cms_WV: 4044
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 4044 | TAYLOR HEALTH CARE CENTER | 515057 | 2 HOSPITAL PLAZA | GRAFTON | WV | 26354 | 2017-03-01 | 329 | E | 0 | 1 | WA6611 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on medical record review and staff interview, the facility failed to ensure the resident's medication regimen was free of unnecessary medications for two (2) of five (5) residents reviewed for unnecessary medications. Residents #34 and #49 received PRN (as needed) antianxiety medication without evidence of nonpharmacological methods attempted prior to the administration of the PRN medication. Nursing administered PRN antianxiety medications without evidence the behaviors warranted the PRN medication. Resident identifiers: #34 and #49. Facility census: 61. Findings include: a) Resident #34 Review of the resident's medical record on 02/15/17 found diagnoses, which included [MEDICAL CONDITION] disorder, [MEDICAL CONDITION], depression, and anxiety. The physician prescribed an antianxiety medication, [MEDICATION NAME] one (1) milligram (mg) every eight (8) hours as needed (PRN). - Review of the medical record found a nurse administered 1 mg of [MEDICATION NAME] on 12/07/16 at 8:00 p.m. There was no evidence in the nursing progress notes of what behaviors were present at that time, and what, if any, nonpharmacological methods were attempted prior to administering the PRN medication. The medical record was silent as to whether the medication was effective. There was no evidence to support the use of the PRN [MEDICATION NAME]. - Review of the medical record found a nurse administered 1 mg of [MEDICATION NAME] on 12/11/16 at 9:00 p.m. for anxiety and verbal abuse after nursing staff got her out from behind the nurses' station. There was no evidence of what behaviors were present at the time other than the staff did not want her behind the nurses' desk. There was no evidence of what, if any, nonpharmacological methods were attempted prior to giving the PRN medication. The nurse said only, Resident became verbally abusive with staff on redirection from behind the nurse's station. Then followed a staff aid to the kitchen asking for a cigarette. There was no evidence to support the use of the PRN [MEDICATION NAME]. - Review of the medical record found a nurse administered a 1 mg dose of PRN [MEDICATION NAME] to this resident on 12/13/16 at 10:20 p.m. According to nurse progress notes, the resident ambulated back and forth around the nurses' desk and day area, requesting food and coke, and becoming agitated. The nurse gave the PRN [MEDICATION NAME]. Review of the medical record found no evidence of what, if any, non-pharmacological methods were attempted prior to giving the PRN medication. - Review of the medical record found a nurse administered a 1 mg [MEDICATION NAME] tablet to this resident on 12/16/16 at 9:45 p.m. due to aggression toward staff and hitting staff after she could not be redirected. The medical record was silent as to whether or not the medication was effective. - Review of the medical record found a nurse administered 1 mg of PRN [MEDICATION NAME] to this resident on 01/14/17 at 11:43 p.m. Review of the medical record found no evidence of what behaviors were present at that time, or what if any nonpharmacological methods were attempted prior to giving the PRN medication. There was no evidence to support the use of the PRN [MEDICATION NAME]. On 02/16/17 at 8:45 a.m., the director of nursing (DON) provided the documentation she could find regarding the resident's behaviors when given [MEDICATION NAME], what nonpharmacological methods were tried prior to giving the [MEDICATION NAME], and assessment of the effectiveness of the PRN [MEDICATION NAME]. On 02/20/17 at 2:30 p.m., the lack of evidence of behaviors to support the use of the PRN [MEDICATION NAME] was briefly discussed with the DON. There was no evidence that any nonpharmacological methods were attempted prior to administering the 12/07/16, 12/11/16, 12/13/16, and 01/14/17 PRN [MEDICATION NAME]. There was no evidence as to whether the 12/07/16 and the 12/16/16 doses of [MEDICATION NAME] were effective. There was no evidence as to the extent of the behaviors on 12/07/16, and 01/14/17. On 02/22/16 at 1:00 p.m., Registered Nurse #111 said she was unable to find any further information. In an interview with the administrator on 02/28/17 at 3:00 p.m., she acknowledged that nursing staff did not always justify the use of the PRN [MEDICATION NAME]. b) Resident #49 Medical record review on 02/15/17 found this resident had [DIAGNOSES REDACTED]. Review of physician's orders [REDACTED]. Review of the medical record found this resident received PRN [MEDICATION NAME] on two (2) occasions without evidence to support those administrations. A nurse progress note dated 02/07/17 at 3:00 p.m. described the resident was agitated over a band playing music in the solarium. She cursed and talked loudly, so that she had to be removed due to her disruptions. The nurse administered the PRN 0.5 mg [MEDICATION NAME] without any evidence of first attempting nonpharmacological methods to help the resident calm. On 02/08/17 at 3:00 p.m., a nurse administered a PRN dose of [MEDICATION NAME] 0.5 mg for anxiety. Review of the progress note for that time found no description of the type of behaviors she exhibited. There was no evidence any nonpharmacological interventions were attempted prior to medicating her. The nurse did not assess the effectiveness of the medication. On 02/20/17 at 2:15 p.m., Registered Nurse #111 printed nursing progress notes for (MONTH) (YEAR) for the two (2) doses of the PRN antianxiety medication. She agreed the nurses did not show evidence of any nonpharmacological methods attempted prior to medicating the resident with the [MEDICATION NAME] and one of the two did not note the effectiveness. During a brief interview with the director of nursing (DON) on 02/20/17 at 2:30 p.m., she was informed of the administration of PRN [MEDICATION NAME] before first attempting nonpharmacological methods. No further information was provided prior to exit. In an interview on 02/28/17 at 3:00 p.m., the administrator acknowledged that nursing staff did not always justify the use of the PRN [MEDICATION NAME]. | 2020-02-01 |