cms_SC
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33 rows where "inspection_date" is on date 2014-06-19
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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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 6256 | 6256 | MAGNOLIA MANOR - GREENVILLE | 425090 | 411 ANSEL ST | GREENVILLE | SC | 29601 | 2014-06-19 | 156 | C | 0 | 1 | 336311 | On the days of the survey, based on Liability Notices and Beneficiary Appeal Rights form review and interview, the facility failed to use the correct mandated form for Notice of Medicare Provider Non-Coverage (NOMNC) for 3 of 3 residents reviewed. The findings included: On 06/18/14 at approximately 10:00 AM, during the review of liability notices issued by the facility, it was revealed that the facility was using the form instead of the updated NOMNC form. Interview with the Business Office Manager at the time of the findings confirmed that the updated NOMNC forms were not being used and he/she was unaware the form had been updated. | 2018-04-01 |
| 6257 | 6257 | MAGNOLIA MANOR - GREENVILLE | 425090 | 411 ANSEL ST | GREENVILLE | SC | 29601 | 2014-06-19 | 157 | D | 0 | 1 | 336311 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the recertification survey, based on record review and interview, the facility failed to notify the physician and interested family member of changes in the resident's condition requiring potential physician intervention for 1 of 11 sampled residents reviewed for notification. There was no evidence that the physician and/or family were notified of Resident #9 pocketing/hoarding medication. The findings included: The facility admitted Resident #9 to the facility with [DIAGNOSES REDACTED]. On 6/17/2014 at approximately 11:30 AM, record review of the 2-25-14 Nurse's Notes revealed that Resident #9 was pocketing her/his narcotic medication by using her/his tongue to tuck the pill in her/his bottom lip and on the side of her/his mouth until the nurse walked out of the room. During an interview on 6-17-14 at 5 PM, Licensed Practical Nurse (LPN) #3 confirmed the incident and stated, I took the medication into the resident's room mixed in applesauce because I had heard that she (he) was pocketing her (his) medication and a pill was found at the bedside. (Resident #9) refused to take the medication mixed in the applesauce. LPN #3 reviewed the Nurse's Notes and confirmed that there was no documentation about notifying the physician or the responsible party of the incident. On 6/17/2014 at approximately 11:40 AM, interview with the Unit Manager of the West Wing revealed s/he was not aware of the incident. On 6/17/2014 at approximately 12:10 PM, interview with the Social Services Director revealed s/he was not aware of the incident. | 2018-04-01 |
| 6258 | 6258 | MAGNOLIA MANOR - GREENVILLE | 425090 | 411 ANSEL ST | GREENVILLE | SC | 29601 | 2014-06-19 | 274 | D | 0 | 1 | 336311 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the Recertification Survey, based on record reviews, interviews, and review of CMS's (Centers for Medicare & Medicaid Services) RAI (Resident Assessment Instrument) Version 3.0 Manual, the facility failed to conduct Significant Change in Status Assessments for Residents #4, #6, and #10, 3 of 3 residents reviewed with a significant change in status. The findings included: The facility admitted Resident #4 with [DIAGNOSES REDACTED]. On 6/17/14 at 2:34 PM, review of the Annual MDS (Minimal Data Set) dated 6/3/14 revealed Resident # 4 was coded as requiring extensive assistance with bed mobility, transfers and locomotion on and off the unit and for eating. Comparison to the previous Quarterly MDS assessment dated [DATE] indicated the resident had been coded as limited assistance for these aspects of ADLs (Activities of Daily Living) indicating the resident had experienced a decline. Further review revealed the resident had also experienced a decline in urinary and bowel continence and was newly coded as always incontinent where he/she had previously been coded as frequently incontinent. In addition, Resident #4 was coded as having verbal behaviors 1-3 days during the assessment period and other behaviors daily and had an unstageable pressure ulcer that were not present on the previous assessment. Review of the record revealed the resident's behaviors had began in April, 2014 and the Pressure ulcer onset date was 5/2/14. The facility admitted Resident #6 with [DIAGNOSES REDACTED]. On 6/17/14 at 3:00 PM, review of the Annual MDS (Minimal Data Set) dated 2/6/14 revealed Resident #4 was coded as requiring limited assistance with bed mobility. In addition, the resident was coded as having a poor appetite or overeating on 2-6 days during the assessment period resulting in a mood severity score of 1. Comparison to Quarterly MDS assessment dated [DATE] indicated the resident was newly coded as requiring extensive assistance for bed mobilit… | 2018-04-01 |
| 6259 | 6259 | MAGNOLIA MANOR - GREENVILLE | 425090 | 411 ANSEL ST | GREENVILLE | SC | 29601 | 2014-06-19 | 278 | D | 0 | 1 | 336311 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of Recertification Survey, based on record review and interview, the facility failed to accurately assess Residents #4 and #6, 2 of 11 sampled residents reviewed for assessments. The facility failed to interview the residents for cognition and mood despite the fact the residents were not coded as rarely or never understood. The findings included: The facility admitted Resident #4 with [DIAGNOSES REDACTED]. On 6/17/14 at 2:01 PM, review of the Annual Minimal Data Set ((MDS) dated [DATE] revealed Resident #4 was coded as usually understands and usually understood in Section B for for Hearing, Speech, and Vision. Section C, Cognitive Patterns, C0100, Should Brief Interview for Mental Status be Conducted, was coded 0 No (resident is rarely/never understood). Section C0600, Should the Staff Assessment for Mental Status be Conducted, was not coded but a Staff Assessment was conducted that coded the resident as severely impaired, rarely/never made decisions. Further review revealed Section D of the MDS for Mood, D0100, Should Resident Mood Interview be Conducted, was also coded 0 No (resident rarely/never understood and a Staff Assessment of Resident Mood was conducted. There was no indication that the facility attempted to interview the resident for cognition of mood indicators. The facility admitted Resident #6 with [DIAGNOSES REDACTED]. On 6/18/14 at 3:00 PM review of the Annual Minimal Data Set ((MDS) dated [DATE] revealed Resident #6 was coded as usually understands and usually understood in Section B for for Hearing, Speech, and Vision. Section C, Cognitive Patterns, C0100, Should Brief Interview for Mental Status be Conducted, was coded 0 No (resident is rarely/never understood). Section C0600, Should the Staff Assessment for Mental Status be Conducted, was not coded but a Staff Assessment was conducted that coded the resident as severely impaired, rarely/never made decisions. Further review revealed Section D of the MDS for Mood,… | 2018-04-01 |
