LAKE PARK NURSING AND REHABILITATION CENTER
LOCATED 3315 FAITH CHURCH ROAD, INDIAN TRAIL, NC 28079
LAKE PARK NURSING AND 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 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.
LEVEL OF HARM –ACTUAL HARM
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY**
Based on record review and Physician and staff interviews the facility failed to change an indwelling urinary Foley catheter per physician order [REDACTED].
The findings included:
Resident #112 was admitted to the facility on [DATE] with [DIAGNOSES REDACTED].
Review of the quarterly Minimum (MDS) data set [DATE] revealed Resident #112 was moderately cognitively impaired and had an indwelling urinary catheter.
Review of the care plan dated 01/28/16 revealed Resident #112 had an altered pattern of urinary elimination with an indwelling Foley catheter and was at risk for infection. The goal was for Resident #112 to be free from urinary tract infection through the next review. Interventions included catheter care per facility protocol and change Foley catheter per physician orders [REDACTED].
Review of physician order’s dated 11/08/15 revealed Resident #112’s indwelling urinary Foley catheter was to be changed every 30 days.
Review of the treatment records (TAR) for Resident #112 revealed the following:
-11/01/15 through 11/30/15 – change the Foley catheter every 30 days. Documented on TAR as changed on 11/08/15.
-12/01/15 through 12/31/15 – no order to change the Foley catheter every 30 days on TAR.
-01/01/16 through 01/31/16 – no order to change the Foley catheter every 30 days on TAR.
-02/01/16 through 02/25/16 – no order to change the Foley catheter every 30 days on TAR.
Review of the nurse’s notes from 10/23/15 through 02/25/16 revealed no note that Resident #112’s urinary Foley catheter had been changed. Review of the nurse’s note dated 01/14/16 at 6:25 AM revealed Nurse #5 deflated the balloon of Resident #112’s urinary Foley catheter and retracted the Foley catheter out some due to bleeding around the external urethra. Review of nurse’s note dated 01/15/16 at 11:36 PM revealed Resident #112 had an episode of vomiting and an anti-nausea medication was administered. Vital signs were as follows: blood pressure – 140/78, pulse – 54, respirations – 18, temperature – 103 axillary. Nurse’s note dated 01/16/16 at 12:20 AM revealed Resident #112 was sent to the emergency room via emergency management system.
Review of the hospital discharge summary revealed Resident #112 was admitted to the hospital for [MEDICAL CONDITION] most likely due to catheter associated urinary tract infection from his indwelling Foley catheter. Resident #112 was managed in the intensive care unit [MEDICAL CONDITION] being gradually resolved at discharge back to the facility on [DATE].
Personal Note from NHA – 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 others across the country are cited for abuse and neglect.
You can make a difference. If you have a loved one living in this nursing home or any other nursing home where you suspect any form of abuse or neglect, contact us immediately.
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