cms_SC
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31 rows where "inspection_date" is on date 2013-03-22
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| Link | rowid ▼ | facility_name | facility_id | address | city | state | zip | inspection_date | deficiency_tag | scope_severity | complaint | standard | eventid | inspection_text | filedate |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 7740 | 7740 | ALPHA HEALTH & REHAB OF GREER, LLC | 425138 | 401 CHANDLER RD | GREER | SC | 29651 | 2013-03-22 | 157 | E | 0 | 1 | IEVG11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on record review and interview, there was no evidence Resident # 277's family was notified of medication and treatment change(s)or a change in condition resulting in hospitalization on [DATE]. There was no evidence Resident # 187 was aware/informed of a physician ordered medication dose change. (2 of 4 resident's reviewed for notification of changes. ) The findings included: The facility admitted Resident # 277 on 2/6/13 and discharged the Resident on 2/8/13. The Resident was again admitted on [DATE] and discharged on [DATE]. The Resident scored a 6 on the Brief Interview for Mental Status (BIMS) completed for both facility admissions, indicating a severe cognitive impairment. Physician order [REDACTED]. Additionally, new orders received on 2/14/13 for a wound vac to the left hip, oxygen administration and the start of therapy on 2/15/13 showed no evidence of family notification. The lack of documentation related to family notification was verified by Licensed Practical Nurse # 4 on 3/20/13 after reviewing the record. Further record review revealed no evidence of family notification in either the nurses notes or social service notes related to a change in condition necessitating a transfer to the emergency room for evaluation and treatment on 2/16/13 which resulted in the resident being admitted to acute care as verified by the SSD (Social Service Director) on 3/22/13. When questioned on 3/22/13 at 8:10 AM, the Assistant Director of Nursing stated there was no written policy related to the notification of family members/residents related to changes of care. The facility admitted Resident #187 with [DIAGNOSES REDACTED].#187 revealed the resident had concerns with not being informed of medication changes. An additional interview on 3/20/13 at approximately 8:56 AM with the resident revealed he/she received a medication change on 3/19/13 and was not informed of the medication change. The resident stated he/she wo… | 2016-11-01 |
| 7741 | 7741 | ALPHA HEALTH & REHAB OF GREER, LLC | 425138 | 401 CHANDLER RD | GREER | SC | 29651 | 2013-03-22 | 165 | D | 0 | 1 | IEVG11 | On the days of the survey, based on interview, the facility failed to assure a randomly chosen resident felt free to voice grievances in Resident Council without discrimination or reprisal. (1 of 1 resident interviews related to Resident Council) The findings included: During the days of the survey, a randomly selected resident was interviewed related to Resident Council Meetings. The Resident was selected from a list of 6 resident names provided by the facility of residents who regularly attended Resident Council, who could be interviewed. On 3/20/13, the resident stated s/he did not feel comfortable voicing concerns in the resident council meetings. The resident further explained You have to watch out for yourself .you never know what they may think of you. I complained once and the person came back to me. On 3/20/13 following the resident interview, the Activity Director (AD) was interviewed and stated s/he was not aware of the incident. The AD explained when concerns are voiced, they are passed onto the appropriate department for resolution. On 3/21/13 at 1:45pm, the Resident was again interviewed as to when the concern arose and s/he stated within the last several months. The resident explained s/he had complained about a staff member and the staff member came back and said s/he should not have done that. The resident stated, as a result, s/he does not feel comfortable expressing concerns in the meeting. | 2016-11-01 |
| 7742 | 7742 | ALPHA HEALTH & REHAB OF GREER, LLC | 425138 | 401 CHANDLER RD | GREER | SC | 29651 | 2013-03-22 | 166 | D | 0 | 1 | IEVG11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on interviews and record review, the facility failed to ensure that a grievance related to missing eye glasses was resolved for 1 of 1 sampled residents reviewed for grievances related to missing eye glasses. (Resident #114) The findings included: The facility admitted Resident #114 with [DIAGNOSES REDACTED].#114 had 2 pair of eye glasses missing in the last six months. The family member/responsible party further stated he/she had not heard anything from the facility about the missing eye glasses. An interview on 3/19/13 at approximately 10:45 AM with the Social Services Assistant revealed there was a grievance related to the missing glasses dated 1/04/13. Further review of the grievance log revealed there was no documentation to indicate the facility made an effort to locate the missing glasses. The grievance log indicated the family was notified that the glasses were likely thrown away and the family needed to purchase a new pair. An interview with the Administrator revealed they (the facility) would try to find the missing items or replace the missing items. The Administrator confirmed the family was requested to purchase another pair of glasses and confirmed there was no documentation the facility made efforts to locate the resident's glasses. | 2016-11-01 |
| 7743 | 7743 | ALPHA HEALTH & REHAB OF GREER, LLC | 425138 | 401 CHANDLER RD | GREER | SC | 29651 | 2013-03-22 | 170 | C | 0 | 1 | IEVG11 | On the days of the survey, based on multiple interviews, the facility failed to assure residents received mail delivery including on Saturday. The findings included: During the days of the survey, a randomly selected resident was interviewed related to mail delivery The Resident was selected from a list of 6 resident names provided by the facility of residents who regularly attended Resident Council, who could be interviewed. On 3/20/13, the resident stated s/he was not aware of any mail being delivered on Saturdays. The Business Office Manager stated, when interviewed on 3/20/13 following the resident interview, that the facility did not receive mail on Saturdays. However, the Activity Director stated the Activity Assistant delivered mail on Saturdays which was then verified by the Activity Assistant. When the discrepancy was mentioned, the Activity Assistant stated: When there is mail on the desk I deliver it. I haven't been here long, maybe I mixed up the days. The facility Administrator then contacted the Postal Services, who verified there was no current Saturday mail delivery. | 2016-11-01 |