| 6260 | 6260 | MAGNOLIA MANOR - GREENVILLE | 425090 | 411 ANSEL ST | GREENVILLE | SC | 29601 | 2014-06-19 | 280 | D | 0 | 1 | 336311 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the Recertification survey, based on record review and interview, the facility failed to update the care plan for 1 of 3 residents reviewed for careplan's related to behaviors. The care plan was not updated for Resident #9 who had an onset of a previously unidentified behavior of pocketing/hoarding medication. The care plan was also not updated for 1 of 1 sampled residents reviewed for falls. The findings included: The facility admitted Resident #9 to the facility with [DIAGNOSES REDACTED]. Record review on 6/17/2014 at approximately 11:30 AM revealed an entry in the Nurse's Notes dated 2-25-14 at 11:45 PM which stated: Resident has been allegedly pocketing her (his) narcs (narcotics) . On 2-26-14 at 2:45 AM, .Resident admitted to this nurse she (he) has been hoarding her (his) narcs. Resident demonstrated .how she (he) uses her (his) tongue to tuck the pill in her (his) bottom lip or on the side of her (his) mouth until nursing staff walks out of her (his) room. Record review revealed that the Care Plan had not been updated to reflect the new behavior and no new interventions had been added. On 6/17/2014 at approximately 11:40 AM, interview with the Unit Manager of the West Wing revealed s/he was not aware of the incident. On 6/17/2014 at approximately 12:10 PM, interview with the Social Services Director revealed s/he was not aware of the incident and that the care plan had not been updated for this new behavior of pocketing medication. | 2018-04-01 |
| 6261 | 6261 | MAGNOLIA MANOR - GREENVILLE | 425090 | 411 ANSEL ST | GREENVILLE | SC | 29601 | 2014-06-19 | 282 | D | 0 | 1 | 336311 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the Recertification Survey, based on record review and interview, the facility failed to follow the care plan related to fall prevention interventions for Resident #6, 1 of 11 residents reviewed for implementation of the care plan. The findings included: The facility admitted Resident #6 with [DIAGNOSES REDACTED]. On 6/17/14 at 3:14 PM, review of the resident's care plan dated 2/17/14 - 6/17/14 revealed Falls was identified as a problem area. The care plan indicated the resident had a fall on 1/23/14 and on 3/11/14. Further review of the care plan indicated a new intervention was added dated 3/11/14 for Anti tippers on wheelchair. There was no intervention added following the 1/23/14 fall listed on the comprehensive care plan. Review of the Patient /Resident Incident /Accident Investigation Worksheet dated 1/23/14 revealed Follow up/steps taken to prevent reoccurrence . was listed to Check resident Q (every) hour during 11-7 shift added to profile. Review of the Patient /Resident Incident /Accident Investigation Worksheet dated 3/12/14 revealed the Follow up/steps taken to prevent reoccurrence . stated Talk with Therapy about placing resident in Geri-chair. Review of the Resident Profile revealed the hourly checks during the night shift was listed. Review of the Point of Care CNA (Certified Nursing Assistant) documentation 1/23/14 through 6/18/14 revealed there was no documentation that the resident was checked hourly during the night shift. Review of the Occupational Therapy Notes revealed a note dated 3/17/14 that stated Measured patient for appropriate size w/c (wheel chair) to be at 16 inches wide. Further review review revealed a note dated 3/19/14 that stated Patient continues to be in 18 inch w/c at 17/5 inch height with anti thrust cushion and rear anti tippers. Resident #6 was observed on 6/16/14 at 2:50 PM, and 4:07 PM and on 6/17/14 at 8:54 AM and 12:35 PM, with no anti-tippers observed on the wheel chair. During an … | 2018-04-01 |
| 6262 | 6262 | MAGNOLIA MANOR - GREENVILLE | 425090 | 411 ANSEL ST | GREENVILLE | SC | 29601 | 2014-06-19 | 317 | D | 0 | 1 | 336311 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of survey based on record review, interview, review of the facility provided policy for Restorative Nursing Policies and Procedures (revised 2/2012) the facility failed to ensure that a resident who enters the facility does not experience a reduction in range of motion (ROM) for one of two residents reviewed with decline in ROM. Resident # 10 experienced a decline in range of motion without evidence the facility assessed and or provided preventative services to prevent the decline. The findings included: Resident #10 was admitted to the facility with [DIAGNOSES REDACTED]. On 06/18/14 at approximately 9 AM, review of Resident #10's MDS (Minimum Data Set), revealed documentation of a decline in ROM (Range of Motion) since admission. A Joint Mobility Screen was completed on 02/01/13 and documented the resident as having full ROM. The initial resident's MDS, dated [DATE] showed no upper or lower extremity impairment. An annual assessment MDS, dated [DATE], also documented no upper or lower extremity impairment. A restorative plan of care was initiated 8/2013 documented the Resident was to receive upper body strengthening and mobility participation. The restorative plan of care was discontinued on 1/24/14. A quarterly MDS dated [DATE], Section G, documented a decline in range of motion for the Resident's kip, knee, ankle and foot. The assessment instructions stated: Code for limitation that interfered with daily functions or placed the resident at risk of injury. The same MDS also documented no Range of Motion services were being provided. (Section O). Review of the facility provided policy for Restorative Nursing Policies and Procedures (revised 2/2012) stated: Patients/residents will be assessed for joint mobility limitation upon admission, re-admission, quarterly, annually, and with significant changes through the comprehensive nursing assessment. A restorative program will be implemented through the care plan to increase, maintain … | 2018-04-01 |
| 6263 | 6263 | MAGNOLIA MANOR - GREENVILLE | 425090 | 411 ANSEL ST | GREENVILLE | SC | 29601 | 2014-06-19 | 318 | D | 0 | 1 | 336311 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the Recertification Survey, based on observation, record review, and interview, the facility failed to ensure that splints were applied as ordered to prevent decrease in Range of Motion (ROM) for Residents #4 and #6, 2 of 4 residents reviewed with orders for splints. The Findings included: The facility admitted Resident #4 with [DIAGNOSES REDACTED]. Resident #4 was observed during the initial tour on 6/16/14 and at 2:45 PM and 4:30 PM and on 6/17/14 at 8:57 AM and 12:15 PM. No splints were observed on the resident's right hand. On 6/16/14 at 4:19 PM, review of the Physician order [REDACTED]. Review of the May and June, 2014 Nursing Rehab/Restorative Plan of Care revealed the Plan of Care was implemented on 3/17/14 and listed as Approach #1 was ROM technique to R(ight) hand/wrist/elbow. Approach #2 was listed as Application of splint up to 8 hrs. Review of the Plan of Care revealed no documentation for Approach #2 for the month of June, 2014. During an interview on 6/19/14 at 9:50 AM, Certified Nursing Assistant (CNA) #3 confirmed the right hand splint was not on Resident #4. The CNA stated that s/he was about to give the resident a bath and would apply the splint afterwards. The CNA stated that s/he was sure it was on yesterday but did not state whether it was on on Monday and Tuesday. The facility admitted Resident #6 with [DIAGNOSES REDACTED]. On 6/16/14 at 3:05 PM, review of the Physician order [REDACTED]. Resident #6 was observed in bed on 6/16/14 at 4:07 PM with no splints observed. On 6/17/14 at 5:15 PM, Registered Nurse (RN) #1 provided copies of the May and June, 2014 Nursing Rehab/Restorative Plan of Care. Review of the documentation revealed the Plan of Care was implemented 5/6/14 and listed Approach #1 was bilateral ROM. Approach #2 was listed as Don/Doff splints. Additional review revealed documentation of performance of approach #1 but no documentation for Approach #2. RN #1 confirmed there was no documentation of … | 2018-04-01 |
