Department of Health & Human Services

Centers for Medicare & Medicaid Services
Form Approved

OMB No. 0938-0391
Statement of Deficiencies (X1) Provider/Supplier/CLIA Identification Number 713026 (X3) Date Survey Completed 04/09/2026
Name of Provider or Supplier Bogalusa Rehabilitation Hospital Street Address, City, State 621 Columbia Street, Bogalusa, LA
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)
A0395 RN SUPERVISION OF NURSING CARE
CFR(s): 482.23(b)(3)

A registered nurse must supervise and evaluate the nursing care for each patient.


This STANDARD is not met as evidenced by:
Based on record review and interview, the hospital failed to ensure a registered nurse evaluated the nursing care for each patient. This deficient practice was evidenced by: 1) Failure to perform dressing change on a peripherally inserted central catheter (PICC) per policy in 1 (#10) of 30 medical records reviewed; 2) Failure to perform daily weight per provider order in 3 (#12, #15, #23) of 30 medical records reviewed; and 3) Failure to administer medication as prescribed in 1 (#22) of 30 medical records reviewed; Findings: 1) Failure to perform dressing change on a peripherally inserted central catheter (PICC) per policy in 1 of 30 medical records reviewed A review of the hospital document titled, "Bogalusa Rehabilitation Hospital PICC Line," Policy 05-17-02, adopted 03/2021, and date unavailable for last reviewed/revised, revealed in part: "PROCEDURE Dressings will be changed within 24 hours of insertion and every 7 days hours or as needed." A review of Patient #10's medical record revealed an admission date of 03/03/2026 and a discharge date of 03/15/2026. A review of document titled, "Nursing Shift Assessment," dated 03/15/2026 with a start time of 7:00 a.m. and end time of 7:00 p.m. revealed a nursing note at 10:25 a.m. by S28LPN as follows, "1025-Changed Tegaderm dressing d/t dressing last changed on 3/3 & was coming off." In an interview on 04/08/2026 at 10:35 a.m., S28LPN confirmed above-mentioned information and confirmed the dressing had not been changed since 03/03 as was indicated on the Tegaderm dressing. 2) Failure to perform daily weight per provider order in 3 (#12, #15, #23) of 30 medical records reviewed A review of medical records revealed: --Patient #12's medical record revealed an admission date of 02/26/2026 and a discharge date of 03/13/2026. A review of the document titled, "Physician Admission Orders" dated 02/26/2026 revealed an order for "Daily" weights. A review of the patient's Medication Administration Record (MAR) revealed a row labeled "DAILY WEIGHTS EVERY NIGHT" and a performance time indicated as 5:00 a.m. on each day. The MAR failed to reveal the documentation of a weight on 02/27/2026 to 03/06/2026, 03/10/2026, 03/11/2026 and 03/13/2026; --Patient #15's medical record revealed an admission date of 02/04/2026 and a discharge date of 02/13/2026. A review of the document titled, "Physician Admission Orders" dated 02/04/2026 revealed an order for "Daily" weights. A review of the patient's Medication Administration Record (MAR) revealed a row labeled "DAILY WEIGHTS EVERY NIGHT" and a performance time indicated as 5:00 a.m. on each day. The MAR failed to reveal the documentation of a weight on 02/05/2026 to 02/13/2026; and --Patient #23's medical record revealed an admission date of 11/07/2025 and a discharge date of 11/17/2025. A review of the document titled, "Physician Admission Orders" dated 11/07/2025 revealed an order for "Daily" weights. A review of the patient's Medication Administration Record (MAR) revealed a row labeled "DAILY WEIGHTS EVERY NIGHT" and a performance time indicated as 5:00 a.m. on each day. The MAR failed to reveal the documentation of a weight on 11/08/2025 to 11/11/2025 and 11/13/2025 to 11/17/2025. In an interview on 04/09/2026 at 11:00 a.m., S25Consult confirmed above-mentioned findings and the daily weight would be documented on the MAR section of the medical record. 3) Failure to administer medication as prescribed in 1 (#22) of 30 medical records reviewed A review of Patient #22's medical record revealed a provider order dated 11/22/2025 at 9:30 a.m. for, "Vitamin D 50,000 units po weekly on Sundays." A review of the patient's Medication Administration Record (MAR) revealed a row labeled with handwritten print as follows: "Vitamin D 50,000 units PO Q weekly (Sundays) 11-22-25." This row also had a handwritten box surrounding the day indicated as 11/23/2025. However, the MAR failed to reveal the administration of this prescribed medication on 11/22/2025 or 11/23/2025. In an interview on 04/09/2026 at 11:00 a.m. S25Consult confirmed the above-mentioned findings.