| 7744 | 7744 | ALPHA HEALTH & REHAB OF GREER, LLC | 425138 | 401 CHANDLER RD | GREER | SC | 29651 | 2013-03-22 | 172 | C | 0 | 1 | IEVG11 | During the days of the survey, a randomly selected resident was interviewed related to the Ombudsman and services available through the Ombudsman's office. The Resident was selected from a list of 6 resident names provided by the facility of residents who regularly attended Resident Council, who could be interviewed. On 3/20/13, the resident stated s/he was not familiar with the term and did not have knowledge concerning the Ombudsman. Following the interview, the Activity Director (AD) was interviewed and asked how residents were informed about the Ombudsman. The AD pulled a copy of the Ombudsman poster from the front of the resident council minutes book and stated s/he regularly reviews the information and even holds up the form for residents to see. However, the interviewed resident was noted to be visually impaired. The Activity Director verified the information was not in braille, therefore a sight impaired resident would not be able to read it. On the days of the survey, based on multiple interviews, the facility failed to provide residents and or family members information concerning access to the Ombudsman office and the services it provides. (5 of 5 resident/families interviewed related to the provision of services provided by the Ombudsman office) The findings included; During interviews conducted during the days of the survey of two resident families and two cognitively intact residents, all parties stated that they were unaware of the Ombudsman office and the services which they provided. | 2016-11-01 |
| 7745 | 7745 | ALPHA HEALTH & REHAB OF GREER, LLC | 425138 | 401 CHANDLER RD | GREER | SC | 29651 | 2013-03-22 | 201 | D | 0 | 1 | IEVG11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On days of survey, based on record review and interview the facility failed to provide evidence of the necessity for transfer/discharge of Resident # 277. The Resident was discharged from the facility on 2/16/13 without evidence of need and or cause. Cross refer to F 281 as it relates to the lack of professional standards for clinical documentation related to the skilled services/ provided for Resident # 277. The findings included: Resident # 277 was last admitted to the facility on [DATE] and discharged on [DATE]. Review of the closed medical record revealed there was a partial admission assessment completed on admission of 2/14/13 and a subsequent nurses note dated 2/16/13 at 3:14 am that stated: pt (patient) resting in bed. No c/o (complaint of) pain or discomfort, No s/s (signs or symptoms) of distress. Call light in reach. Will continue to monitor. The medical record contained a physician telephone order dated 4/16/13 (not timed) that stated : Send to xx ER (emergency room ) for eval (evaluation) and tx. (treatment). There was no other documentation in the record indicative of the resident being medically unstable and requiring emergency services or other reason for transfer. Interviews conducted with Medical Records, the facility Nurse Consultant, Social Worker, Registered Nurse #1 on 3/21/13 all verified there was no additional information or documentation available. A call placed to the nurse practitioner on 3/22/13 by this surveyor was not returned. Copies of the facility 24 hour report for 2/16/13 were requested but could not be located. A copy of the resident hospital admission for 2/16/13 and emergency services transfer were requested but could not be provided per Administration. | 2016-11-01 |
| 7746 | 7746 | ALPHA HEALTH & REHAB OF GREER, LLC | 425138 | 401 CHANDLER RD | GREER | SC | 29651 | 2013-03-22 | 221 | D | 0 | 1 | IEVG11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on observation, record review, interview and review of facility policy for Restraints (last revised 7/07), the facility failed to identify an abdominal binder as a potential restraint and failed to assess the resident to assure it was the least restrictive device for Resident # 174. (1 of 3 sampled residents reviewed for restraints) The findings included: On 3/21/13, Resident # 174 was observed in bed, with Licensed Practical Nurse (LPN) # 3 present in the room. The LPN was overheard telling the resident s/he had removed the abdominal binder in case the resident was sent to the hospital so it would not get lost. The nurse was observed with a white cloth Velcro abdominal binder in his/her hand as s/he placed it in the resident's drawer. Record review revealed a physicians order for an abdominal binder was written on 2/22/13. However, a nurses note dated 2/21/13 at 2:02pm documented abd (abdominal) binder in place . There was no nursing note documentation on 2/21 or 2/22/13 that the resident had behaviors requiring the application of the binder. During an interview on 3/21/13 at 11:21 AM with LPN # 3, s/he stated the Director of Nursing was responsible to complete all restraint assessments. When LPN # 3 and the Unit Manager were asked if the resident could remove the binder, they both stated stated not now. An interview with the Director of Nursing, LPN # 3 and the Nurse Consultant present, revealed they were not aware an abdominal binder had the potential to be a restraint. It was verified that no assessment to determine if the device was restraint, and no informed consent or careplan had been done for the device. During an interview with the Minimum Data Set Coordinator on 3/21/13 at 11:45 am, s/he also stated at one time the resident could remove the binder but currently cannot. At approximately 1 PM, the nurse consultant asked the surveyor to come to the resident's room as the resident had removed the binder… | 2016-11-01 |
| 7747 | 7747 | ALPHA HEALTH & REHAB OF GREER, LLC | 425138 | 401 CHANDLER RD | GREER | SC | 29651 | 2013-03-22 | 224 | G | 0 | 1 | IEVG11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on record review, interview, and policy review of Reporting of Alleged Abuse to Facility Management, the facility failed to ensure freedom of neglect for 1 of 7 residents reviewed for abuse. Resident #95 was transferred incorrectly by staff resulting in a fracture that required surgery. The findings included: On 3/18/13 at 2:18 PM interview with Resident #95 for question Have you ever been treated roughly by staff? revealed that a Certified Nursing Assistant (CNA) transferred him/her without the required assistance. Resident #95 stated his/her foot got caught at the railing and when he/she told the CNA, he/she yanked her foot loose and broke his/her ankle. On 3/19/13 at approximately 3:00 PM review of Resident #95's medical record revealed a [DIAGNOSES REDACTED]. A Brief Interview for Mental Status (BIMS) of 15 on the 12/10/12 Comprehensive Assessment (MDS) indicated the resident was cognitively intact. The assessment documented the resident Expects to be discharged to the community on the 9/1/13 MDS (Minimum Data Set) , and Expects to remain in this facility. on the 11/19/12 MDS. Record review of Radiology report dated 09/09/2012 revealed Examination: Ankle Comp, Min 3V, Left. Results: There is regional soft tissue [MEDICAL CONDITION]. [MEDICATION NAME], minimally displaced distal fibula and tibia fractures a the level of the plafond are present with slight lateral talar subluxation. Conclusion: Fracture as described. On 3/19/13 3:20 PM interview with the resident revealed I probably would have gone somewhere. That is why I am here permanently now. The way I got hurt my children are not able to take me and take care of me. I will be here the rest of my life On 3/19/13 at 4:30 PM record review of Departmental Notes E-NURSE (electronic charting) dated 9/9/2012 at 9:30 PM revealed Resident informed this nurse at 7:30 p.m. that his/her ankle was hurting. This nurse examined the resident's left ankle. Swelling and… | 2016-11-01 |
