§ 483.25 Quality of care
Quality of care is a fundamental principle that applies to all treatment and care provided to facility residents. Based on the comprehensive assessment of a resident, the facility must ensure that residents receive treatment and care in accordance with professional standards of practice, the comprehensive person-centered care plan, and the residents' choices.
|
Observations:
Based on policy review, clinical record review, and resident and staff interviews, it was determined that the facility failed to ensure residents receive treatment and care in accordance with professional standards of practice for one of five residents reviewed (Resident 5).
Findings Include:
A review of the facility's policy, titled "Transportation and Escort: Patient", effective April 1, 2003, read, in part, "Centers will arrange for ambulance and other appropriate transportation services to provide transportation of patients/residents (hereinafter 'patient') for scheduled appointments as well as emergencies." The policy continued, "Center staff will provide assistance in scheduling transportation for patients who need transportation outside of the Center (doctor's appointments, etc.)."
A review of Resident 5's clinical record revealed diagnoses that included muscle weakness and ileus (also known as paralytic ileus or pseudo-obstruction, is a condition where the intestines are blocked and stop working properly. It occurs when the muscles in the intestines stop squeezing to move food and waste through the body).
A review of Resident 5's physician's orders revealed a documented telephone order dated October 11, 2024, that read "...Gastroenterology Associates 11/15/2024 @ 1400 [2:00 PM]."
A review of Resident 5's progress notes revealed a note dated November 18, 2024, written by the Certified Registered Nurse Practitioner (CRNP), that read " Of note she [Resident 5] was scheduled to ... GI [Gastrointestinal] on 11/15/2024, however, transportation was not set up and the appointment was rescheduled in December."
An interview with Resident 5 on December 2, 2024, at 11:01 AM, revealed the CRNP was able to reschedule the appointment on November 22, 2024, instead of waiting until December 2024.
An interview with the Nursing Home Administrator on December 2, 2024, at 11:35 AM, confirmed the facility missed scheduling transportation to Resident 5's appointment on November 15, 2024.
28 Pa. Code 211.12 (d) (1) (5) Nursing services
| | Plan of Correction - To be completed: 12/17/2024
The statements made on this plan of correction are not an admission to and do not constitute an agreement with the alleged deficiency (s) herein. To remain in compliance with all federal and state regulations, the facility has taken, and will take, the actions set forth in the following plan of correction. The following plan of correction constitutes the center's allegation of compliance. All alleged deficiencies cited have been, or will be corrected by the date or dates indicated. The facility is committed to taking all actions necessary to remain in substantial compliance with state and federal regulations. The plan of correction addresses our intention to promote care for our residents which enhances their dignity and is designed to meet their interests and promote the highest practicable level of physical, mental, and psychosocial well-being.
Resident 5 appointment was rescheduled and resident was transported
Residents with scheduled transport in the last week will be audited to ensure they were transported to their appointments.
Director of nursing / Designee will educate licensed staff on Ftag 0684 quality of care, focusing on arranging transports to appointments.
Audits of 5 random residents with scheduled appointments will be completed by unit managers /designee per week for 4 weeks to ensure transports are arranged. Results of the audits will be reviewed by the QAPI committee for recommendations.
|
|
