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“I CAN ONLY DESCRIBE AS SIGNIFICANT NEGLECT…THERE WAS STOOL PACKED IN HIS WOUNDS” ER REPORTS STATES...

KINDRED TRANSITIONAL CARE & REHAB – PARK PLACE LOCATED: 1500 32ND ST S, GREAT FALLS, MT 59405 KINDRED TRANSITIONAL CARE & REHAB – PARK PLACE was cited by the DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES for the following deficiencies: PLEASE NOTE: The following highlighted quoted text is only a portion of the full report/survey submitted by DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES. The full report/survey can be found here. FACILITY FAILED TO GIVE RESIDENTS PROPER TREATMENT TO PREVENT NEW BED (PRESSURE) SORES OR HEAL EXISTING BED SORES. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview and record review, the facility failed to prevent the development of 3 Stage II pressure ulcers, the worsening of pressure ulcers, the development of 2 Unstageable pressures ulcers, and a wound infection for 1 (#13) of 17 sampled residents. The facility failed to prevent the development of an Unstageable pressure ulcer for 1 (#6) of 17 residents. Review of resident #13’s ER admission note, dated 12/18/16 at 1:43 a.m., showed (physical exam in the ED has revealed what I can only describe as significant neglect resulting in serious ulceration, possible perirectal fistula and even ulceration and swelling of the posterior scrotum. There was stool packed into his wounds. His urinalysis shows significant infections. Skin break down was noted on both heels, pressure sore with damage down to the fascia on the scrotum and pressure sore on coccyx with damage down to the muscle. Review of the resident’s hospital notes, dated 12/25/16, showed the resident had septic shock secondary to urinary tract infection present on admission; stage IV decubitus ulcer, which was noted to have stool inside the wound at admission. A culture, dated 12/19/16, showed drainage from the penis had E. coli, and Proteus Mirabilis. The two urine cultures were contaminated with the same 2 organisms. The left ischial necrotic tissue had the same two organisms, plus Pseudomonas aeruginosa. The bone culture also had [MEDICAL CONDITION][MEDICATION NAME]. Resident #13 had surgery for [REDACTED]. He was placed on Hospice 12/28/16. The resident passed away on 12/29/16. Review of resident #13’s Progress Note, dated 6/22/16, showed his penis was swollen and macerated. Review of resident #13’s Progress Note, dated 6/22/16, showed he had a small amount of thick green drainage from the open area on the penis. Will request orders for antibiotic ointment. Personal Note from NHAA – Advocates: NHAA shares with all the families of loved ones who are confined to nursing homes the pain and anguish of putting...

WOUND CARE NURSE STATES,” IT IS NOT IDEAL FOR PRESSURE ULCERS TO BE DISCOVERED AT STAGE 3”...

KINDRED NURSING AND REHABILITATION-RIVER POINTE LOCATED: 4142 BONNEY ROAD, VIRGINIA BEACH, VA 23452 KINDRED NURSING AND REHABILITATION-RIVER POINTE was cited by the DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES for the following deficiencies: PLEASE NOTE: The following highlighted quoted text is only a portion of the full report/survey submitted by DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES. The full report/survey can be found here. FACILITY FAILED TO GIVE RESIDENTS PROPER TREATMENT TO PREVENT NEW BED (PRESSURE) SORES OR HEAL EXISTING BED SORES. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations, clinical record review, staff interviews and review of the facility’s policy, the facility staff failed to provide the necessary treatment, care and services, consistent with professional standards of practice, to prevent a new avoidable pressure ulcer (any lesion caused by unrelieved pressure that results in damage to the underlying tissue) from developing for 1 of 26 residents (Resident 6), in the survey sample. The facility’s staff did not identify Resident #6 had developed a sacral (the part of the spinal column which sits between the two hipbones) pressure ulcer until it had advanced to a stage three (3)* resulting in harm. Resident #6 was originally admitted to the facility 07/13/16 and has never been discharged. During the 2/9/17 interview at approximately 1:50 p.m., with the wound care nurse, the Pressure Ulcer Investigation was reviewed. The Pressure Ulcer Investigation revealed Resident #6 was identified with a stage 3 pressure ulcer acquired in house on 1/17/17. The wound care nurse stated the investigation revealed the resident had the following risk factors; impaired transfer and bed mobility, chronic urinary incontinence, chronic bowel incontinence, diabetes, immobility, and inadequate nutrition/hydration therefore; the pressure ulcer was unavoidable. The wound care nurse stated it is not ideal for pressure ulcers to be discovered at a stage 3, early on when there is only redness is optimal. The wound care nurse also stated the Certified Nurse Assistants (CNA)s are the first line of defense for early detection as they provide routine bathing and incontinent care. Personal Note from NHAA – Advocates: NHAA shares with all the families of loved ones who are confined to nursing homes the pain and anguish of putting them in the care of someone else. We expect our loved ones to be treated with dignity and honor in the homes we place them. We cannot emphasize enough to family members of nursing home residents; frequent visits are essential to our loved ones’ well-being and safety. This nursing home and many...

