cms_WV: 3278
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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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 3278 | MAPLES NURSING HOME | 515186 | 1600 BLAND STREET | BLUEFIELD | WV | 24701 | 2017-02-09 | 282 | E | 0 | 1 | UXFJ11 | Based on resident interview, resident observation, record review and staff interview the facility failed to implement Resident #30's activities of daily living (ADL) care plan on multiple occasions by not providing her showers three times weekly and by not cleaning her glasses every shift as directed by her care plan. This was true for one (1) of three (3) residents reviewed for the care area of ADL's during Stage 2 of the Quality Indicator Survey (QIS). Resident identifiers: #30. Facility census: 58. Findings include: a) Resident #30 1. Showers During a Stage 1interview with Resident #30, at 3:00 p.m. on 02/06/17, when asked if she received the number of showers in a week she would like she stated, No, I am supposed to be showered three (3) times a week and they only shower me once a week or once every two weeks. A review of Resident #30's medical record at 8:29 a.m. on 02/09/17 found the following care plan related to Resident #30's ADL care: --Problem statement with a start date of 08/07/15 read as follows, Inability to maintain health state independently r/t (related to) dementia, limited mobility, and muscle weakness. --The goal associated with this problem read as follows: Residents' care will be provided for based on their preferences and cognitive/functional abilities EB (evidenced by) staff completing P[NAME] (plan of care) Kardex and updating as needed. This goal had a target date of 06/16/16. --The interventions associated with this problem statement and goal included: Bathing PM (evening) Shower assist of 1 Days Monday, Wednesday, and Friday. This intervention was added to the care plan on 03/16/16. Review of the Resident #30's shower documentation from 06/20/16 through present found the following: --For 06/20/16 through 06/30/16, Resident #30 was scheduled to receive five (5) showers and only received two (2) on 06/25/16 and 06/28/16. She did not receive her shower as scheduled on 06/21/16, 06/23/16, and 06/30/16. --For the month of (MONTH) (YEAR) (07/01/16 through 07/31/16), Resident #30 was scheduled to receive 12 showers. She received a shower on 07/05/16, 07/11/16, 07/19/16, and 07/31/16, four (4) of the 12 opportunities. She was out of the facility on 07/07/16 resulting in her not receiving her scheduled shower on this date. Resident #30 had documented refusals of showers on 07/21/16 and 7/23/16. On 07/02/16, 07/09/16, 07/14/16, 07/16/16, and 07/27/16 she did not receive a shower and the record contained no documented reason. --For the month of (MONTH) (YEAR) (08/01/16 through 08/30/16), Resident #30's shower schedule was changed to only receiving two showers per week. This change took place on the week of 08/14/16 and has remained the schedule until present. Documentation was not provided by the facility for the week of 08/07/16 through 08/13/16 therefore it is assumed Resident #13 did not recieve a shower during this week. During the month of August, Resident #30 was scheduled to receive nine (9) showers, she only received four (4) on 08/02/16, 08/23/16, 08/27/16, and 08/30/16. She had a documented refusal on 08/20/16. She did not receive a shower four (4) of the scheduled day on 08/06/17, 08/09/16, 08/12/16, and 08/16/16. The record contained no documented reason as to why she did not receive her showers on these dates. --For the month of (MONTH) (YEAR) (09/01/16 through 09/30/16), Resident #30 was scheduled to receive nine (9) showers. She received a shower on 09/06/16, 09/17/16, and 09/23/16, three (3) of the nine (9) opportunities. Resident #30 had documented refusals of showers on 09/13/16 and 9/30/16. On 09/03/16, 09/10/16, 09/19/16, and 09/26/16 she did not receive a shower and the record contained no documented reason. --For the month of (MONTH) (YEAR) (10/01/16 through 10/31/16), Resident #30 was scheduled to receive nine (9) showers. She received a shower on 10/07/16, 10/14/16, 10/20/16, 10/24/16 and 10/28/16, five (5) of the nine (9) opportunities. Resident #30 had documented refusals of showers on 10/03/16, 10/10/16, and 10/16/16. On 10/31/16, Resident #30 did not receive a shower and the record contained no documented reason. --For the month of (MONTH) (YEAR) (11/01/16 through 11/30/16), Resident #30 was scheduled to receive eight (8) showers. She received a shower on 11/04/16, 11/07/16, and 11/21/16, three (3) of the eight (8) opportunities. Resident #30 had a