Baton Rouge Health Care Center

In the surveyor’s words

From the most serious findings on record at Baton Rouge Health Care Center, in the surveyor’s own words.

• Immediate jeopardy, patternF684Jul 6, 2023

  Based on interviews and record reviews, the facility failed to ensure residents received treatment and care in accordance with professional standards of practice and the comprehensive person-centered care plan by failing to ensure: 1. S5MRLPN reconciled and clarified Physician Orders upon admission and/or readmission to the facility for 2 (#2 and #4) of 3 (#2, #4, and #5) residents reviewed with hospitalization s; and 2. S6RN, S7LPN, S8LPN, S9LPN and S14 LPN assessed and documented residents' blood glucose levels via accucheck prior to administering antidiabetic medications for 2 (#2 and #4) of 3 (#2, #4, and #5) residents reviewed with hospitalization s. […]

• Immediate jeopardy, patternF726Jul 6, 2023

  Based on interviews and record reviews, the facility failed to ensure Licensed and Registered Nurses had the specific competencies and skill sets necessary to care for residents' needs, as identified through resident assessments, and described in the plan of care. The facility nursing staff failed to ensure: 1. S5MRLPN reconciled and clarified Physician Orders upon admission and/or readmission to the facility for 2 (#2 and #4) of 3 (#2, #4, and #5) residents reviewed with hospitalization s; and 2. […]

• Immediate jeopardy, patternF835Jul 6, 2023

  Based on interviews and record reviews, the facility failed to be administered in a manner that enabled it to use its resources effectively and efficiently to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident. The facility failed to ensure: 1. A system was in place to ensure Physicians' Orders were transcribed accurately and clarified prior to implementation for 2 (#2 and #4) of 3 (#2, #4, and #5) residents reviewed with hospitalization s; and 2. Licensed and Registered Nurses were competent to assess and document blood glucose levels prior to medication administration for 2 (#2 and #4) of 2 (#2 and #4) residents reviewed with a diagnosis of Diabetes Mellitus. […]

• Immediate jeopardy, isolatedF867Jul 6, 2023

  Based on interview and record review, the facility failed to ensure the Quality Assurance Committee developed and implemented appropriate plans of action to correct identified quality deficiencies following identified errors in clarification and obtaining parameters of antidiabetic medication on admission orders for 1 (#RF2) of 6 (#F4, #RF1, #RF2, #RF3, #RF4, #RF5) residents selected for receiving antidiabetic medications. This deficient practice resulted in an immediate jeopardy situation for Resident #RF2 on 07/14/2023 when blood glucose parameters were not clarified or obtained from the physician for the order of insulin lispro subcutaneous 100 units/ml inject 7 units before meals. On 07/24/2023, Resident #RF2's blood glucose dropped from 102 to 58 after insulin lispro was administered. […]

• Actual harm, isolatedF689Jun 20, 2024

  Based on record reviews and interviews, the facility failed to ensure residents, who required the assistance of two staff and a mechanical lift for transfers, remained free of accident hazards for 1 (#1) of 4 (#1, #2, #3, and #R1) residents reviewed. This deficient practice resulted in an actual harm on 05/26/2024 at 7:15 a.m. when S3CNA transferred Resident #1, who required the assistance of 2 staff and a mechanical lift for transfers, from her bed to her wheelchair alone without using a mechanical lift. At 3:30 p.m., Resident #1 complained of pain rated at an 8 on a scale to 10. The resident's left leg was slightly edematous and she yelled out in pain when the leg was moved. […]