| 6264 | 6264 | MAGNOLIA MANOR - GREENVILLE | 425090 | 411 ANSEL ST | GREENVILLE | SC | 29601 | 2014-06-19 | 322 | D | 0 | 1 | 336311 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of survey, based on observation, interview, and review of the manufacturer's guidelines (Abbott Nutrition - [MEDICATION NAME] 1.5) the facility failed to provide appropriate treatment and services for one of one sampled residents reviewed with a gastric tube. Resident # 8's gastric feeding was not administered as ordered by the physician. The findings included: On 06/17/14 at approximately 6:15 PM, Resident #8 was observed sitting in a geri-chair and a tube feeding scheduled to start at 4:00 PM was not running. A partially empty [MEDICATION NAME] 1.2 formula with tubing dated 06/16/14 at 4 AM was in place on the pole. During an interview with Licensed Practical Nurse (LPN) #4 at approximately 6:25 PM, the nurse was questioned as to why the tube feeding had not been begun as ordered and why s/he had documented on the Medication Administration Record that it was infusing as ordered. LPN #4 replied that s/he was waiting for the resident to be put back to bed and that s/he had initialed it but left blank on the MAR where it stated stated on. When informed that the physician's orders [REDACTED].#4 and the Assistant Director of Nurses placed the resident back to bed and began the feeding. | 2018-04-01 |
| 6265 | 6265 | MAGNOLIA MANOR - GREENVILLE | 425090 | 411 ANSEL ST | GREENVILLE | SC | 29601 | 2014-06-19 | 333 | E | 0 | 1 | 336311 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the Recertification survey, based on record review and interview, the facility failed to ensure that 3 of 11 residents reviewed for medication assessment were free of significant medication errors. The facility failed to administer insulin per Fingerstick Blood Sugar (FSBS) results as ordered for Resident #3 and Resident #4. Resident #11 did not receive [MEDICATION NAME] as ordered for low hemoglobin results. The findings included: The facility admitted Resident #3 to the facility with [DIAGNOSES REDACTED]. On 6/18/14 at approximately 4:00 PM, record review revealed a 1-4-11 physician's orders [REDACTED].Check BS (blood sugar) before meals and HS (bedtime). Give additional 15 units of [MEDICATION NAME] if BS > (greater than) 400 then Recheck in 1 hour and call MD (physician) if > 400. Review of the 4/14 Medication Flowsheet on 6/18/14 revealed that a FSBS was not checked on 4/23/14 at 11:30 AM and 4/13/14 at 9:00 PM. The FSBS was not rechecked in 1 hour as ordered for results > 400 on 4/6/14 at 11:30 AM when the BS was 508 and on 4/14/14 at 11:30 AM when the BS was 495. Review of the 5/14 Medication Flowsheet revealed that on 5/2/14 at 9:00 PM, a blood sugar of 422 was recorded with no noted insulin given or recheck of the BS as ordered. On 5/12/14 at 4:30 PM, a blood sugar of 507 was recorded with no noted insulin given or BS recheck. Also, there were no FSBS results documented for 5/31/14 at 4:30 PM. Review of the 6/14 Medication Flowsheet revealed that the blood sugar for 6/13/14 at 4:30 PM was not done as ordered. During an interview with the Assistant Director of Nursing on 6/18/14 at approximately 4:00 PM, s/he verified that the blood sugars were not documented as done per the physician's orders [REDACTED]. The facility admitted Resident #11 with [DIAGNOSES REDACTED]. On 6/19/2014 at approximately 8:30 am, record review revealed 1-29-13 physician's orders [REDACTED].Injection .Give if Hgb (Hemoglobin) Review of the Medica… | 2018-04-01 |
| 6266 | 6266 | MAGNOLIA MANOR - GREENVILLE | 425090 | 411 ANSEL ST | GREENVILLE | SC | 29601 | 2014-06-19 | 367 | D | 0 | 1 | 336311 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the Recertification Survey, based on observation, interview, and record review, the facility failed to provide the diet ordered by a physician for Resident #4 , 1 of 8 residents reviewed with orders for a therapeutic diet. The findings included: The facility admitted Resident #4 with [DIAGNOSES REDACTED]. On 6/16 at 4:19 PM, review of the Physician order [REDACTED]. On 6/17/14 at 12:15 PM, observation of the resident's lunch meal revealed the resident received 1 polish sausage, sauerkraut, mashed potatoes and a fruit cup. At 1:55 PM, review of the 2014 Diet Guide sheet revealed regular portions of the meal consisted of 1 polish sausage, ? cup sauerkraut and ? cup of mashed potatoes. The resident's portion of sauerkraut appeared to be the same as the mashed potatoes and both appeared to be about ? cup. Observation on 6/18/14 at 12:18 PM of the resident's lunch tray revealed a turkey club sandwich, potato chips and pudding. During an interview on 6/18/14 at 12:25 PM, the Dietary Manager (DM) confirmed Resident #4 had 2 slices of turkey on his sandwich and that it was not a double portion. The DM also confirmed that 1 sausage on 6/17/14 was not a double portion. The DM also confirmed the resident was supposed to receive double portions of meat or protein and vegetable three times a day and that no vegetable had been served on 6/18/14 except the lettuce and tomato on the turkey club sandwich. | 2018-04-01 |
| 6267 | 6267 | MAGNOLIA MANOR - GREENVILLE | 425090 | 411 ANSEL ST | GREENVILLE | SC | 29601 | 2014-06-19 | 425 | D | 0 | 1 | 336311 | On the days of the survey based on observations, record reviews, interviews, manufacturer product labeling and Drug Facts and Comparisons (updated monthly), the facility failed to follow a procedure to ensure that expired medication were not stored in 1 of 2 medication rooms. The findings included: On 6/16/14 at approximately 12:00 PM inspection of the West Wing medication room refrigerator revealed the following: -One opened vial of Tuberculin Purified Protein Derivative Aplisol 5 TU (test units)/0.1 ml (milliliter), 1 ml (10 tests) Lot 5. This vial was approximately 1/4 full and had been dated on the vial by the facility as opened 5/6/14. The manufacturer's (JHP Pharmaceuticals) label stated once entered, vial should be discarded after 30 days. The manufacturer's package insert and the Drug Facts and Comparisons book (updated monthly) page 2001 states (in reference to Tuberculin Purified Protein Derivatives): Discard vials in use for more than 30 days because of possible oxidation and degradation that may affect potency. This finding was verified by LPN (Licensed Practical Nurse) #1 on 6/16/14 at approximately 12:05 PM. During an interview on 6/17/14 at approximately 10:30 AM, LPN #2 stated that both the 3rd shift nurse and the nurse administering medications are responsible for checking the medication room for expired medications. | 2018-04-01 |
| 6268 | 6268 | MAGNOLIA MANOR - GREENVILLE | 425090 | 411 ANSEL ST | GREENVILLE | SC | 29601 | 2014-06-19 | 496 | D | 0 | 1 | 336311 | On the days of the survey, based on review of personnel files and interview, the facility failed to obtain registry verification for 1 of 2 newly hired Certified Nursing Assistants (CNA's) reviewed for registry verification. CNA #2 did not have the abuse registry checked prior to hire. The findings included: On 6/18/2014, review of personnel records for two newly hired CNA's revealed that CNA #2 did not have a registry verification in the file. During an interview on 6/18/2014 at approximately 4:30 PM, the Regional Clinical Services Director confirmed that a registry verification was not done for CNA #2 prior to hire, and that only a copy of the CNA's Registry wallet card was obtained. | 2018-04-01 |
