cms_GA
Data source: Big Local News · About: big-local-datasette
30 rows where "inspection_date" is on date 2015-10-15
This data as json, copyable, CSV (advanced)
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 4194 | 4194 | PRUITTHEALTH - SWAINSBORO | 115533 | 856 HIGHWAY 1 SOUTH | SWAINSBORO | GA | 30401 | 2015-10-15 | 166 | D | 0 | 1 | 3IL511 | Base on record review and interview, the facility failed to resolved a grievance related to one (1) resident B on a sample of twenty-three (23) residents. Findings Include: During an interview on 10/14/15 at 3:02 p.m. the family member of resident B stated that resident B was admitted to the facility on the 200 hall, and that initially resident B was unable to shower due to a recent stroke. After receiving therapy services, resident B was beginning to go to the shower. Shortly afterwards, stated resident B did not want to go to the shower anymore. The family member of resident B continued to state that he/she came to the facility to speak with the Social Worker (SW) to find out why resident B was refusing showers and to request a room change. During an interview on 10/15/15 at 8:00 a.m. the Social Worker (SW), they acknowledged that the family member of resident B came to the facility with concerns about resident B not wanting to take showers and requesting a room change. SW stated that the family member of resident B informed him/her last week of these issues. When asked to explain the process for family/resident concerns or complaints, SW stated that a concern or complaint is written on a grievance form. The Social worker stated a grievance form was not completed for the family member of resident B because the SW had told another staff but could not recall whom. Review of the Grievance Log entries from 03/15 through 10/14/15 revealed there were no documented entries in the Grievance Log for resident B. Review of the facility policy entitled Grievances: Healthcare Center Section Procedure: (4.) The Social Services Partner will be responsible for following up with the patient/resident, authorized individual or other representative to make sure that the grievance has been resolved or that they understand what actions have been take. And number (5.) The Grievance/Complaint should be completed within three business days. | 2020-02-01 |
| 4195 | 4195 | PRUITTHEALTH - SWAINSBORO | 115533 | 856 HIGHWAY 1 SOUTH | SWAINSBORO | GA | 30401 | 2015-10-15 | 309 | D | 0 | 1 | 3IL511 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview, the facility failed to take measures to prevent a fecal impaction and follow physician standing order for one (1) resident (#115) from a sample of twenty-three (23) residents. Findings Include: Review of the Minimum Data Set (MDS) Admission assessment dated [DATE] revealed Section G Functional Status for Toilet Uses that resident #115 was independently toileting and need set up only. Section C Cognitive Patterns Summary Score noted 03 indicating significant impairment. Section [NAME] Behavior revealed no resistance of care. Section I listed [DIAGNOSES REDACTED]. Review of Nurse's Note and the Nursing Home to Hospital Transfer Form dated 08/24/15 revealed resident #115 was found on the floor and was sent to[NAME]Regional Medical Center with an admitting [DIAGNOSES REDACTED].#115 returned to the facility on [DATE]. The Minimum Data Set (MDS) 5 day assessment dated [DATE] revealed Section I Active Diagnosis, of a [MEDICAL CONDITIONS], Hypertension and [MEDICAL CONDITION]. Section G Functional Status for Toilet Uses was extensive assistance. Section [NAME] Behavior revealed no resistance of care. Review of the Nurse's Note and a Nursing Home to Hospital Transfer Form dated 09/14/15 revealed that resident #115 was noted to have rectal bleeding was sent the Hospital Emergency Department for evaluation. admitting [DIAGNOSES REDACTED]. The Nurse's notes dated 08/30/15 through 09/14/15 revealed that the resident was assessed as incontinent of bowel and bladder and total dependent on staff for toileting. There were four (4) documented Nurse's Note entries that the resident were administered narcotics to ease the pain of his/her [MEDICAL CONDITION]. The Certified Nursing Assistant (CNA) Care Interventions Record Signature Sheet Form dated (MONTH) (YEAR) revealed during the month of (MONTH) 28-31, (YEAR) there was no documented bowel movement and was there was missing data. September 2-4, (YEAR) there were no documen… | 2020-02-01 |
| 4196 | 4196 | PRUITTHEALTH - SWAINSBORO | 115533 | 856 HIGHWAY 1 SOUTH | SWAINSBORO | GA | 30401 | 2015-10-15 | 406 | D | 0 | 1 | 3IL511 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and staff interview, it was determined that the facility failed to provide continuing mental health services for one (1) (#97) of one (1) sampled residents for Pre-Admission Screening/Resident Review (PASRR) from a total sample of twenty-three (23) residents. Findings include: Review of the the medical record for resident #97 revealed the following [DIAGNOSES REDACTED]. Review of the 07/28/14 Level II Pre-Admission Screening/Resident Review (PASRR) revealed that the resident was eligible to receive additional specialized specialized services and/or supports according to an individualized plan of care to treat the resident's serious mental illness. Review of the 06/29/15 Quarterly Minimum Data Set (MDS), and the 08/07/15 Annual MDS revealed the resident had not displayed any behaviors and had not received Psychological therapy in the past seven days. During interviews with the Director of Nursing, the Administrator and the Nurse Consultant on 10/15/15 at 3:50 p.m., they stated there was not a staff person who was responsible for reviewing the Level II PASRR reviews, that it was a team approach. However, the facility could not provide any documentation of where the team had reviewed this resident's Level II PASRR or discussed his/her recommended ongoing psychiatric care. They further stated the resident had not had any behaviors until (MONTH) (YEAR) when the resident started throwing him/herself from bed or the chair. After the resident was found on the floor on 09/01/15, the resident's physician gave an order to send the resident to the emergency room for psychiatric evaluation. The resident was admitted for inpatient psychiatric treatment and returned to the facility on [DATE]. When they were asked who was responsible for determining if this resident would receive the recommended services they all stated the physician. They then confirmed that the resident's primary care physician was not a psychiatrist. They stated if … | 2020-02-01 |
| 4270 | 4270 | EASTMAN HEALTHCARE & REHAB | 115622 | 556 CHESTER HIGHWAY | EASTMAN | GA | 31023 | 2015-10-15 | 159 | E | 0 | 1 | 528G11 | Based on record review, staff and resident interview, the facility failed to have resident's personal funds available on the weekends and holidays for four (4) (#36, #51, #72), and #32 of six (6) residents from a sample of thirty two (32) residents. Findings included: During an interview on 10/13/15 at 3:24 p.m., resident #36 stated he/she was not able to get any of his/her personal funds on the weekends when the business office was closed. During an interview on 10/14/15 at 10:34 a.m., resident #51 stated that he/she was not able to get any of his/her personal funds on the weekends when the business office was closed. During an interview on 10/14/15 at 8:33 a.m., resident #72 stated they were not able to get any of their personal funds on the weekends when the business office was closed. In addition, the resident complained that they had not been able to receive any of their personal funds this month. Also stated that they had made several attempts to receive their money but was told to come back each time. They stated they would go back this date to attempt to receive their funds. During a review of resident #72's personal funds account on 10/16/15 at 2:41 p.m., the Administrator confirmed the resident's funds were deposited on 10/2/15, however they did not had those funds available to them until 10/14/15. During an interview on 10/13/15 at 2:21 p.m., resident #32 stated they were not able to get any of their personal funds on the weekends when the business office was closed. During an interview with the Administrator on 10/16/15 at 2:41 p.m., the Administrator confirmed the resident funds are not available to the residents on weekends. | 2020-01-01 |
