cms_DC: 2
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 |
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2 | WASHINGTON CTR FOR AGING SVCS | 95014 | 2601 18TH STREET NE | WASHINGTON | DC | 20018 | 2019-07-11 | 600 | G | 1 | 0 | 4UMZ11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** > Based on staff interview and record review for one (1) of seven (7) residents reviewed, it was determined that facility staff failed to stop giving morning care to a combative resident who was attempting to scratch the employee. Subsequently, the resident sustained [REDACTED]. Resident #1 The findings include: Resident #1 was admitted to the facility on (MONTH) 29, (YEAR). According to the Minimum Data Set (MDS) assessment with a target date of (MONTH) 3, 2019, he/she was assessed with [REDACTED]. He/she was assessed as requiring extensive assistance of one (1) for bed mobility, transfers, dressing, personal hygiene and totally dependent for bathing and toilet use with the assistance of two (2) in Section G (Functional Status). Disease [DIAGNOSES REDACTED]. According to a nurse's note dated (MONTH) 16, 2019 at 12:30 PM: Writer was called by CNA to come to resident room, when asked CNA said He/she was trying to give care to resident when he/she became combative and in the process of turning, resident hit his/her head on the side rail of the bed. Happened at 11:35 am. Writer went and assessed resident and noted a swelling on his/her left face. Supervisors were informed. NP was called , who gave orders for resident to be transported via EMR/911. To the nearest ER. Resident #1 is alert and unable to explain what happened. His/her [DIAGNOSES REDACTED]. On assessment resident noted with swelling of the left fore head near the left eye with a cut on the left upper lip with minimal bleeding which was cleansed with normal saline. Ice pack applied to the left forehead swelling. V/S laying 138/69, P74, T 97.7, Spo2 98% on room air. V/S sitting B/P 157/80, P77, T98.2, R 18. Pulse ox room air 97% . Finger stick 142 mg/dl. Tylenol 2 tabs 325 mg was administered for pain 4/10 and was very effective. Neuro check initiated. RP made aware. According to a progress note written by the dentist on (MONTH) 21, 2019: Received a call on 6/19 regarding patient injury. Informed charge nurse that [MEDICATION NAME] would be added prior to procedure. He/she told me he/she would call me once it was received (after NP left orders and X-ray results). S/P hit face on bed railing. Patient has black eye (periorbital) swollen lip (upper/inner) and slightly bruised periocular area. Patient is .lying in bed/sleep. Comprehensive exam of oral soft/hard tissues completed to rule out fractured teeth. Patient has fractured [MEDICATION NAME] teeth unrelated to this incident. There is no associated mobility or intra-oral trauma. Patient does have swelling of face and lips which are clearly trauma related. Patient's teeth which are broken also have excessive decay which is unrelated to incident. Recommend that area of trauma be resolved prior to any future clinical treatment unless patient's teeth become symptomatic due to patient's altered mental status. Dr. contacted (RP) to inform him/her of findings. A telephone interview was conducted with Employee #1 on (MONTH) 8, 2019 at 9:40 AM. He/she was giving care to Resident #1 when the incident occurred. Employee #1 stated, I was cleaning him/her up and I had his/her diaper and pants to pull up. Then I was done with the job. He/she started to wave around his/her arms and tried to scratch me. I turned him/her to pull up his/her pants and his/her arms went under him/her. Then he/she hit her face on the side rail. It's metal. I called the charge nurse who called the supervisor and then they did an assessment and we sent him/her out 911. Employee #1was asked if he/she stopped caring for Resident #1 when he/she became combative. Employee ##1 stated, I left him/her alone. I went to the bathroom and cleaned up the items I used. I went back to the resident. He/she was still combative . I know that I was supposed to wait a few minutes to let him/her calm down, but I had to get the job done. I had to finish pulling up his/her pants because I had to finish the job. Facility staff continued to complete morning care despite the resident being combative and attempting to scratch Employee #1. Subsequently, the resident sustained [REDACTED]. A face-to-face interview was conducted with Employee #2 on (MONTH) 1, 2019 at 10:45 AM, who acknowledged the above findings. The record was reviewed (MONTH) 1, 2019. | 2020-09-01 |