| 7748 | 7748 | ALPHA HEALTH & REHAB OF GREER, LLC | 425138 | 401 CHANDLER RD | GREER | SC | 29651 | 2013-03-22 | 225 | E | 0 | 1 | IEVG11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on record review, interview, and policy review of Reporting Abuse to State Agencies and Other Entities, the facility failed to report 2 of 4 reviewed reportable's to the State Agency. The reportable's involved an incident of injury/neglect resulting in fracture for Resident #95 and an injury of unknown origin resulting in fracture for Resident #115. The findings included: On 3/19/13 at 10:40 AM record review of Incident Report of sampled resident #95 revealed an incident occurred on 9/9/12 at 5:00 PM with a Incident Witness Account by CNA #1 that stated Around 5:00 PM Resident #95 needed to go to the restroom, however the toilet was mess up.(sic) I told resident #95 I put him/her in the bed instead.(sic) As I proceed to transfer him/her, I ask him/her if he/she can stand, he/she said with assisted. (sic) As I proceed to transfer him/her to the bed, his/her feet got stuck under the bed rail. I slowly untwist his/her foot. Describe anything unusual that may have contributed to the incident? I have transfer Resident #95 several times one person assist, he/she always perform well in helping with transfers. Resident #95 is two person assist. I felt comfortable transfer him/her. (The CNA acknowledged awareness the resident was to be transferred with assistance of two staff members.) Further review revealed a South Carolina Licensure Reporting Form signed on 9/11/12 without a fax confirmations sheet. No documentation was noted stating that the incident was reported to the Certification Agency. Contained within this report was a statement by the Director of Nursing : Counsell with CNA in r/t (related to) sic proper transfers indicative of the facility awareness that the resident had been inappropriately transferred. On 3/19/13 at 4:30 PM record review of Departmental Notes ENURSE dated 9/9/2012 at 9:30 PM revealed the Resident reported the incident to the nurse at 7:30 p.m. that his/her ankle was hurting. This nurse e… | 2016-11-01 |
| 7749 | 7749 | ALPHA HEALTH & REHAB OF GREER, LLC | 425138 | 401 CHANDLER RD | GREER | SC | 29651 | 2013-03-22 | 226 | E | 0 | 1 | IEVG11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on record review, interview, and policy review of the facility provided Freedom from Abuse or Neglect and policy review of Abuse Investigations , the facility failed to follow policies implemented for the identifying and reporting of abuse and neglect for 2 of 4 sampled residents; Resident #95 and Resident #115. The findings included: On 3/19/13 at 10:40 AM record review of an incident on 9/9/12 involving Resident #95 revealed Investigation of Incident/Accident report. Section E - Intervention / Corrective Action / Supervisor Follow Up revealed answer to; Is Abuse or Neglect Suspected or Alleged? as NO. Also revealed was an Incident Report stating CNA (certified nursing assistant) #1 as the CNA involved in the incident on 9/9/12. Incident Witness Account by CNA #1 documented the resident was transferred with the assistance of one and the resident's feet/foot caught under the bedrail, requiring the CNA to slowly untwist her foot. The CNA did not report the incident but the resident complained to the nurse of his/her ankle hurting. Record review of South Carolina Licensure Reporting Form revealed Resident was sitting in her room A+Ox3 (Alert and orientated to person, place, and time) no c/o (complaints) voiced. CNA was transferring the resident to her bed. Her left foot got caught on the bed + (and) twisted. Fracture caused by L (left) foot getting caught. The form also documented Describe preventative action taken by living center to prevent reoccurrence: Consult c (with) CNA in r/t (related to) proper transfer. On 3/20/13 at 9:00 AM record review of Physical Therapy Plan of Care Initial Assessment electronically signed on 8/27/12 reveals Resident #95's current level of functional deficits for Transfers, Bed/Chair to be Max Assistance x 2 (76-99% assist with 2 people). Rehab (Rehabilitation) Potential: Good due to: Independence in prior ambulation ability. Stable medical condition. Strong social support at home… | 2016-11-01 |
| 7750 | 7750 | ALPHA HEALTH & REHAB OF GREER, LLC | 425138 | 401 CHANDLER RD | GREER | SC | 29651 | 2013-03-22 | 248 | D | 0 | 1 | IEVG11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On days of the survey based on record review, observation, and interview, Resident # 51 was only observed to attend one activity during the days of the survey. ( 1 of 3 sampled residents reviewed for activities.) The findings included: The facility admitted Resident # 51 on 6/20/11 with [DIAGNOSES REDACTED]. During observations of Resident # 51 on 4 days of the survey, the resident was noted either in bed or in his/her gerichair at the nurse' station or in the West Unit Dayroom. On 3/21/13 the resident was placed in a corner where the TV was not visible to the resident. On two days, facility staff were observed in the dayroom working on paper work and had no interaction with any of the residents. One time an Activity person was observed to ask the resident about attending an activity. The Resident stated yes. Staff were to come back to transport the resident to the activity. However, no one returned and the resident did not attend the activity. A Minimum Data Assessment (1/30/13 Significant change assessment) noted the resident had interest in music, animals, pets, doing things with groups, time outdoors, and religious activities. The Resident was discontinued from Hospice on 1/14/13 due to an improvement in his/her condition. During the Surveyors observations, the resident was observed looking around at people and speaking if spoken to. Interview with the Activity Director on 3/21/13 at 9:30 AM revealed that the Activity Department keeps a monthly calendar for each resident and highlights what they do with that resident each month. When asked if they document how the resident participates or acknowledges the activity, the Director stated: If we spent all our time documenting, we wouldn ' t ' have time to do activities. A copy of Resident # 51's calendar was presented for review. The dates of March 4, 5, 6, 11, 12, and 13, 2013 were highlighted in yellow to designate 1:1 's were done on those days. No time frames were listed, nor what was don… | 2016-11-01 |
| 7751 | 7751 | ALPHA HEALTH & REHAB OF GREER, LLC | 425138 | 401 CHANDLER RD | GREER | SC | 29651 | 2013-03-22 | 250 | D | 0 | 1 | IEVG11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on record review and interview, the facility failed to provide medically related social services to one of one sampled residents reviewed for these services. There was no evidence of social service interventions for documented behaviors, depression, or use of psychoactive medications for Resident #7. There was no evidence of or plan for alternative services in lieu of a discontinued hospice consultation for Resident #7. The findings included: Review of the 1-17-13 and 10-12-12 Quarterly Minimum Data Set (MDS) Assessments for Resident #7 on 3-20-13 at 11 PM revealed a decline in cognitive function from a BIMS (Brief Interview for Mental Status) score of 12 to O, indicating a change from moderate to severely impaired cognition. On the most recent assessment, s/he was noted as having behaviors directed at others. Resident #7 was also noted with changes in psychoactive medications. Record review on 3-20-13 at 11:06 AM revealed that [DIAGNOSES REDACTED]. Review of Nurse's Notes on 3-20-13 at 11:46 AM revealed that on 1-11-13 the resident became agitated with staff and threw a tray. The on-call physician was notified and Haldol was ordered. There was no evidence of non-medication interventions attempted. Continued agitation was noted through 1-16-13, with loud profanity, again without non-medication interventions. Review of Departmental Notes for Social Services on 3-20-13 at 12:02 PM revealed no reference to or plans for interventions related to the new behaviors, use of antipsychotic/psychoactive medications, or non-drug interventions. Review of the 1-10-13 hospital discharge information revealed that the resident was documented as appropriate for hospice referral. A physician's orders [REDACTED]. Social Services and family were notified. A Nurses Note dated 3-5-13 documented that the consult was discontinued due to inability to contact the resident's family member. There was no evidence of Social Service interven… | 2016-11-01 |
