cms_GA
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30 rows where "inspection_date" is on date 2012-06-21
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Suggested facets: facility_name, facility_id, address, city, zip, deficiency_tag, scope_severity, complaint, standard, eventid, filedate, filedate (date)
| Link | rowid ▼ | facility_name | facility_id | address | city | state | zip | inspection_date | deficiency_tag | scope_severity | complaint | standard | eventid | inspection_text | filedate |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 7401 | 7401 | FOUR COUNTY HEALTH AND REHABILITATION | 115481 | 124 OVERBY DRIVE | RICHLAND | GA | 31825 | 2012-06-21 | 431 | D | 0 | 1 | B9IP11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation and record review, it was determined that the facility failed to properly discard two expired vials of Lantus insulin on one (100 hall) of three medication carts. Findings include: According to the Nursing 2012 Drug Handbook, opened vials of Lantus insulin should be discarded after 28 days. The American Diabetes Association's insulin storage guidelines documented that, even though each insulin was stamped with an expiration date, a loss of potency might occur after the vial had been in use for more than 30 days. On [DATE] at 9:40 a.m., there were two vials of expired Lantus insulin stored in the 100 Hall medication cart. There was a label attached to each vial stating the vial expired 28 days after first use. The vials were dated as first used on [DATE] (39 days after opening) and [DATE] (37 days after opening). | 2017-04-01 |
| 7628 | 7628 | SEARS MANOR NURSING HOME | 115520 | 3311 LEE STREET | BRUNSWICK | GA | 31521 | 2012-06-21 | 314 | D | 0 | 1 | E41T11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, record review and staff interview, it was determined that the facility failed to ensure that two residents (#38 and # 96) of four residents, who had pressure sores, received the necessary treatment and care to promote healing and prevent infection in a total sample of 30 residents. Findings include: 1. On the 5/16/12 significant change of status Minimum Data Set (MDS) assessment, licensed staff coded resident #96 as having four unstageable pressure sores. The 3/31/12 nurses notes documented that the resident was observed to have eschar on two areas of the right medial great toe that measured 1.5 x 1.5 centimeters (cm), and on the bony prominence of the right great toe that measured 2.0 x 2.0 cm. The licensed nurse also documented that the resident had a red broken area of skin on the left hip that measured 2.0 x 2.0 cm. Review of a 4/18/12 History and Physical form revealed documentation that the area on the left hip and the right foot were decubitus ulcers. The 5/08/12 physician's progress notes documented that the areas on the resident's left foot were pressure areas. The 5/04/12 Resident Data Collection form, documented after the resident's hospitalized from [DATE] until 5/04/12, described necrotic tissue on the area on the left hip that measured 3.0 x 2.0 cm , on the right great toe that measured 1.0 cm x .75 cm, on the right lateral foot that measured 1.5 cm x 1.0 cm and black necrotic tissue on the left great toe that measured 1.5 x 1.0 cm. There was documentation that the resident's left inner great toe had black necrotic tissue that measured 3.5 cm x 3.5 cm and the left inside heel had black necrotic tissue that measured 3.0 cm x 4.0 cm. a. The facility's policy on Pressure Ulcer Documentation was for nursing staff to document, date and initial treatments in the Treatment Administration Record. There was a 5/04/12 physician's orders [REDACTED]. That treatment was ordered to have been done every shift every day un… | 2017-02-01 |
| 7629 | 7629 | SEARS MANOR NURSING HOME | 115520 | 3311 LEE STREET | BRUNSWICK | GA | 31521 | 2012-06-21 | 318 | D | 0 | 1 | E41T11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, record review and staff interview, it was determined that the facility failed to ensure that staff had applied hand rolls to prevent further decline in range of motion for one resident (#38) of three residents with limitations in range of motion from a sample of 30 residents. Findings include: Resident #38 was admitted on [DATE] with [DIAGNOSES REDACTED]. On 6/11/12, the resident was placed on in-house comfort care. The resident was coded on the 5/14/12 quarterly Minimum Data Set (MDS) assessment as being totally dependent on staff for bed mobility and transfer, and as receiving restorative nursing for passive range of motion exercises. The resident was treated by the occupational therapist (OT) from 6/5/12 to 6/8/12 for neuro-muscular needs and positioning in his/her geri-chair. The OT documented on the 6/5/12 Plan of Treatment form that the resident had bilateral hand contractures and that restorative nursing staff applied hand rolls to the resident's hands daily. However, on 6/18/2012 at 11:00 a.m., 1:30 p.m. and 3:30 p.m., on 6/19/12 at 9:00 a.m., 11:00 a.m., 130 p.m. and 4:00 p.m., on 6/20/12 at 7:45 a.m. and 9:30 a.m., and on 6/21/12 at 7:45 a.m., the resident was observed with both hands clenched in a fisted position. Nursing staff had not placed hand rolls in the resident's hands. On 6/21/12 at 9:00 a.m., the OT stated that the resident should have had hand rolls placed in both hands to prevent further contractures. On 6/21/12 at 11:00 a.m., the Director of Nursing (DON) stated that the certified nursing assistants (CNAs) providing care for the resident, were responsible for applying any devices/rolls/splints for the resident when they got the resident up in the morning. The DON stated that the restorative aide would check the residents to ensure that needed devices had been applied by the CNAs when she arrived in the morning. The DON stated that the Charge nurses were ultimately responsible for ensuring that nee… | 2017-02-01 |