| 6269 | 6269 | MAGNOLIA MANOR - GREENVILLE | 425090 | 411 ANSEL ST | GREENVILLE | SC | 29601 | 2014-06-19 | 502 | D | 0 | 1 | 336311 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the Recertification Survey, based on interview and record review, the facility failed to ensure that laboratory (lab) studies were obtained as ordered by the physician for Residents #6 and #11, 2 of 11 residents reviewed for labs. The findings included: The facility admitted Resident #6 with [DIAGNOSES REDACTED]. On 6/16/14 at 3:05 PM, review of Physician order [REDACTED]. During an interview on 6/18/14 at 4:15 PM, the Director of Nursing (DON) confirmed the March labs were missing and that the November labs could not be located in the current or thinned record. The DON stated that the facility recognized a problem related to missing labs in November and December and that a PIP (Performance Improvement Plan) had been initiated in January related to missing labs. The DON also confirmed the March labs were also missed and that the facility was not aware the labs were not done. On 6/19/14 at approximately 8:30 AM, record review revealed an open ended 10/05/12 physician's orders [REDACTED]. Review of laboratory reports revealed that the quarterly lab tests were drawn on 11-1-13, but the results of the CMP could not be located. On 3-26-14, 4 months later, all labs were drawn and reported. On 5/5/14, all lab tests were reported except for the results of the CBC. During an interview on 6/19/14 at approximately 8:45 AM, the Assistant Director of Nursing verified that the labs were not done timely and labs were not done as ordered. | 2018-04-01 |
| 6270 | 6270 | MAGNOLIA MANOR - GREENVILLE | 425090 | 411 ANSEL ST | GREENVILLE | SC | 29601 | 2014-06-19 | 507 | D | 0 | 1 | 336311 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the Recertification survey, based on record review and interview, the facility failed to have laboratory (lab) test results available in the record for clinical management for 1 of 11 residents reviewed for labs. Resident #11 did not have Hemoglobin results in the medical record and readily accessible for medication administration. The findings included: The facility admitted Resident #11 with [DIAGNOSES REDACTED]. On 6/19/2014 at approximately 8:30 am, record review revealed 1-29-13 physician's orders [REDACTED].Injection .Give if Hgb (Hemoglobin) Further review revealed that the laboratory results were not in the medical record and easily accessible for the staff to review for appropriate medication administration. During an interview on 6/19/14 at approximately 8:45 AM, the Assistant Director of Nursing stated that s/he had to obtain the laboratory results from the computer as they were not maintained in the chart. | 2018-04-01 |
| 6271 | 6271 | MAGNOLIA MANOR - GREENVILLE | 425090 | 411 ANSEL ST | GREENVILLE | SC | 29601 | 2014-06-19 | 520 | D | 0 | 1 | 336311 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the Recertification Survey, based on interview and record review, the facility failed to implement a quality assessment and assurance (QAA) plan of action for missing laboratory (lab) studies that included monitoring of the plan of action and implementing changes as needed to ensure that labs were obtained as ordered for Residents #6, 1 of 11 residents reviewed for labs. The findings included: The facility admitted Resident #6 with [DIAGNOSES REDACTED]. On 6/16/14 at 3:05 PM, review of 6/1/14 - 6/30/14 Physician order [REDACTED]. At 4:42 PM on 6/17/14, record review revealed no March or November results for the serum ferritin, iron level, iron sat, B12 level, or folate in the record. During an interview on 6/18/14 at 4:15 PM, the Director of Nursing (DON) confirmed the missing labs. The DON stated that the facility recognized a problem related to missing labs in November and December and that a PIP (Performance Improvement Plan) had been initiated in January related to missing labs. The DON stated that an audit had been done to identify any residents whose labs had not been done. The DON further confirmed the labs for Resident #6 were missed when the audit was completed and that the facility was not aware the labs were not done. On 6/19/14 at 9:30 AM, an interview was conducted with the Assistant Director of Nursing (ADON). The ADON confirmed a 100% audit had been conducted in March relative to the QAA Performance Improvement Plan and stated that the lab orders were now recorded in the lab book. The ADON further stated that, during the audit, any orders for labs that had not been done were re-written and recorded in the lab book. The ADON confirmed the lab orders for Resident #6 were missed and the labs were not obtained in March. When asked why the audit had not been done until March for a QAA that had been implemented in January, the ADON stated I don't know. I didn't realize we did it (the PIP) in January. On 6/19/14 at appr… | 2018-04-01 |
| 6282 | 6282 | HONORAGE NURSING CENTER | 425115 | 1207 NORTH CASHUA ROAD | FLORENCE | SC | 29501 | 2014-06-19 | 248 | D | 0 | 1 | CZWK11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey based on observations, record review and interviews, the facility failed to provide a resident with an ongoing program of activities for 1 of 2 sampled residents reviewed for activities and random observations of multiple residents not being provided with activities. Resident #7 was observed several times in the room while activities of his/her preference were being offered. The findings include: The facility admitted Resident #7 with the [DIAGNOSES REDACTED]. Review of the Annual Minimum Data Set with the Assessment Reference Date of 8/27/13, documented the resident had short and long term memory impairment and moderately impaired cognitive skills for daily decision making. The MDS also indicated it was important for the resident to do his/her favorite activities, important for him/her to listen to music, very important to do things with group of people and very important to participate in religious activities. During an interview with Resident #7's responsible party on 6/17/14 at approximately 9:53 AM, s/he stated that the resident does not participate in activities due to being bedfast and was not aware if the resident attended activities. Review of Resident #7's Activity Evaluation on 6/17/14 at approximately 2:28 PM revealed the residents current interest included music and spiritual/religious activities. Review of the Activities progress note form dated 2/13/14 on 6/17/14 at 2:44 PM revealed a Quarterly Activity assessment that specified the resident current interests were religious services, group socializing and frequent visitors. Resident #7's activities care plan with a problem onset of 2/20/14 noted: Dependent on staff for all activities, cognitive stimulation and social interaction due to [MEDICAL CONDITION] and Dementia. S/he has frequent visits from his/her family and church family. Interventions related to activities noted Assist to and from activities as needed and invite to scheduled activities. Resi… | 2018-04-01 |
