cms_GU: 25
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 25 | GUAM MEMORIAL HOSPITAL AUTHORITY | 655000 | 499 NORTH SABANA DRIVE | BARRIGADA | GU | 96913 | 2016-09-29 | 241 | E | 0 | 1 | H7FJ11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview and record review, the facility did not ensure that residents were treated with dignity and respect residents' individuality for 3 of 10 sampled residents (Residents 3, 4, and 5). Findings include: 1. On [DATE] at 2:30 p.m., during an interview, Resident 4 complained about the facility's slow response to call light when he calls for assistance. The resident indicated that at one instance he needed to be changed and he had to wait for a long time. Review of a nurses' progress notes dated [DATE] at 20:41 revealed that at 1730, a licensed nurse went to the resident's room to give his medicine and the resident was so mad and cursed the nurse. Resident 4 refused to take his medication because he was wet, pointing his diaper. The licensed nurse documented, I told him I will call (name of assigned CNA) to help you. Review of Resident 4's latest quarterly assessment dated [DATE] revealed the resident has a Brief Interview of Mental Status (BIMS) of 9 indicating moderate impairment of cognitive skills. Also the resident's functional status for toilet use was extensive assistance with one-person physical assist. Although the resident was identified as always continent of urine, he was assessed as frequently incontinent of bowel. This was confirmed by a licensed nurse (LN1) during the initial tour of the facility on [DATE] at 10:40 a.m. LN1 indicated that the resident uses the urinal located at the resident ' s bedside. Review of the resident council meeting minutes dated [DATE] revealed an old business related to resident concern indicating that a resident called for help and it took them more than 20 minutes. The resident ended up having to call anyone else out there. The facility's corrective action revealed that the Unit supervisor has discussed the issues with her staff at the monthly staff meeting and reminded them of the importance of responding to resident call lights and bedside manners. Review of the resident council meeting minutes dated [DATE] revealed a nursing issue that stated, they (nurses) moved my (call) bell too far away from my reach after I rang it. The corrective action revealed, Nurse Aides will ensure all call bell/switches are well within reach for each resident. There was no indication of how the facility will monitor the implementation of the corrective actions formulated to ensure that staff response to resident calls will be addressed accordingly. On [DATE] during lunch meal observation Resident 4 stated that food spills from the disposable Styrofoam plate because it was slippery. The latest quarterly assessment dated [DATE] revealed the resident was independent with setup help only with eating indicating the resident needed no help or staff oversight at any time. On [DATE] at 12:15 p.m. the resident was observed up in the dining area eating lunch. The resident's plate was a styrofoam disposable container with a cover used for takeout food items. The resident stated that type of container held the food better but he preferred to eat using a regular plate. On [DATE] at 12:10 p.m. Resident 4 stated that he was told by a nurse that he should not be calling for assistance because a resident has expired that time. The resident kept asking the identity of the resident who expired. Further investigation confirmed that another resident in the unit expired that time. LN1 indicated that services continue to be delivered to all the residents in the facility regardless of a death event. 2. On [DATE] at 8:30 a.m. during breakfast meal observation, Resident 5 was observed in his room eating pureed meal with foamy liquid at the side of his mouth. A nurse at the hallway was notified and assisted the resident in suctioning his mouth by himself. Review of the resident's electronic record revealed the resident was admitted to the facility on [DATE] with [DIAGNOSES REDACTED]. Review of the latest assessment dated [DATE] revealed the resident has a BIMS of 15 indicating that he was cognitively intact and he was totally dependent with one person physical assist with eating. Interview with LN1 revealed the resident receives a pureed diet for oral pleasure in addition to tube feedings four times a day. Interview with a licensed nurse revealed the resident is capable of eating independently once the tray is set up next to him. The resident was observed using his back scratcher to lift the lid of the disposable styrofoam plate to access the pureed food served. 3. Resident 3 was admitted to the facility on [DATE] with several [DIAGNOSES REDACTED]. The most current quarterly MDS (minimum data set) assessment dated [DATE] described the resident as having no short or long term memory problems, had intact cognitive skills for daily decision making, and had no mood, [MEDICAL CONDITION], or behavioral problems. During the initial tour on [DATE], a licensed facility staff (LN6) described the resident as alert and oriented but non-verbal as a result of the stroke, and able to communicate or make his needs known by gestures. During the same initial tour, Resident 3 was observed in a wheelchair wearing a hospital gown that was open at the top exposing his upper back. This same observation was made throughout the survey. While the resident went up and down the hallway in his wheelchair, or spent time in the day room watching TV with other residents, none of the staff intervened to protect the resident and ensured that he was fully covered. 4. During the survey, residents were also observed wearing hospital gowns at all times while they were in bed or in the day room. None of the residents were observed wearing their own personal clothing even while they were around visitors or other residents and during meals or group activities. There was no indication that residents were being offered to wear their own clothes in a home-like environment instead of an institutional setting. (Reference Residents 3 and 9) During an interview on [DATE], Resident 3 shrugged his shoulders as a response to why he was not wearing his own clothing. When the question was repeated, the resident shook his head side-to-side indicating that he did not know. 5. During meal observations including those made on [DATE] and [DATE], residents were observed eating their meals using disposable Styrofoam plates and food containers, and plastic eating utensils. During the lunch meal observation on [DATE], Resident 3 was observed eating pureed fruit straight out of the disposable Styrofoam cup, raising the cup over his mouth and waiting until the last of the fruit was gone. When asked why he wasn't using the spoon, the resident was unable to respond verbally. During the meal, the resident was also observed having some difficulty eating from the Styrofoam container because it was too light and the plate would slide especially when the resident would scoop food against the sides. The resident could not use his other hand to keep the container in place because of the [MEDICAL CONDITION]. During the kitchen/trayline observation (on [DATE]), a dietary staff worker (DS01) stated that the facility's dishwasher was broken and that disposable Styrofoam containers and plates, and eating utensils were being used instead. DS01 stated that the dishwasher had been broken for months. In a separate interview on [DATE], a maintenance staff member (MS1) stated that the dishwasher's booster pump was broken and that the required water temperature to adequately sanitize the plates could not be reached. In the same interview, MS1 stated that the dishwasher had been broken since (MONTH) (YEAR). | 2020-09-01 |