cms_RI: 44
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 44 | APPLE REHAB WATCH HILL | 415015 | 79 WATCH HILL ROAD | WESTERLY | RI | 2891 | 2019-10-04 | 725 | E | 1 | 1 | II8Y11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** > Based on record review, resident interview, and staff interview, it has been determined that the facility failed to have sufficient nursing staff to provide nursing and related services to assure resident safety and maintain the highest practicable physical, mental, and psychosocial well-being of each resident, as determined by resident assessments and individual plans of care related to 5 of 5 residents (ID#s 4, 7, 13, 25, 32) reviewed for showers, 3 of 4 residents (ID#s 7, 17, and 19) reviewed for weights, and 4 of 4 substantiated complaints involving staffing. Findings are as follows: During the Resident Council meeting with the surveyor on 10/2/2019 at approximately 1:30 PM, ID#s 4, 7, 13, 25, and 32 revealed concerns relative to staffing. Furthermore, they indicated that they are supposed to receive a shower weekly; however, they sometimes need to wait two to three weeks. Review of the Resident Council Meeting minutes from (MONTH) 24, 2019, (MONTH) 29, 2019 and (MONTH) 19, 2019 revealed the following: - June: .Residents are concerned that there is only one to two CNAs (Certified Nursing Assistants) on evening/night time shifts and only one nurse, as this is not safe staffing for the amount of residents per care taker . - July: .Residents are concerned about the staffing .Residents are concerned they are not being cared for properly. They are not getting showered regularly . - August: .Residents are concerned they are not getting their scheduled showers . During a surveyor interview with the Activities Director on 10/4/2019 at 1:02 PM, she revealed that residents have been complaining for months about not getting showers regularly. The Administration will address the residents about the concerns and tell them they are doing the best they can. Review of the residents' records revealed the following: 1. Resident ID #4 was admitted to the facility on [DATE]. The resident's quarterly Minimum Data Set (MDS), dated [DATE], revealed the resident is alert and oriented. Review of the Nursing Assistant's documentation related to shower/baths from 9/3/2019 to 10/3/2019 revealed that the resident last had a shower on 9/19/2019 (approximately 2 weeks without a shower). During an additional surveyor interview with the resident on 10/3/2019 at 11:41 AM, s/he indicated that there is not enough staff to give residents regular showers. 2. Resident ID #7 was admitted to the facility on [DATE]. The resident's quarterly MDS, dated [DATE], revealed the resident is alert and oriented. Review of the Nursing Assistant's documentation related to shower/baths from 9/3/2019 to 10/3/2019 revealed that the resident last had a shower on 9/19/2019 (approximately 2 weeks without a shower). 3. Resident ID #13 was admitted to the facility on [DATE]. The resident's quarterly MDS, dated [DATE], revealed the resident is alert and oriented. Review of the Nursing Assistant's documentation related to shower/baths from 9/3/2019 to 10/3/2019 revealed that the resident did not receive a shower from 9/3/2019 (or prior) until 9/28/2019 (more than 3 weeks without a shower). During a surveyor interview with the resident on 10/3/2019 at 11:40 AM, s/he revealed that they have assigned shower days; however, staff will say there is not enough help to give them a shower. 4. Resident ID #25 was admitted to the facility on [DATE]. The resident's quarterly MDS, dated [DATE], revealed that the resident has moderate cognitive impairment. Further review revealed that the resident requires total dependence with a two or more-person physical assist for bathing. Review of the Nursing Assistant's documentation related to shower/baths from 9/3/2019 to 10/3/2019 revealed that the resident received a shower on 9/8/2019 and 9/28/2019. There is no evidence that the resident received a shower in-between this time (approximately 3 weeks). 5. Resident ID #32 was admitted to the facility on [DATE]. The resident's quarterly MDS, dated [DATE], revealed the resident is alert and oriented. Further review revealed that the resident requires physical help of one person for bathing. Review of the Nursing Assistant's documentation related to shower/baths from 9/3/2019 to 10/3/2019 revealed that the resident last received a shower on 9/19/2019 (approximately 2 weeks since last shower). During subsequent surveyor interviews with Nursing Assistant's G, H, and I on 10/3/2019 at 3:44 PM, 4:32 PM, and 4:38 PM, they revealed that they are not always able to meet the residents care needs because there are not enough staff. Furthermore, they acknowledged that residents, at times, go weeks without having a shower because they do not have enough time/staff. Four community-reported complaints involving staffing were investigated. One of the four complaints alleged that residents have not had showers for weeks and residents who are on daily weights are not being weighed due to a lack of staff. 1. Record review for Resident ID #7 revealed a current physician's monthly order to weigh the resident three times every week on Monday, Wednesday, and Friday. Review of the record from 9/1/2019 to 9/30/2019 revealed that the resident's weight was not checked on 2 of 13 opportunities. 2. Record review for Resident ID #17 revealed a current physician's orders [REDACTED]. Review of the record from 7/1/2019 to 10/2/2019 revealed the weight was not checked on 11 out of 40 opportunities. 3. Record review for Resident ID #19 revealed a 5/16/2019 physician's orders [REDACTED]. Review of the record from 9/1/2019 to 10/4/2019 revealed that the resident's weight was not checked on 3 of 5 opportunities. During a surveyor interview with the Administrator on 10/4/2019 at 1:41 PM, she was unable to provide evidence that residents were offered showers weekly. Additionally, she acknowledged that the facility was currently short-staffed. | 2020-09-01 |