department of health and human services centers for medicare ...

More documents

Recommendations

Info

DEPARTMENT OF HEALTH AND HUMAN SERVICES PRINTED: 10/24/2011 FORM APPROVED CENTERS FOR MEDICARE & MEDICAID SERVICES OMB NO. 0938-0391 STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION A. BUILDING ______________________ B. WING _____________________________ (X3) DATE SURVEY COMPLETED 295037 03/04/2011 NAME OF PROVIDER OR SUPPLIER HENDERSON HEALTHCARE CENTER STREET ADDRESS, CITY, STATE, ZIP CODE 1180 E. LAKE MEAD DRIVE HENDERSON, NV 89015 (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (EACH DEFICIENCY MUST BE PRECEDED BY FULL REGULATORY OR LSC IDENTIFYING INFORMATION) ID PREFIX TAG PROVIDER'S PLAN OF CORRECTION (EACH CORRECTIVE ACTION SHOULD BE CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) (X5) COMPLETION DATE F 000 Continued From page 1 F 000 Medications are not supplied to residents upon discharge. Prescriptions were given to the resident's family to fill. Complaint #NV00027572 alleged a resident did not see a doctor during the entire stay period, did not have a bath during the the stay, and had dry feet. The complaint also alleged the facility was going to transfer a resident without notification and improperly kept a resident when the facility should have discharged the resident. The complaint was unsubstantiated. Allegation #1: A physician saw the resident as documented in the file in the form of a history and physical. Therefore, this allegation was unsubstantiated. Allegation #2: The bath/shower log showed the resident had several bed baths and linen changes. Staff also showered the resident upon request prior to discharge. Therefore, this allegation was unsubstantiated. Allegation #3: The resident was status post left foot fluid collection with aspiration and cellulitis. The resident was provided a podiatry referral upon discharge. Therefore, this allegation was unsubstantiated. Allegation #4: The resident made several comments, which concerned social services about a safe discharge. The resident demonstrated borderline competency upon evaluation. Elder protective services became involved. The resident initially agreed to stay at FORM CMS-2567(02-99) Previous Versions Obsolete Event ID: J8O811 Facility ID: NVS263S If continuation sheet Page 2 of 68
DEPARTMENT OF HEALTH AND HUMAN SERVICES PRINTED: 10/24/2011 FORM APPROVED CENTERS FOR MEDICARE & MEDICAID SERVICES OMB NO. 0938-0391 STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION A. BUILDING ______________________ B. WING _____________________________ (X3) DATE SURVEY COMPLETED 295037 03/04/2011 NAME OF PROVIDER OR SUPPLIER HENDERSON HEALTHCARE CENTER STREET ADDRESS, CITY, STATE, ZIP CODE 1180 E. LAKE MEAD DRIVE HENDERSON, NV 89015 (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (EACH DEFICIENCY MUST BE PRECEDED BY FULL REGULATORY OR LSC IDENTIFYING INFORMATION) ID PREFIX TAG PROVIDER'S PLAN OF CORRECTION (EACH CORRECTIVE ACTION SHOULD BE CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) (X5) COMPLETION DATE F 000 Continued From page 2 F 000 the facility. Upon proper notification of Medicare services ending and a long term bed opening, the resident changed her mind. The physician documented the pending discharge as unsafe. The facility eventually discharged the resident with a responsible party with follow up instructions and a home health referral. The facility tried to ensure a safe discharge. Therefore, this allegation was unsubstantiated. Complaint #NV00027432 alleged a resident did not receive proper hygiene care and call lights were not answered. This allegation was not substantiated through clinical record review, document review and interviews with facility staff. The findings and conclusions of any investigation by the Health Division shall not be construed as prohibiting any criminal or civil investigation, actions, or other claims for relief that may be available to any party under applicable federal, state or local laws. F 221 SS=D The following regulatory deficiencies were identified: 483.13(a) RIGHT TO BE FREE FROM PHYSICAL RESTRAINTS The resident has the right to be free from any physical restraints imposed for purposes of discipline or convenience, and not required to treat the resident's medical symptoms. F 221 This REQUIREMENT is not met as evidenced by: Based on observation, interview, and record review, the facility failed to ensure residents were FORM CMS-2567(02-99) Previous Versions Obsolete Event ID: J8O811 Facility ID: NVS263S If continuation sheet Page 3 of 68
Page 1: DEPARTMENT OF HEALTH AND HUMAN SERV
Page 5 and 6: DEPARTMENT OF HEALTH AND HUMAN SERV
Page 53 and 54:
DEPARTMENT OF HEALTH AND HUMAN SERV
Page 55 and 56:
Page 57 and 58:
Page 59 and 60:
Page 61 and 62:
Page 63 and 64:
Page 65 and 66:
Page 67 and 68:
show all

department of health and human services centers for medicare ...

Create successful ePaper yourself

Delete template?

Save as template?