Linwood Nursing And Rehabilitation Center

Findings included:

A review of facility policy titled General Dose Preparation and Medication Administration, reviewed last by the facility on May 10, 2024, revealed that during medication administration, facility staff should take all measures required by facility policy and applicable law, including, but not limited to, the following: administer medications within timeframes specified by facility policy or manufacturer's information.

A clinical record review revealed Resident 7 was admitted to the facility on [DATE], with diagnoses that include atrial fibrillation (a condition that causes the heart to beat irregularly and sometimes much faster than normal), cardiomyopathy (a disease of the heart muscle that makes it harder for the heart to pump blood to the rest of the body), and heart failure (a condition that develops when the heart doesn't pump enough blood to meet the body's needs).

A review of a quarterly Minimum Data Set assessment (MDS - a federally mandated standardized assessment process conducted periodically to plan resident care) dated May 23, 2024 revealed that Resident 7 is cognitively intact with a BIMS score of 14 (Brief Interview for Mental Status- a tool within the Cognitive Section of the MDS that is used to assess the resident's attention, orientation, and ability to register and recall new information; a score of 13-15 indicates cognition is intact).

The resident had a physician order for Metoprolol Succinate extended-release oral tablet 24 hour 50 mg (a beta blocker medication that relaxes the blood vessels and slows heart rate to improve blood flow and decrease blood pressure) by mouth two times a day related to hypertension (high blood pressure) initiated May 19, 2024; Tramadol HCL oral tablet 50 mg (an opioid medication that changes how the body feels and responds to pain) by mouth two times a day for pain management initiated on May 19, 2024; Eliquis oral tablet 5.0 mg (apixaban- an anticoagulant medication that helps to prevent the body from forming blood clots) by mouth two times a day related to atrial fibrillation dated May 19, 2024; and Cefdinir Oral Capsule 300 MG (an antibiotic medication) 300 mg by mouth two times a day for a urinary tract infection for 7 days initiated on June 20, 2024.

A review of Resident 7's Medication Administration Record for June 2024 revealed that nursing staff failed to timely administer Metoprolol Succinate extended release oral tablet 24 hour 50 mg to Resident 7 on the following dates:

June 1, 2024, at 9:15 AM (one hour and 15 minutes late)

June 2, 2024, at 9:23 AM (one hour and 23 minutes late)

395717

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 395717 B.

Wing 06/28/2024

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

Linwood Nursing and Rehabilitation Center 100 Florida Avenue Scranton, PA 18505

According to the note, a call was placed to the physician, and message left.

Nurse's note dated February 18, 2024, at 1 PM indicated that a follow-up call placed to physician's answering service regarding swelling on resident's left ankle.

Voicemail left with answering service requesting call back.

Nurse's note dated February 21, 2024, at 1:33 PM indicated that another follow-up call placed to physician regarding family concern over swelling noted on left ankle.

Message left with answering service.

Review of nurse's note dated February 21, 2024, at 3:47 PM, revealed that orders were received from the physician, four days after initial concern identified.

The physician ordered an x-ray of the left ankle.

On February 21, 2024, at 7:52 PM, documentation indicated that Resident 48 had fracture(s) of the left ankle and orders were obtained to apply an Ace wrap, to the left ankle, elevate, apply ice to the area, and for resident to see orthopedics on February 22, 2024.

There was no evidence that the facility attempted to reach an on-call physician or contact the facility's medical director in the absence of a timely response to Resident 48's change in condition.

Nursing noted that Resident 48 was transferred to the emergency roiagnom on [DATE], from the orthopedics office and was admitted .

According to nurse's note dated February 25, 2024, at 10 AM, resident was readmitted to the facility after being hospitalized for a fractured leg, pain management, and exacerbation of cardiac condition.

395717

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 395717 B.

Wing 06/28/2024

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

Linwood Nursing and Rehabilitation Center 100 Florida Avenue Scranton, PA 18505

Review of the facility's QA/QAPI committee attendance sheets for the QA meetings held since the last annual survey ending July 23, 2023, through annual survey ending June 28, 2024, revealed that the QA/QAPI committee only held one quarterly meeting that was conducted on April 30, 2024.

Interview with the NHA, at approximately 12:33 p.m., reported that she was unable to locate the QA/QAPI signature sheets to show documented evidence that the facility's QA/QAPI committee met at least quarterly.

28 Pa.

Code 201.18 (e)(2)(3)(4) Management.

395717

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 395717 B.

Wing 06/28/2024

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

Linwood Nursing and Rehabilitation Center 100 Florida Avenue Scranton, PA 18505