cms_NH: 30
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 |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
30 | GREENBRIAR HEALTHCARE | 305005 | 55 HARRIS ROAD | NASHUA | NH | 3062 | 2019-10-28 | 697 | D | 0 | 1 | TYS711 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview, it was determined that the facility has failed to ensure that proper pain management is provided to meet professional standards of care for 1 resident in a final survey sample of 35 residents. (Resident identifier is #47) Findings include: Interview on 10/24/19 at 9:47 a.m. with Resident #47 stated that they were not getting enough pain control. Review on 10/24/19 of the medial record shows Resident #47 is receiving scheduled pain medication along with PRN (as needed), these orders are written as follow: [MEDICATION NAME] Tablet 325 mg Give 2 tablet by mouth every 6 hours as needed for mild to moderate Pain NTE (Not to Exceed) 3 GM(grams)/24 hours . [MEDICATION NAME] HCI Tablet 5 MG (milligrams) Give 1 tablet by mouth as needed for for muscle pain Take one tablet once daily as needed. [MEDICATION NAME] HCI Tablet 50 MG Give 1 tablet by mouth every 6 hours as needed for moderate to severe pain. Pain Monitoring using Verbal/Non-Verbal 0-10 Scale every shift for Monitoring Level of Comfort Interview on 10/28/19 at 12:30 p.m. with Staff B (Director of Nurses) was asked if a resident is cognitively intact and what type of pain scale would be used. Staff B stated the numerical scale because Resident #47 is cognitively intact. Staff B was then shown the orders which are written above and asked if you are using the verbal pain scale and documenting using 1-10 but are administering PRN medication using mild-moderate or moderate to severe. Staff B was then asked what would the numerical pain scale in translation to mild-moderate or moderate to severe be. Staff B was not able to answer the question. Staff B then was asked if these levels are from the Wong backer assessment tool for pain, Staff B said yes. On review of this tool it is rated as 1-3 mild, 4-6 moderate, 7-10 severe. Review on 10/28/19 of the PRN orders for [MEDICATION NAME] 325 mg 2 tablets being given using numerical numbers from 7-10 which when using the mild-severe scale would be coded as sever meaning the wrong pain medication was given for the pain level told 6 times in a row. Review on 10/28/19 of the PRN orders for [MEDICATION NAME] tablet 50 mg given by mouth every 6 hours shows it being given 3 times a day almost every day for the month of (MONTH) with pain levels fluctuating from pain levels of 3-8. On review of the times and doses this medication was being given always at 8:00 a.m., 2:00 p.m., and 8:00 p.m. Review on 10/28/19 of the PRN order for [MEDICATION NAME] 5 mg for muscle pain revealed this medication is again being given every day around 11-12 p.m. Interview on 10/28/19 with Staff B was shown the clinical information regarding substance abuse and Staff B stated it was a long time ago and it was not pills but alcohol. Staff B also stated the resident and physician have agreed to administer medication on a PRN schedule making Resident #47 feel like they have control of their pain. | 2020-09-01 |