| 4271 | 4271 | EASTMAN HEALTHCARE & REHAB | 115622 | 556 CHESTER HIGHWAY | EASTMAN | GA | 31023 | 2015-10-15 | 160 | D | 0 | 1 | 528G11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review, and staff interview the facility failed to ensure that resident personal funds were disbursed within thirty (30) days of death for one (1) out of three (3) resident accounts reviewed. Findings include: Review of deceased resident personal funds accounts for the past six (6) months revealed the following. 1. Resident #51 had a date of death of [DATE], with an outstanding balance of $2642.16 . This was not disbursed until [DATE], sixty one (61) days after death. An interview on [DATE] at 3:16 p.m., the Business Office Coordinator confirmed the funds were not conveyed within thirty days after death. | 2020-01-01 |
| 4272 | 4272 | EASTMAN HEALTHCARE & REHAB | 115622 | 556 CHESTER HIGHWAY | EASTMAN | GA | 31023 | 2015-10-15 | 253 | E | 0 | 1 | 528G11 | Based on observation and staff interview, the facility failed to provide effective housekeeping and maintenance services to maintain a sanitary, orderly and comfortable interior as evidenced by floors with missing finish, doors and walls with missing paint and finish; paint missing from beds; holes in walls, bedside tables and chest with missing finishes; bathroom floors with brown/black discoloration; stained privacy curtains; shower rooms with worn/discolored flooring and missing tile on the walls; discolored grout in shower room floors; and missing baseboards. This failure affected five (5) of five (5) hallways, twenty-four (24) of forty-eight (48) resident rooms, two (2) of two (2) shower rooms, and eleven (11) of twenty-eight (28) resident bathrooms. Findings include: 100 Hall: During observation of the 100 hall on 10/13/15 at 10:30 a.m. scuffed walls and baseboards were present and cracked flooring was observed. During observation of room 101 on 10/13/15 at 10:30 a.m. the door frame had missing paint, the door had the finish missing in areas and the chest had areas where the finish was missing . During observation of room 105 on 10/14/15 at 10:47 a.m. the door frames had missing paint, the finish was missing on the doors and the bedside table next to A bed had the finish missing on the top edges. During observation of room 107 on 10/13/15 at 10:30 a.m. the finish was missing on the door on the outside, the walls had missing paint next to B bed and the door frames and chest had missing paint. During further observation of room 107 on 10/13/15 at 1:53 p.m. the over bed table had missing paint on the base and the wall behind A bed had missing paint . During observations of Room 109 on 10/13/15 at 10:30 a.m. the chest was missing the finish, three (3) nails were protruding from the wall over the B bed and the built in dresser was missing paint . Further observation of Room 109 on 10/13/15 at 5:02 p.m. doors with the finish missing. During observation of room 110 on 10/13/15 at 2:10 p.m. the A bed over bed table… | 2020-01-01 |
| 5856 | 5856 | GOODWILL HEALTH AND REHAB | 115486 | 4373 HOUSTON AVE. | MACON | GA | 31206 | 2015-10-15 | 151 | D | 1 | 0 | 7J0Y11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, the facility failed to honor resident choices related to use of personal wheelchair and personal choice of diet for one (1) resident (#30) of the forty-seven (47) sampled. Findings include: Interview with resident #30 on 6/26/2015 at 2:30 p.m. revealed that her personal wheelchair had been removed from her use. Resident #30 stated the facility took it away and they brought in a different one, but it was too big for the transport van. The resident stated that the wheels on the facility's wheelchair were too wide for the ramp used for transport. The resident stated that she had not asked anyone about the old chair. Interview on 6/26/15 at 6:00 p.m. with the Administrator revealed the wheelchair had been placed in storage and another wheelchair was given to the resident for use. The administrator stated that the personal wheelchair of resident #30 was too small to fit her. Resident #30 also states that she has [MEDICAL CONDITION] and is supposed to be on a low salt diet but the diet she gets tastes like it has salt. Record review of the physician orders [REDACTED]. | 2018-05-01 |
| 5857 | 5857 | GOODWILL HEALTH AND REHAB | 115486 | 4373 HOUSTON AVE. | MACON | GA | 31206 | 2015-10-15 | 225 | J | 1 | 0 | 7J0Y11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations, and interviews, the facility failed to report misappropriation of property for three (3) residents (#32, #31, #33) (medications) and failed to report a fall with injury to the Department for one (1) resident (#35)with an injury affecting four (4) of the forty-seven (47) sampled residents. Finding include: 1. Interview on 8/26/15 at 2:26 p.m. with the Unit Manager - Faith 1 and Haven 1 revealed that there was an issue of narcotics missing. She revealed that there was an incident where a whole sheet of [MEDICATION NAME] which belonged to resident #32 was missing. As a result of the missing medication the nurses implemented a count of all narcotics. She revealed that the medications were for a resident that never asked for pain medication. Interview on 8/26/15 at 3:07 p.m. with the Unit Manager - Faith II and Haven II halls revealed that medication was missing around July 15, 2015, an audit was completed which revealed that [MEDICATION NAME] and the control count sheets was missing for resident #33 and resident #31. She revealed that the medication cart audits were completed on Sunday; and, by Wednesday the drugs sheets and medication were missing. She revealed that resident #33 did not use medications often. She revealed the Medical Director, Administrator, Director of Nursing and the Pharmacy were notified of missing medications. She revealed that a new count system was implemented to prevent further medication errors. The Unit Manager further revealed that an inservice was given to all nurses. She revealed that the residents never went without medication as the medication was refilled by the pharmacy. She revealed that the narcotics missing were for residents that were not alert and did not use, or ask for medication. Review of the Medication Error Report dated 7/13/15 for resident #33 revealed the following: Medication as ordered: [MEDICATION NAME] 5/325 milligram (mg) one (1) by mouth (po) every (q) six 6 hours (hrs).… | 2018-05-01 |