| 7707 | 7707 | PRUITTHEALTH - GREENVILLE | 115658 | 99 HILLHAVEN RD. | GREENVILLE | GA | 30222 | 2012-06-21 | 281 | D | 0 | 1 | X8VO11 | Based on observation, review of facility policy, staff interview, and review of the Nurse Practice Act, the facility failed to ensure placement of a feeding tube was checked prior to medication administration for one (1) resident (Z) from a sample of forty-two (42) residents. Findings include: Observation conducted 6/19/12 at 8:15am of medication administration for resident Z revealed that the nurse failed to check the resident's feeding tube for placement before administering medications via the tube. Review of the facility policy on Tube Feedings indicated feeding tubes would have placement checked before bolus feedings, manual flushes, and medication administration. Interview with the Licensed Practical Nurse (LPN) BB on 6/19/2012 at 11:20am revealed she forgot to check feeding tube placement prior to administering medications to resident Z via the tube. Review of the Georgia Practical Nurses Practice Act revealed that the practice of licensed practical nursing means the provision of care under the supervision of a physician, or a registered nurse, including but not limited to, administering treatments and medication | 2017-01-01 |
| 7708 | 7708 | PRUITTHEALTH - GREENVILLE | 115658 | 99 HILLHAVEN RD. | GREENVILLE | GA | 30222 | 2012-06-21 | 309 | D | 0 | 1 | X8VO11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on review of physician's orders, review of Medication Administration Record [REDACTED]. Findings include: During a medication review for resident # 52 a physician's order dated 6/17/12 indicated the resident was to receive [MEDICATION NAME] five (5) milligrams (mg) by mouth daily. Further review of the MAR indicated [REDACTED]. Review of the pharmacy packing slip revealed the medication had been faxed to the pharmacy on 6/18/12, delivered 6/19/12. Interview with the Director of Nursing (DON) on 6/21/12 at 3:25pm revealed that the resident should have had the first dose on 6/19/12. If the pharmacy had not delivered the medication in time, staff should have obtained the medication from the local Greenville Pharmacy. | 2017-01-01 |
| 7709 | 7709 | PRUITTHEALTH - GREENVILLE | 115658 | 99 HILLHAVEN RD. | GREENVILLE | GA | 30222 | 2012-06-21 | 332 | E | 0 | 1 | X8VO11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations conducted during the medication pass, it was determined that the facility failed to ensure that it was free of a medication error rate of five (5) percent or greater. Findings include: Observations of medication pass were conducted on 6/19/12 at 8:15am. Observations were made of three (3) nurses administering medications on three (3) halls. Five (5) medication errors were observed out of fifty three (53) opportunities. This resulted in a medication error rate of 9.43 percent (%). 1. A resident had an order for [REDACTED]. 2. A resident had an order for [REDACTED]. 3. A resident had an order for [REDACTED]. The count was off but the nurse suggested that the surveyor check the Medication Administration Record [REDACTED]. When the nurse realized there were two (2) Aspirin 325mg, one (1) was removed before administration. This same resident had an order for [REDACTED]. | 2017-01-01 |
| 7710 | 7710 | PRUITTHEALTH - GREENVILLE | 115658 | 99 HILLHAVEN RD. | GREENVILLE | GA | 30222 | 2012-06-21 | 441 | E | 0 | 1 | X8VO11 | Based on observation, record review and staff interview, the facility failed to sanitize contaminated reusable equipment used for wound care for one (1) resident (#126), and failed to store respiratory equipment in a sanitary manner for three (3) residents (#102, N, O) on one (1) of three (3) halls. The sample size was forty-two (42 ) residents. Findings include: 1. On 06/19/12 at 3:00 p.m., a pressure ulcer dressing change was observed for resident #126. Mid-way during the procedure, the resident's colostomy bag was noted to be leaking. The Licensed Practical Nurse (LPN) Treatment Nurse removed the colostomy bag and put it in a trash can liner which had been placed on top of an overbed table. Liquid stool from the colostomy bag spilled over the side of the trash bag onto the overbed table, mattress, floor, and privacy curtain. After containing the bag, the Treatment Nurse cleaned the skin around the resident's stoma, removed her gloves, picked up her scissors, put them down, sanitized her hands, then picked up the scissors again to cut the wafer for a new colostomy bag. After the wound care was over, the Treatment Nurse placed the scissors in her pocket without sanitizing them. Afterwards, she stated she normally disinfected her scissors with a Clorox wipe, and verified that she had not. In addition, LPN AA, who assisted during the procedure, was noted to place a small multiple-use spray bottle of skin barrier directly on top of the overbed table that had been contaminated with feces after the wound care was completed. This bottle was then placed in the treatment cart without first sanitizing it; this was verified by the Treatment Nurse. Interview on 06/21/12 at 9:06 a.m. with the Registered Nurse (RN) Infection Control Coordinator revealed that scissors should be cleaned with Clorox wipe as soon as a treatment is over. Review of the facility's Dressing Changes/Tips for Aseptic Technique policy and procedure revealed that scissors must be wiped well with a germicidal wipe, then with an alcohol prep pad, after co… | 2017-01-01 |
| 7831 | 7831 | SCEPTER REHABILITATION AND HEALTHCARE CENTER, LLC | 115643 | 3000 LENORA CHURCH DRIVE | SNELLVILLE | GA | 30078 | 2012-06-21 | 156 | E | 0 | 1 | U3SV11 | Based on record review and staff interview the facility failed to send the required notice to three (3) residents (#186, #116, and #4) of thirty-five (35) sampled residents informing them of their right to request a claim be submitted to Medicare for review related to the termination of skilled Medicare services. Findings include: Residents # 186, #116 and #4 were admitted to the facility receiving Skilled Medicare Services. Each remained in the facility after skilled services were discontinued. Review of the advance notices each received informing them of their appeal rights revealed they only received notification of their right to an expedited review by an independent review board. There was no documentation they had received notice of their right to file an appeal to Medicare. Business Office staff member HH was interviewed on 6/21/12 at 3:30 p.m. and stated residents being discharged from skilled services are presently only being informed of their right to an expedited review. | 2016-11-01 |
