Wibaux County Nursing Home

Review of resident #23's current MDS, dated [DATE], showed resident #23 had a BIMS of 4, reflecting severe cognitive impairment.

Review of resident #23's nursing progress notes, dated 2/16/25, showed resident #23 had opened a dining room window and climbed out of the window. Resident #23 had obtained a shovel, and when found, he was already shoveling snow in the courtyard. Resident #23 was wearing a jacket, a baseball hat, and medical gloves. Resident #23 refused to return to the facility until he was finished shoveling and staff remained with him.

The facility did not assess the resident for injuries following this elopement.

Review of resident #23's nurses notes, dated, 2/23/25 at 1:37 p.m., showed, CNA alerted this nurse 10 minutes ago that resident had crawled through his window and was headed toward the facility garage. Resident #23 was returned to the facility by staff, and had no injury.

Review of resident #23's nursing note, dated 2/27/25, showed the CNA alerted the nurse at 10:50 a.m., that resident #23's window was open, and he was missing.

All staff were notified, and a search was started. Resident #23 was located behind the nursing home, at the clinic, unharmed.

Review of resident #23's elopement evaluation, with an observation date of 2/23/25 at 8:14 p.m., was completed on 3/10/25 at 5:15 p.m., by staff member B.

Review of resident #23's elopement evaluation, with an observation date of 2/27/25, was also not completed until 3/10/25.

The assessments were not completed until all three elopements occurred. No other elopement assessments were located in the resident's medical record.

275079

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 275079 B.

Wing 03/13/2025

NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE

Wibaux County Nursing Home 712 Wibaux St S Wibaux, MT 59353