| 5858 | 5858 | GOODWILL HEALTH AND REHAB | 115486 | 4373 HOUSTON AVE. | MACON | GA | 31206 | 2015-10-15 | 226 | K | 1 | 0 | 7J0Y12 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and staff interview, the facility failed to thoroughly investigate and report resident to resident altercations for six (6) residents (R#3, R#23,R#40, R#42, R#44, and R#45) of seven (7) residents with resident to resident altercations, from a total sample of thirty-eight (38) residents. It was determined that the facilities non-compliance with one or more requirements of participation had caused or was likely to cause serious injury or harm to resident therefore on 12/10/15 at 3:20 p.m. the Corporate Director of Operations, Corporate Clinical Director of Clinical Services, and Administrator were notified that an Ongoing Immediate Jeopardy (IJ) caused, or had the likelihood to cause, serious injury, harm, impairment or death to residents of the one-hundred twenty-three (123) residents that reside in the facility. The Ongoing IJ was determined to exist beginning on 9/05/2015 at 1:30 p.m. Findings include: 1) Review of the Admission Minimum Data Set (MDS) assessment for R #42 dated 9/24/15 revealed a Brief Interview for Mental Status (BIMS) summary score of thirteen (13) which indicated the resident was cognitively intact. Review of the resident's incident report dated 11/12/15 at 11:00 a.m. revealed the resident's roommate R #40 was yelling out repeatedly, when resident R #42 came near resident R #40's bed. R #40 kicked and struck R #42 in the left eye. An assessment of R #42 ' s left eye revealed slight redness. Review of R #42's Initial Social Service history 9/14/15 revealed the resident had a history of [REDACTED]. Review of the Quarterly MDS assessment for R #40 dated 7/31/15 revealed a BIMS summary score of eleven (11) indicating moderate impairment. Further review of the MDS revealed behaviors directed toward others as occurred one (1) to three (3) days out of seven (7) days assessed. Review of resident #40 ' s monthly nursing summaries dated 11/18/15 and 12/3/15 revealed the resident was easily upset and hostile f… | 2018-05-01 |
| 5859 | 5859 | GOODWILL HEALTH AND REHAB | 115486 | 4373 HOUSTON AVE. | MACON | GA | 31206 | 2015-10-15 | 242 | J | 1 | 0 | 7J0Y12 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review, resident interview and staff interviews, the facility failed to ensure that residents rights/choices of allowed visitors was honored for one (1) resident (#14) from a sample of thirty-eight (38)residents. This failure resulted in psychological harm when R #14 said I don't want the identified family member here. The identified family member had been abusing me and I'm scared of them. It was determined that the facilities non-compliance with one or more requirements of participation had caused or was likely to cause serious injury or harm to resident therefore on 12/10/15 at 3:20 p.m. the Corporate Director of Operations, Corporate Clinical Director of Clinical Services, and Administrator were notified that an Ongoing Immediate Jeopardy (IJ) caused, or had the likelihood to cause, serious injury, harm, impairment or death to residents of the one-hundred twenty-three (123) residents that reside in the facility. The Ongoing IJ was determined to exist beginning on 9/05/2015 at 1:30 p.m. Findings include: Review of the following: Police Report dated 10/14/15 indicated Incident Type: Terroristic Threats. Incident date of 10/04/15 at 5:00 p.m. Incident Day: Sunday. Police report indicated: On Wednesday October 14, 2015 at 12:03 p.m., officer responded to facility in reference to terroristic threats. Upon arrival the officer met with the Director of Nursing (DON) who stated that R #14 told the Social worker that an identified family member threatened to get rid of him on Sunday, October 4, 2015. The DON stated that he/ she was told by the on duty nurse that worked on October 4, 2015 that the identified family member had not come to visit the on that day. The officer spoke to R#14 and he/she stated the the identified family member came to visit on October 4, 2015 and threatened to kill him/her. Resident #14 stated that the family member told him they were going to shoot him. Resident #14 stated that he/she had no witnesses to th… | 2018-05-01 |
| 5860 | 5860 | GOODWILL HEALTH AND REHAB | 115486 | 4373 HOUSTON AVE. | MACON | GA | 31206 | 2015-10-15 | 248 | E | 1 | 0 | 7J0Y12 | Based on observation, interview and record review the facility failed to provide an ongoing meaningful program of meaningful activities to meet the interests, physical, mental and psychosocial well-being of the residents on the secure unit (Faith Two). This failure affected nineteen (19) residents (#1, # 4, #5,#23, #24, #44, #47, #48, #49, #50, #51, #52,#53, #54, #55, #56, #57, #58, #59) that remain in the secured unit to attend activities of the twenty-nine (29) residents who reside on the secured unit. Findings include: Review of the daily census provided on 12/07/2015 revealed twenty-nine (29) residents reside on the secured unit (Faith II). Observation on 12/07/2015 at 9:55 a.m. of activity calendar revealed exercise activity being offered. Observation on the secured unit revealed eleven (11) random residents in the day room/dining room with the television (TV) on. Staff members present were sitting with the residents. Other residents were moving about in the hallway and in their rooms. Observation revealed no other activity being offered on the secured unit at that time. Observation on 12/07/2015 at 11:00 a.m. of the activity calendar revealed crossword puzzles activity. Revealed random residents in dining room with TV on and two staff members present sitting with the residents. Observation revealed no other activity being offered on the secured unit at that time. Observation on 12/07/2015 at 11:45 a.m. of a random female resident attempting to push another random sampled female resident, in the wheelchair, who was objecting loudly. Staff intervened to disengage resident from pushing the wheelchair and the resident continued walking in the hallway but did not re-approach the wheelchair. No other activity was offered to the either resident. Observation on 12/07/2015 at 12:00 p.m. of a random sampled resident in the hallway who had a firm grip on the doors at the entrance to the unit. Staff attempting to disengage resident from the doors but the resident was not easily redirected. Two other staff members were … | 2018-05-01 |
| 5861 | 5861 | GOODWILL HEALTH AND REHAB | 115486 | 4373 HOUSTON AVE. | MACON | GA | 31206 | 2015-10-15 | 250 | J | 1 | 0 | 7J0Y12 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review, and interview the facility failed to ensure that the Social Service Department responded to needs of the one (1) resident (R #14) that requested help obtaining a protective order after an alleged threat of death was made by a family member. This failure resulted in psychological harm when the resident said the alleged family member threatened to get rid of them. It was determined that the facilities non-compliance with one or more requirements of participation had caused or was likely to cause serious injury or harm to resident therefore on 12/10/15 at 3:20 p.m. the Corporate Director of Operations, Corporate Clinical Director of Clinical Services, and Administrator were notified that an Ongoing Immediate Jeopardy (IJ) caused, or had the likelihood to cause, serious injury, harm, impairment or death to residents of the one-hundred twenty-three (123) residents that reside in the facility. The Ongoing IJ was determined to exist beginning on 9/05/2015 at 1:30 p.m. Findings include: Review of a Police Report dated 10/14/15 indicated Incident Type: Terroristic Threats. Incident date 10/04/15 at 1700 (5:00 p.m.) to 10/14/15. Incident Day: Sunday. Police report states: On Wednesday October 14, 2015 at 1203 hours, officer responded to facility in reference to terroristic threats. Upon arrival officer met with (name of nursing director) who stated that (name of R #14) told his social worker that his mother threaten to get rid of him on Sunday October 4, 2015. (Name of Nursing Director) stated that she was told by the on duty nurse that worked on October 4, 2015 that his mother didn ' t come to visit him on that day. Officer spoke to resident and he advised that his mother came to visit him on October 4, 2015 and threaten to kill him. Resident stated that his mother told him she was going to shoot him. Resident stated that he had no witnesses to the threats that were made and stated that he doesn ' t want his mother around him a… | 2018-05-01 |
