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 309 Continued From page 37 F 309 The facility's reference book titled, "30th Anniversary Edition Nursing 2010 Drug Handbook" pages 385-387 documented "always check a patient's apical pulse rate before giving the drug. If it's slower than 60 beats per minute with hold the drug and call the prescriber immediately." Resident #22's Medication Administration Record (MAR) dated 2/11, lacked documentation the resident's pulse rate was recorded prior to each dose of Metoprolol 25 milligrams orally during the month. According to the MAR the resident's pulse rate was not taken prior to administration of her 8:00 AM medication dose 12 times and not taken prior to administration of her 8:00 PM dose 5 times in 2/11. The MAR documented Resident #22 received Metoprolol 25 milligrams orally on 2/14/11, when her blood pressure was documented as 108/72 and a pulse rate of 60. On 3/3/11 at 2:25 PM, a Licensed Nurse (LN) stated the drug Metoprolol "lowers the blood pressure and heart rate. The heart rate and blood pressure should be taken before the medication was given." The LN stated if the medication was given to a resident with a low blood pressure/or heart rate the medication would cause them to drop further and could cause dizziness or a fall. The LN reviewed the MAR for 2/11 and stated the physician's order was not followed regarding monitoring the pulse rate and the medication should not have been given on 2/14/11. F 311 483.25(a)(2) TREATMENT/SERVICES TO F 311 FORM CMS-2567(02-99) Previous Versions Obsolete Event ID: J8O811 Facility ID: NVS263S If continuation sheet Page 38 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 311 Continued From page 38 F 311 SS=G IMPROVE/MAINTAIN ADLS A resident is given the appropriate treatment and services to maintain or improve his or her abilities specified in paragraph (a)(1) of this section. This REQUIREMENT is not met as evidenced by: Based on observation, interview, record review, and document review, the facility failed to give appropriate treatment to maintain or improve his or her abilities for 3 of 30 residents (Resident #19, #20, #4). Findings include: Resident #4 Resident #4 was a 31 year old female who was treated at an area hospital from 1/21/2010 - 2/13/2010, for status post anoxic encephalopathy secondary to drug overdose and status post PEG (percutaneous endoscopic gastrostomy) tube placement. Resident #4 was admitted to the facility on 2/13/2010, with diagnoses including anoxic brain damage, adult failure to thrive, anxiety, generalized pain, dysphagia, hypotension, convulsions, gastrostomy, and hypoglycemia. Resident #4 moved all extremities spontaneously, she was unable to follow direction and was not verbally responsive. Resident #4 was unable to make her needs known. Resident #4 opened her eyes spontaneously but did not keep eye contact with verbal stimuli. A complete physical therapy evaluation was initiated by the facility on 3/4/2011, after the FORM CMS-2567(02-99) Previous Versions Obsolete Event ID: J8O811 Facility ID: NVS263S If continuation sheet Page 39 of 68
Page 1 and 2: DEPARTMENT OF HEALTH AND HUMAN SERV
Page 37: DEPARTMENT OF HEALTH AND HUMAN SERV

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

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?