cms_SC
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33 rows where "inspection_date" is on date 2017-03-09
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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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2304 | 2304 | SPRINGDALE HEALTHCARE CENTER | 425169 | 146 BATTLESHIP ROAD | CAMDEN | SC | 29020 | 2017-03-09 | 253 | D | 0 | 1 | G49I11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations, interviews, and policy review the facility failed to provide adequate housekeeping services to maintain a sanitary and comfortable living environment for one resident (R81) out of a random sample of 40 residents. Findings include: Review of the clinical record revealed R81 is an [AGE] year-old resident admitted to the facility on [DATE] with [DIAGNOSES REDACTED]. R81 had a Brief Interview for Mental Status (BIMS) score of 4, (a score of 0-7 indicates severe cognitive impairment). Observation on 3/6/17 at 4:49 p.m. as stated by team surveyor revealed, There was a brown substance smeared across the white base board in the resident's bathroom. Room 100. Observation on 3/8/17 at 2:45 p.m. as stated by team surveyor revealed, The brown substance on the white base board in the resident's bathroom was still present. Observation on 3/09/17 at 11:00 a.m. while conducting environmental rounds with Maintenance Director, revealed the bathroom in room 100 (vacant) was noted to have a large amount of dark brown substance smeared across the baseboards and wall next to toilet. Per Maintenance Director the room was occupied by resident (R) R81, up until yesterday. The resident was transferred to another room based on R81's request and preference. Interview conducted with Housekeeping Supervisor on 3/09/17 at 11:02 a.m. who stated she was hired just 3 weeks ago. She observed the area and stated she would have someone come and clean it immediately. She further stated, We are in the process of reeducating and re-training all housekeeping staff members on proper cleaning techniques. I too will be performing frequent audit checks of all housekeeping assignments to ensure the quality of housekeeping services is sustained and maintained. On 3/09/17 at 11:06 a.m. Housekeeping Aide (E2) arrived and sprayed the baseboard with a bleach cleaner and immediately wiped the baseboard clean. The brown substance was observed to be easily removed with the… | 2020-09-01 |
| 2305 | 2305 | SPRINGDALE HEALTHCARE CENTER | 425169 | 146 BATTLESHIP ROAD | CAMDEN | SC | 29020 | 2017-03-09 | 278 | D | 0 | 1 | G49I11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview, the facility failed to ensure that the Minimum Data Set (MDS) assessments were coded accurately for medications. This deficient practice had the potential to affect 1 Resident (R158) of 32 in the Stage 2 sample. Findings include: Review of the medical record for R158 revealed that he was admitted to this facility on 10/12/15 with [DIAGNOSES REDACTED]. Review of the physician's orders [REDACTED]. [REDACTED]. Review of the quarterly Minimum Data Set (MDS) assessments dated 10/24/16 and 1/22/17 revealed that the facility failed to code R158 as receiving an anticoagulant. An interview with the MDS Coordinator on 3/8/17 at 9:58 a.m. confirmed that the facility failed to ensure that R158's MDS assessments were coded accurately for receiving an anticoagulant on a daily basis. The MDS Coordinator stated that she would have to complete a corrected MDS for R158. An interview with the Administrator on 3/8/17 at 4:00 p.m. revealed that the facility did not have a policy and procedure that specified how the MDS was to be completed relative to accuracy. She stated that the facility's policies and procedures were vague and the Assessment and Care Plan policy and procedure addressed the timing of the assessments but it did not address the importance of the accuracy of each assessment. | 2020-09-01 |