| 7752 | 7752 | ALPHA HEALTH & REHAB OF GREER, LLC | 425138 | 401 CHANDLER RD | GREER | SC | 29651 | 2013-03-22 | 272 | G | 0 | 1 | IEVG11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on record review and interview, the facility failed to comprehensively assess 2 of 3 residents for wounds. Resident #267 was not assessed at risk for pressure ulcers and acquired pressure ulcers while in the facility. Resident #277 had conflicting information related to wound assessment date for their first admission and no wound assessment completed on second admission. The findings included: On 3/20/13 at 2:15 PM record review revealed Resident #267 to have [DIAGNOSES REDACTED]. Record review of admission Care Plan revealed problem of I am resistant to daily care. On 3/21/13 at 1:35 PM record review of Initial Nursing Summery completed on 3/1/13 documented the resident was admitted with generalized [MEDICAL CONDITION]. On admission the resident was documented as having no pressure areas , no stasis ulcers but the presence of bruises was noted. Under Nursing Interventions / Initial Care Plan 1. Pressure reduction device needed? No; Bed Yes; Chair Yes. The Anatomical Figure Body Assessment revealed a Skin Tear to right forearm and a Skin Tear to right calf. 4. Wound care protocol implemented? Yes. The Resident Risk Assessment Profile (RAP) for Skin Conditions was left blank. Pressure Ulcer RAP Item Any of the items listed below that are checked on your Resident Risk Assessment Profile indicate either an existing pressure ulcer or risk for pressure ulcer. Care plan for treatment/prevention left blank. A record review of the residents Care Plan prior to 3/14/13 did not address any concerns for pressure ulcers risk. On 3/21/13 at 10:30 AM record review of Wound Assessment Report dated 3/14/13 revealed three stage III (3) pressure ulcers on Resident #267's back. Review of the physician Telephone Orders revealed new orders on 3/14/13 (without a time) for D/C (discontinue) Pressure Reducing device to bed. Air mattress to bed. Check function + Placement Q shift. and Cleanse top mid back and bottom mid back c (with) w… | 2016-11-01 |
| 7753 | 7753 | ALPHA HEALTH & REHAB OF GREER, LLC | 425138 | 401 CHANDLER RD | GREER | SC | 29651 | 2013-03-22 | 279 | D | 0 | 1 | IEVG11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On days of the survey, based on record review and interview, the facility failed to develop, review and revise the plan of care for 3 of 17 sampled resident careplan's reviewed. Resident # 277 did not have a care plan for skin care concerns related to multiple skin tears,stasis ulcers, and a poorly approximated left hip surgical wound. Resident # 104's care plan goals were expired and did not reflect the current needs for the resident. Resident # 7 was not care planned for Range of motion services. The findings included: Resident # 277 was admitted with diagnoses not limited to aftercare of [MEDICAL CONDITION]. An Initial Careplan developed on [DATE] for Resident # 277 included a plan for a left [MEDICAL CONDITION] but did not note the poorly approximated wound edges, treatment or documented signs of potential infection. No initial careplan was developed for the documented stasis ulcers, or numerous skin tears that were present on either ,[DATE] or [DATE]. The resident was transferred to acute care on [DATE] with a dehisced left hip wound. The hospital admitting [DIAGNOSES REDACTED]. The findings were verified during an interview with Licensed Practical Nurse # 4 on [DATE] and Medical Records on [DATE] at 9:15 AM also verified there was no additional medical record information was available. A closed record review was completed for Resident # 104 on [DATE]. Record review revealed the careplan contained in the closed record contained goals that had expired on [DATE]. The resident had been admitted to the facility on [DATE] and expired at the facility on [DATE]. Prior to discharge the resident had been admitted to the hospital on [DATE] and discharged on [DATE] with [MEDICAL CONDITION] and [MEDICAL CONDITION], dehydration, and coagulopathy secondary to malnutrition. When the resident was readmitted , s/he was place on Hospice care, with changes to the diet, and antibiotic therapy. On [DATE] at 10:23 AM, during an interview with the Care Plan Co… | 2016-11-01 |
| 7754 | 7754 | ALPHA HEALTH & REHAB OF GREER, LLC | 425138 | 401 CHANDLER RD | GREER | SC | 29651 | 2013-03-22 | 280 | D | 0 | 1 | IEVG11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on record review and interview, the facility failed to review and revise the care plan to reflect the residents current status for one of seventeen sampled records reviewed for care plans. Resident #115 's care plan was not updated related to pain, medications, gastrointestinal upset, and non-medication interventions for behaviors. The findings included: Review of the medical record for Resident #115 on 3-19-13 at 4 PM and 3-20-13 at 7:45 AM revealed a Care Plan for a Problem/Need: .at risk for gastric upset secondary [MEDICAL CONDITION](Gastro-[MEDICAL CONDITION] Reflux Disease) with an onset date of 7-27-12. Interventions included to Provide me with meds as ordered. No medications were ordered for this diagnosis, either routine or on an as needed basis. During an interview at 8 AM on 3-20-13, Registered Nurse #3 (administering medications) confirmed that the resident was not on any medication for treatment of [REDACTED]. A Problem/Need of I am at risk for side effects from antipsychotic drug use was identified on 7-27-12. The Approaches did not address attempts at gradual dose reduction. During an interview at 8:05 AM on 3-20-13, Registered Nurse #3 (administering medications) confirmed that the resident was not on any antipsychotic medication. Review of physician's orders [REDACTED].#115 had current orders for and was receiving [MEDICATION NAME] 50 mg (milligrams) q (every) 6 hrs (hours) since 2-5-13, as well as [MEDICATION NAME] every six hours as needed for pain. No interdisciplinary Care Plan could be located to address pain, though the resident had been placed on Hospice. No Care Plan with interventions including non-medication interventions could be located related to anxiety/behaviors though the resident was observed on two days of the survey running into other residents with her (his) wheelchair and taking clothes off at the nursing station. The resident had current physician's orders [REDACTED]. Dur… | 2016-11-01 |
