CLAREMORE, OK – EMERALD CARE CENTER CLAREMORE

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY**

Based on observation, interview, and record review, it was determined the facility failed to assess, monitor, and intervene in a timely manner for a resident with constipation for one (#5) of eight sampled residents whose records were reviewed. The resident required removal of impacted stool at the hospital.

A progress note, dated 09/03/18 at 1:40 p.m., documented, resident having episodes of trying to dig bowl (sic) out of rectum resident covered in bm x3 today, having increased confusion. Resident having x1 episode of vomiting .Resident also requesting to go to hospital x2 after resident vomited he got choked alittle (sic) this nurse was called to room and resident was breathing normal but had decreased loc. contacted (name deleeted) from hospice and family – family requested resident be sent to (hospital) for eval and tx with ct of stomach to eliminate obstruction. Resident does have sluggish bowl (sic) sounds vs 98/62 pulse 100 – notified don.

An emergency room note, dated 09/03/18 at 4:40 p.m., documented .dug out a huge amount of hard feces from patient’s rectum.

The next progress note, dated 09/04/18 at 2:00 p.m., documented, Aprox (approximately) 0945 (9:45 a.m.) said resident not responding to stimuli, resp shallow and vs 94/80, 70 o2 (oxygen) unable to obtain, pupils sluggish. notified hospice nurse (name deleted) on her way to facility .1400 (2:00 p.m.) resident had 0 resp (respirations) 0 pulse 0 b/p (blood pressure) .

The resident’s death certificate documented the immediate cause of death [MEDICAL CONDITION] with Parabacteroides Species. Significant condition contributing to his death included + Fecal Impaction.