| 2306 | 2306 | SPRINGDALE HEALTHCARE CENTER | 425169 | 146 BATTLESHIP ROAD | CAMDEN | SC | 29020 | 2017-03-09 | 279 | D | 0 | 1 | G49I11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, resident and staff interview, record review and review of the facility policy and procedure titled the Care Plan Process, the facility failed to develop a care plan for one of 32 sample residents (R) (R176) to address her behavioral psychosocial needs. Findings include: On 3/6/17 at 3:39 p. m. interview with R176, she stated 3 months ago, someone beat me-arms, butt; I had to have surgery; I was whipped with a yard stick and they said I deserved it. I told a member of the staff; The staff said I must have needed it. Review of Complaint/Grievance Roll-up from 1/2016 through 2/2017 did not show any complaints about allegations of abuse or mistreatment. Review of abuse allegations from 4/2016 through 2/2017 identified one abuse allegation from R176 on 6/14/16 at 6:42 p.m. when she called 911 to state that nurses were hurting her. On review of the 4/26/16 History and Physical for R176 assessment included the following Diagnosis: [REDACTED]. Documentation of the Physician's visit on 1/24/17 identified the same [DIAGNOSES REDACTED]. On review of the Reportable Incident from 6/14/16 at 6:42 p.m. revealed that R176 called 911 to state that nurses were hurting her. The Responding Officer (RO) from the County Sheriff's office arrived at the facility between four and five o'clock; spoke with the administrator, social worker, nurse, resident and pastor of resident while in the facility. The RO reviewed the file on R176 in reference to the complaint, interviewed R176 with the Social Worker. The RO gathered that the complaint was unfounded and that she was hurting while they were changing her and that is why she said they were hurting her, but weren't doing anything intentionally to her. The facility investigation of R176's call to 911 and report she was being abused included that R176 is constantly concerned about having her treatment to her wound and about administration on her insulin shot. Her son, rp (resident's responsible party)… | 2020-09-01 |
| 2307 | 2307 | SPRINGDALE HEALTHCARE CENTER | 425169 | 146 BATTLESHIP ROAD | CAMDEN | SC | 29020 | 2017-03-09 | 282 | E | 0 | 1 | G49I11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, record review, interview and review of policies and procedures, the facility failed to implement each Residents (R) Activity of Daily Life (ADL) care plan to ensure that they received the necessary services to maintain their grooming and personal hygiene. This deficient practice had the potential to affect 4 of 32 Residents in the Stage 2 sample. Residents, R17, R161, R81 and R158 were unable to carry out their ADLs independently; they required the assistance from facility staff on a daily basis. Findings include: 1. Resident (R) R17 was admitted to the facility on [DATE] with the following pertinent [DIAGNOSES REDACTED]. Review of R17's significant change Minimum Data Set (MDS) assessment dated [DATE], indicated that under Section C, the assessment specified the resident had a score of 08 out of 15 on the Brief Interview for Mental Status (BIMS), which indicated the resident had a moderate cognitive impairment. Under Section G, the assessment identified that R17 required extensive assistance of one for personal hygiene. Observations during the survey 3/6/17 through 3/9/17 revealed that the resident was able to make his needs known but required extensive assistance of one to complete personal hygiene tasks. Resident observed to have periods of confusion and needed re-direction and assistance. Observation on 3/6/17 at 1:25 p.m. R17 was sitting in the #100 hall dining room at the table. He had long bushy eyebrows, his hair was sticking out the side of his hat, and he had a scraggly bread and mustache. Observation on 3/07/17 at 8:50 a.m. R17 looked unkempt, his eye brows were long, and sticking upward, he had a full beard and mustache that were not trimmed or combed and his hair was not combed. On 3/9/17 at 8:40 certified nursing assistant (CNA) 4 stated she was new but she tries to take her time with the residents and that it was the expectation that the resident be groomed (hair combed, shave, teeth brushed) and clothing … | 2020-09-01 |