| 7755 | 7755 | ALPHA HEALTH & REHAB OF GREER, LLC | 425138 | 401 CHANDLER RD | GREER | SC | 29651 | 2013-03-22 | 281 | E | 0 | 1 | IEVG11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on record review, interview, and review of the professional resource of Perry /Potter Clinical Nursing Skills and Techniques 7th Edition, and the facility provided policy for documentation, the facility failed to follow professional standards of nursing practice related to documentation of the completion of wound assessments, failed to document skilled services provided, and failed to develop an admission careplan for Resident # 277. The medical record for Resident # 267 contained missing documentation related to treatment and medication records. (Two of four sampled residents reviewed for professional standards) The findings included: Resident # 277 was last admitted to the facility on [DATE] and discharged on [DATE]. The resident was previously admitted on ,[DATE] and discharged on [DATE]. There was no admission careplan noted in the medical record for the resident's second admission as confirmed by an interview with the MDS (Minimum Data Set) Coordinator and medical records on 3/21/13. On 3/21/13 at 10:52 am, an interview with medical records verified there was only one nurses note in the computerized system and in the closed medical record related to the residents second admission and it was dated 2/16/ 13. Both Medical Records and the Nurse Consultant verified there was no admission note, no nursing notes ( except one on 2/16/13) nor a note on the day of transfer to the hospital, and no skin assessment records. There was no evidence nursing provided skilled services from 2/14- 2/16/13. On 3/22/13 at 10:30 am, interview with Licensed Practical Nurse # 4 confirmed s/he had done the residents admission on 2/14/13 and did not complete wound assessment portion of admission form and completed no additional wound assessment forms. S/he verified there was no documentation in medical record of skin issues on readmission other than treatment orders. She confirmed the resident had multiple skin concerns on his/her r… | 2016-11-01 |
| 7756 | 7756 | ALPHA HEALTH & REHAB OF GREER, LLC | 425138 | 401 CHANDLER RD | GREER | SC | 29651 | 2013-03-22 | 282 | D | 0 | 1 | IEVG11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on record review, observation, and interview, the care plan was not followed for Resident # 51 related to positioning. ( 1 of 3 sampled residents reviewed for following the plan of care related to positioning) The findings included: The facility admitted Resident # 51 on 6/20/11 with [DIAGNOSES REDACTED]. For two days of the survey, the resident was observed to be leaning to the right with his/her head near the edge of his/her geri-chair. His/her legs would be bent at the knees and feet would be hanging off the foot rest. Staff were observed walking by the resident several times without changing the resident's position. In bed, the resident was also observed with his/her head resting near the side rail on the right side of the bed. Again his/her knees would be bent at the knees. The resident was observed on one occasion to straighten his/her legs out straight and try to move around in an attempt to change his/her position. On 3/21/13 a 8:30 AM, the resident was observed in a geri-chair in the dayroom. The Resident was leaning to the right with his/her head leaning over the right arm of the chair. There were no pillows for positioning per the care plan. Review of the care plan revealed a problem r/t (related to) self care deficit . An approach was written for PT, OT (Physical and Occupational Therapy) evaluation for potential improvement in bed mobility participation or independence per MD (medical Doctor) order. Another care problem listed approaches of : use pillows or other supportive/protective devices to assist positioning, reposition every 2 hours and PRN (as necessary), place pressure relieving device/product on bed and geri-chair. An interview with LPN (Licensed Practical Nurse) #1 confirmed the resident usually lays with his/her head over to the right most of the time. The nurse read the care plan and confirmed there was no pillow used to position the resident, nor was there a pressure relieving device… | 2016-11-01 |
| 7757 | 7757 | ALPHA HEALTH & REHAB OF GREER, LLC | 425138 | 401 CHANDLER RD | GREER | SC | 29651 | 2013-03-22 | 309 | E | 0 | 1 | IEVG11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey based on record review and interview the facility failed to provide necessary care and services for Resident # 277 related failing to follow physician orders. There was a lack of evidence physician orders [REDACTED]. There was no evidence physician orders [REDACTED]. ( 2 of 3 sampled resident reviewed for the provision of care and services related to following physician orders.) The findings included: Resident # 277 was admitted to the facility on [DATE] and discharged to acute care on 2/9/13 for a dehisced left hip wound. S/he was again admitted on [DATE] and discharged on [DATE] to acute care. A closed record review conducted during the days of the survey revealed a lack of evidence the facility followed physician orders [REDACTED]. Verified missing evidence of medication administration and provision of treatments included: [MEDICATION NAME]- no evidence of administration on 2/8/13 Fingerstick blood sugar with sliding scale insulin coverage: No evidence this was done on 2/8 at 12p, 6pm,9pm. [MEDICATION NAME] - scheduled for administration at 8am, administered at 9:23 am on 2/9/13 (late) [MEDICATION NAME] - no evidence of administration on 2/9 at 8am [MEDICATION NAME] - no evidence of administration on 2/7, 2/8 pm dose, 2/9/13 at 9am, [MEDICATION NAME] - no evidence of administration on 2/8 at 4pm, 2/9 at 8am [MEDICATION NAME]- no evidence of administration on 2/8 at 2pm , 8pm, 2/9 at 2am,8am Atrovent - no evidence of administration on 2/8 at 12pm, 2/9 at 12am or 6am [MEDICATION NAME] - no evidence of administration on 2/9 at 8am [MEDICATION NAME]- no evidence of administration on 2/9 at 8am [MEDICATION NAME] - no evidence of administration on 2/8 at 4pm, 2/9 at 8am Magnesium Oxide - no evidence of administration on 2/8 at 4pm and 2/9 at 8am [MEDICATION NAME] - no evidence of administration on 2/9/13 at 8am Verified missing treatment documentation included: There was no documentation of wound care to the left hip, l… | 2016-11-01 |
| 7758 | 7758 | ALPHA HEALTH & REHAB OF GREER, LLC | 425138 | 401 CHANDLER RD | GREER | SC | 29651 | 2013-03-22 | 314 | G | 0 | 1 | IEVG11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on record review and interview, the facility failed to assess and implement interventions to prevent pressure ulcer development for 1 of 2 sampled residents reviewed for pressure ulcers. Resident #267, was not identified at risk for skin alterations and acquired three Stage III (3) pressure ulcers within 14 days of admission. The findings included: On 3/20/13 at 2:15 PM record review revealed Resident #267 to have [DIAGNOSES REDACTED]. On 3/21/13 at 1:35 PM record review of the Initial (admission) Nursing Summary completed on 3/1/13 revealed the resident was admitted with generalized [MEDICAL CONDITION] and bruises. There were no pressure ulcers or stasis ulcers noted on admission. Under Nursing Interventions / Initial Care Plan 1. Pressure reduction device needed? No; Bed Yes; Chair Yes. The Anatomical Figure Body Assessment revealed a Skin Tear to right forearm and a Skin Tear to right calf. A Resident Risk Assessment Profile (RAP) for Skin Conditions was left blank. The Pressure Ulcer RAP Item Any of the items listed below that are checked on your Resident Risk Assessment Profile indicate either an existing pressure ulcer or risk for pressure ulcer. The Care plan for treatment/prevention was left blank. Record review of the resident's Care Plan prior to 3/14/13 did not address any active pressure ulcer concerns or identify the resident at risk for pressure ulcers. Nurses Notes documented on 3/13/13 12:15 PM Res. (resident) c/o (complaint of) pain. PRN (as needed) pain med. admin at 12 PM. No further wants or needs voiced at this time. Dressings to skin tears were also changed at this time The resident's skin condition was not documented again until 3/16/13 at 7 PM when the Resident stated I was using the urinal + I rubbed it on my skin [MEDICAL CONDITION] skin tear to R thigh. There was no notation of pressure ulcers in the Nurses Notes from identification on 3/14/13 through 3/20/13. A Wound Assessment Repo… | 2016-11-01 |
