THOMASTON, GA – PROVIDENCE HEALTHCARE

Based on record review, review of the facility policy titled Skin Management Standard, and staff interviews, the facility failed to clarify and obtain treatment orders after one resident (R) (#5) had a bilateral below knee amputation (BKA), failed to provide treatment to the BKA, failed to accurately assess R#5’s surgical wound with a drain and failed to ensure the resident went to a scheduled follow-up appointment with the surgeon from a sample of two residents with surgical wounds.

On [DATE] a determination was made that a situation in which the facility’s noncompliance with one or more requirements of participation had the likelihood to cause serious injury, harm, impairment, or death to residents.

The facility’s Administrator and Director of Nursing (DON) LL were informed of the Immediate Jeopardy (IJ) on [DATE] at 1:55 p.m. The noncompliance related to the first IJ was identified to have existed on [DATE]. The noncompliance related to the second IJ was identified to have existed on [DATE].

Resident (R) #5 was admitted to the facility on [DATE] and required bilateral below the knee amputations (BKA’s) due to severe peripheral artery disease (PAD) with occlusion on [DATE]. Upon return from hospitalization status post [MEDICAL RECORD OR PHYSICIAN ORDER] . R#5 was diagnosed on [DATE] at the hospital emergency room with a wound infection to the left BKA. R#5 underwent a revision to the left BKA on [DATE] and returned to the facility the same day. The facility again failed to clarify/obtain treatment orders on return from the hospital on [DATE]. There was no evidence of wound care being provided from [DATE] through [DATE]. In addition, the left BKA revision site was not accurately assessed by nursing staff on hospital return and a scheduled follow up appointment with the surgeon was not kept on [DATE]. The resident expired at the facility on [DATE]. The death certificate listed diabetes as the cause of death.