cms_AK: 26
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 26 | KETCHIKAN MED CTR NEW HORIZONS TRANSITIONAL CARE | 25010 | 3100 TONGASS AVENUE | KETCHIKAN | AK | 99901 | 2019-08-23 | 657 | D | 0 | 1 | 0OWF11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview the facility failed to update and revise the care plan to reflect the current care and services for 2 residents (#s 6 and 17) out of 14 sampled residents. This failed practice placed the residents at risk for not receiving appropriate and/or necessary care and services. Findings: Resident #6 Record review on 8/19-23/19 revealed Resident #6 was admitted to the facility with [DIAGNOSES REDACTED]. Resident #6 had difficulty walking and used a wheelchair for mobility. During an interview on 8/21/19 at 8:32 am, Resident #6 stated that he/she was concerned because he/she had gained approximately 80 pounds since admission. Resident #6 further stated the facility had not addressed his/her weight gain and the weight gain had caused difficulty to independently attend to his/her activities of daily living. Record review of the weight chart revealed Resident #6 weighed 166.2 kilograms on 2/27/19 and 191.1 kilograms on 8/20/19. The weight calculator revealed a 14.98% weight gain in less than 6 months. During an interview on 8/21/19 at 1:53 pm, Resident #6 stated he/she had discussed the weight gain with both the doctor and the dietitian. The Resident further stated he/she had not been provided with any information or options to address the weight gain. During an interview on 8/21/19 at 3:16 pm, the Registered Dietitian (RD) stated Resident #6 was difficult because he/she would not follow diet recommendations, bought in food from outside the facility, and failed to follow recommendations of the staff and RD. The RD further stated the weight gain could be due to fluid retention and Resident #6 had been on fluid restrictions, but that there were no current restrictions. Record review of Resident #6's most recent MDS (Minimum Data Set- a federally mandated assessment tool), a quarterly assessment dated [DATE], revealed the increased need for assistance in the following areas of functional status independence; 1) transfer from bed, wheelchair, standing, 2) dressing, and 3) personal hygiene. Record review of the Resident #6's most recent care plan revealed no changes to the care plan since initiation on 2/27/18. Interventions implemented in the care plan related to weight loss, and include monitoring weight trends (with) [MEDICAL CONDITION], I&0s (intake and output) . During an interview on 8/22/19 at 1:47 pm, the MDS Coordinator (MDSC), stated she felt Resident #6 had experienced a significant change in functional ability and she did not complete a significant change update. The MDSC further stated that the change had been discussed in the care conference meeting but the team thought the weight gain was due to personal choices so it was not addressed. When asked if a significant change assessment should have been done for Resident #6, the MDSC replied, probably, yes. Resident #17 Record review from 8/19-23/19 revealed Resident #17 was admitted to the facility with [DIAGNOSES REDACTED]. Review of Resident #17's weight log for the timeframe of 2/24/19-8/18/19 revealed the resident had a history of [REDACTED]. The documented weights revealed the most recent weight on 4/28/19 was 41.2 kg and a weight done on 2/24/19 revealed 47.7kg. During an interview on 8/21/19 at 3:14 pm, the Registered Dietician (RD) stated Resident #17 had been refusing to be weighed, however his/her observation revealed weight lost. The RD stated he/she had made adjustments to the Resident's diet to help decrease the weight loss, such as initiation of finger foods. The RD further stated that Resident #17's intake had improved since the initiation of the finger foods. Review of Progress Note LTC (long term care) Initial/Re-assessment Visit, dated 7/18/19 revealed Diet orders are in place offering a mechanical soft diet with finger foods for ease of intake and independence with self-feeding. Resident #17's current diet was Diet General; Mechanical soft; Finger Foods. Review of the most recent MDS (Minimum Data Set, a federally required nursing assessment) assessment, an annual assessment dated [DATE], revealed Nutrition approach .Mechanically altered diet. Review of the Resident's most current care plan entitled Multidisciplinary Problems (Active), not dated, revealed Current Diet: Diet General; High protein with start date 8/27/18. There was no documentation of finger foods in the care plan. During an interview of 8/22/19 at 1:33 pm, the MDSC stated the Resident's care plan should have been updated to state the nutrition recommendations with the finger foods added to the care plan. | 2020-09-01 |