| 7832 | 7832 | SCEPTER REHABILITATION AND HEALTHCARE CENTER, LLC | 115643 | 3000 LENORA CHURCH DRIVE | SNELLVILLE | GA | 30078 | 2012-06-21 | 244 | E | 0 | 1 | U3SV11 | Based on record review and, staff, resident and family interview, the facility failed to address Resident Council grievances related to call lights not being answered timely, as well as the lack of available linen for resident care for four (4) residents (A, B, C, D) from a sample of thirty-five (35) residents. Findings include: Review of the resident Council Minutes from 7/2011 through 4/2012 revealed repeated concerns related to nursing staff not answering call lights in a timely manner and turning off lights promising to be back, but not returning to complete the task. Call lights were a concern in the minutes dated 7/28/11, 11/10/11, 1/26/12, 2/28/12, 3/30/12, and 4/26/12. Further review revealed multiple concerns related to the lack of linen available for resident care. Linen shortage, especially towels and washcloths, was a concern 8/25/11, 9/29/11, 10/13/11, 12/15/11, 1/26/12, 2/28/12, 3/30/12, and 4/26/12. The minutes dated 9/29/2011 revealed the staff was using pillow cases as towels and the minutes dated 12/15/11 documented staff has used gowns in place of towels. There is no indication old business was discussed each month except for 10/13/ 11 when the minutes did reflect Old Business was reviewed at the meeting. Means to address the resident's concerns were for the Director of Nursing (DON) to make unscheduled visits on the 11p.m. -7 a.m. shift to check on whether call lights were answered promptly. However, review of the 11/10/11 minutes revealed it still takes a long time for staff to respond to call lights, or staff will tell resident's they are not their Certified Nursing Assistant (CNA), or to use their briefs instead of taking them to the bathroom. There was no documentation to indicate the DON had addressed the problem of call lights. Resident D was interviewed on 6/21/12 at 11:30 a.m. and stated she regularly attends Resident Council meetings. He/she stated most months call lights and the shortage of linens remain issues. They further stated the linen shortage will get a little better, but it … | 2016-11-01 |
| 7833 | 7833 | SCEPTER REHABILITATION AND HEALTHCARE CENTER, LLC | 115643 | 3000 LENORA CHURCH DRIVE | SNELLVILLE | GA | 30078 | 2012-06-21 | 278 | D | 0 | 1 | U3SV11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, record review, and staff interview, the facility failed to accurately assess three (3) residents, (#137, #186, #3) from a sample of thirty-five (35) residents. Findings include: 1. Record review revealed resident # 137 was admitted in 01/2012 with primary diagnosis' of [MEDICAL CONDITION], muscle weakness, and difficulty in walking. The Minimum Data Set ((MDS) dated [DATE] assessed the resident under 'transfers' as a three (3); requiring extensive assistance with two (2) person assist and 'balance' during transitions as not steady. The resident was observed on 6/18/12, 6/19/12, and 6/20/12 walking throughout the facility, to and from the dining room without assistance, and visiting with other residents and staff. During an interview with MDS Coordinator AA on 6/20/12 at 1:30 p.m., staff reported that the transfer information on the MDS dated [DATE] was obtained by the Certified Nursing Assistant (CNA) daily trackers, nursing monthly summaries, and observation of the resident. After reviewing the CNA tracking sheets, the physical therapy discharge summary and observing the resident, staff agreed that the 4/25/12 MDS was incorrect. During an interview with Licensed Practical Nurse (LPN) CC on 6/19/12 at 3:00 p.m., staff reported that since the resident was transferred to the C Hall in February, the resident has been ambulatory and able to transfer herself with only verbal cues. Review of the Physical Therapy Progress Report and Discharge Summary dated 3/07/12 revealed that the resident's current level of function for transfers is the patient is able to safely transfer to and from bed/wheelchair requiring supervision (needs verbal cueing but no physical assist). Summary of the skilled services provided since start of care: Patient made excellent progress under skilled Physical Therapy (PT) services and is currently at her maximum functional potential. Therefore, the patient is discharged from skilled PT services at this tim… | 2016-11-01 |
| 7834 | 7834 | SCEPTER REHABILITATION AND HEALTHCARE CENTER, LLC | 115643 | 3000 LENORA CHURCH DRIVE | SNELLVILLE | GA | 30078 | 2012-06-21 | 309 | D | 0 | 1 | U3SV11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review, staff and resident interview, the facility failed to provide care and services in accordance with physician's orders for rehabilitation therapy for one (1) resident B and the use of a chair/bed alarm for another resident (#136) from a sample of thirty-five (35) residents. Findings include: 1. Review of a physician's hospital discharge orders for resident B , dated 5/10/12 at 8:00 a.m. included a physician order for [REDACTED].'s order sheet indicated the nurse had checked line item # twelve (12) indicating received physician's orders for physical and occupational therapy. Interview with resident B on 6/21/12 at 8:30 a.m. revealed she had not received physical or occupational therapy since admission to the nursing facility in March 2012. Interview with the Director of Rehabilitation (DOR) on 06-21-12 at 10:25 a.m. revealed he was unaware that the resident returned to the facility from the hospital with physician's orders for rehabilitation. 2. Record review revealed resident #136 had a Physician Order dated 02/5/12 for a bed and/or chair alarm to be used and to check placement and function every shift. Observation on 6/20/12 at 8:00 a.m., 10:00 a.m., 12:23 p.m. and 2:00 p.m., revealed resident # 136 sitting in a wheelchair. The Tab alarm was not connected to the chair or resident. The Tab alarm case was observed on the back of the wheelchair. Interview on 6/20/12 at 2:00 p.m. with Licensed Practical Nurse (LPN) FFrevealed that there was no tab alarm connected to resident # 136 and that there was no alarm in the case. | 2016-11-01 |
