Grandview Healthcare Center

During an interview on 08/29/25 at 10:00 A.M., CNA F said CNA's are responsible for documenting residents' bowel movements every shift. He/She said if a resident has not had a bowel movement in three days, they are supposed to notify the charge nurse. He/She said he/she did not know the resident had not had a bowel movement since 07/24/25, and staff did not report to him/her the resident was constipated. 3.

Review of Resident #2's quarterly MDS, a federally mandated assessment tool, dated 08/13/25, showed staff assessed the resident as occasionally incontinent of bowels.

Review of the resident's Care Plan, updated 07/23/25, showed staff assessed the resident at risk for constipation and dehydration.

Review showed staff are directed to monitor the resident's bowel movements every shift and to report no bowel movement in two days to the nurse.

Review of the resident's POS, dated July 2025, showed a diagnosis of constipation.

Review showed physician's orders for the following:-Celexa 20 mg daily (an antidepressant, with the possible side effect of constipation) 10 mg one tablet daily;-Docusate Sodium 100 mg two capsules daily at bedtime;-Famotidine (an antihistamine, with the possible side effect of constipation) 10 mg every morning;-Bisacodyl suppository 10 mg one suppository rectally daily as needed for constipation;-Milk of Magnesia 400 mg/5 ml 30 ml as needed for constipation;-Miralax 17 gm/dose 17 gm daily as needed for constipation, Ondansetron (an antinausea meditation, with the possible side effect of constipation) 4 mg every eight hours as needed.

Review of the resident's MAR, dated 07/01/25 through 07/31/25, showed it did not contain documentation that Bisacodyl, Milk of Magnesia, or Miralax had been administered from 07/01/31 through 0731/25.

Review of the resident's vital records showed it did not documentation the resident had a bowel movement from 07/04/25 to 07/11/25 (seven days), from 07/13/25 to 07/21/25 (eight days) or from 07/22/25 to 08/02/25 (eleven days).

During an interview on 08/25/25 at 11:30 A.M., Licensed Practical Nurse (LPN) B said CNA's should document residents' bowel movements each shift, and licensed staff should monitor to see if a resident has not had a bowel movement for three days. If a resident does not have a bowel movement for three days, licensed staff should administer as needed medications for constipation. He/She said the corporate nurse recently began printing reports for residents' bowel movement monitoring. He/She said if staff do not document monitoring a resident's bowel movement, then he/she would think staff did not monitor the resident's bowel movements.

During an interview on 09/05/25 at 10:07 A.M., the administrator said CNA's are responsible for documenting residents' bowel movements in the electronic charting. He/She said he/she does not know why staff did not document bowel movements for Resident #1 or Resident #2. He/She said Certified Medication Technicians (CMT's) and licensed staff should monitor residents' bowel movements, and if a resident has not had a bowel movement in two days, they should administer as needed medications for constipation. He/She said approximately two weeks ago, the new MDS Coordinator showed staff how to add bowel movements to the Plan of Care documentation in the electronic medical records, which will not allow staff to document other care they performed until they document if the resident has had a bowel movement.

During an interview on 09/05/25 at 11:35 A.M., CMT D said aides are responsible for documenting residents' bowel movements each day. He/She said if a resident does not have a bowel movement in three days, staff should administer an as needed medication for constipation. He/She said licensed staff are supposed to monitor residents' bowl movements and notify CMT's is a resident needs an as needed medication for constipation.

Complaint # 2590452

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