cms_AK: 95
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 95 | PROVIDENCE TRANSITIONAL CARE CENTER | 25018 | 910 COMPASSION CIRCLE | ANCHORAGE | AK | 99504 | 2018-07-13 | 656 | E | 0 | 1 | FK4811 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview, the facility failed to develop/implement care plans to: 1) Address certain medical, mental and/or psychosocial needs and 2) Implement written care plan approaches for 4 out of 17 sampled residents (#s 24, 39, 194 and 195). This failed practice had the potential to effect all residents (based on a census of 47) of the facility by providing necessary services to maintain the residents highest practicable level of well being. Findings: Resident #24 Pacemaker Record review from 7/9-13/18 revealed Resident #24 was admitted to the facility on [DATE] with [DIAGNOSES REDACTED]. Review of Resident #24's care plan, last updated 6/6/18, revealed no documentation of the presence of a cardiac pacemaker. In addition, there was no documentation any type of pacemaker device monitoring. Review of Resident #24's Resident Daily Care Plan (RDCP), dated 6/28/18, revealed no mention of a cardiac pacemaker. Random observations of the Residents room from 7/9-13/18 revealed no telephonic equipment for cardiac pacemaker monitoring for the Resident. Resident #39 Anti-coagulant Therapy Record Review from 7/9-13/18 revealed Resident #39 was admitted with [DIAGNOSES REDACTED]. Review of the Resident's Admission History & Physical dated5/25/18 revealed he/she was on [MEDICATION NAME] (a blood thinner that interferes with Vitamin K- clotting factors in the blood. [MEDICATION NAME] is a drug that may cause major or fatal bleeding, requires frequent blood monitoring, careful dosing adjustment, and diet monitoring. Other medications and over the counter supplements can affect this medication that may result in further thinning of the blood. It is important to avoid activities that could cause injury or bleeding as this has the potential to be fatal.) Record review of Resident #39's care plan, last updated 6/13/18, revealed no need/approach, preference, or goals to for issues related to anticoagulant therapy. Record review of the Resident Daily Care Plan (RDCP), dated 6/1/18 listed anticoagulant therapy as a special precaution but listed no interventions or goals. Observation and interview on 7/12/18 at 3:00 pm, Resident #39 was observed looking uncomfortable in the bed, asked if he/she was feeling okay, Resident #39 stated I'm not feeling so well today, I took a tumble in PT (physical therapy). Pacemaker/BI-V ICD (BI-V ICD- a special type of pacemaker with a defibrillator used to resynchronize the heart muscle in heart failure patients) Interview with Resident #39 on 7/9/18 at 9:17 am, Resident stated he/she had a pacemaker (bi-ventricular implantable cardiac defibrillator; BI-V ICD- a special type of pacemaker with a defibrillator used to resynchronize the heart muscle in heart failure patients) for many years and recently had and left ventricular assistive device (LVAD- a mechanical heart pump that is implanted into the person's chest where it helps the heart in circulation when the heart muscle function is failing) placed which caused him to throw a clot and have a stroke. Review of the medical record from 7/9-13/18 revealed Resident #39 was admitted to the facility for rehabilitation from physical weakness secondary to the stroke. Record review of the Nursing Facility Needs Assessment (a facility form used for residents who are being admitted to the facility) dated 5/17/118 revealed under Cardiac, documentation that Resident #39 had a pacemaker/BI-V ICD. Record review of Resident #39's care plan, last updated 6/13/18, revealed no documentation of a plan to monitor Resident's pacemaker. Review of Resident #39's Resident Daily Care Plan (RDCP), dated 6/1/18, revealed no mention of a cardiac pacemaker/BI-V ICD. Random observations in Resident # 39's from 7/9/18 through 7/13/18 revealed no telephonic equipment for cardiac pacemaker/defibrillator monitoring for the Resident. Resident #194 Activities Record review from 7/9-13/18 revealed Resident #194 was admitted to the facility with a [DIAGNOSES REDACTED]. Resident #194 had severe mobility issues. Observation on initial rounds on 7/9/18 at 8:32 am, revealed Resident #194 lying in bed awake. When surveyor came into the room for introduction, the Resident was observed to be in tears. The Resident was unable to verbalize cause due to the inability to speak. Record review of the care plan, last updated on 7/9/18 revealed Resident #194 would like individual activities because Resident has difficulty communicating and feels lonely, isolated and depressed. Listed approaches included inviting and assisting Resident to participate in activities and to engage Resident in 1:1 (one to one) activities, provide music, outdoor time, and pet visits. During an telephone interview on 7/10/18 at 1:07 pm the Resident's Power of Attorney (POA) stated that Resident has had difficulty with transition to the facility from home and was likely depressed. Random observations from 7/9-13/18 revealed Resident #194 in bed with the TV on. No 1:1 activity interactions by facility staff were observed. Observation of facility activities on 7/11/18 at 4:00 pm, revealed a music activity in the common area. Two dogs were observed present on the unit, one belonging to a staff person, and the other visiting the facility. Other residents present in the activity room were observed interacting with the dogs. Interview on 7/12/18 with a visitor that spent most of the past two days with Resident #194 revealed that no activities staff had been by to offer Resident activity choices. The Resident did not have a visit with the animals that were present on the unit the previous day. Record review of Activity Notes from 7/3-10/18 reveal two entries, with no description other than active participation for 1:1 visitation for the week. Resident #195 Hydration During an interview with Resident #195 on 7/10/18 at 8:50 am, Resident stated he/she was admitted facility post hip, rib, and humerus bone fractures for routine healing. Resident #195 stated he/she was on fluid restriction. An observation of Resident #195's room on 7/10/18 at 8:50 am, revealed a sign posted on wall indicating Resident #195 was on fluid restriction. Record review of Resident #195's care plan, last updated on 7/9/18 revealed no hydration/fluid concerns listed as a need, approaches or goal. Activities Record review of care plan last updated 7/9/18 revealed that Resident #195 did not like to attend many activities because of lack of motivation. Approach indicated nurses and activity staff to invite and assist Resident to participate in activities, activity staff to invite Resident to activities he/she might enjoy, spend time outdoors, pet visits, music, and games, and all staff to encourage participation and/or offer conversation. During an interview on 7/12/18 at 9:15 am, Resident #195 stated he/she had not participated in any activities since admission on 6/27/18. Resident #195 was unaware of ever meeting activities staff and indicated staff had never come to encourage/invite participation in any activity or provided a 1:1 activity. | 2020-09-01 |