| 7835 | 7835 | SCEPTER REHABILITATION AND HEALTHCARE CENTER, LLC | 115643 | 3000 LENORA CHURCH DRIVE | SNELLVILLE | GA | 30078 | 2012-06-21 | 431 | D | 0 | 1 | U3SV11 | Based on observation, review of the facility policy, and staff interviews the facility failed to ensure that one (1) expired medication was discarded, and three (3) multi-dose vials of medications were dated when opened in one(1) of eight (8) medication carts. Findings include: During review of the contents of the C Hall Medication Cart, the following was noted: 1. One (1) bottle of Tab-A-Vite Multi Vitamins had a manufacturer expiration date of 02-2012 2. One opened (1) bottle of Xalatan 0.005% (Latanoprost) eye drops, without a date as to when opened 3. One (1) vial of Novolin R Insulin and one (1) vial of Novolin 70/30 insulin both opened without dates when opened. Interview with the C Hall Unit Manager, LPN EE on 6/20/12 at 2:00 p.m. revealed that all multidose vials should be dated when opened and all expired medications should be discarded. She further revealed that is was the responsibility of each charge nurse to check the medication carts every day for the appropriate storage. Review of the facility policy Medication Storage and Medications with Special Expiration Date Requirements included documentation of: -All multidose vials would be dated when opened -Xalatan should be discarded 42 days after opening -Novolin R and Novolin 70/30 should be discarded 42 days after opening. | 2016-11-01 |
| 7882 | 7882 | EAST LAKE ARBOR | 115482 | 304 FIFTH AVENUE | DECATUR | GA | 30030 | 2012-06-21 | 151 | D | 0 | 1 | 2XUF11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations, record review, resident, family, and staff interview the facility failed to provide supervision for smoking for one (1) resident Z from a sample of thirty five (35) residents Findings include: Review of the medical record revealed that resident Z was admitted to the facility on [DATE] with [DIAGNOSES REDACTED]. Review of the annual Minimum Data Set (MDS) assessment dated [DATE] revealed that the resident was assessed as totally dependent for Activities of Daily Living (ADLs) and had limited function to both upper and lower extremities. The resident was assessed with [REDACTED]. Interview on 06-18-12 at 2:10 PM with resident Z revealed that he/she was not allowed to smoke every day because the facility informed him/her that he/she could only smoke if a family member would come to the facility to assist him/her. The resident acknowledged that he/she would like to go out side during smoke breaks. Continued interview revealed that the resident had burned his/her clothing in the past and needs assistance to smoke because of the inability to use his/her hands to hold the cigarette. The resident indicated that that the Administrator told him/her that the facility did not have anybody to assist the resident one on one. Observations on 06/19/12 at 10:30 a.m. and on 06/20/12 at 10:30 a.m., during smoke break, revealed two (2) smoking areas, one (1) at the end of the thee hundred (300) Hall and the other off the two hundred (200) Hall. Continued observations revealed more than one (1) staff member outside with the smoking residents at each of the two (2) smoking locations. Interview with the Director of Nursing (DON) on 06/20/12 at 8:25 a.m. revealed that the resident had burned his/her clothing about two years ago because he/she drops the cigarettes as is unable to hold the cigarettes in his/her hands. Continued interview revealed that that the family was notified of the resident burning himself and since the facility does not ha… | 2016-10-01 |
| 7883 | 7883 | EAST LAKE ARBOR | 115482 | 304 FIFTH AVENUE | DECATUR | GA | 30030 | 2012-06-21 | 241 | D | 0 | 1 | 2XUF11 | Based on observation and staff interview, the facility failed to provide dignity during dining for one (1) resident (#56) from a sample of thirty-five (35) residents. Findings include: Observation of lunch service on the 400 hall on 6/18/12 at 1:15 p.m. revealed Certified Nursing Assistant (CNA) EE standing on the left side of resident #56's bed feeding him. Observation of breakfast service on 6/19/12 on the 400 hall at 8:05 a.m. revealed staff CNA EE standing on the left side of resident #56's bed to feed him. During interview with staff CNA EE on 6/19/12 at 8:14 a.m. she revealed that she should be sitting in a chair to feed the resident but that she is pregnant and it was more comfortable for her to stand to feed the resident. She confirmed that she stood to feed the resident lunch on 6/18/12 and breakfast on 6/19/12. Interview with staff registered nurse BB, on 6/19/12 at 8:32 a.m. revealed she expects staff to be seated while they are feeding residents and that is what CNAs are taught. | 2016-10-01 |
| 7884 | 7884 | EAST LAKE ARBOR | 115482 | 304 FIFTH AVENUE | DECATUR | GA | 30030 | 2012-06-21 | 253 | D | 0 | 1 | 2XUF11 | Based on observations, and staff interviews the facility failed to maintain a clean enteral feeding pump for one (1) resident (#33) from a sample of thirty five (35) residents. Findings include: Observation on 6/19/2012 at 9:10 a.m revealed the enteral feeding pump for resident #33 was soiled with a dried brown substance along the front and back of the pump and down the support pole. Observation on 6/19/2012 at 9:15 a.m. revealed License Practical Nurse (LPN) AA turn off the pump and after ten (10) minutes disconnect and flush the tubing, draping the tubing over the pump, and left the room without cleaning the pump. Observation on 6/19/2012 at 1:30 p.m. revealed that the enteral feeding pump continued with a dried brown substance on the front, the back and the supporting pole. Observation on 6/20/2012 at 8:00 a.m. revealed that the enteral feeding pump had a dried brown substance on the front, the back and down the supporting pole. Observation and interview with Charge Nurse AAon 6/20/2012 at 8:15 a.m. revealed that she did not notice the substance on the pump during provision of care on 6/19/12. Continued interview revealed that she thought that the 11-7 shift were responsible for cleaning the machine. Observation and interview conducted with Unit Manager BB on 6/20/2012 at 8:20 a.m., who noted that the pump was not clean, revealed that the there was no staff assigned to clean the machine, that all the nurses were responsible for cleaning the enteral feeding pumps. | 2016-10-01 |
