interests of each resident. The resident's interests are assessed upon admission and according to the Resident Assessment Instrument (RAI) manual with MDS reference periods and a comprehensive care plan is developed and reviewed and revised as needed. AD #80 verified the policy wasn't followed to provide activities to Residents #74 and #80. | 2020-09-01 |