cms_AK: 46
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 46 | WRANGELL MEDICAL CENTER LTC | 25015 | P.O. BOX 1081 | WRANGELL | AK | 99929 | 2019-04-24 | 656 | D | 0 | 1 | FNNN11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview the facility failed to develop and implement a resident-centered care plan, based on dental care needs identified during an MDS (Minimum Data Set, a federally required nursing assessment) assessment for 1 resident (#4), out of 8 sampled residents. This failed practice delayed dental care/repair of loose dentures which placed the resident at risk for impaired nutritional intake, as well as, optimal health and well-being. Findings: Record review on 4/15-19/19 revealed Resident #4 was admitted to the facility with [DIAGNOSES REDACTED]. (MONTH) manifest as weight loss, decreased appetite, poor nutrition, and inactivity). Review of the most recent MDS (Minimum Data Set, a federally required nursing assessment) assessment, an admission assessment dated [DATE], revealed Resident #4 was coded as having broken or loosely fitting full or partial denture (chipped, cracked, uncleanable, or loose). Review of Care Area Assessment (CAA) Summary of the admission MDS assessment revealed dental care was a care area triggered within the MDS and should have been addressed in Resident #4's care plan. Review of Resident #4's care plan, start date 3/15/19, revealed dental/dentures were not an identified problem. There were no goals or interventions associated to dental/denture care. During an interview on 4/16/19 at 1:32 pm, Resident #4's Daughter stated Resident #4's dentures are too big and they fall out of his/her mouth at times and this had affected his/her ability to chew. The Daughter stated the facility had not mentioned to her what they were going to do about Resident #4's dentures. During an interview on 4/16/19 at 3:42 pm, the Senior Office Specialist stated all appointments, to include dental appointments, for the Long Term Care Residents were logged in the appointment book kept at the front desk. He/she stated there had been no dental appointments made for Resident #4. During an interview on 4/17/19 at 9:15 am, the MDS Coordinator stated all care areas triggered in the MDS should have been added to Resident's care plan so a plan of care could be initiated. When Resident #4's care plan was reviewed, the MDS Coordinator stated Resident #4's denture issue was not on the care plan. During an interview on 4/18/19 at 8:10 am, the MDS Coordinator stated a dentist appointment was made for Resident #4 during the course of this survey for 4/22/19. Review of the facility policy Dental Services, revision date 5/2017, revealed: The facility will have an advisory dentist who proves consultation, recommends policies concerning oral hygiene, and is available in case of emergency. It shall be the responsibility of the facility, when necessary, to arrange for resident to be transported to the dentist's office. During an interview on 4/19/19 at 11:00, the Director of Nursing (DON) stated there was no facility policy for oral hygiene. Review of the facility policy Resident MDS Assessment and Care Planning, revision date 6/2018, revealed: CAA triggers are used as basis for care planning. Additional areas care planned as determined by (interdisciplinary team), additional assessment, diagnoses, facility policy or other concerns specific to resident. | 2020-09-01 |