cms_WV: 5456
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 5456 | LOGAN CENTER | 515175 | 55 LOGAN MINGO MENTAL HEALTH CENTER ROAD | LOGAN | WV | 25601 | 2015-06-22 | 155 | D | 0 | 1 | N2E611 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and staff interview, the facility failed to ensure one (1) of one (1) resident reviewed for the care area of choices during the Quality Indicator Survey (QIS), was afforded the right to have her advance directive incorporated into her care and treatment. The resident indicated on her POST form, she did not want a feeding tube; however, a feeding tube was inserted. Resident Identifier: #67. Facility Census: 62. Findings include: a) Resident #67 Feeding Tube Resident #67's POST form, reviewed at 9:46 a.m. on 06/17/15, also revealed the resident indicated No feeding tube. Under section C titled: Medically administered fluids and nutrition: Oral fluid and nutrition must be offered as tolerated, an X was placed in the box beside, No feeding Tube, indicating the resident's wish to not have a feeding tube. According to information on the POST form, LPN #6 assisted the resident in completing the form on 12/20/14. The resident's medical record contained a Physician Determination of Capacity, completed on 12/30/14, by Licensed Psychologist #77. This form indicated Resident #67 lacked capacity to make healthcare decisions due to Multiple Infarct Dementia, cognitive loss, inappropriate answers to questions, and inability to understand or make medical decisions. Licensed Psychologist #77 indicated the incapacity would be short term in nature and would likely improve as the resident's medical condition improved. Also contained in Resident #67's medial record, was a medical power of attorney (MPOA) form, completed by Resident #67 on 08/26/13, appointing her niece as her MPOA. Additional review of the medical record found a physician's progress note dated 04/13/15, which contained the following text (typed as written): Spoke with MPOA and agreed for PEG (Percutaneous endoscopic gastrostomy) placement with (Name of local Physician) ASAP (as soon as possible). Resident #67's medical record contained information which indicated the resident had a gastrostomy tube ([DEVICE]) placed at a local hospital on [DATE]. An interview with the Director of Nursing (DON), at 11:24 a.m. on 06/17/15, confirmed Resident #67 had a [DEVICE] inserted on 04/15/15. When asked why the resident's directive for No feeding tube on the POST form was not honored, the DON stated the resident did not fully understand the form when it was completed with her on 12/20/14. She said she felt Resident #67 did not fully comprehend the form. The DON was unable to answer, when asked if the resident's wishes were honored. An interview with Resident #67's attending physician, at 11:32 a.m. on 06/17/2015, revealed Resident #67 needed the feeding tube because her wounds were getting worse, she was losing weight, and she was refusing to eat. He stated he talked to Resident #67's MPOA, who was in agreement with having the tube inserted. When asked why the MPOA was allowed to make a decision contrary to the resident's wishes, the physician stated, I don't really think she was capacitated when she completed the POST form. He stated he wanted to wait for the psychologist to review her capacity because of her [DIAGNOSES REDACTED]. The physician said later, the information the resident provided was found inaccurate. When asked why the resident was sent for a feeding tube when her POST form indicated she did not want one, he stated, She knew what she was going for she could have refused to go to the appointment if she did not want it. | 2019-01-01 |