| 7885 | 7885 | EAST LAKE ARBOR | 115482 | 304 FIFTH AVENUE | DECATUR | GA | 30030 | 2012-06-21 | 278 | D | 0 | 1 | 2XUF11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, record review and resident and staff interviews, the facility failed to accurately assess the oral/dental status of one (1) resident (D) from a sample of thirty five (35) residents. Findings include: Observation on 6/19/12 at 9:46 a.m. revealed resident D with broken and decayed teeth. Review of the annual Minimum Data Set (MDS) assessment dated [DATE] revealed the resident was assessed with [REDACTED]. Review of the physician's progress notes dated 3/07/12 and 4/02/12 revealed poor dentition noted on the oral cavity exam. Interview on 6/19/12 at 2:37 p.m. with the Social Services Director revealed the nurses refer the residents for dental services when they complain of dental pain or assess the residents as needing dental care. There is a Mobile Dentistry service that comes to the facility on a monthly basis. The dentist will clean and treat or extract teeth as needed. The facility also has a second dental service to call if needed. The dental services are available for all residents. Interview on 6/20/12 at 8:15 a.m. with resident D revealed the resident knows his/her teeth are bad and they need dental work but was not aware the facility could seek dental services for him. Interview on 6/21/12 at 12: 02 p.m. with the MDS Coordinator, revealed the assessments are done quarterly and discussed at the care plan meetings. Usually the nurses will address any dental problems if there is inflammation or problems that need to be addressed. Continued interview revealed that the MDS Coordinator goes to assess the resident's herself prior to completing the quarterly or annual assessments. | 2016-10-01 |
| 7886 | 7886 | EAST LAKE ARBOR | 115482 | 304 FIFTH AVENUE | DECATUR | GA | 30030 | 2012-06-21 | 282 | D | 0 | 1 | 2XUF11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations and record review, the facility failed to follow the care plan related to interventions for falls for one (1) resident (#67) from a sample of thirty five (35) residents. Findings include: Review of the care plan for resident #67, dated 5/01/12 revealed that the resident had been care planned at risk for falls related to a history of falls secondary to [MEDICAL CONDITION]. Interventions included: tab monitor for bed and chair, helmet to be worn at all times, staff to check resident every two hours as resident may remove helmet, place resident near the nurses station for supervision during the day, anti-tippers on wheelchair, non-skid socks or proper shoes when ambulating, and bed at lowest level. Observation on 6/18/12 at 1:20 p.m. and on 6/19/12 at 7:15 a.m. revealed the resident lying in bed. There was no safety helmet or non skid socks on the resident. Observation on 6/19/12 at 2:50 p.m. revealed the resident standing at the closet in his room. The resident had no safety helmet on. Continued observation revealed the Tab alarm was attached to the wheelchair but was not sounding. Observation on 6/20/12 at 8:15 a.m. revealed the resident sitting up in bed eating breakfast. There was no safety helmet on the resident's head. Interview on 6/20/12 at 1:40 p.m. with Certified Nursing Assistant (CNA) II revealed that the resident should have a Tab alarm attached when he is in bed or up in the wheelchair, a safety helmet on, even when in bed and that the resident was to checked every two (2) hours. Continued interview revealed that the resident takes the helmet off. Interview on 6/20/12 at 2:50 p.m. with the Director of Nursing (DON) revealed that the resident will take his helmet off but that the staff is to check him every two (2) hours to ensure that the helmet is in place. Continued interview revealed that the resident was to be next to the nurses station in the day room during the day to be monitored. | 2016-10-01 |
| 7887 | 7887 | EAST LAKE ARBOR | 115482 | 304 FIFTH AVENUE | DECATUR | GA | 30030 | 2012-06-21 | 309 | D | 0 | 1 | 2XUF11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and staff interview, the facility failed to follow physician's orders related to laboratory testing for one (1) resident (#8) from a sample of thirty five (35) residents. Findings include: Resident #8 is a [AGE] year old readmitted [DATE] with [DIAGNOSES REDACTED]. Review of the physician's orders revealed an order dated 3/16/12 for a [MEDICATION NAME] level to be drawn on 3/22/12. There was no evidence that a [MEDICATION NAME] level was done on 3/22/12, although blood was drawn for testing on this date from the resident. Interview with the Director of Nursing on 6/21/12 at 12:10 p.m. confirmed a [MEDICATION NAME] level was ordered for 3/22 but was not done. Interview with Licensed Practical Nurse DD on 6/21/12 at 1:52 p.m. revealed she ordered a [MEDICATION NAME] level instead of a [MEDICATION NAME] level on 3/22/12. Continued interview revealed that the resident was not on [MEDICATION NAME]. | 2016-10-01 |
| 7888 | 7888 | EAST LAKE ARBOR | 115482 | 304 FIFTH AVENUE | DECATUR | GA | 30030 | 2012-06-21 | 322 | D | 0 | 1 | 2XUF11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, record review and staff interview, the facility failed to properly determine gastrostomy tube placement for one (1) resident (#32) from a sample of thirty-five (35) residents. Findings include: Review of the physician's orders [REDACTED]. Observation of Licensed Practical Nurse (LPN) CC on 6/19/12 at 1:30 p.m. revealed that the nurse assessed for tube placement by measuring the length of the gastrostomy tube. Interview with the Director of Nursing (DON) on 6/19/12 at 2:28 p.m. revealed that two (2) methods are required when assessing for tube placement. Continued interview revealed that the nurse had not followed facility policy when checking tube placement. Interview on 6/20/12 at 1:33 p.m. with LPN CC revealed that she had forgotten to check for residual during tube placement assessment. Review of the facility's policy for enteral feedings revealed to check tube placement and patency using a sixty (60) cubic centimeter (cc) luer lock syringe, place syringe in end cap of tube and slowly aspirate . observe color and consistency of any aspirate. | 2016-10-01 |