| 7759 | 7759 | ALPHA HEALTH & REHAB OF GREER, LLC | 425138 | 401 CHANDLER RD | GREER | SC | 29651 | 2013-03-22 | 318 | D | 0 | 1 | IEVG11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on observation, record review, and interviews, the facility failed to provide services to prevent further decline in range of motion (ROM) for one of three sampled residents reviewed for ROM. The facility failed to reassess Resident #7 for limited ROM/contracture following readmission from the hospital on 1-10-13, failed to develop a plan of care, and failed to provide services to prevent further decline in ROM. The findings included: Observation on 3-18-13 at approximately 11:50 AM revealed Resident #7 in bed with arms folded over her/his chest. The left hand appeared fisted and had a washcloth in place. No splints or other positioning devices were observed. At this time, the resident requested that the Certified Nursing Assistant (CNA) reposition the washcloth in her/his hand. The resident said, I'm gonna yell, and did, as the CNA did as requested. While conducting a staff interview during Stage 1 of the survey on 3/18/2013 at 11:50 AM, the Poinsettia Hall Unit Manager stated that Resident #7 had contractures of the left hand and shoulder and received no ROM or splinting. During an interview on 3-20-13 at 1:38 PM, the Unit Manager stated that the resident had a splint before s/he went to the hospital in January (2013). Upon readmission, s/he stated that the resident was unable to wear it because of pain. The nurse stated that a therapy referral had been made the week prior to the survey. S/he thought therapy had screened the resident after hospitalization . When asked if any restorative services were provided, such as ROM, s/he stated that the surveyor would need to speak to the Restorative Aide. During an interview on 3-20-13 at 2:55 PM, CNA #3, identified as responsible for restorative services, stated s/he had never worked with Resident #7. Review of the 1-17-13 and 10-12-12 Quarterly Minimum Data Set (MDS) Assessments on 3-20-12 at 11 PM revealed no limitations in ROM coded on either assessment. No thera… | 2016-11-01 |
| 7760 | 7760 | ALPHA HEALTH & REHAB OF GREER, LLC | 425138 | 401 CHANDLER RD | GREER | SC | 29651 | 2013-03-22 | 322 | D | 0 | 1 | IEVG11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on record review and interview, the facility failed to ensure Resident # 104 received appropriate gastric tube hydration. The facility failed to follow two physician order [REDACTED]. (1 of 3 sampled resident's reviewed with gastrostomy tubes) The findings included: Resident # 104 was admitted to the facility on [DATE] and expired at the facility on [DATE]. The resident was hospitalized from [DATE] to [DATE]. The hospital discharge summary documented the resident was treated for [REDACTED]. On [DATE] a review of the closed record revealed a nutrition screen completed on [DATE] that stated the resident was at 84% of an ideal body weight; has PEG (percutaneous gastrostomy) but no formula ordered to run; inadequate fluid intake. On [DATE] at 9:45 am during an interview with the Licensed Practical Nurse # 1, s/he verified the following concerns after reviewing the medical record while in the presence of the surveyor and after leaving the interview: On [DATE] a physician's orders [REDACTED]. The order was not initiated until [DATE] with no explanation. On [DATE] an physicians order was written: please give an additional 240 cc fluid ,[DATE] and 3- 1 (sic) shifts and the order was not transcribed/documented on the MAR. (Medication Administration Record) On [DATE] an order was written to increase flush to 175 cc of water via peg tube TID (three times a day). However, the MAR documentation stated N for not administered. LPN # 1 was unable to explain why it was not administered. The resident had been receiving ensure 1 can by mouth daily, the MAR documented N for February ,[DATE]- [DATE] and indicated the order was discontinued on [DATE]. No corresponding physician order [REDACTED]. | 2016-11-01 |
| 7761 | 7761 | ALPHA HEALTH & REHAB OF GREER, LLC | 425138 | 401 CHANDLER RD | GREER | SC | 29651 | 2013-03-22 | 323 | G | 0 | 1 | IEVG11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on record review and interview, the facility failed to promote a facility free of hazards/accidents for 1 of 4 residents reviewed for accidents. Resident #95 was transferred inappropriately resulting in a fracture that required surgery. The findings included: On 3/18/13 at 2:18PM interview with resident #95 revealed that a certified nursing assistant (CNA) transferred him/her without the required assistance. Resident #95 stated his/her foot got caught at the railing and when he/she told the CNA he/she yanked his/her foot loose and broke his/her ankle. On 3/19/13 at 4:30PM record review of Departmental Notes ENURSE dated 9/9/2012 at 9:30PM revealed Resident informed this nurse at 7:30 p.m. that his/her ankle was hurting. This nurse examined the resident's left ankle. Swelling and bruising was noted. Resident informed this nurse that it happened during transfer from wheel chair to bed around supper time. Mobile X Ray ordered per T.O. (Telephone Order) Dr. (doctor) Tadd Venn. Departmental Notes ENURSE dated 9/10/2012 at 1:22PM revealed Resident returned from doctor's appt. (appointment) with no new order for L (left) ankle. MD (medical doctor) in facility notified. New order to send to ER for Tx and evaluation. Family notified. On 3/19/13 at approximately 3:00PM record review of Resident #95 revealed [DIAGNOSES REDACTED]. Record review of Radiology report dated 09/09/2012 revealed Examination: Ankle Comp, Min 3V, Left. Results: There is regional soft tissue edema. Transverse, minimally displaced distal fibula and tibia fractures a the level of the plafond are present with slight lateral talar subluxation. Conclusion: Fracture as described. On 3/19/13 at 10:40AM record review of Incident Report revealed CNA #1 as the CNA involved in the incident on 9/9/12. Incident Witness Account by CNA #1 revealed Around 5:00PM resident #95 needed to go to the restroom, however the toilet was mess up. I told resident #95 I put h… | 2016-11-01 |