| 6283 | 6283 | HONORAGE NURSING CENTER | 425115 | 1207 NORTH CASHUA ROAD | FLORENCE | SC | 29501 | 2014-06-19 | 249 | E | 0 | 1 | CZWK11 | On the days of the survey based on record review and interview, it was determined the facility failed to have a qualified activities professional to direct the provision of activities for facility residents as required. A review of the qualifications of the facility's Activity Director (AD) revealed the AD had not received an approved training course or had the required full time experience for the provision of activities. The findings include: A review of the qualifications of the facility's Activity Director revealed it did not meet the regulatory requirement as an Activity Director. S/he was not a qualified Therapeutic Recreation Specialist or an Activities Professional who was licensed or registered; or had two years experience in a social or recreational program within the previous five years, one of which was full-time in a patient activity program in a health care setting; or was a qualified Occupational Therapist or assistant and/or has completed a training course approved by the state. During a review of the personnel file for the current Activities Director on 6/19/14 at approximately 9:00 AM revealed the AD was previously employed as a Housekeeping Supervisor in 2008 and in December 2010 became an activity employee. The Activity Director from 2010 to present had been working as the Housekeeping Supervisor and in activities. There was no evidence in the personnel folder to indicate the AD met the appropriate qualifications. An interview with the Administrator on 6/19/14 at approximately 9:20 AM revealed the AD had been working as the Housekeeping supervisor and Activity Director. The Administrator verified s/he did not meet the appropriate qualifications. | 2018-04-01 |
| 6284 | 6284 | HONORAGE NURSING CENTER | 425115 | 1207 NORTH CASHUA ROAD | FLORENCE | SC | 29501 | 2014-06-19 | 309 | D | 0 | 1 | CZWK11 | **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 to attain or maintain the highest practicable physical well-being for 1 of 19 residents reviewed for care and services. The facility failed to notify the physician and start treatment in a timely manner for Resident #58 with no documented bowel movement for 6 days. The findings included: The facility admitted Resident #58 with [DIAGNOSES REDACTED]. The resident is currently receiving Hospice services. Review of the medical record revealed the care plan noted the potential for alteration in bowel pattern related to [DIAGNOSES REDACTED]. Documented interventions included monitor for adverse drug events affecting bowel pattern (constipation .) and notify MD if observed and observe for s/s (signs and symptoms) of constipation. Review of the Nurses's Notes dated 6/2/14 indicated, hospice Nurse in facility, made hospice Nurse aware that resident has not had a bowel movement since 26th, Hospice nurse made dr. aware and wishes to order [MEDICATION NAME] for resident, awaiting order and directions from dr. Review of the Hospice Nurses's Notes dated 6/2/14 revealed, .last BM 5/26/24. No bowel regimen. Will notify MD to restart bowel regimen. Review of the BM Report Roster confirmed the finding that Resident #58 had not had a bowel movement from 5/27/24 until 6/2/14. Review of the Physician's Telephone Orders dated 6/5/14 indicated Senna-S twice daily was ordered on that date. Review of the June 2014 Medication Administration Record [REDACTED]. During an interview on 6/18/14, the Director of Nursing (DON) reviewed the above documentation and confirmed the findings. The DON was asked if the facility had a Bowel Protocol policy and stated that there was no written protocol. During the interview, the DON stated that the Certified Nursing Assistants document daily in the BM Report Roster, and the report is reviewed daily during the sta… | 2018-04-01 |
| 6579 | 6579 | FLORENCE REHAB & NURSING CENTER | 425163 | 133 WEST CLARKE ROAD | FLORENCE | SC | 29501 | 2014-06-19 | 155 | D | 0 | 1 | T4HW11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on observation, record review, and interview, the facility failed to afford one of 22 sampled residents reviewed the right to formulate his/her own advance directive. Resident #122 was not informed of nor afforded the right to formulate his/her own advance directive. The findings included: During multiple observations throughout the survey (on 6-16-14 at 3:24 PM and 4 PM; on 6-17-14 at 8:55 AM and 3 PM; on 6-18-14 at 9 AM, 11:45 AM; and on 6-19-14 at 8:40 AM), and during the Resident Interview during Stage 1 of the survey (6-17-14 at 9:48 AM), Resident #122 was able to respond reasonably to all questions posed. Record review on 6-17-14 at 3:45 PM revealed no [DIAGNOSES REDACTED]. Admission Nursing Assessments dated 6-3, 6-9, and 6-14-14 revealed no documented confusion or memory problems. Further review of the medical record revealed that the resident's family member signed the Advance Directives-Acknowledgement of Receipt form on 6-3-14, indicating the resident has chosen to formulate and issue an Advance Directive of Do Not Resuscitate (DNR). A physician's orders [REDACTED]. During an interview on 6-18-14 at 2:30 PM, Social Services verified that the resident's family had signed the advance directive instead of the resident. S/he stated that, since admission, Resident #122 had been able to answer questions appropriately and was a '12' on the BIMS (Brief Interview for Mental Status), indicating minimal cognitive impairment. Social Services stated s/he was confused about the middle category of BIMS being interviewable. | 2017-12-01 |
| 6580 | 6580 | FLORENCE REHAB & NURSING CENTER | 425163 | 133 WEST CLARKE ROAD | FLORENCE | SC | 29501 | 2014-06-19 | 157 | E | 0 | 1 | T4HW11 | **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 facility policy entitled Physician Notification (11-10-09), the facility failed to notify the physician and interested family member of changes in the residents' medical conditions potentially requiring physician intervention for one of twenty-two sampled residents reviewed for notification. Nursing staff failed to notify the attending physician and family of both low and high blood pressure (BP) readings for Resident #122 who was on [MEDICAL TREATMENT] and routine antihypertensive medication. The findings included: The facility admitted Resident #122 with [DIAGNOSES REDACTED]. Review of Daily Skilled Nurse's Notes on 6-17-14 at 4:40 PM revealed that the 7 AM-3 PM shift that day had documented an untimed BP of 68/34. There was no narrative entry for that shift to indicate that the physician had been notified. When questioned, the 3-11 PM Licensed Practical Nurse (LPN) #6 and LPN #3 were unaware of the low BP. After contacting Licensed Practical Nurse (LPN) #5, who had worked the day shift, LPN #3 confirmed that the physician had not been notified. When asked about what the BP reading was that afternoon, the nurses obtained a result of 80/60 from a Certified Nursing Assistant. Further review of Daily Skilled Nurse's Notes revealed a BP of 80/60 recorded on the evening shift on 6-12-14. There was no evidence of physician notification in the record. The next BP recorded was taken at approximately 5:30 PM prior to the resident being sent to the emergency room when noted to be anxious, SOB (short of breath), + having labored breathing .80/62 . On 6-10-14, an untimed BP of 189/71 was recorded on the evening shift. There was no narrative entry for that shift, indicating that the physician had been notified. During an interview at approximately 4:45 on 6-17-14, LPN #3 reviewed the medical record and confirmed that the physician had not been notified of the above. Review o… | 2017-12-01 |