| 5862 | 5862 | GOODWILL HEALTH AND REHAB | 115486 | 4373 HOUSTON AVE. | MACON | GA | 31206 | 2015-10-15 | 252 | F | 1 | 0 | 7J0Y12 | Based on observation and staff interview the facility failed to provide a homelike environment for four (4) of four (4) resident halls, the main dining area, and resident smoking area. This deficient practice had the potential to affect all one hundred twenty three (123) residents residing in the facility. It was determined that the facilities non-compliance with one or more requirements of participation had caused or was likely to cause serious injury or harm to resident therefore on 12/10/15 at 3:20 p.m. the Corporate Director of Operations, Corporate Clinical Director of Clinical Services, and Administrator were notified that an Ongoing Immediate Jeopardy (IJ) caused, or had the likelihood to cause, serious injury, harm, impairment or death to residents of the one-hundred twenty-three (123) residents that reside in the facility. The Ongoing IJ was determined to exist beginning on 9/05/2015 at 1:30 p.m. Findings include: Review of the Guardian Angel Program policy revealed that the Guardian Angel Room Rounds form will be completed to ensure a comfortable, home like setting present and satisfactory to resident/family. The Guardian Angel Program policy continues to state that resident room issues identified will be addressed immediately when possible or brought to attention to the executive director for resolution. However, per observations the Guardian Angel Program Policy failed to assure a comfortable environment for residents who reside in the facility. Common Areas: On 12/07/15 at 11:30 a.m., 2:30 p.m., and 6:00 p.m. observation revealed that two (2) of the two (2) resident smoking areas that were located off of the main dining room alcove and on the secured unit Faith Two (2) were not located twenty five (25) feet from the entrance doors, as revealed in the facility's smoking policy. Observations revealed the odor of smoke was coming into the facility when the exit doors, located at desinated smoking areas, were opened during the resident smoking times. On 12/07/15 at 10:00 a.m. observations revealed cigare… | 2018-05-01 |
| 5863 | 5863 | GOODWILL HEALTH AND REHAB | 115486 | 4373 HOUSTON AVE. | MACON | GA | 31206 | 2015-10-15 | 253 | E | 1 | 0 | 7J0Y11 | AMENDED: Based on observation and interview the facility failed to provide housekeeping and maintenance services necessary to maintain a sanitary, orderly and comfortable interior in resident's rooms and bathrooms and maintain bathroom fixtures in good working order for nineteen (19) rooms effecting four (4) of seven (7) halls and in common areas used by all residents that reside in the facility. Findings include: August 2015 1. Observation on 8/25/2015 at 1:30 p.m. of room number 52, bathroom revealed the sink faucet was leaking, hair, dirt and debris in corners, in the doorway and behind the toilet. 2. Observation on 8/25/2015 at 1:35 p.m. of room number 56, revealed that the vinyl cover on the entry door is falling off (held in place by a tack), and there are cobwebs and dead bugs in corners of windowsill. Interview with the resident revealed the vinyl cover has been like that a long time. 3. Observation on 8/25/2015 at 1:40 p.m. of room number 74, revealed that the bathroom floor is dirty, entry to bathroom and behind the toilet is caked with dust, dirt and debris. 4. Observation on 8/25/2015 at 2:00 p.m. of room number 44, revealed in the bathroom the hand sanitizer dispenser is off the wall, sitting on the toilet, rust stains on the sink, the plumbing under the sink is dripping, stains on the wall, the bathroom corners, entry, and behind the toilet are caked with hair, dirt and debris. 5. Observation on 8/25/2015 at 2:10 p.m. of room number 49, bathroom revealed that the toilet was leaking, hair, dirt and debris were observed in the corners, in the doorway and behind the toilet. 6. Observation on 8/25/2015 at 1:30 p.m. of room number 52, bathroom revealed the sink faucet was leaking, hair, dirt and debris in corners, in the doorway and behind the toilet. 7. Observation on 8/25/2015 at 1:35 p.m. of room number 56, revealed that the vinyl cover on the entry door is falling off (held in place by a tack), and there are cobwebs and dead bugs in corners of windowsill. Interview with the resident revealed the viny… | 2018-05-01 |
| 5864 | 5864 | GOODWILL HEALTH AND REHAB | 115486 | 4373 HOUSTON AVE. | MACON | GA | 31206 | 2015-10-15 | 279 | E | 1 | 0 | 7J0Y12 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, record review, and staff interview, the facility failed to ensure the development of a comprehensive care plan, regarding one (1) resident (#41) receiving [MEDICATION NAME] therapy from a sample of seven (7) residents reviewed; and failed to develop a comprehensive plan of care to address preferences and risk factors related to mental and psychosocial needs for two (2) residents with behaviors (#3 and #42) out of ten (10) residents reviewed. Findings include: Review of the medical record revealed that R #41 had the following Diagnoses: [REDACTED]. Review of the 12/01/15 physician's medication orders revealed that the resident was ordered the following medications: [REDACTED]. Continued review of the 12/01/15 physician's orders [REDACTED]. Review of the Laboratory results revealed that the resident had an INR completed on 12/01/15 with the results of 1.58 (low). Review of the plan of care revealed a Focus area for pacemaker and to the related history of automatic implantable cardiac defibrillator. Further review revealed that the plan of care included risk for bleeding and bruising due to use of [MEDICATION NAME] and Eliquis. Intervention included to monitor vital signs weekly (Sundays) and notify the physician of significant abnormalities; and observe/document/ report as needed (PRN) any signs or symptoms of altered cardiac output or pacemaker malfunction: dizziness, [MEDICAL CONDITION], difficulty breathing (dyspnea), pulse rate lower than programmed or lower than baseline blood pressure (BP). Further review of the Care Plan revealed no Focus or interventions addressing the use of [MEDICATION NAME]. During an interview on 12/10/15 at 1:45 p. m. the Minimum Data Set (MDS) Coordinator Licensed Practical Nurse (LPN) DD confirmed that a care plan for [MEDICATION NAME] use and interventions was not present . During an interview on 12/10/15 at 1:48 p.m. the Unit Manager Registered Nurse (RN) BB confirmed that the resident did… | 2018-05-01 |
