| 465 |
MORGANTOWN HEALTH AND REHABILITATION CENTER |
515049 |
1379 VAN VOORHIS RD |
MORGANTOWN |
WV |
26505 |
2018-11-15 |
838 |
J |
0 |
1 |
T4YY11 |
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on staff interview and Facility Assessment review, the facility identified providing services to residents receiving Intravenous (IV) therapy via a peripheral IV and peripherally inserted central catheter (PICC); however, failed to ensure staff were competent to provide the care needed for this resident population resulting in Immediate Jeopardy. This affected two (Resident #48 and #32) of two sampled residents receiving Intravenous (IV) therapy via a PICC. The facility census was 87. On 11/13/18 at 7:56 PM, the Administrator and Director of Nursing were notified verbally that Immediate Jeopardy began on 10/05/18 when Resident #48 was admitted to the facility with a PICC and receiving IV antibiotics. The Immediate Jeopardy continued 11/05/18 when the facility readmitted Resident #32. The Facility assessment dated [DATE] identified providing care and services to residents receiving IV therapy via peripheral IVs and PICC. LPN's #27, #33, #49 and #59 performed IV therapy for Resident #48 and LPNs #6, #20, #39, #49 and #64 performed IV therapy for Resident #32 without adequate training and skill competency in accordance with the Facility Assessment. Immediate Jeopardy was abated on 11/13/18 at 8:10 PM. The facility revised the staffing schedule to ensure a Registered Nurse (RN) would be performing IV therapy for the two residents any newly admitted residents with IV access. Although the Immediate Jeopardy was removed, the facility remained out of compliance at a severity level two (no actual harm, with potential for more than minimal harm that is not Immediate Jeopardy) until LPNs are trained and competent with IV therapy as identified in the Facility Assessment. See F684 (Quality of Care), F867 (QAPI) and F726 (Staff Competency) for additional information. The facility census was 87. Findings include: The Facility Assessment tool dated 11/10/17 was reviewed on 11/15/18 at 10:10 AM. The facility assessment included a the section titled, Special Treatments and Resident Care Needs. At the time the facility assessment was completed, the facility had one resident with a peripheral IV, five residents with PICC lines and two residents receiving IV medications. Additionally, included in the facility assessment was a section titled, Additional References to the Facility Assessment. The facility assessment quoted the Code of Federal Regulations regarding Nursing Services and Training Requirements. The facility assessment stated: CFR 483.35 Nursing Services from the Code of Federal Regulations- The facility must have sufficient nursing staff with the appropriate competencies and skills sets to provide nursing and related services to assure resident safety and attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident, as determined by the resident assessments and individual plans of care and considering the number, acuity and [DIAGNOSES REDACTED]. CFR 483.95 Training Requirements- A facility must develop, implement, and maintain an effective training program for all new and existing staff; individuals providing services under contractual arrangement; and volunteers, consistent with their expected roles. A facility must determine the amount and types of training necessary based on the facility assessment as specified at 483.70(e) of the code of federal regulations. The section titled, Resident Support/Care Needs Medications was reviewed. The section stated administer medications by appropriate route including intravenous (peripheral or central lines). The section titled, Staff training/education and competencies was reviewed. The : Training Requirements for Licensed Nurses included a valid Nursing license (RN or LPN) and Annual CEUs, LPNs 24 hours each two-year reporting period. Compliance training, HIPPA General Privacy training, Sexual Harassment Education, Dementia training See Licensed Nurse Competency Checklist. The Licensed Nurse Competency Checklist used by the facility to assess competency with Intermittent administration of intravenous fluids was reviewed. The checklist did not include care of a resident with a PICC line. During an interview conducted on 11/14/18 at 1:15 PM, Director of Clinical Resources RN #112 verified the training material used by the facility during new employee orientation and the Licensed Nurse Competency Checklist did not specifically include care of a resident with a PICC line. In addition, she verified the training material for the IV Certification conducted on 07/05/17 did not include content for residents receiving intravenous medications through a PICC line. During an interview on 11/15/18 at 10:30 AM, Administrator #45 stated he was not employed by the facility at the time of the development of the Facility Assessment; and therefore, was not aware of the content of the Facility Assessment. During an interview conducted on 11/15/18 at 10:45 AM, Director of Nursing #46 stated she participated in the development of the Facility Assessment. She verified the Facility Assessment identified caring for residents receiving intravenous therapy through the Facility Assessment. She verified the facility assessment did identify the need for competency with PICC lines even though at the time of the assessment there were five residents with PICC lines. |
2020-09-01 |