| 6581 | 6581 | FLORENCE REHAB & NURSING CENTER | 425163 | 133 WEST CLARKE ROAD | FLORENCE | SC | 29501 | 2014-06-19 | 241 | E | 0 | 1 | T4HW11 | On the days of the survey, based on observation, review of the facility provided policy related to dignity, and interview, the facility failed to provide an environment to promote dignity of residents during the dining experience and while transporting residents. Staff placed gowns and clothing protectors over Residents #82, #6, and one randomly observed resident in one of two dining rooms. Staff were also noted to move randomly observed residents in gerichairs/ wheelchairs without addressing the residents. The findings included: During meal observations on 6-16-14 at 12:53 PM, on 6-17-14 and 6-18-14 at breakfast and lunch meals, and on 6-19-14 at 8:28 AM, Resident #82 was noted at a table facing the door in the dining room on East Hall with a gown and clothing protector over his/her clothing. Two other residents (#6 and a randomly observed resident) seated at another table were also noted dressed/draped in the same manner. Resident # 6 was being fed by a staff member seated at his/her side and the randomly observed resident was feeding him(her)self. During an interview on 6-18-14 during the breakfast meal, Licensed Practical Nurse #3 noted that the resident had increased spillage and stated, That's why we put the gown on him (her). During an interview on 6-19-14 at approximately 11:30 AM, the Director of Nursing and Registered Nurse (RN) Consultant stated they had never observed residents draped with gowns in the dining room and were unaware staff were in the habit of doing so. At 1:15 PM on 6-19-14, the residents were again observed in the West Hall dining room in the same condition. This was brought to the attention of the RN consultant who confirmed the observation. Random observations on 6/18/14 at 12:25 PM and 3:34 PM revealed CNA (Certified Nursing Assistant) #1 approached two different residents and without addressing the residents, began moving the resident(s) to another location. He/she also was observed to pull a resident backwards and out of the way of another resident with informing the resident of h… | 2017-12-01 |
| 6582 | 6582 | FLORENCE REHAB & NURSING CENTER | 425163 | 133 WEST CLARKE ROAD | FLORENCE | SC | 29501 | 2014-06-19 | 253 | E | 0 | 1 | T4HW11 | On the days of the survey, based on random observations and interviews, the facility failed to provide necessary housekeeping and maintenance services to maintain a sanitary, orderly, and comfortable interior on 3 of 3 Halls. There were housekeeping/maintenance concerns identified during the survey related to furniture, vents, doors, and walls. The findings included: During the Initial Tour of the facility on 06-16-14 at approximately 10:00 AM and on all days of the survey, random observations revealed the following: East Unit: 1. Room #10: Vent and toilet tissue holder with rust-color noted in the bathroom. Lower area of 4 drawer dresser with black/brown stains noted. 2. Room #16 A: Vent with rust color noted under the bathroom window, brown rust color noted around bathroom sink faucet. 3. Room #17 B: Headboard rough to touch. Center Hall: 1. Room #21: Paint on inside of the bathroom door scraped, scraped paint to the left side of the bed beside the wall. 2. Room #24 B: Vent with rust color noted under the bathroom window, 2 small holes noted in the wall to the right side of the picture in the bathroom, scraped paint to the left side of the wall beside the bed. West Hall: 1. In the area of Shower room near Room #35: Floor tile noted with approximately 5 inch gouge. 2. Shower near Room #43: Tile loose at right side of toilet. 3. Room #26 A: Broken toilet paper holder. 4. Room #31 A: Scuffed room door. During a Walking Tour on 06-19-14 at approximately 3:00 PM, in the presence of the Maintenance Supervisor, the Housekeeping Manager, and the Housekeeping Supervisor, the above findings were verified. During an interview on 06-19-14 with the Administrator, h/she stated many environmental issues presently identified were previously identified by the facility and corrections have begun. However, review of the information provided by the facility did not address the above environmental findings. | 2017-12-01 |
| 6583 | 6583 | FLORENCE REHAB & NURSING CENTER | 425163 | 133 WEST CLARKE ROAD | FLORENCE | SC | 29501 | 2014-06-19 | 272 | D | 0 | 1 | T4HW11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the day of the survey based on observation, record review and interview the facility failed to accurately assess functional capability for 1 of 3 residents reviewed for assessments related to range of motion. There was no evidence of a contracture assessment related to potential contractures for Resident #25's hands. The findings included: Resident #25 was admitted to the facility on [DATE] with [DIAGNOSES REDACTED]. Observations of Resident #25 throughout the days of the survey revealed apparent contractures of both hands. Observation on 6/16/2014 at 3:45 PM revealed Resident #25 in bed asleep with both hands in a closed fist position on top of his/her stomach area. Observation on 6/17/14 at 8:50 am and on 6/18/14 at 9:00 am revealed both hands to be clenched in a fist. Observation of Resident #25 on 6/19/14, following the lunch meal, revealed the resident could feed self with his/her left hand using a spoon. Review of the current Care Plan dated 4/7/14 revealed Resident #25 required assistance with activities of daily living. Goal approaches included: PROM (passive range of motion) with ADL (activities of daily living) care daily. Review of Physical Therapy assessment dated [DATE] documented impaired for upper left and right extremities. During an interview with the OTR (Occupational Therapist) on 6/19/14 at approximately 1:55 PM revealed Resident #25 had been discharged from Physical Therapy on 5/6/14. Further interview revealed Resident #25 had not been assessed by Occupational Therapy because the resident had good upper body strength. The OTR verified both hands were contracted and the right hand was more so than the left. S/he also stated that Resident #25's hand contractures had gotten worse because the resident could open both hands upon admission to the facility. When asked if Resident #25's hand contractures had been assessed for the need of additional intervention, the OTR stated No, they have not. ? | 2017-12-01 |
| 6584 | 6584 | FLORENCE REHAB & NURSING CENTER | 425163 | 133 WEST CLARKE ROAD | FLORENCE | SC | 29501 | 2014-06-19 | 309 | E | 0 | 1 | T4HW11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on observation, record review, and interview, the facility failed to provide necessary care and treatment for one of one resident reviewed receiving [MEDICAL TREATMENT] services. The facility failed to monitor the [MEDICAL TREATMENT], failed to monitor fluid intake, and failed to communicate amended diet and fluid intake orders to the [MEDICAL TREATMENT] clinic for Resident #122. Also, there was no evidence of communication of laboratory results from the [MEDICAL TREATMENT] clinic to the facility for Resident #122. Additionally, the facility failed to accurately monitor/document the intake and output as ordered by the physician for two of five sampled residents reviewed for hydration/intake and output (Residents #122 and #82). Cross refer to F 315 as it relates to the care of a resident with a Foley catheter The findings included: The facility admitted Resident #122 with [DIAGNOSES REDACTED]. Record review on 6-17-14 at approximately 3:15 PM revealed that the resident was hospitalized from 6-7-14 to 6-9-14 for Volume Overload and 6-12-14 to 6-14-14 for [MEDICAL CONDITION]. Record review on 6-16-14 at 4 PM revealed that Resident #122 was admitted with a physician's orders [REDACTED]. Intake & Output. A dietary assessment was completed on 6-6-14. Nutritional Interventions Recommended and physician's orders [REDACTED]. Record review on 6-17-14 at 3:25 PM revealed a Fluid Restriction form in front of the chart to delineate the breakdown of fluid to be administered by nursing and dietary. Nursing was to give 60 cc of fluids with the medication pass four times daily. Dietary was to give 360 cc with each meal. Total = 1080 + 240=1320 cc which left 180 cc for the remainder of the day. No intake and output record was noted in the resident's room, closet, or bathroom for Certified Nursing Assistant (CNA) use to record total intake. During an interview on 6-17-14 at 3:30 PM, Licensed Practical Nurses (LPNs) #3 and #5 wer… | 2017-12-01 |