Florence, Alabama – Mitchell-Hollingsworth Nursing and Rehabilitation Center...

Reeves (Lauderdale County Detention Center photo) Updated Nov 8, 8:00 PM; Posted Nov 8, 7:56 PM By Ashley Remkus ;aremkus@al.com A 21-year-old certified nursing assistant is accused of sexually assaulting an elderly person at a Florence nursing home, police said. Zachariah Lee Reeves was arrested today on charges of first-degree sodomy and second-degree elder abuse, Florence police said in a news release. Reeves is held in the Lauderdale County Detention Center with bail set at $60,000. Reeves, a CNA at Mitchell-Hollingsworth Nursing and Rehabilitation Center, was working when the victim was assaulted this past Thursday, said Sgt. Greg Cobb. The Center is at 805 Flagg Circle. Further details about the case haven’t been made public. Police weren’t immediately available to provide further details. If convicted, Reeves faces up to life in prison and would be required to register as a sex offender. If you have concerns about the care your loved one received at this facility or another, we can help you and your loved one. CONTACT US AT 1-800-645-5262...

Resident states, “I have gone about 1 ½ weeks without a shower because there is no shower aide.”...

LYNNWOOD POST ACUTE REHABILITATION CENTER LOCATED: 5821 188TH SOUTHWEST, LYNNWOOD, WA 98037 LYNNWOOD POST ACUTE REHABILITATION CENTER was cited by the DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES for the following deficiencies: PLEASE NOTE: The following highlighted quoted text is only a portion of the full report/survey submitted by DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES. The full report/survey can be found here. FACILITY FAILED TO HAVE ENOUGH NURSES TO CARE FOR EVERY RESIDENT IN A WAY THAT MAXIMIZES THE RESIDENT’S WELL BEING. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview and record review the facility failed to provide sufficient qualified staffing to treat residents with respect and dignity, receive services to improve/maintain Daily Living, answer call lights in a timely manner, prevent urinary incontinence, and provide medications timely for 14 of 25 sampled residents (3, 4, 18, 27, 29, 35, 45, 67, 75, 80, 92, 109, 111 and 138) and 3 of 3 (52, 61 and 74) sampled family members. This failure potentially put residents at risk of feelings of frustration and humiliation, diminished quality of life and unmet care needs of the residents and caused actual harm to residents. Additionally 11 of 18 sampled residents (4, 27, 29, 35, 36, 47, 52, 61, 67, 74 and 78) reviewed for bathing, were not bathed timely and regularly. Findings include: Upon entrance to the facility it was discovered that the Director of Nursing, who had been there for aproximately 9 months, left her position on 07/16/16. An Interim DNS had been appointed on 07/20/16 but was replaced by another Interim DNS on 08/30/16. There was no information supplied as to when a permanent DNS would be appointed. Residents, family members and facility staff were asked the following question: Do you feel there is enough staff available to make sure you get the care and assistance you need without having to wait a long time? RESIDENT INTERVIEWS Resident 3 stated on 08/26/16 at 11:23 AM, They need more staff, particularly more shower aides. It seems like they are short staffed. I don’t think it is that they don’t want to help me, they are just too busy. They need to hire more people. Resident 4 stated on 08/25/16 at 10:51 AM, Everyone keeps saying they are short staffed. They tell everybody that. I wait over an hour, sometimes 2 hours or they don’t come period. They help others that need more help than me. It makes me feel stressed out. Resident 18 stated on...

KINDRED TRANSITIONAL CARE – CNA FORCEFULLY THROWS RESIDENT AND STATES, “WHAT THE [***] IS THE MATTER WITH YOU?”...