| 7889 | 7889 | EAST LAKE ARBOR | 115482 | 304 FIFTH AVENUE | DECATUR | GA | 30030 | 2012-06-21 | 323 | D | 0 | 1 | 2XUF11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations, record review, and staff interviews, the facility failed to provide adequate supervision related to fall prevention for one (1) residents (#67) from a sample of thirty five (35) residents. Findings include: Review of the medical record for resident #67 revealed that the resident was readmitted to the facility on [DATE] with [DIAGNOSES REDACTED]. Review of the quarterly Minimum Data Set (MDS) assessment dated [DATE] revealed that the resident was assessed as requiring one (1) person physical assist with transfer, extensive assistance with dressing, hygiene and total assist with toileting. The resident was also assessed with [REDACTED]. Review of the resident Occurrences History Log revealed that the resident had fourteen (14) falls from January 07, 2012 until June 12, 2012 with no major injury. Review of the care plan for resident #67, dated 5/01/12 revealed that the resident had been care planned at risk for falls related to a history of falls secondary to Parkinson's Disease. Interventions included helmet to be worn at all times, staff to check resident every two hours as resident may remove helmet, place resident near the nurses station for supervision during the day. Observations on 6/18/12 at 1:20 p.m., on 6/19/12 at 7:15 a.m., 6/19/12 at 2:50 p.m. and 6/20/12 at 8:15 a.m. revealed the resident in his room with no safety helmet on. Review of the clinical record for resident #67 revealed no evidence that the resident was being monitored/supervised every two hours. Interview on 6/20/12 at 2:50 p.m. with the Director of Nursing (DON) revealed that the resident will take his helmet off but that the staff is to check him every two (2) hours to ensure that the helmet is in place. Continued interview revealed that the resident was to be next to the nurses station in the day room during the day to be monitored. Telephone interview with the Administrator on 7/06/12 at 12:15 p.m., during the Quality Assurance Process, reveale… | 2016-10-01 |
| 7890 | 7890 | EAST LAKE ARBOR | 115482 | 304 FIFTH AVENUE | DECATUR | GA | 30030 | 2012-06-21 | 406 | D | 0 | 1 | 2XUF11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on medical record review and staff interview, the facility failed to provide mental health rehabilitative services for mental illness/mental [MEDICAL CONDITION] for one (1) resident (#2) from a sample of thirty-five (35) residents. Findings include: Review of medical record for resident #2 revealed that the resident was admitted to the facility on [DATE] with [DIAGNOSES REDACTED]. Continued review revealed that the resident was assessed as a Preadmission Screening and Annual Resident Review (PASARR) Level II for specialized services. Review of the Psychiatrist's progress note dated 6/30/11 revealed the following: Axis I: Organic anxiety disorder; Axis II: Mental [MEDICAL CONDITION]: Axis III: [MEDICAL CONDITION]; Hypertension; [MEDICAL CONDITION]. Continued review revealed that, per the staff, the resident had exhibited a recent increase in temper behavior, especially when not getting his way, still with occasionally sexually inappropriate behavior, limited speech and fair sleep and appetite. Recommendations: Increase [MEDICATION NAME] for mood and anxiety to forty (40) milligrams (mg), [MEDICATION NAME] as needed (prn) and follow-up in six to eight (6-8) weeks. There was no evidence that the Psychiatrist had assessed the resident since 6/30/11. Interview on 6/21/12 at 11:26 a.m. with the Social Services Director revealed the resident is seen by psychiatric services. The psychiatric visit notes should be in the medical record. Interview on 6/21/12 at 11:40 a.m. with the Director of Nursing (DON) revealed the psychiatric notes should be in the medical record and believes that the resident has been seen regularly by psychiatric services. Continued interview revealed the records since 6/30/11 would be requested from the psychiatrist. Interview on 6/21/12 at 12:30 p.m. with the DON revealed no other psychiatric progress notes could be located. Interview on 6/21/12 at 12:38 p.m. with the DON revealed that the staff at the Psychiatrist's offi… | 2016-10-01 |
| 7891 | 7891 | EAST LAKE ARBOR | 115482 | 304 FIFTH AVENUE | DECATUR | GA | 30030 | 2012-06-21 | 504 | D | 0 | 1 | 2XUF11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and staff interviews, the facility obtained a laboratory test for which there was no physician's order for one (1) resident (#8) from a sample of thirty-five (35) residents. Findings include: Review of the clinical record for resident #8 revealed that the resident is a [AGE] year old admitted [DATE] and re-admitted [DATE] with [DIAGNOSES REDACTED]. Review of the physician's orders reveal a current order for [MEDICATION NAME] 200 milligrams (mg) by mouth every morning at 9:00 a.m. and [MEDICATION NAME] 300 mg by mouth at bedtime and [MEDICATION NAME] levels to be done monthly. Review of the laboratory results for the [MEDICATION NAME] levels revealed that on 3/16/22 the [MEDICATION NAME] level was reported at 44.5 ,with normal being 10-20. The physician was contacted and an order was received to hold the morning and bedtime doses of [MEDICATION NAME] through the 3/22/12 morning dose and repeat the [MEDICATION NAME] level on 3/22/12. There was no evidence that a [MEDICATION NAME] level was done on 3/22/12, however, a [MEDICATION NAME] level was done Interview with the Director of Nursing on 6/21/12 at 12:10 p.m. confirmed a [MEDICATION NAME] level was ordered for 3/22/12, but a [MEDICATION NAME] level was done instead. Interview with Licensed Practical Nurse (LPN) DD on 6/21/12 at 1:52 p.m. revealed she ordered a [MEDICATION NAME] level instead of a [MEDICATION NAME] level on 3/22/12. Continued interview revealed that the resident is not on [MEDICATION NAME] and should not have had a [MEDICATION NAME] level drawn. | 2016-10-01 |