| 5865 | 5865 | GOODWILL HEALTH AND REHAB | 115486 | 4373 HOUSTON AVE. | MACON | GA | 31206 | 2015-10-15 | 309 | G | 1 | 0 | 7J0Y11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview the facility failed to follow physicians' orders related to sliding scale insulin coverage for ten (10) residents (#1, #3, #5, #6, #8, #11, #12, #13, #14, #20) of forty-seven (47) sampled residents; failed to follow finger stick blood sugar (FSBS) assessments causing actual harm to one (1) resident (#1), when the resident was found unresponsive and sent to an acute care facility with a greater than (>) 2000 blood sugar after the facility failed to have blood sample testing supplies available for the residents and increasing the likelihood of hyper/hypo glycemia to all diabetics in the facility. Findings include: 1. Resident #1 was admitted to the facility on [DATE], with [DIAGNOSES REDACTED]. Record review of the residents' physician orders [REDACTED]. for FSBS of 150-199 = 2 units; for FSBS of 200-249 = 4 units; for FSBS of 250-299 = 6 units; for FSBS of 300-349 = 8 units; for FSBS of 350--400 = 10 units; for FSBS of greater than 400 = 12 units, notify MD; FSBS before meals with sliding scale coverage; FSBS at bedtime without sliding scale coverage and notify MD if greater than 400 at 9:00 p.m. Record review of the Medication Administration Record [REDACTED]. Continued review revealed a SBAR communication form and Progress Note dated 8/4/15, revealed that the resident was clammy and lethargic. The physician and family were notified and at 6:05 a.m. and Emergency Management Services (EMS) was notified for transport to the emergency room . Review of the emergency room History and Physical dated 8/4/15 at 9:16 a.m., revealed that the chief complaint was [MEDICAL CONDITION], unresponsive with a blood sugar of >2000. Before admission to the nursing home, the resident had been seen in the emergency room numerous times for Diabetic Ketoacidosis and was known to be noncompliant with diabetes control. After a discussion with the emergency room doctor, the poor quality of life for the resident, the family asked for… | 2018-05-01 |
| 5866 | 5866 | GOODWILL HEALTH AND REHAB | 115486 | 4373 HOUSTON AVE. | MACON | GA | 31206 | 2015-10-15 | 319 | K | 1 | 0 | 7J0Y12 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Record review revealed R#45 was admitted to the facility on [DATE]. Review of the Minimum Data Set (MDS) annual assessment dated [DATE] for R#45 revealed the following: Section B: Hearing, Speech and vision - resident understood when expressing ideas and wants, resident usually understands - misses some part/intent of message but comprehends most conversation; Section C: Cognitive Patterns - short term and long term memory problems, able to recall current season, location of room, staff names and faces, and that he/she is in a nursing home. Moderately impaired Cognitive skills for making decisions regarding tasks of daily life, decisions poor, and cues/supervision required; Section E: no behavior symptoms or wandering. Section F: Interview for daily preferences not completed - resident rarely/never understood and, Section I - Active [DIAGNOSES REDACTED]. Review of PASRR Level II dated 07/25/2013 revealed the resident required Service Planning for Diagnostic/ongoing paychiatric care. Review of the Physician's progress notes revealed a psychiatric consult completed 07/16/2015 with follow-up in two (2) to three (3) months. Record review and requests for psychiatric records from the facility failed to reveal R#45 received ongoing psychiatric care. Review of the Physician's telephone orders revealed an order dated 06/22/2015 for Care Now Services to Evaluate and treat for [MEDICAL CONDITION], anxiety, [MEDICAL CONDITIONS] and dementia. Record review and requests for psychiatric records from the facility failed to reveal R#45 received a Care Now Evaluation after it was ordered. Based on observation, record review and staff interview, the facility failed to provide services to evaluate, diagnose, and/or treat two (2) resident's (#42 and #40) with a history of behaviors and failed to provide psychiatric services as ordered/recommended for one (1) resident (#45) for a total of three (3) residents with behaviors from ten (10) residents reviewed with be… | 2018-05-01 |
| 5867 | 5867 | GOODWILL HEALTH AND REHAB | 115486 | 4373 HOUSTON AVE. | MACON | GA | 31206 | 2015-10-15 | 323 | K | 1 | 0 | 7J0Y12 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on resident observation, interview, record review, facility policy review and review of the facility's State reported investigations, the facility failed to assure that one (1) resident (#23), who wandered into other resident's rooms, was free from physical abuse and three (3) resident (#3, #44, #45), into whose rooms resident #23 wandered, was free from mental abuse of the ten (10) sampled. The facility failed to ensure disposable razors were properly stored for one (1) resident #40; failed to ensure two (2) sharp objects were removed from the residents smoking area and the cabinet containing resident smoking paraphernalia was locked; failed to ensure a power strip was mounted properly to provide a safe environment for one (1) resident #29, from a sample of forty (40) residents reviewed and twenty (20) smoking residents. The facility's failure to assure that resident #23 did not wander into other residents rooms, caused resident #23 actual harm increasing the likelihood of/or was likely to cause serious harm, impairment or death to resident(s). Resident #23, has suffered actual harm with skin tears, abrasions, and bruises/discolorations, because the facility failed to protect the resident from wandering behaviors. As a result of the wandering behavior of R#23, R #3, R#44 and R#45 have suffered mental abuse including the daily fear of lack of a secure environment and R#23 has suffered mental abuse by the physical, threatening behavior of the other residents. It was determined that the facilities non-compliance with one or more requirements of participation had caused or was likely to cause serious injury or harm to resident therefore on 12/10/15 at 3:20 p.m. the Corporate Director of Operations, Corporate Clinical Director of Clinical Services, and Administrator were notified that an Ongoing Immediate Jeopardy (IJ) caused, or had the likelihood to cause, serious injury, harm, impairment or death to residents of the one-hundred twenty-th… | 2018-05-01 |
| 5868 | 5868 | GOODWILL HEALTH AND REHAB | 115486 | 4373 HOUSTON AVE. | MACON | GA | 31206 | 2015-10-15 | 354 | D | 1 | 0 | 7J0Y11 | Based on interview, and record review the facility failed to have a Registered Nurse for at least eight (8) consecutive hours a day to assess the residents residing in the facility and a Director of Nursing on a full time basis. Findings include: Interview on August 18, 2015, with the Human Resources staff revealed that the facility did not have a Registered Nurse on duty for eight (8) consecutive hours on August 14 and 15, 2015. The interview also revealed that the Director of Nursing (DON) did not return from a leave of vacation on August 12, 2015, therefore, the facility was without a Director of Nursing from August 12, 2015 until the morning of August 16, 2015. Interview on 8/26/15 at 3:07 p.m. with the Unit Manager of the Faith II revealed that there has been no shortage of staff on Haven II. She revealed that there is shortage of staff if the Census is decreased and that the Certified Nursing Assistant (CNA) is pulled from the unit to help cover the facility. Review of the two week staffing sheet for the pay period 8/9/15 confirmed there was no Registered Nurse coverage for 8/10/15, 8/14/15, and 8/15/15. | 2018-05-01 |
