The resident at issue was admitted to the nursing home on July 10 with a Stage IV bed sore to her coccyx. A Stage IV bed sore is the most severe kind, involving exposed muscle and/or bone. It carries a high risk of becoming infected and may lead to osteomyelitis. On July 24, the resident’s wound care doctor ordered the use of a wound vac. Due to a breakdown in communications at the nursing home, the order was not placed.
On August 7, the surveyor for IDPH was in the facility and made inquiries after speaking to the resident and finding out that the wound vac had not been obtained and that the size of the wound had increased, indicating a decline in the overall condition of the wound. The order was placed that same day after the surveyor began asking questions and the director of nursing acknowledged a breakdown in communications at the nursing home.
Federal regulations provide that when a resident enters a facility with a bed sore, the nursing home is required to provide care and treatment necessary to promote healing, prevent infection, and prevent the development of new skin breakdown. The wound vac was part of that required treatment.
At its heart, a nursing home is a business. Well-run businesses run on systems that ensure that the work of the business gets accomplished. The care planning process is an example of system. It helps make sure that the care that residents need gets delivered. The supply ordering process is another system which in this case did not work right, and as a result the care that the resident was supposed to get was not provided. It also amounts to a violation of at least one and likely several federal regulations.
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