cms_WV: 11461
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 11461 | MCDOWELL NURSING AND REHABILITATION CENTER, LLC | 515162 | PO BOX 220 | GARY | WV | 24836 | 2010-11-18 | 240 | G | FROJ11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** . Based on family interview, medical record review, ambulance personnel interviews, and staff interview, the facility failed to promote care for one (1) of nine (9) sampled residents in an environment that enhanced each resident's quality of life. A facility staff member forced Resident #49 to attend an appointment with a psychiatrist against her will, despite the resident's repeated and vocal statements that she did not want to go. The resident was placed on a gurney, loaded into an ambulance, and subjected to a two-hour trip to attend an appointment which she expressly did not want to attend. It was determined the resident arrived at the appointment in extreme emotional and physical distress. Resident identifier: #49. Facility census: 104. Findings include: a) Resident #49 An interview with Resident #49's daughter, on 11/15/10 at 7:42 p.m., found the daughter was present at a psychiatrist's office on 11/02/10 when her mother arrived by ambulance for a scheduled appointment. The daughter stated her mother was very upset, crying, and extremely short of breath. She relayed that her mother reported to her "they had thrown her out and made her go". She stated her mother was so upset that she was unable to interact with the psychiatrist and that she (the daughter) had to answer the questions posed to her mother by the psychiatrist due to her mother's emotional distress. She stated that both ambulance personnel told her that her mother had refused to go, but the nurse made them take her. An interview was conducted with the resident's son and medical power of attorney representative (MPOA) at 8:10 p.m. on 11/15/10. He stated that he visited the facility on 11/01/10, and was informed that his mother had an appointment with the psychiatrist the following day. He stated he informed Employee #98 (a licensed practical nurse - LPN), "If there was any way possible, I would like her to go, but she probably won't." He stated his mother had regularly refused to attend appointments outside the facility and he had always been notified by nursing staff she was refusing to go. He stated that neither he nor any staff at the facility had forced his mother to attend an appointment against her wished until this incident. He stated that, if the nurse had contacted him, he would have had them cancel the appointment. He stated his mother still refers to the incident and continues to be upset. Review of Resident #49's medical record found [DIAGNOSES REDACTED]. The resident was receiving seven (7) medications for treatment of [REDACTED]. Review of the resident's most recent minimum data set (MDS) assessment, with an assessment reference date (ARD) of 10/14/10, found the resident was assessed as having no hearing difficulty, demonstrating clear speech and understanding of others, and displaying the ability to make herself understood. Her cognitive skills were assessed as modified independence - with some difficulty in new situations only. Review of the nursing notes found the resident was afforded the right to refuse physician appointments on 05/03/10, 05/12/10, 06/04/10, 07/20/10, 07/29/10, 08/19/10, and 09/28/10. An interview with a member of the ambulance crew (AC) who took the resident to the 11/02/10 appointment (AC #1) was conducted at 12:20 p.m. on 11/17/10. He relayed that Resident #49 was alert and oriented and able to answer questions appropriately. He stated the resident repeatedly verbalized that she did not want to go. He stated she was very upset when they arrived at the appointment and accused them of throwing her on a cot and kidnapping her. He stated that neither he nor the second AC personnel wanted to take the resident after she had refused, but the nurse insisted that they take her. He stated the nurse told them that the POA wanted her to go so they had to take her. An interview with AC #2 was conducted via telephone at 3:30 p.m. on 11/18/10. He stated that, when he arrived with AC #1, the resident was using the porta potty. He stated the resident said four (4) or five (5) times that she did not want to go. He stated the resident was alert and oriented and answered questions appropriately. He stated the nurse insisted that the resident had to go, that her son was POA and wanted her to go, and that they had to take her. He stated that, when they arrived at the appointment, the resident could hardly breath and told her daughter that she had been kicked out of the nursing home. An interview with Employee #98 was conducted at 2:40 p.m. on 11/18/10. She confirmed she was the nurse who sent the resident out for the appointment on 11/02/10. She confirmed that Resident #49 had refused to go when the ambulance crew came to pick her up. She agreed she told the ambulance crew that the family wanted her to go and they had to take her. She stated that the resident had been yelling out constantly for help and calling the family in the middle of the night. She stated the son was in wanting a "psych" evaluation to get medicine to make her sleep. When inquiry was made concerning a resident's right to refuse treatment, Employee #98 stated that, if they do not have capacity and the family wants them to go to an appointment, "then I make them go unless the family calls and tells me that the resident does not have to go." She stated that, since the family did not call, she forced the resident to go. When asked if she made any attempts to call the family to inform them that the resident had refused to go to the appointment, she stated that she did not try to call them. An interview was conducted with the administrator and director of nursing at 4:45 p.m. on 11/18/10. Both stated that a resident cannot be forced to go to an appointment if they refuse. The DON stated the family should be notified and the appointment rescheduled. . | 2014-03-01 |