| 2308 | 2308 | SPRINGDALE HEALTHCARE CENTER | 425169 | 146 BATTLESHIP ROAD | CAMDEN | SC | 29020 | 2017-03-09 | 309 | D | 0 | 1 | G49I11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, record review, interview and review of the Agreement for [MEDICAL TREATMENT] Services, this Long-Term Care (LTC) facility failed to ensure that the [MEDICAL TREATMENT] Clinic communicated with them effectively relative to Resident (R) 158's weekly [MEDICAL TREATMENT] treatments. This deficient practice had the potential to affect 1 (R158) of 32 Residents in the Stage 2 sample. Failure to communicate effectively, placed R158 at risk for a lack of care and services to ensure that he could maintain or improve his quality of life. Findings include: Observation of R158 on 3/7/17 at 3:00 p.m. revealed that he was seated in his wheelchair and waiting on staff to transfer him to the afternoon activities. R158 stated at that time, that he went for [MEDICAL TREATMENT] treatments every Monday, Wednesday and Friday and he did not feel good after his treatments. When interviewed about why he did not feel good after his [MEDICAL TREATMENT] treatments, R158 stated, I don't know, I just don't Review of the quarterly Minimum Data Set ((MDS) dated [DATE] revealed that the facility coded R158 as a 15 out of 15 on the Brief Interview for Mental Status (BIMS) which indicated that he was not cognitively impaired. Review of the [MEDICAL TREATMENT] care plan dated 8/2/16 with a Target Date of 4/23/17 revealed that the goal for R158 was, Resident will not experience complications r/t (relative to) [MEDICAL TREATMENT]. Review of the medical record and the [MEDICAL TREATMENT] Communication Form(s) dated 11/2/16 - 2/24/17 revealed that the forms were incomplete. The communication forms were to include information about the resident's health before his treatment, which was documented by the LTC facility, and the resident's health post treatment which was to be documented by the [MEDICAL TREATMENT] Clinic. The LTC facility was to complete the top portion of the form and the [MEDICAL TREATMENT] Clinic was to complete to bottom portion of the form. The… | 2020-09-01 |
| 2309 | 2309 | SPRINGDALE HEALTHCARE CENTER | 425169 | 146 BATTLESHIP ROAD | CAMDEN | SC | 29020 | 2017-03-09 | 312 | E | 0 | 1 | G49I11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, record review, resident and staff interviews the facility failed to ensure 4 of 32 sampled resident's (R) R17, R81, R161 and R158 who were unable to carry out activities of daily living without assistance received the necessary services to maintain good grooming and personal hygiene. Findings included: 1. Resident (R) R17 was admitted to the facility on [DATE] with the following pertinent [DIAGNOSES REDACTED]. Review of R17's significant change Minimum Data Set (MDS) assessment dated [DATE], indicated that under Section C, the assessment specified the resident had a score of 08 out of 15 on the Brief Interview for Mental Status (BIMS), which indicated the resident had a moderate cognitive impairment. Under Section G, the assessment identified that R17 required extensive assistance of one for personal hygiene. According to the Activities of Daily Living (ADL) care plan dated 2/7/17 identified the following problem, R17 required assist with ADL's related to forgetfulness. The goal was to provide the resident with his preferred routines. The pertinent approach was; include resident preferences in rendering care and services. Observation on 3/6/17 at 1:25 p.m. R17 was sitting in the #100 hall dining room at the table. He had long bushy eyebrows, his hair was sticking out the side of his hat, and he had a scraggly bread and mustache. Observation on 3/07/17 at 8:50 a.m. R17 looked unkempt, his eye brows were long, and sticking upward, he had a full beard and mustache that were not trimmed or combed and his hair was not combed. Review of R17's Central Information Tool (a report used by nursing staff to quickly identify the resident's needs) provided on 3/8/17 indicated R17 did not have a heading under ADL assistance for personal hygiene. There was no information on the form to identify what R17's personal hygiene preference were. Review of the certified nursing assistant (CNA) - ADL Tracking Form, for the month of 3/17 for the … | 2020-09-01 |