| 5869 | 5869 | GOODWILL HEALTH AND REHAB | 115486 | 4373 HOUSTON AVE. | MACON | GA | 31206 | 2015-10-15 | 372 | F | 1 | 0 | 7J0Y12 | Based on observation and staff interviews the facility failed to ensure the area surrounding the dumpster was free from garbage items and cigarette butts as recommended by the contracted pest control company for prevention of pest/insects in order to provide the residents with a pest/insect free environment. Findings include: Observation on 12/07/15 at 10:15 a. m. of the facility's large compacting dumpster revealed that it was located towards the back left side of the building off o the laundry department and sat on an asphalt pad. Continued observation revealed garbage scattered around on the ground of the compacting dumpster and consisted of empty food containers such as ice cream cups, juice cups, Gatorade bottles, and plastic water bottles. Additional garbage items included eight (8) clear plastic disposable gloves, plastic drinking cup lids, and plastic drinking straws. The ground surrounding the dumpster was also covered with cigarette butts. Interview on 12/07/15 at 10:15 a. m. with the Registered Dietitian (RD) revealed that she confirmed that there was garbage and cigarette butts scattered on the ground around the dumpster. The RD also confirmed that several pieces of garbage were empty food containers from the kitchen. The RD stated that housekeeping was responsible for the area surrounding the dumpster but did expect dietary staff to make sure kitchen garbage went into the dumpster and not on the ground. Interview on 12/07/15 at 10:15 a. m. with the Interim Dietary Manager confirmed that there was garbage and cigarette butts on the ground surrounding the dumpster area. She confirmed that they were empty food containers from the kitchen on the ground and expects dietary staff to pick up the trash and dispose of it properly. The Interim Dietary Manager revealed that she monitors the dumpster area once a day for garbage, debris, and spillage usually in the afternoon. She revealed that housekeeping is responsible for the dumpster area but dietary does assist if kitchen trash has spilled. Interview on 12/0… | 2018-05-01 |
| 5870 | 5870 | GOODWILL HEALTH AND REHAB | 115486 | 4373 HOUSTON AVE. | MACON | GA | 31206 | 2015-10-15 | 428 | D | 1 | 0 | 7J0Y12 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and staff interview the consultant pharmacist failed to identify and report medication irregularities, related to Insulin orders and administration, for one (1) resident (#18) of sixteen sampled residents. Findings include: Review of the physicians order for resident #18 dated 12/1/15 revealed a [DIAGNOSES REDACTED]. Review of the physician's telephone order dated 11/18/15 revealed an order for [REDACTED]. Further review of the November 2015 Medication Administration Record [REDACTED]. Review of the December 2015 physician's orders [REDACTED]. Further review of the December MAR indicated [REDACTED]. Review of the physician orders [REDACTED]. Start Lantus 40 units sq. Review of the Medication Regimen Reviews revealed a medication review was done by the Consultant Pharmacist on 12/1 /15 with no new suggestions documented on the regimen review sheet. During an interview on 12/7/15 at 4:33 p.m. the Consultant Pharmacist stated the December physician's orders [REDACTED]. The Consultant Pharmacist revealed that he/she does a monthly drug regimen review and reviews the physician's orders [REDACTED]. Further interview on 12/9/15 at 11:45 a.m. the Consultant Pharmacist confirmed that when he/she came to the facility on [DATE] he/she would not have identified the Insulin dosage issue because he/she did not have the December physician order [REDACTED]. [REDACTED]. During interview on 12/10/15 at 4:30 p.m. the Associate Director of Nursing (ADON) and Director of Nursing (DON) stated they were not aware the Consulting Pharmacist was not able to review the December physician's orders [REDACTED]. The ADON and DON further revealed that they are the ones who are responsible for the pharmacy recommendations and reports and so they would have been the ones to be notified that the physician's orders [REDACTED]. During further interview on 12/11/15 at 9:30 a.m. the Consultant Pharmacist revealed the DON should have known he/she was not able… | 2018-05-01 |
| 5871 | 5871 | GOODWILL HEALTH AND REHAB | 115486 | 4373 HOUSTON AVE. | MACON | GA | 31206 | 2015-10-15 | 441 | F | 1 | 0 | 7J0Y12 | Based on observations, staff interviews, and policy review the facility failed to follow infection control policy and handling of soiled laundry for all one hundred twenty three (123) residents. Findings include: On 12/07/15 at 11:00 a. m. observation of the laundry department revealed that it was located in an alcove section of the building and excess by going through the resident smoking area. Continued observation revealed that the facility had three (3) washing machines and 3 dryers. Further observation of all 3 dryers revealed a build-up of lint in the filter and lint on the back and sides of the dryer machines. On top of the center washing machine was a box with discarded used plastic gloves. Continued observation of the center washing machine revealed four (4) yellow personal protection gowns. A black plastic garbage bag was tied and hung to the door of the center washing machine. This black plastic garbage bag contained lint and other black garbage bags filled with trash. Continued observation revealed a gray bin located in the corner across from the washing machines that was full and overflowing with soiled resident clothing. There were three (3) piles of soiled resident clothing laying on black plastic garbage bags across from the washing machines. Further observation revealed a yellow plastic bin across from the washing machines that contained several used gloves and a wheelchair leg rest. Observation of the washing machine on the right revealed a large white soiled blanket on the floor in front of the washing machine. Observation revealed that the laundry department floors were soiled and had a build-up of dirt and lint around the equipment and in the corners. Observation also revealed a signage document scotched taped to the wall which indicated Attention all Laundry Aides; 1) make sure all shelves are clean and neat, 2) make sure floors are swept and mopped, 3) empty all trash. Observation of an additional room leading from the three large dryers revealed additional piles of resident clothing piled … | 2018-05-01 |
| 5872 | 5872 | GOODWILL HEALTH AND REHAB | 115486 | 4373 HOUSTON AVE. | MACON | GA | 31206 | 2015-10-15 | 456 | D | 1 | 0 | 7J0Y11 | Based on observation, and interview, the facility failed to maintain a comfortable environment for one (1) resident (#30) related to air conditioning; failed to ensure that two (2) of three (3) washing machine and one (1) of three (3) dryers in the laundry room was operational. Findings include: 1. Interview with resident #30 on 6/26/2015 at 2:30 p.m. who states she is much cooler now. The resident stated a family member brought in a fan for use. Resident #30 further states that no one at the facility offered a fan, but someone brought in the smaller one after the resident complained. 2. Observation and interview on 6/26/15 at 3:45 p.m. with the Maintenance Director revealed the following temperature monitoring using the facility's infra-red temperature gauge in the Dining room - 77 ; in the Hallway - 72 (AC Vent directly overhead); in room # 14 the temperature was - 78 ; in the Locked unit - 76 and on the Back hallway - 77 . There were no temperatures of 80 degrees observed. The Maintenance Director revealed he was called into the residents room two weeks or so ago because the resident was complaining that it was too hot. The temperature in the room measured 76 at that time. He worked on the thermostat the next day to make sure it was working correctly. He further states that the facility is doing all that it can to ensure residents are comfortable. He has performed maintenance on the units and they are working at maximum capacity. Interview on 6/26/2015 at 5:50 p.m. with Assistant Director of Nursing (ADON) and Administrator revealed that he went to resident MM room to investigate the room temperature and called Maintenance to service the thermostat and a fan for resident MM. The Administrator revealed that on 6/16/2015 an air condenser fan motor went out on one of the Air Conditioning (AC) units on Haven 2 hall. It was replaced on 6/18/2015 and residents were offered extra hydration. The same issue occurred on 6/24/2015 on Haven 1 hall and was repaired. Residents again were offered additional ice and water and… | 2018-05-01 |