KINDRED TRANSITIONAL CARE & REHABILITATION-FORESTVIEW LOCATED: 50 INDIAN NECK ROAD, WAREHAM, MA 02571 KINDRED TRANSITIONAL CARE & REHABILITATION-FORESTVIEW was cited by the DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES for the following deficiencies: PLEASE NOTE: The following highlighted quoted text is only a portion of the full report/survey submitted by DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES. The full report/survey can be found here. FACILITY FAILED TO PROTECT EACH RESIDENT FROM ALL ABUSE, PHYSICAL PUNISHMENT, AND BEING SEPARATED FROM OTHERS. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interviews and records reviewed, for one of three sampled residents (Resident #2) the Facility failed to prevent Resident #2 from being abused on 4/11/17 when Certified Nurse Aide #1, who stood five feet ten inches tall lifted Resident #2 up to his full height and forcefully threw Resident #2 down onto his/her bed and stated what the [***] is the matter with you. The Police Report indicated Resident #2 fell about two feet from CNA #1’s arms to the bed. Although the Surveyor could not interview Resident #2 due to Resident #2’s cognitive impairments, an unimpaired individual would experience pain and mental anguish when being dropped from a height by a caregiver. Findings include: Resident #1’s Minimum Data Set Assessment Form, dated 3/29/1, indicated that his/her cognitive patterns were severely impaired and he/she was dependent on the physical assistance of two staff members with bed mobility and transfers between surfaces. CNA #2’s written statement, dated 4/11/17, indicated that around 8:15 P.M. he walked passed Resident #2’s room and observed CNA #1 pick Resident #2 up from the floor. CNA #2’s written statement indicated that CNA #1 told Resident #2 words to the effect of what the [***] is the matter with you. CNA #2’s written statement indicated that CNA #1 stood, brought Resident #2 to his full height and tossed Resident #2 forcefully into the bed. CNA #2’s written statement indicated that Resident #2 began to scream. The Surveyor interviewed Nurse #1 at 11:00 A.M. on 4/27/17. Nurse #1 said that on 4/11/17, CNA #2 called her and told her that he had seen CNA #1 put Resident #2 into the bed roughly and spoke to him/her using profanity. Nurse #1 said that she suspended CNA #1 pending the Facility investigation and notified the Director of Nurses of the allegation. The Surveyor interviewed the Director of Nurses at 12:50 P.M. on 4/27/17. The Director of Nurses said that on 4/11/17 Nurse #1 told her that CNA #2...

KINDRED TRANSITIONAL CARE – THE DON INDICATED THEY DID NOT KNOW RESIDENT HAD FOLEY CATHETER...

KINDRED TRANSITIONAL CARE AND REHAB-COLUMBUS LOCATED: 2100 MIDWAY STREET, COLUMBUS, IN 47201 KINDRED TRANSITIONAL CARE AND REHAB-COLUMBUS was cited by the DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES for the following deficiencies: PLEASE NOTE: The following highlighted quoted text is only a portion of the full report/survey submitted by DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES. The full report/survey can be found here. FACILITY FAILED TO MAKE SURE THAT EACH RESIDENT WHO ENTERS THE NURSING HOME WITHOUT A CATHETER IS NOT GIVEN A CATHETER, AND RECEIVE PROPER SERVICES TO PREVENT URINARY TRACT INFECTIONS AND RESTORE NORMAL BLADDER FUNCTION **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, the facility failed to identify a Foley catheter for a resident (Resident D) upon readmission to the facility; failed to document urinary output; and failed to monitor for signs of occlusion which resulted in an occluded catheter for 1 of 1 resident reviewed for indwelling catheters. Findings include: The clinical record for Resident D was reviewed on 2/9/17 at 2:45 p.m. [DIAGNOSES REDACTED]. The re-admission assessment, dated 1/11/17, indicated Resident D did not have an indwelling Foley catheter. The nurses’ note, dated 2/3/17 at 7:38 p.m., indicated at approximately 1:30 p.m. the resident was observed to be breathing rapidly with a pulse of 112 and respirations of 28. The NP (Nurse Practitioner) examined the resident and gave an order to send to the emergency room for evaluation. The hospital history and physical, dated 2/3/17 at 2:06 p.m., included, but was not limited to, the following: was sent to the ER (emergency room ) today suspecting [MEDICAL CONDITION] given that the patient was shaking his extremities. However, his pupils were not changing, his eyes were not rolling back, he was not hypertonic .Upon arrival to the ER he was [MEDICAL CONDITION] (elevated heart rate) and with these shaking spells of and on. He was noted to have a Foley catheter in but with scant output. Decision in the ER in changing the catheter was made and immediate 1500 ml (milliliters) of cloudy, thick sedimented urine was obtained. After that the patient stopped having those episodes and his HR (heart rate) started to come down . During an interview on 2/10/17 at 11:38 a.m., the DON (Director of Nursing) indicated they did not know Resident D had a Foley catheter because when he was readmitted to the facility, on 1/11/17, the admitting nurse did not document it on the admission, therefore nothing related to the Foley catheter...