| 6585 | 6585 | FLORENCE REHAB & NURSING CENTER | 425163 | 133 WEST CLARKE ROAD | FLORENCE | SC | 29501 | 2014-06-19 | 315 | E | 0 | 1 | T4HW11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on record reviews, interviews, and review of the facility policy titled Intake and Output, the facility failed to provide appropriate care and services for 2 of 2 residents reviewed with a Foley Catheter. Resident #55 and Resident #89 had incomplete documentation of Intake and Output. The findings included: The facility admitted Resident #55 with [DIAGNOSES REDACTED]. Record review on 06-18-14 at approximately 10 AM of the Cumulative Physician's Orders dated 05-01-14 through 05-31-14 and 04-01-14 through 04-30-14 revealed the following orders, Foley Catheter care every shift second to Sacral Decubitus and Intake and Output (I&O) every (q) shift. Further record review on 06-18-14 of the Intake and Output Monitoring Log for April 2014 revealed the following omissions: 04-06-14: 3p-11p output 04-09-14: 3p-11p intake and output 04-10-14: 3p-11p intake and output 04-11-14: 11p-7a intake and output, 3p-11p output 04-12-14: 11p-7a intake and output 04-13-14: 3p-11p intake and output 04-14-14: 11p-7a intake and output, 3p-11p intake and output 04-15-14: 3p-11p intake and output 04-17-14: 7a-3p intake and output, 3p-11p intake and output 04-18-14: 3p-11p intake and output 04-20-14: 11p-7a intake and output, 7a-3p intake and output 04-21-14: 7a-3p intake and output, 3p-11p intake and output 04-22-14: 3p-11p intake and output 04-24-14: 3p-11p intake and output 4-25-14: 3p-11p output 04-28-14: 3p-11p intake and output 04-29-14: 3p-11p intake and output Additional record review on 06-18-14 of the Intake and Output Monitoring Log for May 2014 revealed the following omissions: 05-01-14: 3p-11p output 05-02-14: 3p-11p output 05-07-14: 3p-11p output 05-09-14: 7a-3p output 05-12-14: 11p-7a output 05-13-14: 3p-11p intake and output 05-22-14: 7a-3p output 05-25-14: 7a-3p output 05-26-14: 11p-7a intake and output 05-31-14: 7a-3p intake and output During an interview on 06-18-14 with the Corporate Consultant, h/she, after record re… | 2017-12-01 |
| 6586 | 6586 | FLORENCE REHAB & NURSING CENTER | 425163 | 133 WEST CLARKE ROAD | FLORENCE | SC | 29501 | 2014-06-19 | 322 | D | 0 | 1 | T4HW11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the day of the survey based on observation, record review and interview it was determined the facility failed to ensure that Resident# 46, fed via gastrostomy tube, received the appropriate amount of tube feeding as ordered by the physician. Resident #46 was not provided the volume of tube feeding as ordered. (1 of 2 sampled residents reviewed with gastrostomy feedings) The findings included: Resident #46 was admitted to the facility with a gastrostomy (feeding) tube. Review of current physician's orders [REDACTED]. Observation of Resident #46 on 6/16/14 and 6/17/14 revealed the resident receiving a tube feeding of [MEDICATION NAME] 1.5 at 65ml/hr (milliliters per hour) Observation on 6/18/14 at 9:00am revealed Resident #46 lying in bed receiving [MEDICATION NAME] 1.5 at 65ml/hr and there was a little over 1400cc/ml left in the bottle that had been started at 2:00 am per bottle label. During an observation on 6/19/2014 at 1:30 pm Resident #46 lying in bed. Documentation on the bottle indicated [MEDICATION NAME] 1.5 cal (calorie) 1500cc was hung at 5am on 6/19/14 . Further observation revealed the resident's tube feeding was currently running, however, no feeding appeared missing from the bottle. Interview with LPN's (Licensed Practical Nurse) #4 and #2 on 6/19/14 at approximately 1:30 pm revealed night shift was responsible to hang the feedings. Further interview revealed LPN #4 had given Resident #46 his/her afternoon medications but had not noticed the bottle of feeding remained full. LPN's #2 and #4 verified it appeared the resident had not received any feeding thus far on 6/19/14. | 2017-12-01 |
| 6587 | 6587 | FLORENCE REHAB & NURSING CENTER | 425163 | 133 WEST CLARKE ROAD | FLORENCE | SC | 29501 | 2014-06-19 | 323 | E | 0 | 1 | T4HW11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on record review, interview, and observation, the facility failed to maintain appropriate fall prevention measures as ordered for 2 of 3 residents reviewed for accidents/hazards. Resident #44's devices to prevent falls were not working appropriately and #73 did not have devices in place to prevent falls. The findings included: The facility admitted Resident #44 with [DIAGNOSES REDACTED]. Review of the resident's record on 6/18/14 revealed Fall Risk Assessments which documented the resident was a high risk for falls. Review of the Quarterly Minimum (MDS) data set [DATE] revealed the resident was independent in bed mobility, transfer, walking in room and locomotion on the unit. The Resident required limited assistance of one person walking in the corridor and extensive assist with one person for locomotion off of the unit. Resident # 44 was coded as having an impairment to the upper and lower extremity on one side. Review of the facility provided incident reports for Resident # 44 revealed the resident had sustained three falls in May 2014 and one fall in June 2014. The resident's care plan for falls revealed multiple interventions including anti-rollbacks on w/c(wheel-chair). On 6/18/14 at 4:40 PM, the DON (Director of Nursing) was asked if the anti-rollbacks were functioning. He/she confirmed they were not functioning properly and this had been discovered on Monday (6/16/14) and wheels for the wheel-chair had been ordered. On 6/19/14 at 4:08 PM, the facility Consultant was asked if the anti-rollbacks were working properly. During a demonstration with the resident standing up and sitting back in the wheel-chair, the Consultant stated the anti-rollbacks were not working properly and this was confirmed by a staff member from the therapy department. The facility admitted Resident #73 with [DIAGNOSES REDACTED]. Review of the resident's record on 6/18/14 revealed Fall Risk Assessments which indicated the resident wa… | 2017-12-01 |
| 6588 | 6588 | FLORENCE REHAB & NURSING CENTER | 425163 | 133 WEST CLARKE ROAD | FLORENCE | SC | 29501 | 2014-06-19 | 333 | E | 0 | 1 | T4HW11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on observation, record review and interview, the facility failed to administer medications as ordered resulting in significant medication errors for 2 of 2 [MEDICAL TREATMENT] residents. The facility failed to administer extended release metaprolol as ordered for Resident #122. [MEDICATION NAME] was not administered per ordered parameters for Resident #117. The findings included: Record review on 6-17-14 at 3:25 PM revealed the facility admitted Resident #122 with [DIAGNOSES REDACTED]. The resident was hospitalized from 6-7-14 to 6-9-14 for Volume Overload and Exacerbation of [MEDICAL CONDITION] and from 6-12-14 to 6-14-14 for [MEDICAL CONDITION]. Review of the 6-14-14 hospital Discharge Summary on 6-17-14 at 4 PM revealed Resident #122 was discharged with all of his (her) preadmission med(ication)s, including [MEDICATION NAME] XL 100 mg (milligrams) extended release 1 (one) every day. The accompanying Universal Medication Form (Discharge Medication List) also noted the resident was to take [MEDICATION NAME] ([MEDICATION NAME] XL) 100 mg 1 tablet Extended Release 24 h(ou)r. l tablet oral daily at noon. Record review revealed handwritten physician's orders [REDACTED]. The order did not indicate that the extended release type of the medication should be administered. Review of the Medication Administration Record (MAR) revealed that this medication was given on 6-4, 5, 6, 10, 11, 12, 15, 16, 17, 2014 for a total of nine days/doses. Further review with LPN #3 and LPN #5 revealed that the medication cart contained [MEDICATION NAME] 100 mg, not [MEDICATION NAME]/not the [MEDICATION NAME] XL that was ordered. Both nurses verified the content of the cart at 6-17-14 at 4:30 PM. After reviewing and confirming the physician's transfer orders, LPN #3 stated s/he would write a clarification order and notify the physician. Review of Daily Skilled Nurse's Notes on 6-17-14 at 4:40 PM revealed that the 7 AM-3 PM shift that da… | 2017-12-01 |
