cms_WV: 8014

In collaboration with The Seattle Times, Big Local News is providing full-text nursing home deficiencies from Centers for Medicare & Medicaid Services (CMS). These files contain the full narrative details of each nursing home deficiency cited regulators. The files include deficiencies from Standard Surveys (routine inspections) and from Complaint Surveys. Complete data begins January 2011 (although some earlier inspections do show up). Individual states are provides as CSV files. A very large (4.5GB) national file is also provided as a zipped archive. New data will be updated on a monthly basis. For additional documentation, please see the README.

Data source: Big Local News · About: big-local-datasette

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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
8014 E.A. HAWSE NURSING AND REHABILITATION CENTER, LLC 515173 18086 STATE ROUTE 55 BAKER WV 26801 2012-10-23 329 D 0 1 R9MR11 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, clinical record review, review of manufacturer's labels, interview with the consultant pharmacist, staff interview, review of an excerpt from the State Operations Manual (SOM),and review of an action plan provided by the administrator, the facility failed to ensure residents were administered a potassium chloride (KCl) supplement with a sufficient amount of liquids. This had the potential to cause gastrointestinal irritation and a laxative effect. During the observation of medication pass, of the 10 residents observed, two (2) residents received KCl. Resident identifiers: Resident #21 and #48. Facility census: 56. Findings include: a) Resident #21 On 10/17/12 at 8:56 a.m., medications were observed being given to Resident #21 by a licensed practical nurse (LPN), Employee #28. The resident's medications included liquid KCl. After pouring 15 cc of the KCl into a cup, Employee #28 added approximately 30 ml of grape juice to the KCl. Upon taking the first sip of the medication, and with each subsequent sip, the resident grimaced and shook her head. Employee #28 did not offer or encourage the resident to drink more water or juice. A review of Resident #21's physician's orders, on 10/17/12 at 10:00 a.m., revealed the following order: Potassium Chloride 20 MEQ (milliequivalents)/15 ML (10%) Oral (By mouth) - 1x (times) Everyday, 0900 (9:00 a.m.). The physician's order did not contain any information regarding additional fluids with this medication. On 10/24/12 at 9:00 a.m., observation of the pharmacy label revealed no directions regarding giving additional fluids with the KCl. The manufacturer's label on the side of the bottle included, DIRECTION: To minimize gastrointestinal irritation, patients must follow direction regarding dilution. Each tablespoonful (15 mL) should be diluted with three (3) fluid ounce or more of water or other liquid. Three (3) fluid ounces would equal approximately 90 cc of fluid - three (3) times the amount with which the KCl was administered to the resident. b) Resident #48 On 10/17/12 at 8:16 a.m., medications were observed being given to Resident #48 by a licensed practical nurse (LPN), Employee #28. The resident's medications included KCl 20 meq (milliequivalents) in tablet form. This resident took two (2) sips of water with all of her medications. This resident was not encouraged to drink more water by Employee #28. A review of Resident #48's physician's orders, on 10/17/12 at 10:30 a.m. revealed the following order: Potassium Chloride 20meq. Oral (By mouth) - 1x/day Everyday, 0900 (9:00 a.m.). In an interview with the consulting pharmacist, on 10/22/12 at 10:30 a.m., he agreed KCI in any form should be given with 6-8 ounces of water or juice. On 10/22/12 at 11:33 a.m., the administrator provided copies of Resident's #21 and #48's fluid intake. She stated she thought because the residents had had fluids at breakfast that additional fluids would not be needed during medication pass. On 10/23/12 at 10:30 a.m., the administrator brought an Action Plan along with Resident's #21 and #48 Medication Administration Record [REDACTED]Potassium orders do not include give 120 ml's of liquid. Goal: Potassium orders will include give 120 ml's of liquid. In addition each resident's MAR indicated [REDACTED]. Additional information provided by the administrator, was a copy of Section V-Guidance to Surveyors PP-561 of the State Operations Manual (SOM) with the bullet titled Potassium Supplements (solid or liquid dosage forms) such as [MEDICATION NAME], Dlorvess, Kaon, K-Lor, K-Tab, K-Dur, K-Lyte, Slow K, [MEDICATION NAME], Micro K, or Ten K should be administered with or after meals with a full glass (e.g., approximately 4-8 ounces of water or fruit juice). This will minimize the possibility of gastrointestinal irritation and saline cathartic effect. 2016-11-01