Maplewood Nursing And Rehab Center

Based on observations, it was determined that the facility did not ensure an environment which enhanced the dignity of residents was provided for two of 27 residents interviewed. At approximately 11:00a.m. on January 2, 2014, Employee E9, housekeeping aid was observed having a conversation on a cell phone for several minutes while in Resident R148’s room. Employee E9 had her back turned to the resident during this conversation. At 12:00p.m. on January 6, 2014, Employee E8, nursing assistant was overheard and observed having a phone conversation while in Resident’s R127’s room. The resident was in the room while the conversation was taking place.

According to observations, interviews with staff and clinical record review, it was determined that care plans were not implemented as planned for two of the 27 records interviewed. Those findings included the following: A review of the comprehensive assessment dated November 7, 2014, for Resident R138 indicated that the resident had a diagnosis. Nursing progress notes dated November 29, 2013 indicated that Resident R138 had developed a deep tissue injury on the right heel. The wound care specialist examined the resident’s skin on December 3, 2013, and indicated that the resident required adaptive resident care equipment (posey heel slippers). Review of Resident R138’s care plan dated November 21, 2013, revealed that the posey heel slippers were to promote wound healing, provided pressure relief for the right heel and assist with foot safety.

Observation of Resident R138 on January 2 and 6, 2014, revealed that the posey heel slipper did not have the posey heel slippers for use, as care planned. The lack of implementation of the current was confirmed by Employee E4, unit manager at 10:30 a.m. on January 6, 2014. Review of the comprehensive assessment dated November 13, 2013, for Resident R77 had stage III of the sacrum and a stage II of the ischium. Dietary care planning for November 15, 2013 indicated that a protein supplement was planned to meet Resident R77’s nutritional needs to promote wound healing.

Based on clinical review, staff interviews and reviews nursing home policy and procedure, it was determined that the facility failed to administer pain medication as procedure, it was determined that the facility failed to administer pain medication as ordered by the physician for one of the 27 residents reviewed. The findings included the following: Review of Resident r 59’s physician’s orders. Review of Resident R 59’s MAR (medical administration record) for November and December 2013, revealed that the medication was not administered as ordered by the physician on November 29, 2013 at 9:00 p.m., November 30, 2013 at 9:00a.m. and 9:00p.m. December 1, 2013 at 9:00a.m. and December 2, 2013, at 9:00a.m. and 9:00p.m. for a total of six doses missed. In an interview with Employee E3, a licensed nurse on January 6, 2014, at 10:55a.m., confirmed that the medication had not been administered as ordered.