| 7959 | 7959 | NEW LONDON HEALTH CENTER | 115771 | 2020 MCGEE ROAD | SNELLVILLE | GA | 30078 | 2012-06-21 | 278 | D | 0 | 1 | 866711 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and staff interview the facility failed to conduct assessments which accurately reflected the condition of the resident for (1) resident (# 147) from a sample of forty-three (43). Findings include: Resident #147 was admitted to the facility in December 2010 with multiple diagnosis' including but not all inclusive, of [MEDICAL CONDITION], dysphasia, [MEDICAL CONDITION], Alzheimer's, Gastro-esphogeal reflux disease, abnormal blood sugar and obesity. The resident had a physician's orders [REDACTED]. A speech therapy assessment, at the time of admission, identified the need for aspiration precautions secondary to food pocketing and swallowing issues. Record review of the Nutritional assessment dated [DATE] revealed the need for an altered mechanically diet, small portions to encourage weight reduction and to be fed by staff. Record review of Nurses Notes dated 12/28/11 contained documentation that the resident was totally dependent for all care and pockets food at intervals. A note dated 01/16/12 at 4:30 p.m. noted the resident required suctioned for holding fluids in the mouth. Review of the Minimum Data Set (MDS) annual assessment, dated 11/14/11 and the Quarterly MDS Assessments, dated 02/13/12 and 5/26/12 documented incorrectly that the resident had no swallowing disorders. | 2016-09-01 |
| 7960 | 7960 | NEW LONDON HEALTH CENTER | 115771 | 2020 MCGEE ROAD | SNELLVILLE | GA | 30078 | 2012-06-21 | 279 | D | 0 | 1 | 866711 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and staff interview the facility failed to develop a comprehensive care plan for a resident who had a history of [REDACTED].#3, from a sample of forty-three (43) residents. Findings include: Review of the Admission Minimum Data Set ((MDS) dated [DATE] revealed resident #3 was assessed at risk for falls related to a history of falls and a fracture prior to admission. Review of the Comprehensive Care Plan based on the initial assessment revealed the Care Plan did not address the fall risk, or any interventions to prevent further falls. The Care Plan Coordinator was interviewed on 6/20/12 at 10:30 a.m. and stated the Care Plan did not address the resident's fall risk. | 2016-09-01 |
| 7961 | 7961 | NEW LONDON HEALTH CENTER | 115771 | 2020 MCGEE ROAD | SNELLVILLE | GA | 30078 | 2012-06-21 | 282 | D | 0 | 1 | 866711 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based upon staff interview and record review the facility failed to follow the care plan to notify the physician of significant weight loss for one (1) resident (#147) of forty-three (43) sampled residents. Findings include: Resident #147 was admitted to the facility on [DATE] with a [DIAGNOSES REDACTED]. Record review of the resident's weight for 12/2011 was 208 pounds (lbs), 1/2012 was 205 lbs, 2/12 was 189 lbs. Review of Dietary Progress Note dated 2/20/12 revealed the February weight was obtained 2/04/12. The resident had lost 16 pounds between January and February, which was equal to a 7.8 percent (%) weight loss in one month. Record review of the resident's care plan revealed the resident's nutritional status was assessed at risk. An intervention dated 01/04/12 revealed the physician was to be notified of any significant weight loss. Record review of the twenty four (24) hour report for 2/19/12 revealed the resident was placed on the doctor's list to be seen for loss of appetite. A Physician's Progress Note revealed the resident was seen on 02/20/12. Cross to F325 | 2016-09-01 |
| 7962 | 7962 | NEW LONDON HEALTH CENTER | 115771 | 2020 MCGEE ROAD | SNELLVILLE | GA | 30078 | 2012-06-21 | 312 | D | 0 | 1 | 866711 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review, resident interview and staff interview the facility failed to provide routine cleaning of dentures for one (1) resident, A, from a sample of forty-three (43) residents. Findings include: Record review for resident A revealed that he/she had an activities of daily living (ADL) Self Care Performance Deficit related to [MEDICAL CONDITION], paralysis agitans, muscle weakness, difficulty in walking, and left wrist drop(radial nerve palsy). During an interview with resident A on 6/19/12 at 10:15 a.m. the resident stated that his/her dentures were seldom cleaned by staff members. The resident stated that he/she was not able to clean the dentures independently because of his/her health condition. On 6/19/12 at 3:00 p.m. interviews with Certified Nursing Assistants (CNAs) HH and II revealed that residents' dentures are cleaned after every meal. However, an interview with the facility's Director of Nursing (DON) at that time revealed that there was no evidence of documentation confirming that the residents' dentures were cleaned. | 2016-09-01 |
| 7963 | 7963 | NEW LONDON HEALTH CENTER | 115771 | 2020 MCGEE ROAD | SNELLVILLE | GA | 30078 | 2012-06-21 | 323 | D | 0 | 1 | 866711 | Based on record review and staff interview the facility failed to ensure a resident with a history of falls did not sustain additional falls. This affected one (1) resident, #3, from a sample of forty-three (43) residents. Findings include: Record review for resident #3 revealed that she had been admitted to the facility after experiencing a fall at home which resulted in a fractured hip. Further record review revealed the resident's care plan did not address interventions related to her fall risk. Further record review revealed the resident fell out of her wheelchair in the lobby of the facility on 6/19/12 with no injuries resulting. This information was confirmed in an interview with the facility's Care Plan Coordinator in an interview on 6/20/12 at 10:30 a.m. | 2016-09-01 |
