cms_WY: 40
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 40 | GRANITE REHABILITATION AND WELLNESS | 535013 | 3128 BOXELDER DRIVE | CHEYENNE | WY | 82001 | 2018-10-12 | 690 | E | 1 | 1 | P2JJ11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** > Based on observation, resident and staff interview, and medical record review, the facility failed to ensure residents received appropriate services and treatment for 5 of 7 sample residents (#8, #46, #72, #81, #322) who were incontinent. The findings were: 1. Review of the significant change MDS assessment dated [DATE] showed resident #8 had [DIAGNOSES REDACTED]. Further review showed the resident required extensive assistance of one person for transfer, dressing, toilet use, and personal hygiene. Review of the incontinence care plan last revised on 10/4/18 showed check for incontinence . Review of the ADL care plan last revised on 10/4/18 showed nursing to provide assist with bed mobility, transfers, locomotion in w/c, dressing, toilet use, personal hygiene, and bathing. The following concerns were identified: a. Observation on 10/08/18 at 4:21 PM showed resident #8 was assisted off the elevator on the second floor unit and into his/her room by another unidentified resident. Resident #8's pants were visibly soiled between his/her upper inner thighs down to the bottom of his/her pant leg. Interview with the resident at that time revealed the wet area was urine and s/he had just returned to the second floor after being downstairs. b. Observation on 10/11/18 beginning at 8:41 AM showed the resident was sitting at a table in the second floor unit dining room. The resident left the unit and rode the elevator to the first floor at 10:29 AM. The resident returned to the dining room table on the second floor unit at 10:56 AM. Interview with CNA #3 on 10/11/18 at 1:09 PM revealed the resident had not been offered or assisted to use the restroom since s/he got up for the day. Further the CNA revealed she was going to ask the resident at that time. Continued observation showed the resident remained at the dining table until 1:11 PM, 4 hours and 30 minutes after the observation began. Interview with CNA #3 at 1:13 PM confirmed the resident's brief was wet and had to be changed. 2. Review of the significant change MDS assessment completed on 8/23/18 showed resident #46 had [DIAGNOSES REDACTED]. Further the resident required extensive assistance of one person for bed mobility, transfers, dressing, toilet use, and personal hygiene. Review of the bladder incontinence care plan last revised on 8/10/18 showed .Brief Use: (resident's name) uses disposable briefs. Change after each incontinent episode and prn (as needed) . Review of the ADL care plan last revised on 8/24/18 showed .Toilet USE: (resident's name) requires assistance by staff for toileting. Review of the high risk for falls care plan last revised on 10/9/18 showed .Toilet before and after meals and PRN. Provide assistance with toileting needs . The following concerns were identified: a. Observation beginning on 10/10/18 at 8:58 AM showed the resident was in the common area during exercise activity. The resident was sleeping in his/her wheelchair. At 9:25 AM CNA #7, CNA #8 and CNA #9 assisted the resident into his/her room and into bed without assisting him/her to the bathroom or performing incontinence care. The resident remained in bed until 12:21 PM. Observation at that time showed unit manager #1, LPN #2, and CNA #9 assisted the resident out of bed and did not offer toileting or perform incontinence care. The resident was assisted to a dining table and LPN #2 stated We will take you to the bathroom in a little bit when the resident attempted to leave the table. At 12:26 PM the resident left the table and went to his/her room to use the bathroom. At that time CNA #9 assisted the resident onto the toilet (3 hours and 28 minutes later). b. Interview with CNA #9 on 10/10/18 at 12:29 PM revealed the resident's brief was wet when s/he was assisted to the bathroom. 3. Review of the quarterly MDS assessment dated [DATE] showed resident #72 had [DIAGNOSES REDACTED]. Further review showed the resident had short term and long term memory problems, no coded behaviors, and required extensive assistance of two or more people for toilet use, transfers, walking in room and corridor, locomotion, and dressing. Review of the Bowel Incontinence care plan last revised 5/21/18 showed interventions that included Observe for pattern of incontinence and initiate toileting schedule if indicated. Review of the Bladder Incontinence care plan last revised on 5/21/18 showed (resident's name) uses disposable briefs. Clean peri-area with each incontinence episode. The following concerns were identified: a. Observation beginning on 10/10/18 at 9:06 AM showed the resident was in bed sleeping. At 10 AM CNA #7 assisted the resident out of bed and assisted him/her to a dining table without offering to use the bathroom or performing incontinence care. The resident remained at the dining table until 1:09 PM when CNA #9, CNA #7, and LPN #2 assisted the resident to bathroom (4 hours and 3 minutes later). b. Interview with CNA #9 on 10/10/18 at 1:15 PM revealed the resident's brief was wet with urine and further it was confirmed the resident was not toileted or provided incontinence care when s/he was assisted out of bed. 4. Review of the significant change MDS assessment dated [DATE] showed resident #81 had [DIAGNOSES REDACTED]. Further review showed the resident required extensive assistance of two or more people for bed mobility, transfers, dressing, and toilet use. The resident required extensive assistance of one person for personal hygiene. Review of the ADL care plan last revised on 6/3/18 showed .Toilet USE: (resident's name) requires extensive assistance for transfers . The following concerns were identified: a. Observation beginning on 10/10/18 at 8:57 AM showed the resident was in the common area participating in exercises. At 9:40 AM CNA #7 assisted the resident to his/her room to perform hair care and did not offer to take the resident to the bathroom or perform incontinence care. The CNA assisted the resident to return to a dining table in the common area. The resident remained in the common area until s/he asked to use the bathroom at 12:36 PM. CNA #7 assisted the resident to the bathroom at that time (3 hours and 39 minutes later). b. Interview with CNA #7 on 10/10/18 at 12:41 PM revealed the residents brief was soiled. 5. Review of the 48-Hour Baseline Plan of Care Form, dated 10/4/18, showed resident #322 had [DIAGNOSES REDACTED]. Further review showed the resident required 2-person extensive assist with toileting, was incontinent, and utilized incontinence products. Review of a Bladder Evaluation form, dated 10/4/18, showed the resident had functional incontinence related to physical or cognitive limitations and was dependent on caregivers for toileting. The following concerns were identified: a. Interview with the resident on 10/08/18 at 5:33 PM revealed concerns with receiving the assistance s/he needed to toilet. The resident stated s/he had wet the bed through his/her incontinence products while waiting for assistance. Additionally, the resident stated diuretic medication made him/her urinate large amounts. b. Interview on 10/10/18 at 2:50 PM with CNA #5 revealed the resident was usually continent of bladder, unless we don't get to (him/her) in time. c. Interview on 10/10/18 at 6:22 PM with CNA #6 revealed the resident was normally continent, adding the resident will tell you when (s/he) has to go, you just have to help (him/her). d. Review of the resident's bladder function record from 10/3/18 through 10/11/18 showed the resident was continent of bladder 38 times and was incontinent of bladder 19 times. e. Interview on 10/11/18 at 3:54 PM with the DON confirmed the resident required assistance for toileting. She further revealed the resident was usually continent and was able to ask for assistance. 6. Interview with unit manager #1 and DON on 10/11/18 at 3:35 PM revealed the facility expectation was for residents to be taken to the bathroom upon rising, before and after meals, and as needed and the residents should not go longer than 3 hours without toileting. | 2020-09-01 |