| 7762 | 7762 | ALPHA HEALTH & REHAB OF GREER, LLC | 425138 | 401 CHANDLER RD | GREER | SC | 29651 | 2013-03-22 | 332 | E | 0 | 1 | IEVG11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on observations, record reviews, and interviews, the facility failed to ensure a medication error rate of less than 5%. There were 4 medication errors in 25 opportunities for error, equivalent to a medication error rate of 16%. The findings included: Error #1: During observation of the medication pass at 6:20 AM on 3-20-13, Licensed Practical Nurse (LPN) #6, after thoroughly searching the medication cart, noted that there was no [MEDICATION NAME] available for Resident #85 for the 6:30 AM dose. When asked what procedure the nurse would follow in this case, LPN #6 stated that s/he would go in the E(mergency)-box and get it. At 6:38 Am, the Unit Manager stated that the E-box was located on the Transitional Care Unit. A list of the contents was obtained from the Unit Manager and reviewed at 6:43 AM. S/he verified that the list of contents did not include the drug, [MEDICATION NAME]. When asked about reorder procedures for routine medications, the Corporate Consultant noted that the medication should have been reordered seven days previously according to facility policy. When the Unit Manager stated that the medication would be ordered, the surveyor requested s/he be notified upon receipt so that administration could be observed. LPN #3 notified the surveyor of medication receipt and intent to administer the [MEDICATION NAME] at 1:55 PM, after the noon meal. The surveyor verified receipt and administration at this time. Review of the medical record revealed physician's orders [REDACTED]. Take PO (by mouth) daily. Time for administration on the monthly cumulative physician's orders [REDACTED]. Review of current United States Food and Drug Administration information available on www.access.fda.gov notes that food effects absorption and to: Take [MEDICATION NAME] in the morning on an empty stomach, at least one-half hour before eating any food. Error #2, #3, and #4: During observation of the medication pass on the Tr… | 2016-11-01 |
| 7763 | 7763 | ALPHA HEALTH & REHAB OF GREER, LLC | 425138 | 401 CHANDLER RD | GREER | SC | 29651 | 2013-03-22 | 371 | E | 0 | 1 | IEVG11 | On the days of the survey, based on observation, interview, and review of facility policies entitled Sanitation and Infection Control and Feeding-Resident, the facility failed to serve food under sanitary conditions during two of two meals observed on two of three units. Multiple Certified Nursing Assistants (CNAs) in multiple dining locations were observed to handle breads and/or sandwiches with their hands while assisting residents. The findings included: During a random meal observation on the Poinsettia Hall at 12:20 PM on 3-19-13, meal trays were delivered by CNAs #1 and #2 to residents in Room 35. Both staff members were observed to remove rolls from their wrappers and handle them with their hands while preparing/setting up the meals for the residents. The resident in bed B also had a half sandwich that was handled with the CNA's bare hands. At 12:30 PM on 3-19-13, CNA #2 was again observed to handle bread with her/his hands while serving Resident #92 in the dining room on the same unit. Review of the Nursing Policy & Procedure entitled Feeding-Resident, provided by the Assistant Director of Nursing on 3-22-13 at 8:34 AM, revealed no reference to direct handling of food items. Review of the Sanitation and Infection Control policy provided by the Dietary Manager on 3-21-13 revealed: Procedures: All Dining Services Employees should Use a spatula or tongs, or wear disposable gloves when handling food. When handling plates, instructions included to keep thumb and fingers away from food . During a random observation of the lunch meal on 3/18/13 in the West Wing Dayroom, 3 CNA's (Certified Nursing Assistant's) were observed to unwrap the roll on the resident's trays, remove the rolls with their bare hands and place them onto the resident;s plates. On 3/19/13 during the lunch meal observation in the West Wing Dayroom, 3 CNA's were observed to remove 4 rolls from the paper wrappings with their bare hands and place the rolls on separate resident's plates. . | 2016-11-01 |
| 7764 | 7764 | ALPHA HEALTH & REHAB OF GREER, LLC | 425138 | 401 CHANDLER RD | GREER | SC | 29651 | 2013-03-22 | 412 | D | 0 | 1 | IEVG11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on interviews and record reviews, the facility failed to ensure that a resident with known chewing problems receive appropriate dental care. Resident #114 did not receive dental services related to chewing problems. (1 of 1 sampled resident's identified with a dental concern) The findings included: The facility admitted Resident #114 with [DIAGNOSES REDACTED]. Record review revealed an updated care plan that indicated Problems Affecting Nutrition resident on mechanically altered diet related to chewing difficulties and at risk of weight loss due to poor intake at times. Further record reviewed there was no documentation of a dental consultant being done due to the identified chewing difficulties. An interview on 3/20/13 at approximately 1:26 PM with LPN (Licensed Practical Nurse) #1 confirmed that was no documentation of a dental consultant. LPN #1 further stated the resident had a dental appointment in 2012 but the facility did not have results of the dental appointment and that the family took the resident to the appointment. | 2016-11-01 |
| 7765 | 7765 | ALPHA HEALTH & REHAB OF GREER, LLC | 425138 | 401 CHANDLER RD | GREER | SC | 29651 | 2013-03-22 | 425 | D | 0 | 1 | IEVG11 | On the days of the survey, based on observation and review of medical storage, the facility failed to removed expired medications from the Transitional Care Unit. ( 1 of 3 units reviewed for medication storage) The findings included : On 3/21/13, a review of medication storage was conducted on the Transitional Care Unit. The Medication Room and two medication carts were examined for appropriate drug storage. One vial of Humulog 100 insulin was observed to have been opened/punctured on 2/15/13 as verified by LPN # 7 ( Licensed Practical Nurse). The nurse stated the vial should have been discarded 28 days from the date opened per facility policy. A bottle of Aspirin 325mg (milligrams ) was expired noted to have expired on 2/23/13 as confirmed on 3/21/13 at 3:06 PM by LPN # 2. | 2016-11-01 |
| 7766 | 7766 | ALPHA HEALTH & REHAB OF GREER, LLC | 425138 | 401 CHANDLER RD | GREER | SC | 29651 | 2013-03-22 | 428 | E | 0 | 1 | IEVG11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on record reviews and interviews, the pharmacy consultant failed to identify irregularities in the drug regimen of 2 of 10 sampled residents reviewed for medication assessment. The pharmacist failed to identify and notify the facility that physician's orders [REDACTED].#7 and #115. The findings included: Review of the medication regimen on 3-20-13 at 11:06 AM revealed that Resident #7 had a physician's orders [REDACTED]. Give PO (by mouth) twice daily. The form noted that the OTC (over-the-counter) medication had been initially ordered on 8-17-12 and was to be given BID 1 (one twice daily). The 7-6-12 hospital Discharge Instructions and the Nursing Home Initial History & Physical dated 7-9-12 noted medications at transfer included Calcium with D one PO bid A [DIAGNOSES REDACTED]. A prescription was written at the time of discharge for calcium-vitamin D (OYSTER SHELL) 500mg(milligrams) (1200mg)-200 unit per tablet. Take 1 Tab(let) by mouth two (2) times daily (with meals). Records from this hospitalization also noted a history of hypercalcemia . Calcium was high as 17.3 and dropped down to 9 with hydration. Review of the Medication Administration Records (MARs) for January through March, 2013 on 3--20-13 at 12:11 PM revealed no dosage noted for the Calcium+D. Review of Telephone Orders revealed that Calcium was discontinued on 3-4-13. There was no evidence in the medical record that the Pharmacy Consultant had noted that there was no specified dosage ordered for this medication for a period of over 8 months. Record review on 3-19-13 at approximately 3:26 PM revealed that Resident #115 had a [DIAGNOSES REDACTED]. There was no evidence in the medical record that the Pharmacy Consultant had noted that there was no specified dosage ordered for this medication for a period of over 8 months. During an interview on 3-20-13 at 9:47 AM, Registered Nurse (RN) #2 (Unit Manager) verified the physician's orders [REDACTED]. … | 2016-11-01 |