| 5873 | 5873 | GOODWILL HEALTH AND REHAB | 115486 | 4373 HOUSTON AVE. | MACON | GA | 31206 | 2015-10-15 | 463 | E | 1 | 0 | 7J0Y11 | Based on observation, and interview, the facility failed to ensure that all call lights were functioning to alert staff of residents (#28, #29, and #34) needing assistance of the forty-nine sampled residents. Findings include: 1. Interview on 8/25/2015 at 3:05 p.m. with resident # 28, revealed that the call light has not been working for as long as the resident can remember. Observation and a test of the call light for resident # 28 was performed by depressing the button on top of the call light cord which should have caused the light outside of room 30 to turn on, thereby signaling the nurse that the resident requires assistance. The light outside the room did not turn on despite multiple attempts including unplugging and replugging the cord and resetting the call light switch. Interview with the Charge Nurse for Faith One hallway on 8/25/2015 at 3:10 p.m. revealed no knowledge that the call light in room 30 was not operational. Interview on 8/25/2015 at 3:15 p.m. with the Maintenance Supervisor reveals no one has told him the call light was not working, but parts for call lights have been ordered and should be delivered with-in the next 7 -10 days. Observation on 8/25/2015 at 4:05 p.m. revealed the call light was repaired and functioning properly. 2. Observation and interview on 8/25/2015 at 1:40 p.m. with resident #29, revealed that the call light has not worked since admission. The resident is in a single room and is bed bound. Inspection of the call light panel reveals that the call system is non-functional. Interview on 8/25/2015 at 3:20 p.m. with Maintenance Supervisor reveals that he was unaware of the call light not working but recalls that there have been problems with it in the past. Interview on 8/25/2016 at 4:05 p.m. with the Charge Nurse for Haven Two hall revealed no knowledge of the call light not working. Interviews on 8/25/2015 at 4:00 p.m. with the Maintenance Director and Maintenance Supervisor reveals that there is no work order system in place for reporting maintenance issues. Neither employ… | 2018-05-01 |
| 5874 | 5874 | GOODWILL HEALTH AND REHAB | 115486 | 4373 HOUSTON AVE. | MACON | GA | 31206 | 2015-10-15 | 465 | F | 1 | 0 | 7J0Y12 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations and staff interviews, the facility failed to maintain functioning laundry equipment for one (1) of three (3) washing machines and one (1) of three (3) clothes dryers for the facility. Findings include: On 12/07/15 at 11:00 a. m. observation revealed that the facility had two (2) of three (3) washing machines that were in working condition, and two (2) of three (3) dryers in working condition. Observations further revealed piles of resident clothing located in the laundry department. Observations revealed that the equipment was not in operation for five (5) of the five day survey. On 12/07/15 at 11:10 a.m. an interview with the Housekeeping/Laundry Supervisor revealed that the facility had only two working washing machines, and two working dryers for over 10 (ten) years. Interview further revealed that the washer to the right had a history of [REDACTED]. On 12/07/15 at 4:45 p.m. an interview with the Regional Plant and Facility Supervisor revealed that the dryer and washer had not been working for about twelve (12) years. Further interview revealed that the equipment had not been removed because the facility staff uses the equipment for spare parts. Continued interview revealed that there was no place to repair or replace the washer or dryer. It was further revealed that it was not cost effective to repair the dryer or washer. On 12/11/15 at 9:00 a.m. interview with Administrator revealed that there were plans to get estimates for repairing or replacing the broken dryer and washing machine. The Administrator further revealed that the plans had not been completed. On 12/07/15 at 10:15 a.m. during an interview with laundry staff member NN , he stated that the blanket on the floor next to the washing machine on the right was because Sometimes it leaks but it hasn ' t in a while. We just have it there in case it does. | 2018-05-01 |
| 5875 | 5875 | GOODWILL HEALTH AND REHAB | 115486 | 4373 HOUSTON AVE. | MACON | GA | 31206 | 2015-10-15 | 469 | E | 1 | 0 | 7J0Y11 | Based on observation and interview the facility failed to provide an effective pest control program for six (6) resident rooms (# 52, 56, 77, 49, 44, and 42) of the twelve (12) sampled rooms. Findings include: 1. Interview and observation on 8/25/2015 at 1:30 p.m. with the resident who resides in room 52 revealed, one (1) dead bug laying on floor. The resident stated he had killed the bug earlier in the morning. 2. Interview and observation on 8/25/2015 at 1:35 p.m. of room 56, the resident who resides in the room , revealed dead bugs in corners of windowsill. 3. Observation on 8/25/2015 at 1:50 p.m. of room 77, revealed flies were flying in the room. 4. Interview on 8/25/2015 at 2:10 p.m. with the resident who resides in room 49, revealed that bugs have been a problem and reported them to the previous Administrator. 5. Interview on 8/25/2015 at 2:00 p.m. the resident who resides in room 44, stated there used to be a problem with bugs which was reported to the Administrator, but has not had any problems recently. 6. Interview on 8/25/2015 at 1:40 p.m. the resident who resides in room 42, revealed that bugs have been a problem, but not recently. Interview with the Maintenance Director and Maintenance Supervisor on 8/25/15 at 5:00 p.m. revealed that a new pest control contract had been signed on 7/20/2015 for monthly service. The new service includes monthly service inside and outside of the building. The contract also includes insect light traps were installed and bait stations inside and outside of the facility. The contract also includes rodent, flies, and drainage management. The last pest service was on 8/19/15. Interview with the Administrator and the Director of Nursing on 8/25/15 at 5:10 p.m. revealed that the pest control company would be called the next day for additional services. Interview on 10/15/15 at 9:15 a.m. with Certified Nursing Assistant (CNA) ZZ revealed that she was walking through the main dining room at 7:00 a.m. and saw three (3) roaches. The CNA stated that they see bugs everyday, but the… | 2018-05-01 |
