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ST ANTHONY'S REHABILITATION HOSPITAL
STAFFING AND DELIVERY OF CARE
Tag No.: A0392
Based on observation and interview, the facility failed to ensure that there is sufficient nursing staff to provide nursing care to all patients as needed, as evidenced by: observation of 4 of 4 active patients (#'s 3, 4, 5 and 6) in need of attention to hygiene care and grooming.
The findings include:
During a tour of the facility's nursing unit on 6/15/10 between 10:00 and 11:00 AM, most of the patients were off the unit attending therapy/rehab. Several staff members were observed to be at the nurses' station and 3 aides were observed to be in patient rooms making empty beds. The following patients were observed on the unit:
1. Patient #3 was observed to be sitting in a wheelchair in her/his room, watching TV; s/he had a heavy growth of hair on her/his face and her/his hair was unkempt and oily. S/He had a slouched posture and did not make eye contact. When asked, s/he states that s/he has been in the facility for a couple of days and has not had a shower. Review of nursing documentation for the patient, dated 6/14/10, reveals that the patient requires total assist with ADL's (activities of daily living.)
2. Patient #4 was observed to be sitting in a wheelchair in his/her room, grimacing and complaining of severe indigestion; her/his hair was uncombed/unkempt. When asked, s/he states s/he can't remember when s/he had a shower or bath, "maybe yesterday." Review of nursing documentation for the patient, dated 6/14/10, reveals that the patient requires total assist with ADL's.
3. Patient #5 was observed to be sitting in a wheelchair in his/her room; the patient was observed to have unkempt hair and a thickened saliva/mucus film across teeth and lips. When asked, s/he states that facility staff does assist with sponge baths but s/he has not been assisted with a shower because s/he has a central line for TPN (total parenteral nutrition.)
4. Patient #6 was observed to be sitting in a wheelchair, watching TV, in his/her room. When asked, the patient states that s/he has been here for 1 week and has not had a shower. S/he states that s/he has " asked and asked but no one has time. "