documented refusal of a shower on 11/14/16. On 11/11/16, 11/25/16, and 11/28/16 she did not receive a shower and the record contained no documented reason. --For the month of (MONTH) (YEAR) (12/01/16 through 12/31/16), Resident #30 was scheduled to receive nine (9) showers. She received a shower on 12/02/16, 12/19/16, and 12/26/16, three (3) of the nine (9) opportunities. Resident #30 had a documented refusal of a shower on 12/09/16. On 12/05/16, 12/12/16, 12/16/16, and 12/26/16 she did not receive a shower and the record contained no documented reason. --For the month of (MONTH) (YEAR) (01/01/17 through 01/31/17), Resident #30 was scheduled to receive nine (9) showers. She received a shower on 01/02/17, and 01/16/17, two (2) of the nine (9) opportunities. Resident #30 had documented refusals of showers on 01/06/17 and 01/13/17. On 01/09/17, 01/20/17, 01/23/17, 1/27/17, and 01/30/17 she did not receive a shower and the record contained no documented reason. --For the month of (MONTH) (YEAR) (02/01/17 through 02/07/17 the day of this review), Resident #30 was scheduled to receive two (2) showers. She received a shower on 02/06/17. However, for 02/02/17, the resident did not receive a shower and the record contained no documented reason. Please note from (MONTH) (YEAR) through present the facility only scheduled Resident #30 for two (2) showers per week. This is not in agreement with the residents care plan and/or the resident interview both of which revealed she should be scheduled for three (3) showers per week. So in addition to the missed showers mentioned above there is one (1) shower per week for 25 weeks that has not even been scheduled or offered to the resident. The Director of Nursing (DON) at 2:00 p.m. on 02/08/17, in an interview stated, The resident was switched to two (2) showers per week per her request. When asked why the care plan still indicated to offer her a shower three (3) times a week she stated, I guess we did not update it. She was then informed Resident #30 had stated she was scheduled to receive three (3) showers per week and she was not getting them. To this she replied, she does not have capacity. A review of Resident #30's most recent quarterly Minimum Data Set (MDS) with an Assessment Reference Date (ARD) of 12/04/16 found, her Brief Interview of Mental Status (BIMS) score was a 15 out of 15 indicating she was cognitively intact and fully capable of being interviewed. The DON then reviewed the shower documentation and stated, It looks like our documentation is incomplete, but we are giving her showers. She stated, I think they are forgetting to document refusals on the shower schedule sheet. She was asked to provide any documentation she might have pertaining to the residents request for only two (2) showers per week or that she might have regarding her refusals. She provided no additional information. The DON was then asked to Review Resident #30's care plan she agreed the care plan contained the intervention to shower the resident three times weekly and to clean her glasses every shift. 2. Glasses An observation of Resident #30, on 02/06/17 at 3:00 p.m., found her glasses were unclean and smudged. An additional observation of Resident #30, on 02/09/17 at 8:50 a.m., found her glasses were still dirty and were still smudged in the same place as they were on 02/06/17. At this time Resident #30 was asked if her glasses were working good for her and she stated, Well they could be cleaned and I might see a little better. At this time, Registered Nurse (RN) #52 was asked to come to Resident #30's room to see if her glasses needed to be cleaned. RN #52 took Resident #30's glasses and cleaned them and handed them back to the resident. Resident #30 put her glasses back on and stated, There just like new now. She then thanked RN #52 for cleaning her glasses and also thanked the surveyor for getting someone to clean her glasses for her. A review of Resident #30's medical record, at 08:29 a.m. on 02/09/17, found the following care plan related to Resident #30's ADL care: --Problem Statement with a start date of 08/07/15 read as follows, Inability to maintain health state independently r/t (related to) dementia, limited mobility, and muscle weakness. --The goal associated with this problem read as follows: Residents' care will be provided for based on their preferences and cognitive/functional abilities EB (evidenced by) staff completing P[NAME] (plan of care) Kardex and updating as needed. This goal had a target date of 06/16/16. --The goals associated with this problem statement and goals included: Vision: Adequate, wears glasses. Clean glasses every shift. | 2020-09-01 |