| 5876 | 5876 | GOODWILL HEALTH AND REHAB | 115486 | 4373 HOUSTON AVE. | MACON | GA | 31206 | 2015-10-15 | 490 | K | 1 | 0 | 7J0Y12 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, staff interview, and record review the facility administrator failed to assure that a situation in which the facility's non-compliance with one or more requirements of participation had caused, or had the likelihood to cause, serious injury, harm, impairment or death to residents of the one-hundred twenty-three (123) residents that reside in the facility. On [DATE] at 3:05 p.m. Goodwill Health and Rehab, Corporate Director of Operation, Corporate Clinical Director of Clinical Services, and the Administrator were notified that an Ongoing Immediate Jeopardy (IJ) had caused, or had the likelihood to cause, serious injury, harm, impairment or death to residents of the one-hundred twenty-three (123) residents that reside in the facility. The Ongoing IJ was determined to exist beginning on [DATE] at 1:30 p.m. when the Administrator failed to assure that: The Code of Federal Regulations (CFR) 483.13(c) (F226 K) when R #3 and R #23 sustained a Resident to Resident altercation (State Reported Incident #GA 789), dated on [DATE] at 1:30 p.m. when R#23 went into the room of R#3 (4A) and laid down on the bed of R#3 pushed R #23 off the bed and onto the floor. R #23 landed on their knees in the entrance to room [ROOM NUMBER]A sustaining a skin tear to his right posterior forearm that was bleeding, a skin tear to the left nostril and abrasions to the right posterior hand. Continue review revealed that resident to resident altercations for four (4) other residents (R#40, R#42, R#44, and R#45) sustained resident to resident altercations. The CFR 483.13(c)(1)(ii)-(iii)(c)(2)-(4) (F225 K) when R#14 reported to the facility that they had been threatened bodily harm including death by an identified family member reported on [DATE] (the alleged threat occurred on [DATE]), and the Administrator failed to assure interventions were in place to protect the resident even though the facility reported to the State Agency a self report incident (GA 6… | 2018-05-01 |
| 5877 | 5877 | GOODWILL HEALTH AND REHAB | 115486 | 4373 HOUSTON AVE. | MACON | GA | 31206 | 2015-10-15 | 493 | K | 1 | 0 | 7J0Y11 | Based on record review and interview the Governing Body failed to assure that employees were paid, the Quality Assurance Committee was effective, investigations were conducted and reported, equipment was maintained and the facility had 8 hours of Registered Nurse coverage. Cross reference: 1. F225-the governing body failed to assure that investigative reports were completed to the Department within 5 business days after an incident of injury and that narcotics were safe guarded against non-resident use; 2. F309-the governing body failed to assure that the facility had supplies to monitor blood sugar of insulin dependent diabetics causing actual harm to one resident; 3. F354-the governing body failed to assure that a Registered Nurse was on duty at least eight (8) hours a day, and failed to assure a Director of Nursing was in charge of nursing services; 4. F493-the governing body failed to assure that adequate financial support was available to cover expenses for the care and services of all the residents including paying employees, per interview with the Administrator via telephone, payroll checks did not clear the bank, and the payroll has been changed from every other Friday to every other Tuesday. Per interview with twenty-one (21) employees, six (6) employees had payroll funds be insufficient, and; 5. F520-the Qaa Committee failed to monitor the Plan of Correction for the Standard survey with F309 re-cited on the revisit. Findings include: Interview on 8/26/15 at 1:54 p.m. with Accounts Payable revealed that the first time payroll checks bounced was on the 7/31/2015. The corporate office was notified and reported to the employees that any service charges would be paid by the company. Then corporate changed payroll dates would be to every other Tuesday but did not notify the employees of the change. Interview on 8/26/15 at 10:00 a.m. through 12:18 p.m. with twenty-two (22) employees revealed that six (6) staff had payroll checks bounce, including one (1) Licensed Practical Nurse, 1 floor technician, 1 laundry … | 2018-05-01 |
| 5878 | 5878 | GOODWILL HEALTH AND REHAB | 115486 | 4373 HOUSTON AVE. | MACON | GA | 31206 | 2015-10-15 | 514 | D | 1 | 0 | 7J0Y12 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and staff interview, the facility failed to maintain accurate clinical records regarding transcription of physician orders [REDACTED].#18)of sixteen insulin dependent residents. Findings include: Review of the clinical record for resident #18 revealed an 11/18/15 physicians's order for [MEDICATION NAME] 40 units subcutaneous (sq) at bedtime and to discontinue [MEDICATION NAME] 32 units sq at bedtime. Record review of the physicians handwritten and telephone orders from 11/18/15 to 11/30/15 revealed there were no Insulin orders written after the 11/18/15 order for [MEDICATION NAME] 40 units at bedtime. However, review of the December 2015 physicians orders revealed an order for [REDACTED]. Review of the December 2015 Medication Administration Record(MAR) revealed documentation that [MEDICATION NAME] 32 units was administered from 12/1/15 to 12/6/15. During an interview on 12/7/15 at 12:35 p.m. with Licensed Practical Nurse(LPN) KK revealed that the [MEDICATION NAME] 40 units sq at bedtime was not carried forward during the change over done at the end of every month He/she further revealed that the Unit Manager or another LPN does the change over from month to month. During an interview on 12/7/15 at 1:45 p.m. with the Director of Nursing (DON) he/she stated there was an error in the transcription from the November to December 2015 orders and MAR's during the change over at the end of November 2015. The DON further stated that the Unit Manager or person bringing over the orders signs the MAR indicated [REDACTED]. The DON confirmed the 11/18/15 telephone order for [MEDICATION NAME] 40 units sq at bedtime and to discontinue [MEDICATION NAME] 32 units sq at bedtime was not brought over to the December physician orders [REDACTED].# 18 not receiving the correct dose of [MEDICATION NAME] as ordered by the physician. During an interview on 12/9/15 at 8:40 a.m. with the resident's physician revealed it was his/her expectation tha… | 2018-05-01 |
| 5879 | 5879 | GOODWILL HEALTH AND REHAB | 115486 | 4373 HOUSTON AVE. | MACON | GA | 31206 | 2015-10-15 | 520 | K | 1 | 0 | 7J0Y11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview and record review the facility failed to have an effective Qaa Committee monitoring the Plan of Corrective Actions plans for continued compliance with federal regulations. Cross refer to F309 Findings include: A revisit was conducted on 8/26/15, in conjunction with complaint investigations during the revisit Substandard Quality of Care was cited based on actual harm to one (1) resident #1, when the facility failed to assure that supplies to measure blood glucose was present for treatment of [REDACTED]. Based on record review and staff interview the facility failed to follow physicians' orders related to sliding scale insulin coverage for ten (10) residents (#1, #3, #5, #6, #8, #11, #12, #13, #14, #20) of twenty-seven (27) sampled residents; failed to follow finger stick blood sugar (FSBS) assessments causing actual harm to one (1) resident (#1). Findings include: 1. Resident #1 was admitted to the facility on [DATE], with [DIAGNOSES REDACTED]. Record review of the residents' physician orders [REDACTED]. for FSBS of 150-199 = 2 units; for FSBS of 200-249 = 4 units; for FSBS of 250-299 = 6 units; for FSBS of 300-349 = 8 units; for FSBS of 350--400 = 10 units; for FSBS of greater than 400 = 12 units, notify MD; Accuchecks before meals with sliding scale coverage; Accu-check at bedtime without sliding scale coverage and notify MD if greater than 400 at 9:00 PM. Record review of the Medication Administration Record [REDACTED]. Continued review of the record review of a SBAR communication form and Progress Note revealed that on 8/4/15 the resident was clammy and lethargic with a Blood Pressure of 102/68 and pulse of 54 and respirations of 14. The emergency room History and Physical revealed that the chief complaint was [MEDICAL CONDITION] and unresponsive at 9:16 AM on 8/04/2015. The resident's blood sugar was recorded at >2000. 2. Record review of the physician orders [REDACTED]. Record review of the MAR indicated [… | 2018-05-01 |
Advanced export
JSON shape: default, array, newline-delimited
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 );