| 7767 | 7767 | ALPHA HEALTH & REHAB OF GREER, LLC | 425138 | 401 CHANDLER RD | GREER | SC | 29651 | 2013-03-22 | 441 | F | 0 | 1 | IEVG11 | On the days of the survey, based on review of Infection Control Program and interview, the facility failed to have documentation of tracking and trending of infections for all of the facility units since May, 2012 and no general infection control surveillance was being conducted for the facility. The findings included: An interview with the ADON (Assistant Director of Nursing)/ acting designee in charge of Infection Control, on 3/20/13 revealed there was no documentation/tracking of infections in the facility from May, 2012 to December 2012. There was incomplete documentation for December, 2012 and January, 2013. The ADON confirmed there had basically been no ongoing infection control program from May until February of this year. No compliance surveillance of the Dietary, Nursing, Laundry, or Housekeeping Departments had been in place over the same time period to ensure infection control policies were implemented and maintained. Per the facility guidelines for Infection Control Program, the facility wide monitoring program should include surveillance data to identify nosocomiall infections; system for detection, investigation, and control of outbreaks of infectious diseases, isolation/precautions to reduce risk of transmission, inservice/education for infection control prevention and control, resident and employee health program, system for antibiotic review and control, product review and evaluation, and disease reporting to public health authorities. A Quality Assurance Process was not put into place until January, 2013 to tract identified clusters, antibiotic use, monitoring of organisms identified and completion of a monthly summary. | 2016-11-01 |
| 7768 | 7768 | ALPHA HEALTH & REHAB OF GREER, LLC | 425138 | 401 CHANDLER RD | GREER | SC | 29651 | 2013-03-22 | 490 | E | 0 | 1 | IEVG11 | On the days of the survey, based on record review and interview, facility Administration failed to develop and implement written policies and procedures that would effectively and efficiently assist residents to attain or maintain the highest practicable physical, mental, and psychosocial well-being. There was no evidence the facility developed and implemented written policies and procedures for the following care areas that were identified as deficient practice: Notification of residents families; food handling during the serving of resident meals for non-dietary staff; and wound care including assessments. The findings included: During the days of the survey based on record review, observation and interview, concerns were noted in the the following care areas: Notification of residents families; food handling by non dietary staff during the serving of resident meals; and wound care including assessments. During an interview with the Staff Development Coordinator concerning wound care as an example, and how staff would be aware of what to do, s/he stated the wound nurse comes in during orientation and speaks to new employees and verbally reviews what should be done. The facility Nurse Consultant also verified there were no written policies for wound assessment/treatments or the other policies requested. S/he also stated it is gone over in orientation, there are always other nurses on unit available for support. On 3/22/13 at 9:45 AM, when the Assistant Director of Nursing was asked for copies of the facility written policy and or procedure for these areas, s/he stated that there were none. | 2016-11-01 |
| 7769 | 7769 | ALPHA HEALTH & REHAB OF GREER, LLC | 425138 | 401 CHANDLER RD | GREER | SC | 29651 | 2013-03-22 | 498 | D | 0 | 1 | IEVG11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on record review and interview, the facility failed to ensure competency of nursing aides for 1 of 1 employee record reviewed for competency related to transfers. The findings included: On 3/18/13 at 2:18 PM interview with resident #9 5 revealed that a certified nursing assistant (CNA) transferred him/her without the required assistance. Resident #95 stated his/her foot got caught at the railing and when he/she told the CNA he/she yanked his/her foot loose and broke his/her ankle. A Radiology report dated 09/09/2012 revealed a [MEDICATION NAME], minimally displaced distal fibula and tibia fractures. On 3/19/13 at 10:40 AM record review of Incident Report revealed CNA #1 as the CNA involved in the incident on 9/9/12. Incident Witness Account by CNA #1 revealed: . As I proceed to transfer him/her, I ask him/her if he/she can stand, he/she said with assisted. As I proceed to transfer him/her to the bed, his/her feet got stuck under the bed rail. I slowly untwist his/her foot. I have transfer Resident #95 several times one person assist, he/she always perform well in helping with transfers. Resident #95 is two person assist. I felt comfortable transfer him/her. On 3/20/13 at 9:15 AM record review or the resident Care Plan revealed Problem Onset: 8/25/13 for I am at risk for falls related to debility and weakness. Problem Onset: 8/25/13 for I have impaired mobility related to debility and weakness with Approaches Transfer me with appropriate amount of staff/equipment. On 3/21/13 at 11:17 AM interview the Staff Development Coordinator (SDC) revealed that CNA certification training teaches transfers and unless there is an issue then we do not do inservice or training. On 3/21/13 at 12:36 PM Physical Therapy (PT) inservices for Resident #95, delivered by the Interim Rehab Director after request for all PT training for Resident #95, revealed an Inservice Attendance sheet for Slide Board Transfer Training dated 10/24/12… | 2016-11-01 |
| 7770 | 7770 | ALPHA HEALTH & REHAB OF GREER, LLC | 425138 | 401 CHANDLER RD | GREER | SC | 29651 | 2013-03-22 | 520 | F | 0 | 1 | IEVG11 | On the days of the survey, based on review of Infection Control Program, interview, and review of the facility Infection Control Policies, the facility failed to timely identify the failure of the facility wide Infection Control Program and implement prompt corrective action through the quality assurance system. The findings included: Interview on 3/21/13 with the ADON (Assistant Director of Nursing), who had documentation of tracking/trending of infections up until May, 2012. S/he could not provide documentation related to the infection control program after that date. The DON (Director of Nursing) who was new to the facility, had no additional information. A Quality Assurance (QA) study was done 1/15/13 with a goal date of 2/15/13 for the tracking aspect of the infection control program. The Staff could not provide a date or reason for the triggered the QA study or why it had not been previously identified. There was also no documentation of infection control surveillance having been done in the facility since May, 2012 | 2016-11-01 |
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CREATE TABLE [cms_SC] ( [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 );