cms_ID: 24
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 24 | BINGHAM MEMORIAL SKILLED NURSING & REHABILITATION | 135007 | 98 POPLAR STREET | BLACKFOOT | ID | 83221 | 2019-03-01 | 684 | D | 0 | 1 | U2XH11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review, policy review, and staff and resident interview, it was determined the facility failed to ensure professional standards of practice were followed for bowel care and medication administration. This was true for 3 of 9 residents (#10, #25, and #189) reviewed for medications. This failed practice created the potential for harm if residents did not receive medications to prevent constipation or received medications contrary to physicians' orders. Findings include: 1. Resident #25 was admitted to the facility on [DATE] with multiple [DIAGNOSES REDACTED]. Resident #25 was readmitted on [DATE] after a 3 day acute care stay for pneumonia. The 5 day MDS assessment, dated 2/21/19, documented Resident #25 had impaired cognition. Resident #25's admission physician's orders [REDACTED]. * If no BM day 2: Milk of Magnesia 30 cc by mouth 1 dose if not contraindicated, as needed. * If no BM day 2: [MEDICATION NAME] 10 mg by mouth 1 dose if no results from Milk of Magnesia, if not contraindicated, as needed. * If no BM day 3: [MEDICATION NAME] 10 mg rectal suppository 1 dose if not contraindicated, as needed. * If no BM day 3: Fleets enema per rectum 1 dose if not contraindicated, as needed. * If no BM day 3: If no results from enema, notify MD, as needed. The facility's policy and procedure for tracking bowel movements, dated 5/15/18, documented the following: * Bowel tracking protocol is to establish a system for the facility to track resident bowel movements, detect abnormalities of bowel movements, and implement appropriate interventions to prevent constipation and complications associated with constipation. * Bowel movement activity will be recorded in the vital section of the facility electronic record indicating whether the resident did or did not have a bowel movement on the shift and the size of the bowel movement. Resident #25's medical record documented the following: * From 2/1/19 - 2/6/19, for 6 days, there was no documentation of BMs. * From 2/8/19 - 2/11/19, for 4 days, there was no documentation of BMs. * From 2/11/19 - 2/14/19, Resident #25 was out of facility. * From 2/15/19 - 2/20/19, for 6 days, there was no documentation of BMs. * From 2/25/19 - 2/27/19, for 3 days, there was no documentation of BMs. Resident #25's MARs from 1/28/19 to 2/28/19, did not include documentation bowel care medications were provided as ordered by the MD. 2. Resident #189 was admitted to the facility on [DATE], following surgical repair of a left [MEDICAL CONDITION]. Resident #189's admission physician orders, dated 2/23/19, included the following: * If no BM day 2: Milk of Magnesia 30 cc by mouth x 1 dose if not contraindicated, as needed. * If no BM day 2: [MEDICATION NAME] 10 mg by mouth x 1 dose if no results from Milk of Magnesia, if not contraindicated, as needed. * If no BM day 3: [MEDICATION NAME] 10 mg rectal suppository x 1 dose if not contraindicated, as needed. * If no BM day 3: Fleets enema per rectum x 1 dose if not contraindicated, as needed. * If no BM day 3: If no results from enema, notify MD, as needed. Resident #189's medical record documented, he had 2 BMs on 2/23/19. Resident #189's MARs, dated 2/22/19 to 2/28/19, did not include documentation bowel care medications were provided as ordered by the physician. On 2/26/19 at 10:30 AM, Resident #189 stated he needed to find out the last time he had a bowel movement. He said, I think it has been awhile. On 2/27/19 at 10:51 AM, RN #2 stated the 2 BMs were the only documentation she could find for Resident #189. 3. Resident #10 was admitted to the facility on [DATE], with multiple [DIAGNOSES REDACTED]. A (MONTH) 2019 physician order, directed staff to provide Resident #10 with [MEDICATION NAME] light powder (a medication used to treat chronic diarrhea) 4 grams by mouth twice a day. On 2/11/19, additional physician direction was provided to staff to ensure the [MEDICATION NAME] was not administered within 2 hours of other medications. Resident #10's MAR indicated [REDACTED]. Resident #10's (MONTH) 2019 MAR indicated [REDACTED]. The MAR indicated [REDACTED] * [MEDICATION NAME] for [MEDICAL CONDITION] (a diuretic) * [MEDICATION NAME] (a medication for [MEDICAL CONDITION]) * [MEDICATION NAME] (a medication for high blood sugars) * [MEDICATION NAME] (a medication for high blood pressure) * [MEDICATION NAME] Chloride (a medication for urinary incontinence) * Potassium Chloride (a potassium supplement) Resident #10's (MONTH) 2019 MAR indicated [REDACTED]. The MAR indicated [REDACTED] * [MEDICATION NAME] * Potassium Chloride * [MEDICATION NAME] * [MEDICATION NAME] (a medication for high blood cholesterol) On 2/28/19 at 5:11 PM, RN #1 stated the physician's orders [REDACTED].#10 continued to get other medications with the [MEDICATION NAME]. | 2020-09-01 |