cms_UT: 91
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 91 | PIONEER CARE CENTER | 465020 | 815 SOUTH 200 WEST | BRIGHAM CITY | UT | 84302 | 2018-06-21 | 758 | D | 0 | 1 | EUNP11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review it was determined for 2 out of 31 residents that the facility did not ensure that residents receiving [MEDICAL CONDITION] drugs are not given the medication unless necessary to treat a specific condition as diagnosed and documented in the clinical record and that they receive a gradual dose reduction unless clinically contraindicated. Additionally, as needed (PRN) orders are limited to 14 days unless the physician extends it beyond the 14 day requirement and documents the rationale and duration for the PRN order, and a PRN order for anti-psychotic drugs are limited to 14 days unless the physician evaluates the resident for the appropriateness of that medication every 14 days. Resident identifiers: 23 and 31. Findings include: 1. Resident 23 was admitted to the facility on [DATE] with [DIAGNOSES REDACTED]. On 6/18/18, resident 23's medical records were reviewed. Review of the physician orders [REDACTED]. Review of the Medication Administration Record [REDACTED]. No documentation could be found of the physician evaluating the resident every 14 days with a documented rationale for the continuation of the medication. On 6/21/18 at 11:47 AM, the DON was interviewed. The DON was informed of the new regulation regarding PRN orders for anti-psychotic medications. No documentation was provided of a physician evaluation every 14 days. The DON was observed to write down the regulation information on a sticky note. 2. Resident 31 was admitted to the facility on [DATE] with [DIAGNOSES REDACTED]. Review of physician orders [REDACTED]. Review of the Physician Rationale for Clinically Contraindicated Gradual Dose Reduction (GDR) for the [MEDICATION NAME] on 5/13/15 and on 6/10/17 revealed the rationale as noted increase/return behaviors with med (medication) changes. Side effects of [MEDICATION NAME] noted. Increased refusal of cares noted as well. On 6/20/18 at 11:11 AM, the Corporate Resource Nurse (CRN) was interviewed. The CRN stated that the [MEDICATION NAME] was reduced and discontinued on 4/2/15. The CRN stated that the nursing progress note on 5/1/15 indicated increase in negative behaviors of refusing cares and being more aggressive and agitated. The CRN stated that initially the [MEDICATION NAME] was discontinued and [MEDICATION NAME] was ordered. The CRN stated that resident 31 had an Adverse Side Effect (ASE) from the [MEDICATION NAME] so it was discontinued and the [MEDICATION NAME] was restarted at the previous dosage. The CRN stated that once the facility received an order that a GDR was contraindicated then a GDR was not tried again. The CRN stated that she would have to look into if a GDR was every attempted with the [MEDICATION NAME] after it was reinstated. On 6/20/18 at 3:34 PM, the CRN was re-interviewed. The CRN stated there was no documentation of the ASE to the [MEDICATION NAME] and no physician documentation of the rationale for why a GDR of the [MEDICATION NAME] would impair the residents function. On 6/21/18 at 8:17 AM, the DON and CRN were interviewed. The DON stated after the [MEDICATION NAME] ASE occurred the [MEDICATION NAME] was ordered again at the previous dosage, and no additional GDR attempts were tried to see if the resident could tolerate a lower dose. | 2020-09-01 |