cms_NH: 33
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 33 | GREENBRIAR HEALTHCARE | 305005 | 55 HARRIS ROAD | NASHUA | NH | 3062 | 2019-10-28 | 758 | D | 0 | 1 | TYS711 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, it was determined that the facility failed to ensure that residents who use [MEDICAL CONDITION] medication received a gradual dose reduction for 1 resident, and ensure that PRN (as needed) orders for [MEDICAL CONDITION] medication was limited to 14 days, except, if the attending physician or prescribing practitioner believes that it is appropriate for the PRN order to be extended beyond 14 days, he or she should indicate the duration for the PRN order for 1 resident out of a final sample size of 35 residents. (Resident identifiers are #17 and #42.) Findings include: Resident #42 Review on 10/28/19 of Resident #42's current physician order [REDACTED].#42 had an order for [REDACTED].#42's [MEDICATION NAME] order revealed no indicated duration of use. Review on 10/28/19 of Resident #42's (MONTH) to (MONTH) 2019 EMAR (Electronic Medication Administration Record) revealed that Resident #42's [MEDICATION NAME] 0.5 mg PRN with an order date of 6/5/19 was given on 6/10/19, 6/11/19, 6/16/19, 6/22/19, 6/30/19, 8/15/19, 8/19/19, 8/27/19, 8/28/19, 9/1/19, 9/11/19, 9/12/19, 9/20/19, 9/25/19, 9/29/19, 10/2/19, 10/4/19, 10/6/19, 10/14/19, 10/18/19, and 10/19/19. Review on 10/28/19 of Resident #42's Medication Regimen Review (MRR) dated 7/19/19 revealed .Comments: (Resident #42) has a PRN order for an anxiolytic, which has been in place for greater than 14 days without a stop date: [MEDICATION NAME] 0.5 mg BID PRN since 6/5/19 .Recommendation: Please discontinue PRN [MEDICATION NAME]. If the medication cannot be discontinued at this time, current regulations require that the prescriber document the indication of use, the intended duration therapy and the rationale for the extended time period . Further review of Resident #42's MRR dated 7/19/19 revealed that recommendations were declined by the physician on 7/23/19 and rationale to extend therapy was documented but no documented duration of use. Review on 10/28/19 of Resident #42's MRR dated 10/18/19 revealed .Comment: REPEATED RECOMMENDATION (sic) from 7/19/19: Please respond promptly to assure facility compliance with Federal regulations. (Resident #42) has an order for [REDACTED]. Interview on 10/28/19 at 4:36 p.m. with Staff B (Director of Nursing) confirmed above findings. Staff B stated as Resident #42 had an order for [REDACTED].#42's physician or psychiatrist regarding Resident #42's [MEDICATION NAME] PRN duration of use. Resident #17 Review on 10/25/19 of Resident #17's medical record revealed that Resident #17 was on the Anti-psychotic medication Quetiapine since admission on 10/28/18. There was no documentation of Resident #17 having a GDR (Gradual Dose Reduction). Review on 10/25/19 of Resident #17's MAR (Medication Administration Record) revealed that Quetiapine was being administered for the [DIAGNOSES REDACTED]. Interview on 10/28/19 at approximately 1:00 p.m. with Staff K (Licensed Practical Nurse) confirmed that Resident #17 had not had a GDR of the Anti-psychotic medication Quetiapine since admission. Staff K also confirmed that Resident #17 did not have a supporting [DIAGNOSES REDACTED]. | 2020-09-01 |