| 6589 | 6589 | FLORENCE REHAB & NURSING CENTER | 425163 | 133 WEST CLARKE ROAD | FLORENCE | SC | 29501 | 2014-06-19 | 371 | E | 0 | 1 | T4HW11 | On the days of the survey, based on observation, interview, and review of facility policy Nourishments, and Sanitation and Infection Control the facility failed to remove expired nutritional supplements from the medication/supplement storage area for 1 of 3 medication/supplement storage rooms. The deficient practice had the potential to affect all residents receiving this nutritional supplement who resided on the unit. Additionally, the facility failed to serve/distribute food in a sanitary manner, as evidenced by random observations of staff touching bread products with their bare hands. (2 of 3 units observed during meal delivery.) The findings included: On 6/16/14 at 11:20 AM, an observation of the Central Hall medication/supplement storage area with LPN #1 and the Director of Nursing (DON) revealed 3 (32 Fluid Oz./ 946 mL) unopened cartons and 1 opened (approximately 8 Oz.) of Lyons Ready Care No Sugar Added NSA 1.7 High Calorie High Protein Supplement Drink Vanilla (Lot # 4323-D), with a use by date of 5/22/14. LPN # 1 and the DON verified the date and indicated that they should have been removed from use. Review of the facility policy entitled Nourishments, under section Instructions unopened/thawedstated: Shelf stable, monitor manufacture expiration date. During a random observation of the lunch meal on 6/16/14 at 12:33 PM, CNA (Certified Nursing Assistant) #3 was noted to touch two resident's bread with his/her bare hand when applying butter to the bread. During an observation on 6/18/14 at 12:25 PM, CNA #1 touched cornbread with his/her bare hand while applying butter to the bread while serving a resident's meal. During an interview with CNA #1 on 6/18/14 at 4:04 PM, he/she confirmed the cornbread had been touched with his/her bare hand and s/he stated s/he was trying not to let the cornbread fall apart. A random observation on 06-16-14 at approximately 12:32 PM of the Center Hall lunch meal distribution revealed Licensed Practical Nurse (LPN) #3 failed to sanitize his/her hands, cut a resident's sandwic… | 2017-12-01 |
| 6590 | 6590 | FLORENCE REHAB & NURSING CENTER | 425163 | 133 WEST CLARKE ROAD | FLORENCE | SC | 29501 | 2014-06-19 | 431 | E | 0 | 1 | T4HW11 | On the days of the survey, based on observations, interview, and review of the facility policy Storage of medications, the facility failed to follow a procedure to ensure that expired medications were removed from medication storage in 1 of 3 medication carts. The findings included: On 6/16/14 at 11:20 AM, an observation of the Central Hall medication cart with LPN #1 revealed (12) single dose packaged tablets of Acetaminophen 500 milligram (mg) (Lot Number # ). All tablets had an expiration date of 12/18/13. Following the observation LPN #1 and the Director of Nursing (DON) verified the (12) tablets of Acetaminophen were expired and indicated that the medication should have been removed from the cart. Review of the facility policy entitled Storage of Medications, section (M) of Procedures states Outdated, contaminated, or deteriorated medications and those in containers that are cracked, soiled, or without secure closures are immediately removed from stock, disposed of according to procedures for medication disposal and reordered from the pharmacy, if a current order exists. | 2017-12-01 |
| 6591 | 6591 | FLORENCE REHAB & NURSING CENTER | 425163 | 133 WEST CLARKE ROAD | FLORENCE | SC | 29501 | 2014-06-19 | 504 | E | 0 | 1 | T4HW11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on record review and interviews, the facility obtained laboratory tests without a physician's orders for one of seventeen sampled residents reviewed for provision of laboratory services. (Resident #82) The findings included: Record review on 6-18-14 at 5:30 PM revealed that the facility admitted Resident #82 with [DIAGNOSES REDACTED]. Record review on 6-19-14 at 8:30 AM revealed Physicians Orders for BMP (Basic Metabolic Profile) every 6 mo(nths), PAB ([MEDICATION NAME]) every month, and [MEDICATION NAME] every 6 months. Review of lab reports revealed that the BMP was drawn and reported on 6-20-13 and 6-21-13. No orders could be located for the second tests that were done in 6-13. The PAB was drawn on 1-2-14 and 1-15-14. No orders could be located for the second test done for that month. The [MEDICATION NAME] level was done on 5-9-14, 1-15-14, 1-2-14, 12-24-13, and 6-20-13. No orders could be located for the two tests that were done in 1-14. Further review revealed laboratory reports for a 5-12-14 urine culture and sensitivity and a 1-15-14 Hemoglobin and Hematocrit for which no physician's orders could be located. During an interview on 6-19-14 at 10:53 AM, the Director of Nurses and Registered Nurse Consultant reviewed the medical record. No physician's orders were located for the above-listed labs. | 2017-12-01 |
| 6592 | 6592 | FLORENCE REHAB & NURSING CENTER | 425163 | 133 WEST CLARKE ROAD | FLORENCE | SC | 29501 | 2014-06-19 | 505 | E | 0 | 1 | T4HW11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on record review and interviews, the facility failed to promptly notify the attending physician of abnormal laboratory test results so that appropriate action might be taken if indicated for two of seventeen sampled residents reviewed for provision of laboratory services out of a total of 22. (Residents #9 and #82) . The findings included: Record review on 6-18-14 at 5:30 PM of laboratory reports and Nursing Progress Notes for Resident # 82 revealed no evidence that the physician had been notified of abnormal test results for the following: -[MEDICATION NAME] level done on 8-21-13; -Complete Blood Count (CBC) done on 8-20-13, 2-25-14; -[MEDICATION NAME] on 3-25-14 , 2-25-14, 1-2-14, 11-11-13; -Hemoglobin and Hematocrit on 1-15-14; -[MEDICATION NAME] level on 1-2-14, 12-24-13. Record review on 6-18-14 at 2:17 PM revealed the facility admitted Resident #9 with [DIAGNOSES REDACTED]. Review of laboratory reports and Nursing Progress Notes revealed no evidence that the physician had been notified of abnormal test results for the following: -CBC done on 1-15-14; -Basic Metabolic Profile on 12-18-13; -[MEDICATION NAME] level on 1-15-14. During an interview on 6-18-14 at 4:20 PM, the Director of Nurses stated that nurses should note on the lab report that the physician was faxed or notified of results. When asked if the information could be documented elsewhere, s/he stated, The only other place could be in nurses' notes. During an interview on 6-19-14 at 10:53 AM, the Director of Nurses and Registered Nurse Consultant reviewed the medical record. No evidence of physician notification related to lab results could be located. | 2017-12-01 |
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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 );