HospitalInspections.org

Based on observation, interview, record review and policy review the facility failed to:
- Assess specific activity interests for one (#1) current Swing bed (SB, post-acute skilled nursing care) patient of four reviewed.
- Assess specific activity interests within the policy timeframe of 48 hours from admission for two (#3 and #4) patients of four patients reviewed.
- Provide activities, based on the patient's specific interests, for four (#1, #3, #4, and #5) of four patients reviewed.
This had the potential to deny all Swing Bed patients of their physical, mental and social functionality. The Swing Bed census was five. The facility census was 31.

Findings included:

1. Record review of the facility's undated policy titled, "Swing Bed Activities Policy and Procedure," showed the following:
- Activities will be individualized for each patient.
- Charting will occur on the activities flow chart.
- The initial activity assessment will be completed within 48-hours of admission.

2. During an interview on 06/08/16 at 1:20 PM, Staff L, Registered Nurse (RN), Swing Bed Manager, stated that the facility currently had no one to fill in for the regular Swing Bed Activity Coordinator on the weekends, and only had an occasional replacement Monday through Friday.

3. Record review of Patient #1's History and Physical (H&P), dated 06/02/16 showed the patient was admitted to the SB program on 06/01/16.

Record review of the patient's initial activity assessment, dated 06/03/16, showed staff failed to identify specific activity interests of the patient. The goal was for the patient to attend five activity sessions per week.

Record review of the patient's activity documentation, from 06/03/16 through 06/08/16, or five days, showed activity staff had visited the patient one time on 06/08/16, and the patient did not participate because he was nonverbal. Staff failed to provide a pertinent activity for this patient.

During an interview on 06/08/16 at 2:33 PM, Staff M, Activity Coordinator, stated that Patient #1 was asleep when she visited him on 6/08/16. Staff M could not explain why she had not provided more than one visit to the patient.

4. Record review of Patient #3's H&P, dated 06/06/16 showed the patient was admitted to the SB program on 06/03/16.

Record review of the patient's initial activity assessment, dated 06/06/16, showed staff failed to assess the patient within 48-hours of admission. The goal was for the patient to attend five activity sessions per week.

Record review of the patient's activity documentation, from 06/06/16 through 06/08/16, showed activity staff had never provided activities to Patient #3.

During an interview on 06/08/16 at 2:35 PM, Staff M, stated that she left work at 1:20 PM on 06/06/16, the day she did the initial assessment. Staff M could not explain why she failed to do the assessment the next day. Staff failed to provide activities of interest to Patient #3.

5. Record review of Patient #4's H&P, dated 06/04/16 showed the patient was admitted to the SB program on 06/03/16.

Record review of the patient's initial activity assessment, dated 06/06/16, showed staff failed to assess the patient within 48-hours of admission. The goal was for the patient to attend five activity sessions per week.

Record review of the patient's activity documentation, from 06/06/16 through 06/08/16, showed activity staff had never provided activities to Patient #4.

During an interview on 06/08/16 at 2:35 PM, Staff M, stated that she left work at 1:20 PM on 06/06/16, the day she did the initial assessment. Staff failed to provide activities of interest to Patient #4.

6. Record review of Patient #5's admission face sheet showed the patient was admitted to the SB program on 05/31/16.

Record review of the patient's initial activity assessment, dated 06/01/16 showed the goal was for the patient to attend five activity sessions per week.

Record review of the patient's activity documentation, from 06/01/16 through 06/08/16, or seven days, showed only three activity visits. Staff failed to provide activities five times weekly which was the goal for the patient.