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32 | It is alleged R1 has been covered “in poop” and “had pants down with a soiled diaper” due to having uncontrollable diarrhea for which staff did not provide anti diarrheal medication, and the toilet and shower were clogged due to R1 placing toilet paper or paper towels.
Interviews conducted with staff revealed R1 returned from skill nursing facility to the facility on 6/3/24. Upon R1’s returned a declined in cognitive development was observed which prevented R1 from communicating own needs. Per staff upon R1’s return, R1 showed unusual behaviors. Such as, needing to use the bathroom outside of the bathroom, seating without cleaning self after using the bathroom in the bed, combative behaviors when staff attempted to assist with hygiene care. Staff noticed R1 had loose stool on the evening of 6/7/24. Care giving supervisor notified Med-techs, who notified the kitchen staff for a diet adjustment, and monitor for diarrhea. Staff stated that when they notice any resident with diarrhea symptoms the following takes place; If the symptoms continue after 24 hours, the physician is either notified for as needed(PRN) medication to be prescribed or if the PRN medication is already prescribed it is provided to the residents. Per staff in R1’s case the diarrhea did not last longer than 24 hours. Staff stated that the toilet was in fact clogged once due to R1 throwing toilet paper or paper towels inside and flushing it. As well as paper towels found in the shower. However, staff responded to cleaning, removing items that could clog the toilet, and fixing the toilet right away. Per staff R1 was redirected, change as needed after each incident, and provided care. Interviews with residents revealed, residents are assisted as needed with medical care, have not observed fault odors around the facility, and their toilets/showers are in good repair.
Document review revealed, R1’s physician’s report dated: 1/7/24 notes resident needs assistance with incontinence care. On 6/3/24 Skill nursing facility notes R1 may be discharge back to assisted living facility. On 6/4/24 R1 had a physician’s house call due to staff concerns of R1’s behaviors. On 6/6/24 a physician order was place for anti-diarrhea medication. On 6/7/24 and 6/8/24 facility’s clinical notes, noted R1 was refusing assistance with changing and behaviors. On 6/10/24, incident report notes R1 was send to the hospital due to aggressive behaviors. June 2024 medication sheet notes R1 was provided one dose of anti-diarrhea medication on 6/7/24 and a dose on 6/8/24. Although R1 may have had diarrhea and behaviors, per interviews conducted and documents reviewed R1 was provided assistance as needed and facility staff communicated with physician regarding R1’s change in condition and medical needs. During the facility’s tour LPA did not observed any toilets or showers clogged or in disrepair.
(CONTINUED ON LIC 9099C) |