LEMONT CENTER
Facility I..D. Number 0041269
12450 WALKER ROAD
Lemont, IL 60539
Date of Survey 7/26/00
Complaint Investigation 0093151
The facility shall notify the resident's physician of any accident, injury, or significant change in a resident's condition that threatens the health, safety or welfare of a resident, including, but not limited to, the presence of incipient or manifest decubitus ulcers or a weight loss or gain of five percent or more within a period of 30 days. The facility shall obtain and record the physician's plan of care for the care or treatment of such accident, injury or change in condition at the time of notification.
The facility must provide the necessary care and services to attain or maintain the highest practicable physical, mental, and psychosocial well-being of the resident, in accordance with each resident's comprehensive assessment and plan of care. Adequate and properly supervised nursing care and personal care shall be provided to each resident to meet the total nursing and personal care needs of the resident.
General nursing care shall include at a minimum the following and shall be practiced on a 24-hour, seven day a week basis:
Objective observations of changes in a resident's condition, including mental and emotional changes, as a means for analyzing and determining care required and the need for further medical evaluation and treatment shall be made by nursing staff and recorded in the resident's medical record.
Based on record review, staff interview, physician interview and other interviews the facility failed to assure that nursing staff inform physician of a change in medical condition for 1 of 4 sampled residents.
Findings Include:
R#3's diagnoses include Alzheimer's disease and glaucoma.
R#3's nurses notes dated 11-20-99 at 4 p.m. state noticed left eye red and appears to be a white membrane in the center of the eye. No c/o pain. No drainage. No c/o itching. Notified family and inquire whether they have their own eye doctor. I told son she needs to be checked by an eye Dr. as soon as possible. He said we have to wait till Monday and her daughter will make an appointment and let us know the time when on Monday. Continue to observe.' This note was signed by E#3.
On 7-24-00 during interview Z#1 stated R#3 was taken to see Z#5 on 11-22-99 by her daughter and while in office Z#5 began an aggressive antibiotic treatment to treat infection in R#3's left eye. From office R#3 was sent to the hospital and admitted for continuation of treatment to the affected eye. Z#1 stated R#3's eye perforated 11-22-99 in the evening at the hospital and required surgical intervention for the perforation. Z#1 stated that R#3 has lost all vision in left eye and had no functional vision in rt. eye prior to this infection.
During interview on 7-24-00 Z#5 stated R#3 has an eye infection which was a rapidly spreading infection and treatment was started in the office on 11-22-99 and R#3 was sent to hospital that day for continued treatment. Z#5 did state a physician probably should have been notified of the changes in R#3's eye when first noted by staff.
On 7-13-00 at 3:40 p.m. at the nurses's station in the Alzheimer's unit E#3 was interviewed regarding the nurses note dated 11-20-99 at 4 p.m. E#3 was asked if the status of the eye was changed from usual and E#3 did state this was a change in eye status. E#3 was then asked why a physician was not called regarding the redness and the white covering in the eye. E#3 stated we call families because they usually take residents to the eye doctor. E#3 was also asked when she first learned of R#3's eye problems and E#3 stated she was told of the problems in report from the day shift on 11-20-99. Surveyor confirmed with E#3 that nurses did not document any problems for R#3 on the day shift on 11-20-99.