STATE OF MICHIGAN DEPARTMENT OF HUMAN SERVICES

Transcription

1 STATE OF MICHIGAN DEPARTMENT OF HUMAN SERVICES BUREAU OF CHILDREN AND ADULT LICENSING JENNIFER M. GRANHOLM GOVERNOR ISMAEL AHMED DIRECTOR February 11, 2008 Fidelia Okwereogu 4321 Aztec Way Okemos, MI RE: License #: Investigation #: AS A OCE Adult Foster Home Dear Ms. Okwereogu: Attached is the Special Investigation Report for the above referenced facility. Due to the violations identified in the report, a written corrective action plan is required. The corrective action plan is due 15 days from the date of this letter and must include the following: How compliance with each rule will be achieved. Who is directly responsible for implementing the corrective action for each violation. Specific time frames for each violation as to when the correction will be completed or implemented. How continuing compliance will be maintained once compliance is achieved. The signature of the responsible party and a date. If you desire technical assistance in addressing these issues, please feel free to contact me. In any event, the corrective action plan is due within 15 days. Failure to submit an acceptable corrective action plan will result in disciplinary action. P.O. BOX LANSING, MICHIGAN (517)

2 Please review the enclosed documentation for accuracy and feel free to contact me with any questions. In the event that I am not available and you need to speak to someone immediately, please feel free to contact the local office at (517) Sincerely, Mary E Holton, Licensing Consultant Bureau of Children and Adult Licensing 7109 W. Saginaw P.O. Box Lansing, MI (517) enclosure

3 MICHIGAN DEPARTMENT OF HUMAN SERVICES BUREAU OF CHILDREN AND ADULT LICENSING SPECIAL INVESTIGATION REPORT I. IDENTIFYING INFORMATION License #: Investigation #: AS A Complaint Receipt Date: 12/28/2007 Investigation Initiation Date: 12/28/2007 Report Due Date: 01/27/2008 Licensee Name: Licensee Address: Fidelia Okwereogu 4321 Aztec Way Okemos, MI Licensee Telephone #: (517) Administrator: Licensee Designee: Name of Facility: Facility Address: Fidelia Okwereogu N/A OCE Adult Foster Home 4219 Arlene Lansing, MI Facility Telephone #: (517) Original Issuance Date: 05/12/2006 License Status: REGULAR Effective Date: 12/12/2006 Expiration Date: 12/11/2008 Capacity: 6 Program Type: MENTALLY ILL DEVELOPMENTALLY DISABLED 1

4 AGED PHYSICALLY HANDICAPPED TRAUMATICALLY BRAIN INJURED II. ALLEGATION(S) Resident is out of his pain medication and should not have been out until at least Jan 11 or after. Resident said caregiver was hardly giving it to him & she told him he was out. Doctor is reluctant to issue more pain medication due to circumstance involved. III. METHODOLOGY 12/28/2007 Special Investigation Intake 2008A /28/2007 Special Investigation Initiated - Telephone Interview with Ms. Okwereogu. 01/02/2008 Contact - Document received Letter received from Ms. Okwereogu. 01/03/2008 Inspection Completed On-site 01/13/2008 Contact Document Received Letter received from Ms. Okwereogu. 02/05/2008 Contact Telephone call made Phone message to Ms. Okwereogu, attempted exit interview. 02/06/2008 Exit Conference Exit conference with Ms. Okwereogu. ALLEGATION: Resident is out of his pain medication and should not have been out until at least Jan 11 or after. Resident said caregiver was hardly giving it to him & she told him he was out. Doctor is reluctant to issue more pain medication due to circumstance involved. INVESTIGATION: During an interview with Ms. Okwereogu on 12/28/07, she stated that she was contacted by Ingham Community Mental Health today regarding concerns that 2

5 Resident A was not receiving his pain medication as prescribed and that some of it was missing. Community Mental Health told her that Resident A reported he is not receiving his prescribed pain medication, because Staff #1 is telling him (Resident A) that he is out of his pain medication, when Resident A should still have several pills of pain medication left. On 12/28/07, Ms. Okwereogu said that Staff #1 told her that on 12/14/07, she signed for receiving 5 packets of Resident A s pain medication (Hydrocodone) from the pharmacy when she only received 3 packets. Ms. Okwereogu stated that 3 packets of the pain medication would contain a total of 90 pills. Ms. Okwereogu said that Resident A is prescribed Hydrocodone every four hours as needed. Ms. Okwereogu said that Resident A had 9 pills left. Ms. Okwereogu stated that if Resident A received his pain medication every four hours from 12/14/07, and only 3 packets were received, Resident A should have at least 56 or more pills left. Ms. Okwereogu said that Staff #1 was the only staff person that had access to these locked medications. Ms. Okwereogu agreed to administer the pain medication to Resident A until Staff #1 could be replaced. On 1/02/08, Ms. Okwereogu faxed a letter to me indicating that on 12/28/07 she was notified by Ingham Community Mental Health that Staff #1 was not administering Resident A his Hydrocodone as prescribed. Ms. Okewereogu indicated that Staff #1 signed that she received 5 packs of Hydrocodone from the pharmacy but stated she only received three. Ms. Okwereogu contacted the Eaton County Sheriff s Department and also the pharmacy. On 12/28/07, Ms. Okwereogu took the remaining Hydrocodone home with her, and administered the medication to Resident A as needed. Staff #1 left the facility on 1/01/08. During an interview with Resident A on 1/03/08, he stated that he is now receiving his Hydrocodone for his pain, when requested. Resident A said that Staff #1 would not give him his Hydrocodone when he requested it for pain. During an interview with Resident B on 1/03/08, she stated that Staff #1 was fired. Resident B said that Staff #1 did administer her medication as prescribed. Resident B said that Staff #1 would not get out of bed until 9 in the morning. Resident B said that her bus left before 9, so she would need to get her own breakfast. During an interview with Resident C on 1/03/08, he stated that he would have to go and get Staff #1 out of bed to get his morning medication. Staff #1 would yell at him for waking her up. Resident C stated that one morning during the month of December 2007, he did not receive his morning medication until 2:30 in the afternoon. Resident C said that he requested to have Ms. Okwereogu s telephone number, however, Staff #1 refused to give the telephone number to him. Staff #1 would not get up to make breakfast and they (him and the other residents) fed themselves cereal. 3

