of F176 citations were written at actual harm or above. The mark is the share across all tags, 5.4%.
The harm level
How severely F176 is cited
0.0% of citations found actual harm or worse (level G and above).
Citations by CMS scope and severity. Rows are harm level, columns are how widespread the finding was.
Severity
Isolated
Pattern
Widespread
Immediate jeopardy
J—
K—
L—
Actual harm
G—
H—
I—
No harm, potential for more than minimal
D1100.0%
E—
F—
No harm, potential for minimal
A—
B—
C—
Every recorded F176 citation, by the harm level and scope the surveyor assigned.
In the surveyor’s words
What an F176 citation says
One finding from each severity level, most serious first.
Severity is as the surveyor wrote it. Some findings had already been corrected before the survey.
J · Immediate jeopardy, isolatedAugust 30, 2017
Based on interview and record review it was determined the facility failed to assess and develop a plan for self-administration of insulin for 1 of 1 sampled residents (#107) who was discovered to self-administer insulin. This failure, determined to be an immediate jeopardy situation, resulted in the resident self-administering insulin from her/his personal supply. Findings include:
Resident 107 admitted to the facility in August 2017 with [DIAGNOSES REDACTED].
A progress note dated 8/6/17 at 4:00 am indicated Resident 107 self-administered 10 units of insulin from her/his personal supply.
The August 2017 MAR indicated [REDACTED]. …
D · No harm, potential for more than minimal, isolatedNovember 22, 2017
Based on observations, interviews and record review, the faciilty failed to asess one of four residents, Resident (R) # 17 to determine if they were safe to self-administer drugs before they started the self-administration process. The interdisciplinary team also failed to determine where the drug would be stored and who would be responsible for the drug and did not include this information in the resident's plan of care.
.
Findings include:
Review of a quarterly MDS with an assessment reference date of 9/15/17 reveals R#17 has a BIMS score of 14, [DIAGNOSES REDACTED]. R#17 also is noted to have adequate vision.
R#17 has a physician's orders [REDACTED]. …
B · No harm, potential for minimal, patternAugust 16, 2017
Based on observation, interview, and record review, for one (Resident 26 ) of 15 randomly sampled residents the facility failed to assess for the safe self-administration of a dietary suplement when Resident 26 took powdered [MEDICATION NAME] seed (fiber supplement) on his own.
This deficient practice had the potential to result Resident 26 taking the fiber supplement incorrectly.
Findings:
During an observation on 8/14/17, at 7:51 a.m., there was a 23.3 ounce bottle of powdered [MEDICATION NAME] seed (fiber supplement) on Resident 26's over bed table.
During an interview with the Director of Staff Development (DSD) on 8/14/17, at 7:51 a.m., the DSD stated the bottle of fiber supplement belonged to Resident 26. …
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