Crown Point Health Campus
CROWN POINT HEALTH CAMPUS in CROWN POINT, IN — inspection on August 14, 2024.
Found 2 citations. Severity: Standard violations.
Health inspections identify deficiencies that facilities must correct within required timeframes. Violations range from minor documentation issues to serious safety concerns and are subject to follow-up verification.
Inspection Findings
During an interview on 8/14/24 at 9:47 a.m., LPN 4 indicated there was no order for the amount of water with which to flush the feeding tube or to mix the medications.
The policy stated the flush was to be 30 cc's of water and the g-tube should have been flushed with 30 cc's of water after each medication.
She indicated she had to push the medications in to the stomach because they would not flow in by gravity. If she attempted to administer the medications by gravity, they would not go in and the feeding would flow out of the stomach.
The medications were always pushed into the stomach through the feeding tube.
A Professional Resource, titled, Medication Aide Training Curriculum, dated 1/2/24, indicated if more than one medication was being administered, they were to be given separately with a minimum of 10 cc's of warm water or according to facility policy or provider's order before and after each medication.
Tube placement was to be verified prior to medication administration.
Medications and fluids were not to be forced into the tube.
The medications were to be administered by gravity and if necessary, gentle pressure could be applied.
The delivery of the medication was to be slow and steady.
The fluid was not to be administered too quickly.
The g-tube was to be flushed after checking for placement.
A facility policy, dated 9/1/2023 and received from the Administrator as current, indicated the medication was to be dissolved in 5-10 cc's of warm water or the prescribed amount.
The g-tube was to be verified for placement.
The g-tube was to be flushed with 15-30 cc's of water, the preferred amount of flush was 30 cc's, using gravity flow.
The medications were to be given and allowed to flow in by gravity and were to be flushed with 15 cc's of water between medications.
45666
2. On 8/14/24 at 9:07 a.m., Resident J was observed lying in his bed with the head of bed elevated. He had a feeding tube connected to a feeding tube bag containing formula.
The pump was set to 90 milliliters per hour.
The feeding tube bag had no label observed and the formula inside was unidentified.
The enteral feeding syringe was placed in a plastic bag hanging on the tube feeding pole and was dated 8/12/24.
155637
Form Approved OMB
STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A.
Building 155637 B.
Wing 08/14/2024
NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE
Crown Point Health Campus 6685 East 117th Avenue Crown Point, IN 46307
During an interview on 8/13/24 at 2:00 p.m., LPN 3 indicated she was going to notify the physician and get an order to transfer the resident to the hospital for the tubing removal.
During an interview on 8/13/24 at 2:11 p.m., the ADON and the Unit Manager/Infection Control Nurse indicated they had not been notified that the nurse could not remove the feeding line from the g-tube so the medications and flushes could be administered.
During an interview on 8/13/24 at 2:53 p.m., LPN 3 indicated she had just paged the physician and was awaiting a return call.
She indicated the Wound Nurse, the ADON, and the Unit Manager/Infection Control Nurse also tried to get the feeding line and g-tube separated, and they were unable to do so.
The ADON again indicated she had not been notified about the feeding line and g-tube malfunction.
The Medication Administration Record (MAR), dated 8/2024, indicated the flush was scheduled for 2:00 a.m., 8:00 p.m., 2:00 p.m., and 8:00 p.m.
The 325 cc's of water was not administered at 8 a.m. or at 2 p.m.
The morning medications, scheduled for 8:00 a.m. and 9:00 a.m., were marked not given on the MAR on 8/13/24.
The Progress Note, written by LPN 3, dated 8/13/24 at 10:52 p.m., indicated the resident's morning medications and water flush were not administered because she was unable to unhook the feeding line from the g-tube.
The Wound Nurse, the Unit Manager/Infection Control Nurse and the ADON were unable to separate the line.
The Nurse Practitioner was notified and she was waiting on a return call.
The resident's family was in the building and made aware of the situation and did not want the resident sent to the hospital and she could get the feeding line apart from the g-tube.
The Progress Note from 8/13/24 at 10:52 p.m., when investigated further, indicated it had been created at 3:16 p.m.
The Physician had not been notified until after 2:30 p.m. and the family member had not been notified until she arrived at the facility after 2:53 p.m.
During an interview on 8/14/24 at 8:20 a.m., the ADON and Unit Manager/Infection Control Nurse acknowledged the Nurse Practitioner/Physician had not been notified until after 2:30 p.m. and the family had not been notified until they came in to the facility.
The ADON indicated the resident was sent to the hospital for the g-tube to be changed and had returned to the facility.
A facility physician and family notification policy, received from the Administrator on 8/14/24 at 10:44 a.m. as current, indicated the physician and responsible party would be notified with a change in status and the need to significantly alter the resident's treatment.
155637
Form Approved OMB
STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A.
Building 155637 B.
Wing 08/14/2024
NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE
Crown Point Health Campus 6685 East 117th Avenue Crown Point, IN 46307