BLUEGRASS CARE & REHABILITATION CENTER
LOCATED: 3576 PIMLICO PARKWAY, LEXINGTON, KY 40517
BLUEGRASS CARE & 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 SUFFICIENT STAFFING TO ENSURE RESIDENTS’ CARE NEEDS WERE MET
Level of harm – Immediate Jeopardy
A second Immediate Jeopardy was identified on 07/25/14 in the areas of 42 CFR 483.13 Resident Behavior and Facility Practice (F-224, F-225 and F-226), 42 CFR 483.30 Nursing Services (F-353), and 42 CFR 483.75 Administration (F-490) all at a Scope and Severity (S/S) of a K. Based on interviews, record reviews and review of the facility’s Daily Staffing Sheets and time clock punches, during the 08/01/14 survey, it was determined the facility failed to have sufficient staffing to ensure residents’ care needs were met for residents residing on the facility’s two (2) units as evidenced by residents’ complaints and concerns of their call lights not being answered timely, and their request for assistance not being provided for seven (7) of thirty-seven (37) sampled residents (Residents #8, #16, #17, #26, #32, #33 and #36), and staff’s reports of being short staffed on the night shift.
Continuing: Review of the facility’s Roster Sample Matrix, provided by the facility on 06/30/14, revealed the South Unit had forty (40) residents assessed to be incontinent of bladder and/or bowel, and thirty-eight (38) residents assessed to be incontinent of bladder and/or bowel on the facility’s North Unit. Interview, on 07/03/14 at 4:45 PM and on 07/23/14 at 9:08 AM, with SRNA #19 revealed she worked the night shift on the South Unit and at times had been the only SRNA assigned to care for residents on the whole unit. She reported at least one (1) night a week she had to work as the only SRNA on the whole unit. SRNA #19 revealed when she worked as the only SRNA on the unit she could only complete two (2) rounds all night, instead of the every two (2) hour rounds that were required. She stated she could not complete the last round on residents who required two (2) person assist as the nurses couldn’t help her if she was the only SRNA on the unit. She stated there had been a few times when there was only one (1) nurse and one (1) SRNA working on the unit.
Continuing: Per interview, SRNA #19 stated she had heard there were only two (2) SRNAs in the whole building a few nights before. SRNA #19 stated Administration know we need more help; however, she indicated nothing had been done. SRNA #19 revealed she had not been able to perform incontinence care on Resident #26 and Resident #29 during her last rounds on 07/03/14, as those two (2) residents were two (2) person assist.
Continuing: According to SRNA #22, when the unit was staffed like that, all she could do was try to get all the residents changed, and if residents rang their call lights they would have to wait, if she was in another resident’s room and the nurse was busy. Continued interview with SRNA #22 revealed during the times when she was the only SRNA working the unit residents would want to get up out of bed in the morning and she would have to tell them she couldn’t get them up. She stated one (1) SRNA could not take care of fifty (50) to sixty (60) residents by themselves; and could only complete about two (2) rounds the whole night, instead of the every two (2) hour rounds. She stated when she worked as the only SRNA on the unit sometimes residents would have to lay wet and soiled, and she couldn’t turn residents every two (2) hours like she was supposed to. SRNA #22 reported it wasn’t fair to the poor residents to be cared for like that, and she would not want her grandparents treated like that. The SRNA stated she knew SRNA #19 had worked by herself on the South Unit before. Per interview, SRNA #22 stated there had been one (1) time there was only one (1) nurse, one Certified Medication Aide (CMA)/SRNA and herself working the whole unit, and indicated she thought it was 06/06/14. Review of the Daily Staffing Sheets and Time Clock Punches for 06/06/14, on the 11:00 PM to 7:00 AM shift, revealed seven (7) staff present in the entire facility, one (1) SRNA worked the 3:00 PM to 11:00 PM and stayed over until 3:00 AM. Further review of the Staffing Sheets and Time Clock Punches revealed after 3:00 AM, only six (6) staff were present in the facility, four (4) nurses and two (2) SRNAs, (two (2) nurses and an SRNA on each unit).
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 others across the country are cited for abuse and neglect.
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