| 86 |
RIO RANCHO CENTER |
325033 |
4210 SABANA GRANDE SE |
RIO RANCHO |
NM |
87124 |
2018-02-12 |
692 |
D |
0 |
1 |
M2BO11 |
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview, the facility failed to ensure that a resident with a [DIAGNOSES REDACTED].#76) of 8 (R #s 2, 19, 31, 36, 68, 76, 89 and 307) residents reviewed for nutrition. There was no indication that facility staff, other than the admitting physician, was aware that the resident was diabetic, and no supportive interventions were in place. This deficient practice has the potential to result in dangerously high or low blood glucose levels in a diabetic resident. The findings are: [NAME] On 02/05/18 at 2:25 pm, during interview with R #76, he stated, I'm a diabetic and damned near everything here is sweet. I don't take any meds (diabetes medications)- I control it through diet. I don't know how you can control your sugar when everything is sweet. B. Record review of R #76's electronic medical record found: 1. that he was admitted to the facility on [DATE], and discharged on [DATE]. 2. that his listed medical diagnoses included [MEDICAL CONDITION], dependence on [MEDICAL TREATMENT] (filtering of the blood to compensate for impaired kidney function), [MEDICAL CONDITION] (a liver disease), and gastrointestinal hemorrhage (bleeding in the digestive system.) No [DIAGNOSES REDACTED]. 3. a care plan dated 1/22/18 that did not have focus sections related to diabetes management. 4. a physician's orders [REDACTED]. 5. that a nutritional assessment dated [DATE] did not acknowledge the resident's diabetes. It stated that the resident had declined a renal diet, in favor of a regular diet. 6. that an Admission MDS (Minimum Data Set, a data collection tool) assessment, dated 01/22/18, stated, Diabetes mellitus: No. 7. that the Treatment Administration Records for (MONTH) and (MONTH) (YEAR) showed no tasks related to diabetes management. C. Record review of a physician's History and Physical document for R #76, dated 01/18/18, indicated that DM 2 (Type II Diabetes Mellitus) was among his diagnoses in the History of Present Illness section. The resident's diabetes was not mentioned in the Plan section of the document, though there was a statement indicating his chronic medical conditions are stable. D. On 02/09/18 at 1:24 pm, during interview with the Director of Nursing (DON), she confirmed that diabetes was not addressed in R #76's care plan. She acknowledged that a complete care plan, including all information necessary to care for the resident, should have been completed within 21 days of his admission. E. On 02/08/18 at 10:07 am, during interview with the facility's Dietician, she stated I probably didn't know that he was diabetic (when I did his nutritional assessment.) If I had known he was diabetic, I definitely would have put it in my assessment. Sometimes I do my assessment before they're seen by the doctor, so the History & Physical wouldn't be available. F. On 02/08/18 at 3:13 pm, during interview with Nurse Practitioner #1, she stated that liberalized diets for diabetics are intended to reduce sweets, not eliminate them entirely. She indicated that it would have made sense, given the liberalized diet, that his blood sugar should have been checked, maybe every morning. |
2020-09-01 |