Inspection Reports for Gutierrez ARCH
3374 Maunaloa Ave, Honolulu, HI 96816, USA, HI, 96816
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Inspection Report
Annual Inspection
Deficiencies: 7
Sep 12, 2024
Visit Reason
The inspection was conducted as the facility's annual survey to assess compliance with state regulations under Chapter 100.1.
Findings
The report identifies multiple deficiencies related to incomplete or missing PRN indications on physician medication orders for Resident #1, as well as missing documentation in progress notes and medication administration records. The facility submitted plans of correction addressing these issues with future monitoring and review procedures.
Deficiencies (7)
| Description |
|---|
| Physician's medication orders dated 7/2/24 for Resident #1 were incomplete, missing PRN indications and dosages. |
| Physician's medication orders dated 7/12/24 for Resident #1 lacked PRN indications for topical medications. |
| Medication administration record (MAR) showed administration of Cephalexin without a medication order available. |
| Diclofenac gel prescribed on 7/12/24 was not covered by insurance and was not administered; medication order was not discontinued. |
| Physician's medication order dated 7/2/24 for Metoprolol tartrate had a hold parameter but medication was administered without measuring blood pressure as required. |
| Monthly progress notes did not include Resident #1's response to medications. |
| Physician's visit record lacked progress notes on compromised skin integrity and monitoring for Resident #1 with prescribed A&D ointment. |
Report Facts
Deficiencies cited: 7
Inspection Report
Annual Inspection
Deficiencies: 10
Sep 13, 2023
Visit Reason
The inspection was conducted as the annual survey for the facility Gutierrez ARCH Inc to assess compliance with state licensing regulations.
Findings
The report identifies multiple deficiencies related to nutrition, medication management, resident records, and personnel staffing requirements. Plans of correction were submitted for each deficiency, with future plans to prevent recurrence.
Deficiencies (10)
| Description |
|---|
| Resident #2 had no current diet order documented as required. |
| Resident #1 had Polyethylene Glycol medication not included on 2/27/2023 medication reevaluation; medication remained on MAR without order to discontinue and reappeared on 6/1/2023 reevaluation. |
| Resident #1 had a medication order for Polyethylene Glycol 3350 with no documentation of medication administered for constipation prior to hospitalization on 6/8/2023. |
| Resident #1's MAR did not accurately reflect the medication order for Robitussin DM. |
| Resident #1's medications were not reevaluated and signed every four months from 8/1/2022 to 2/7/2023. |
| Resident #1 had no admission assessment completed for readmission on 2/6/2023. |
| Resident #1's monthly progress notes did not include observations of response to medications and diet. |
| Resident #1's inventory of possessions was not updated since July 2021. |
| Substitute Care Giver #1 completed only 11 out of 12 required continuing education hours. |
| Resident #1 had no documented evidence of pneumococcal vaccination. |
Report Facts
Deficiencies cited: 10
Continuing education hours completed: 11
Inspection Report
Annual Inspection
Deficiencies: 22
Sep 15, 2022
Visit Reason
Annual inspection of Gutierrez ARCH Inc facility to assess compliance with Chapter 100.1 regulations.
Findings
Multiple deficiencies were identified related to personnel, staffing, family requirements, admission policies, nutrition, medications, records, and fire safety. The facility submitted plans of correction for each deficiency, indicating future actions to prevent recurrence.
Deficiencies (22)
| Description |
|---|
| No documented evidence of current physical exam for Substitute Care Giver (SCG) #1 and #2 while providing care during March 2022. |
| No documented evidence of tuberculosis clearance for SCG #1 and #2 while providing care. |
| No documented evidence of first aid certification for SCG #1 and #2 while providing care. |
| No documented evidence of training by the primary care giver (PCG) to make prescribed medications available to residents. |
| No documented evidence of cardiopulmonary resuscitation certification for SCG #1 and #2 while providing care. |
| Resident #2 required sliding scale insulin based on Dexcom device reading; insulin order changed 9/1/2022 to three times a day before meals. |
| Resident #2 diet order was 'Regular carb controlled' diet ordered on 2/28/2022; no documented evidence diet order was clarified with physician. |
| Resident #1 had no hold parameters included on medication label for Metoprolol as ordered by physician. |
| Silver Sulfadiazine 1% cream found with oral medications for Resident #2. |
| Medication order for Timolol for Resident #1 did not specify dose/concentration or how many drops to administer in the morning. |
| Medication orders for Resident #1 not reevaluated and signed every four months as required. |
| Resident #1 verbal order from physician on 8/26/2022 to monitor blood glucose; no documented evidence physician was contacted to clarify blood sugar range or notified about readings. |
| Resident #2 had no legend for symbol used on MAR when medication self-administered; no legend for substitute care giver signatures in progress notes; signatures were illegible. |
| Resident #1 monthly progress notes for July and August 2022 did not include observations of resident's response to diet or medications. |
| Resident #2 monthly progress notes did not include observations of resident's non-compliance to diet. |
| Resident #1 progress notes did not include incident report for incident on 1/30/2022 regarding shortness of breath post discharge. |
| Resident #2 rolling walker not recorded on inventory of possessions. |
| Resident #2 medication record not initialed by care giver on multiple dates for insulin medications. |
| Resident #1 Bacitracin ordered but not listed on August MAR. |
| Resident #1 Cephalexin order did not specify how many days to take medication. |
| No documented evidence of monthly smoke detector check for August 2022. |
| Primary and substitute care givers did not document evidence of successful completion of twelve hours of continuing education courses per year. |
Report Facts
Inspection Date: Sep 15, 2022
Medication order dates: 12
Continuing education hours: 12
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