| Statement of Deficiencies | (X1) Provider/Supplier/CLIA Identification Number 531311 | (X3) Date Survey Completed 11/17/2011 |
| Name of Provider or Supplier Crook County Hospital | Street Address, City, State 713 Oak Street, Sundance, WY | |
| For information on the provider's plan to correct this deficiency, please contact the provider or the state survey agency. | ||
| (X4) ID Prefix Tag | Summary Statement of Deficiencies
(Each deficiency should be preceded by full regulatory or LSC identifying information) |
| C0395 | COMPREHENSIVE CARE PLANS CFR(s): 485.645(d)(6) [The CAH is substantially in compliance with the following SNF requirements contained in subpart B of part 483 of this chapter: Comprehensive assessment, comprehensive care plan, and discharge planning (§483.20(b), (k), and (l), except that the CAH is not required to use the resident assessment instrument (RAI) specified by the State that is required under §483.20(b), or to comply with the requirements for frequency, scope, and number of assessments prescribed in §413.343(b)).] Comprehensive care plans (§483.20(k)(1)) "The facility must develop a comprehensive care plan for each resident that includes measurable objectives and timetables to meet a resident's medical, nursing, and mental and psychosocial needs that are identified in the comprehensive assessment. The care plan must describe the following- (i) The services that are to be furnished to attain or maintain the resident's highest practicable physical, mental, and psychosocial well-being as required under §483.25; and (ii) Any services that would otherwise be required under §483.25 but are not provided due to the resident's exercise of rights under §483.10, including the right to refuse treatment under §483.10(b)(4)." This STANDARD is not met as evidenced by: Based on medical record review and staff interview, the facility failed to develop and revise care plans for 1 of 3 swing bed patients (#22) who required comprehensive care plans. The findings were: Medical record review showed patient #22 was admitted to swing bed status on 10/21/11 for rehabilitative services after surgery for a fractured hip and discharged on 11/9/11. Review of the admission assessment showed the patient required assistance with activities of daily living, had a dressing covering an incision on the right hip, had a bruised left heel, and was at risk for falls. Review of the care plan identified the following concerns: a. Although a self care deficit was identified, the interventions did not specify what how much assistance was required nor what assistive devices were needed. b. There were no interventions developed to minimize falls. c. The patient's bruised heel was identified on admission, but "skin-prep" was not initiated until 10/27/11. The care plan was undated so it was unknown when the other interventions related to pressure ulcer prevention were initiated. d. Per the care plan, "skin-prep" was to be applied to the patient's heels daily. The plan had not been revised to reflect the application three times a day. On 11/16/11 at 3 PM the CNO stated staff were to perform a complete assessment on every swing bed patient weekly and as needed and that care plans were to be updated with every assessment. 27095 |