| 91 |
ST JOHN'S LUTHERAN HOME |
275024 |
3940 RIMROCK RD |
BILLINGS |
MT |
59102 |
2019-08-22 |
758 |
D |
1 |
1 |
P5VQ11 |
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** > Based on observation, interview, and record review, the facility failed to ensure PRN orders for [MEDICAL CONDITION] medications were limited to 14 days, for 1 (#30) of 29 sampled residents. Findings include: During an observation and interview on 8/19/19 at 3:57 p.m., resident #30 was in her wheelchair with a baby doll in her lap. Resident #30 stated, Isn't my baby beautiful? Resident #30 then became tearful when discussing that she had nothing to feed the baby, and would have to give him up because of this. Resident #30 stated, What can you do when you are old and have no money? Review of resident #30's Physician's hospice orders, dated 4/17/19, showed, [MEDICATION NAME] 0.5 mg .take 1 tablet by mouth/sublingual every 4 hours as needed. During an interview on 8/20/19 at 9:55 a.m., staff member F stated that resident #30's moods were like a rollercoaster, and it varied from day to day. Staff member F stated that resident #30 had a gradual decline in mental status, and was placed on hospice in (MONTH) 2019. During an interview on 8/21/19 at 1:00 p.m., staff member I stated, I thought the 14 day limit (for [MEDICAL CONDITION]) was only for prn antipsychotic medications. Staff member I stated that she would review the regulations and follow-up with hospice to see if they have any different rules. No additional information was provided by staff member I. Review of resident #30's Care Team Meeting notes, dated 3/13/19, showed behaviors for the resident included, .shoving, cursing, threatening, yelling . Review of resident #30's Nursing Home Recertification documentation, dated 5/24/19, showed a [DIAGNOSES REDACTED]. [MEDICATION NAME] was listed as a prn medication. The note failed to include documentation of the reason for continuing the use of [MEDICATION NAME] on an as needed (PRN) basis, beyond the 14 day limit. The Impression and Plan section showed, .8. [MEDICAL CONDITION] with anxiety: Well-managed with [MEDICATION NAME] and [MEDICATION NAME]. No mention of the use of lorazapam was found. Review of resident #30's Nursing Home Annual Assessment, dated 7/30/19, showed, .6. (A) Patient has chronic depression and anxiety, .Continue [MEDICATION NAME] 100 mg daily and [MEDICATION NAME] . There was no documentation related to the continued use of [MEDICATION NAME] on an as needed basis. Review of resident #30's MAR, dated (MONTH) 2019, showed [MEDICATION NAME] 0.5 mg had been given 14 times between 8/4/19 and 8/21/19. |
2020-09-01 |