6 During an interview with Resident D on 1/03/08, he stated that he is receiving his medications as prescribed. Resident D indicated that he is receiving adequate care and received adequate care from Staff #1. Review of the medication records on 1/03/08 indicated the residents were receiving their medications as prescribed. On 1/13/08, Ms. Okwereogu submitted a letter indicating that Staff #1 was fired on January 1, R Resident medications. (2) Medication shall be given, taken, or applied pursuant to label instructions. ANALYSIS: During an interview Resident A he said that Staff #1 did not administer his pain medication every four hours as needed. Resident C stated that one day in December 2007 he received his morning medication at 2:30 in the afternoon because Staff #1 would not get out of bed. R Direct care staff; qualifications and training. (2) Direct care staff shall possess all of the following qualifications: (a) Be suitable to meet the physical, emotional, intellectual, and social needs of each resident. ANALYSIS: Ms. Okwereogu states Staff #1 is the only person that had access to the locked medications and on 12/28/07, 56 of Resident A s Hydrocodone pills should have been present, when there were only 9 left. Based on Staff #1 s behavior of yelling at Resident C, and failure to provide medications and breakfast to the residents and her inability to account for the missing pain medications, she is not suitable to meet the physical and emotional needs of the residents 4

7 R Resident medications. (6) A licensee shall take reasonable precautions to insure that prescription medication is not used by a person other than the resident for whom the medication was prescribed. ANALYSIS: During interviews, Ms. Okwereogu said Staff #1 was the only person that had access to the locked medications. On 12/28/07, Resident A had 9 Hydrocodone pills left when there should have been a minimum of 56 pills left. ADDITIONAL FINDINGS: INVESTIGATION: During the onsite investigation on 1/03/08, the middle resident s bedroom smelled of urine. R Maintenance of premises. (1) A home shall be constructed, arranged, and maintained to provide adequately for the health, safety, and well-being of occupants. ANALYSIS: The middle bedroom smelled of urine on 1/03/08. INVESTIGATION: During the onsite investigation on 1/03/08, the bathroom flooring was rotted and decayed. The carpet in the Midwest Bedroom was dirty. R Maintenance of premises. (5) Floors, walls, and ceilings shall be finished so as to be easily cleanable and shall be kept clean and in good repair. 5

8 ANALYSIS: During the onsite investigation on 1/03/08, the bathroom flooring was rotted and decayed. The carpet in the Midwest Bedroom was dirty. INVESTIGATION: During the onsite investigation on 1/03/08, Resident A was observed using a wheelchair. Resident A was not wearing his prosthesis on his right leg. This facility is not wheelchair accessible. On 1/03/08, review of Resident A s health care appraisal dated 10/22/07 indicated that Resident A utilizes a walker and a wheelchair. The health care appraisal further indicated Resident A utilizes a prosthesis to ambulate. During an interview with Resident A on 1/03/08, he stated that he regularly uses his wheelchair. R Means of egress; wheelchairs. (1) Small group homes that accommodate residents who regularly require wheelchairs shall be equipped with ramps that are located at 2 approved means of egress from the first floor. ANALYSIS: Resident A requires the use of a wheelchair and this facility is not wheelchair accessible. During an exit interview with Ms. Okwereogu on 2/06/08, she stated that when Resident A was admitted to the home she was told he could walk with his prosthesis. Following Resident A s placement at her facility, Ms. Okwereogu became aware Resident A refused to wear his prosthesis and required regular use of his wheelchair. Ms. Okwereogu requested Resident A s discharge because her facility is not wheelchair accessible. Resident A was placed at another facility when a suitable placement became available. Ms. Okwereogu further stated that the bathroom and bedroom flooring were replaced. 6

9 IV. RECOMMENDATION Contingent upon receipt of an acceptable plan of correction, I recommend the status of the license remain unchanged. 2/11/08 Mary E Holton Date Licensing Consultant Approved By: 2/11/08 Betsy Montgomery Date Area Manager 7