| 7964 | 7964 | NEW LONDON HEALTH CENTER | 115771 | 2020 MCGEE ROAD | SNELLVILLE | GA | 30078 | 2012-06-21 | 441 | E | 0 | 1 | 866711 | Based on observation and staff interview the facility failed to ensure that proper infection control practices were in place to prevent cross contamination for residents receiving nebulizer treatments. This affected one (1) resident, #15, from a sample of forty-three (43) residents. The facility also failed to ensure hygienic practices were in place during residents' dining programs. Findings include: Observation on 6/19/12 at 4:29 p.m. revealed resident #15 had a nebulizer with attached face mask sitting on top of the bed side cabinet. The nebulizer and mask were not being stored in a plastic bag. There was no protective barrier between the cabinet and the nebulizer and mask. At 4:30 p.m. the resident received a respiratory treatment using the nebulizer and mask. Following the treatment at 4:40 p.m. the nebulizer and mask were observed once again sitting uncovered on top of the bed side cabinet. Observation on 6/20/12 at 9:54 a.m. revealed a nebulizer and mask sitting uncovered on the bed side cabinet for resident #15. A respiratory treatment was given at 10:00 am using the nebulizer and mask. At 10:10 a.m. the nebulizer and mask were again observed sitting on top of bed side cabinet uncovered and with no barrier between the cabinet and the mask and nebulizer. The Director of Nursing (DON) was interviewed on 6/21/12 at 11:16 a.m. and stated nebulizers and other respiratory equipment should be covered when not in use. She further stated that after each use respiratory equipment should be cleaned and placed back into a protective bag. During dining observations on 6/18/12 at 12:10 p.m. on Hall D staff members assisting residents with dining were observed picking up beverage glasses by the rims and having their fingers touching the inside of glassware. Staff members were also observed touching residents, readjusting residents' clothes, cutting up residents' food, and leaving the dining room area to carry trays to another residents on the D hall. The staff members were not wearing gloves and had not been observed wa… | 2016-09-01 |
| 9189 | 9189 | GOLDEN LIVINGCENTER - THOMASVILLE | 115501 | 930 SOUTH BROAD ST. | THOMASVILLE | GA | 31792 | 2012-06-21 | 157 | D | 1 | 0 | ILZI11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review, staff interview, and staff written statement review, the facility failed to immediately consult with the physician related to a significant change in condition involving the right foot of one (1) resident (#1) from a survey sample of ten (10) residents. Findings include: Record review for Resident #1 revealed that she was admitted to the facility on [DATE]. The resident's Care Plan identified a Focus area of the resident having non-pressure altered skin integrity related to [DIAGNOSES REDACTED]. On the Skin Conditions sheet of 01/26/2012, the right second toe was described as dark black and purplish in color, with a wound measuring 1.2 centimeters (cm.) by 1.3 cm.; the right third toe was described as dark purple in color with intact skin, and with a wound measuring 0.7 cm. by 0.5 cm. by 0.001 cm.; and, the right fifth toe was described as dark purple and pink in color, with the skin intact, and with a wound measuring 1 cm. by 1 cm. by 0.001 cm. A skin assessment of 03/23/2012 documented that there were no new skin conditions. A Progress Notes entry of 04/06/2012 at 3:38 p.m., written by Nurse "AA", documented that the venous stasis ulcers on the resident's right second and third toes remained the same, with no changes due to poor circulation, and remained black in color and painful to touch. During an interview with Licensed Nurse "AA" conducted on 05/17/2012 at 4:15 p.m., Nurse "AA" stated she that she had last documented on the status of the resident's right toes on 04/06/2012. She further stated that she had stopped doing treatments on 04/06/2012 and that a new treatment nurse had assumed that duty after that date. In a Progress Notes entry of 04/27/2012 timed at 6:18 p.m., Nurse "BB" documented Resident #1's dark areas to the right toes, further documenting that the mid-foot had a darker skin tone. Nurse "BB" further documented that the right toes were extremely sensitive to touch and that the right great toe was … | 2015-08-01 |
| 9190 | 9190 | GOLDEN LIVINGCENTER - THOMASVILLE | 115501 | 930 SOUTH BROAD ST. | THOMASVILLE | GA | 31792 | 2012-06-21 | 309 | D | 1 | 0 | ILZI11 | Based on record review and staff interview, the facility failed to assess, on an ongoing basis, the status of venous stasis wounds on the right foot of one (1) resident (#1) from a survey sample of ten (10) residents. Findings include: Record review for Resident #1 revealed a Skin Conditions sheet of 01/26/2012 (the resident's date of admission) which documented the resident's right second toe was dark black and purplish in color, with a wound measuring 1.2 centimeters (cm.) by 1.3 cm.. This Skin Conditions sheet also described the resident's right third toe as dark purple in color with intact skin, with a wound measuring 0.7 cm. by 0.5 cm. by 0.001 cm.; and the right fifth toe was described as dark purple and pink in color, with the skin intact and a wound measuring 1 cm. by 1 cm. by 0.001 cm.. A Progress Notes entry of 04/06/2012 at 3:38 p.m., written by Nurse "AA", documented that the venous stasis ulcers on the resident's right second and third toes remained the same, with no changes due to poor circulation, and remained black in color and painful to touch. However, further record review revealed no evidence of assessment and monitoring of the status of the wounds on the right foot of Resident #1 until a Progress Notes entry of 04/27/2012 at 6:18 p.m., written by Nurse "BB", which documented Resident #1's dark areas to the right toes, further documenting that the mid-foot had a darker skin tone, that the right toes were extremely sensitive to touch, and that the right great toe was almost translucent in color. During an interview with Licensed Nurse "AA" conducted on 05/17/2012 at 4:15 p.m., Nurse "AA" stated she that she had last documented the status of the resident's right toes on 04/06/2012. She further stated that she had stopped doing treatments on 04/06/2012, at which time new treatment nurse had assumed that duty. Based on the above, there was no evidence to indicate that the facility assessed and monitored the status of the wounds on Resident #1's right foot toes from 04/06/2012 until 04/27/2012, at … | 2015-08-01 |
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CREATE TABLE [cms_GA] ( [facility_name] TEXT, [facility_id] INTEGER, [address] TEXT, [city] TEXT, [state] TEXT, [zip] INTEGER, [inspection_date] TEXT, [deficiency_tag] INTEGER, [scope_severity] TEXT, [complaint] INTEGER, [standard] INTEGER, [eventid] TEXT, [inspection_text] TEXT, [filedate] TEXT );