MAGNOLIA LANE NURSING AND REHABILITATION CENTER
LOCATED: 107 MAGNOLIA DRIVE, MORGANTON, NC 28655
MAGNOLIA LANE 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 GIVE RESIDENTS PROPER TREATMENT TO PREVENT NEW BED (PRESSURE) SORES OR HEAL EXISTING BED SORES
LEVEL OF HARM –ACTUAL HARM
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY**
Based on observations, record reviews and physician and staff interviews the facility failed to assess skin integrity,
prevent re occurrence of a stage 4 pressure ulcer that developed in the facility and failed to provide wound treatments as ordered from a wound clinic physician for 1 of 3 residents sampled for pressure ulcers. (Resident #53).
During an interview on 09/10/15 at 10:38 AM Nurse #1 explained she was assigned to care for Resident #53 last week and she stated she remembered his bottom was red but did not remember anything else about his skin. She stated she might have put a dressing on his bottom since it was red but could not remember exactly what she did. She further stated she was not aware of treatment orders from the wound clinic on 09/02/15 and had not received reports from other nurses that Resident #53 had a new pressure ulcer or had new treatment orders from the wound clinic on 09/02/15.
During an interview on 09/10/15 at 10:38 AM with NA #3 he stated he tried to do the best he could can for Resident #53 but it was a challenge to keep him off his back. He explained sometimes he was the only NA on the hall and he had difficulty making his routine rounds to reposition Resident #53.
During an interview on 09/10/15 at 12:25 PM with the Physician’s Assistant she stated it was her expectation for nursing staff to assess resident’s skin and let her or the physician know if there were problems or issues. She explained nursing staff could call anytime 24 hours a day or they could leave a note in the physician’s communication book and they would see residents when they made rounds. She further stated if a wound was worse or looked infected they should let her or the physician know about it. She explained she felt wound treatments were not always provided consistently and she was not always informed about wounds that needed treatment. She stated staff in the facility were their eyes and ears and staff had to tell her or the physician when something needed to be addressed. She explained she had made rounds in the facility on 09/07/15 but she did not see Resident #53 because she was not aware he had a wound on his sacrum. She further stated she expected staff to turn and reposition Resident #53 even if he did not want to turn to keep him off his bottom to prevent skin breakdown.
During a telephone interview on 09/11/15 at 9:11 AM with the wound care physician he confirmed he had seen Resident #53 earlier that morning and he had a big wound on his sacrum that had to debrided (surgical removal) of necrotic (dead) tissue. He stated he was very surprised to see the condition of the wound since Resident #53 had a healing wound when he was seen in the wound clinic in August. He further stated he could not remember specifics about the wound because he did not have the resident’s chart in front of him but the nurse would provide the information. He explained he had ordered wet to dry dressings on Resident #53’s wound since he had removed dead tissue from it that morning and it was his expectation for dressings to be changed as ordered, turn and reposition Resident #53 and provide an air mattress to relieve pressure. He further stated pressure should be avoided to promote wound healing.
During an interview on 09/11/15 at 5:40 PM the DON stated it was her expectation for the transporter to bring orders from the wound clinic to the nurse when a resident returned to the facility. She further stated the nurse assigned to the resident needed to review the orders and the treatment nurse needed to review the orders and follow through with the treatment orders. She stated they needed to improve the communication system and if the nurse was not available when the transporter brought the resident back to the facility or the treatment nurse was not available the documents should be given to the DON. She confirmed there was no system for weekly skin checks but they needed a better system for skin assessments and skin referrals. She stated it was her expectation for treatments to be done daily or as ordered by the physician and if there was no treatment nurse on duty the nurse assigned to the resident should do the treatments. She further stated if there were no staff initials on the treatment records she interpreted it as the treatment was not provided
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.
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