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Based upon review of medical records and staff interview, the hospital failed to ensure nursing care plans were developed and on-going/current as evidenced by a patient (#16) who failed to have a documented bowel movement for 10 days and experienced nausea and vomiting and did not receive a nursing care plan relative to his lack of bowel movements. Findings:

Review of patient #16's medical record revealed he was admitted on 03/07/13 with diagnosis of pneumonia. Patient #16 had a medical history positive for lung cancer, Chronic Obstructive Pulmonary Disease (COPD), and atrial fibrillation.

Review of nursing care plans, dated 03/07/13, revealed Nursing Diagnoses were Ineffective Airway Clearance and Altered Cardiovascular Status.

Review of initial nursing assessment documentation, dated 03/07/13, revealed S13 Nurse (computer system did not authenticate if Nurse was Licensed Practical Nurse-LPN or Registered Nurse-RN) documented patient #16 did not remember when his last bowel movement occurred. The initial nursing assessment revealed a section titled "Gastrointestinal Assessment"; S13 Nurse documented patient #16's abdomen was round, soft, non-tender, with bowel sounds present in all four quadrants.

Review of daily shift nursing notes revealed patient #16 complained of constipation on 03/09/13. MiraLax 17 grams (gm) was ordered, 03/09/13, to be administered twice a day by mouth.

Review of the Medication Administration Record (MAR), dated 03/09/13 revealed patient #16 received MiraLax 17 gm at 9:56am and 9:14pm. Continued review of the MAR revealed the following: MiraLax 17 gm administered by mouth on 3/10/13 at 9:20am, not given at 9:00pm; 03/11/13 at 9:00am not given, 9:22pm administered; 03/12/12 9:00am held, 9:24pm given; 03/13/13 given at 9:00am, 9:41pm held; 03/14/13 through 03/17/13 not given. Nursing staff documented "patient unable to drink".

Review of the Intake and Output (I&O) Record revealed there failed to be a bowel movement documented from 03/07/13 through 03/17/13 (11:40pm when patient #16 expired).

Review of nursing documentation on the shift assessment form, under the section titled Gastrointestinal Assessment, revealed: 03/12/13 Bowel sounds (BS) hypoactive; 03/13/13 BS hypoactive; 03/14/13 Right upper quadrant (RUQ) tenderness, abdomen "rounded" (previously documented as "flat"); 03/15/13 RUQ and Right lower quadrant (RLQ) tender, no appetite, abdomen firm; 03/16/13 constipated, abdomen firm and 03/17/13 abdomen rounded, firm.

Nursing staff failed to implement a nursing care plan that addressed patient #16's lack of bowel movements from 03/07/13 through 03/17/13.

Review of the Nursing Care Plans revealed there failed to be documentation nursing staff had implemented plans for patient #16 lack of bowel movements.

Interview, on 04/30/13 at 10:30am with S4 Assistant Director of Nursing (ADON), confirmed patient #16 did not receive an updated nursing care plan that addressed his lack of bowel movements for 10 days (03/07/13 through 03/17/13) while in the hospital. Patient #16 expired 03/17/13 at 11:40pm.