cms_WV: 7931
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 7931 | ANSTED CENTER | 515133 | 96 TYREE STREET | ANSTED | WV | 25812 | 2012-12-11 | 280 | E | 0 | 1 | K06L11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on medical record review, policy review, and staff interview, the facility failed to revise the care plans for four (4) of thirty-one (31) Stage 2 sample residents. The care plans were not revised to reflect changes in lift transfer status, contact precautions, wound status, dental needs, feeding tube removal, and constipation. Resident identifiers: #26, #47, #54 and #66. Facility census: 60 Findings include: a) Resident #26 1) The current care plan was reviewed on 12/04/12 at 3:19 p.m., and again on 12/12/12 at 10:00 a.m. It indicated Resident #26 had decreased ability to self perform activities of daily living (ADLs) secondary to recent hospitalization for repair of a right [MEDICAL CONDITION]. Additionally, the care plan noted she required the assistance of a Total Lift 450/FB/Green sling to get out of bed. Review of the medical record, on 12/05/12, at approximately 4:00 p.m., revealed a physician's orders [REDACTED]. Employee #53, a nursing assistant (NA), was interviewed on 12/06/12 at 8:40 a.m. She stated the resident utilized the sit to stand lift for transfers. The care plan had not been revised to accurately reflect the resident's current needs. 2) A physician's orders [REDACTED]. Additionally, an order dated 12/01/12 was written to maintain contact precautions. The care plan did not contain this information Employee #7, a registered nurse (RN), was interviewed on 12/11/12. She stated the care plan was updated daily utilizing the pink slips from the physician's telephone orders. She reviewed the medical record and compared it to the care plan. The employee acknowledged the care plan did not accurately reflect the physician's orders [REDACTED]. 3) The residents's skin integrity report was reviewed on 12/05/1/2 at approximately 2:00 p.m. The resident had a pressure ulcer which was noted as a deep tissue injury (DTI). The information on the skin integrity reports, dated 11/23/12 and 11/30/12, noted a scab in the center of the wound. The facility's skin integrity policy was reviewed on 12/05/12. It described that a pressure ulcer in which the base was covered with eschar was an unstageable wound. Employee #36, the director of nurses (DON), evaluated the wound bed on 12/11/12. She stated the wound bed was a scab. When questioned regarding the stage of the wound, she replied, unstageable. The care plan, reviewed on 12/11/12 at approximately 4:00 p.m., noted the right heel pressure area as deep tissue injury. b) Resident #47 Review of the resident's current care plan, dated 04/07/12, found a problem, Resident exhibits or is at risk for oral health or dental care problems as evidenced by missing and carious teeth that resident and POA (power of attorney) do not wish to address at this time. At risk for pain, infection, and chewing difficulty. Resident frequently refuses to allow staff to brush his teeth and refuses to assist with brushing his own teeth. (residents MPOA (medical power of attorney) aware and also unsuccessful at getting resident to go to dentist or brush his teeth.) Resident will refuse to go to dentist for oral consult. Further review of the medical record revealed a nurse's note, dated 09/04/12, stating, Resident has a broken tooth located on the bottom side, dental appointment made. Review of the medical record found the resident went to the dentist on 09/11/12 for treatment, and had a tooth extracted. He returned to the facility with a proposed detailed treatment plan from the dentist which included seven (7) extractions and six (6) fillings. The care plan did not include this information. Employee #34, an administrative registered nurse, and Employee #79, a registered nurse, were interviewed at 9:00 a.m. on 12/06/12 regarding the failure to update the care plan with the resident's visit to the dentist and the proposed dental plan. Employee #79 agreed the facility should have updated the care plan after the dental appointment on 09/11/12. c) Resident #54 Review of the medical record found the resident had removed her own feeding tube on 11/22/12. The nurse contacted the resident's physician upon discovery of the removal of the feeding tube. The resident's physician did not want the resident to be transferred out of the facility for replacement of her feeding tube. At the time of survey, the resident did not have a feeding tube. The resident was eating well, taking medications by mouth and there were no plans for placement of a feeding tube. Review of the current plan of care, dated, 04/07/11, found a problem: Resident has an enteral feeding tube to assist with meeting nutritional needs as needed The DON was interviewed on 12/05/12 at 2:00 p.m. She agreed the care plan was not updated after removal of the feeding tube. d) Resident #66 Medical record review identified Resident #66 had a [DIAGNOSES REDACTED]. Medical record review revealed the resident was ordered iron 325 mg to be given twice a day on 09/16/12. The administration of iron further complicates constipation. No interventions were put in place to relieve the resident of constipation. The facility continued the use of the standing orders. The care plan was not updated with goals and interventions regarding the resident's problems with constipation. Review of the medical record identified the attending physician ordered, on 10/23/12, Senna S two (2) capsules to be given at bedtime. The care plan was not revised to reflect this new intervention. Although the resident had continuing constipation, the care had no revisions had for constipation since 01/19/12. On 12/06/12 at 1:30 p.m., the DON confirmed the facility failed to revise the care plan for this resident. . | 2016-12-01 |