| 2310 | 2310 | SPRINGDALE HEALTHCARE CENTER | 425169 | 146 BATTLESHIP ROAD | CAMDEN | SC | 29020 | 2017-03-09 | 334 | D | 0 | 1 | G49I11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and staff interview the facility failed to implement the facility's policy and procedure for pneumococcal vaccination in 2 of 5 residents (R95 and R23) eligible to receive the pneumococcal vaccine, as evidenced by lack of administration after approved consent received (R95), and lack of documentation reflecting appropriate subsequent screening (R23). Findings include: Review of the facility form titled, Informed Consent for Pneumococcal Vaccine dated (MONTH) (YEAR) states, The Advisory Committee on Immunization Practice recommends two pneumococcal vaccines for adults [AGE] years of age or older. Recent studies have shown that both the pneumococcal conjugate (PCV13) and the pneumococcal [MEDICATION NAME] (PPSV23) vaccines are needed for the best protection against pneumococcal disease. If you are 65 or older and have not had a pneumonia vaccine, you should receive one dose of PCV13 now, and in 6 - 12 months get a dose of PPSV23. If you have had a pneumonia vaccine after the age of 65, then you received the PPSV23 and should receive the second vaccine PCV13. Per record review, resident (R23) was a [AGE] year-old admitted to the facility on [DATE], immunization record revealed, R23 received the PPSV23 vaccine in 2002. R23's informed consent for pneumococcal vaccine assessment was not completed and signed indicating R23 was screened reflecting his/her approval or refusal for pneumococcal vaccination administration. Further record review revealed R23 was screen for influenza vaccination with consent signed for approval of administration on 10/09/16. R23's immunization record revealed the influenza vaccine Lot number UI634AA was administered in the right deltoid on 10/21/16. Per record review, resident (R95) was a [AGE] year-old admitted to the facility on [DATE], immunization record revealed, R95 was screened for pneumococcal vaccination on 3/11/10 and refused with signature dated 3/11/10. On 10/09/16, R95 was reassessed for… | 2020-09-01 |
| 3617 | 3617 | EMERITUS AT GREENVILLE | 425373 | 1306 PELHAM RD | GREENVILLE | SC | 29615 | 2017-03-09 | 250 | D | 0 | 1 | P3MK11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interviews and record review, the facility failed to ensure that one of one sampled resident reviewed for social services had arrangements to attend scheduled appointments. Resident #127 was not afforded the opportunity to participate in medically scheduled appointments that were made prior to admission into the facility. The findings included: During individual interview on 3/07/17 at approximately 3:17 PM with Resident #127, the resident stated he/she was not informed about medical appointments that were made prior to admission into the facility so the appointments were missed. A review of the medical record on 3/08/17 at approximately 3:05 PM revealed an Admissions Minimum Data Set (A(MDS) dated [DATE] that indicated the resident had a Brief Interview of Mental Status (BIMS) score of 13. Further review of the AMDS indicated the resident was interview-able based on the BIMS score of 13. Further review of the medical record revealed progress notes dated 2/09/17 to 3/07/17 that did not indicate the resident had follow up medical appointments. The social services notes and the nurses' notes did not indicate the resident had follow up medical appointments prior to admission. During an interview on 3/08/17 at approximately 3:23 PM, Licensed Practical Nurse (LPN) #1 revealed it was his/her responsibility to schedule appointments for residents admitted into the facility. LPN #1 confirmed that he/she was responsible for scheduling appointments and not the social services staff. LPN #1 further stated he/she would place the appointments on a calendar to address scheduled appointments for the residents. A review of LPN #1's appointment calendar revealed there were no appointments scheduled for Resident #127. LPN #1 stated he/she had just requested additional hospital discharge information from the hospital on [DATE]. A review of the hospital discharge summary dated 2/09/17 revealed the resident had follow up appointments 2/24/17 and 3/02/17 t… | 2020-09-01 |
| 3618 | 3618 | EMERITUS AT GREENVILLE | 425373 | 1306 PELHAM RD | GREENVILLE | SC | 29615 | 2017-03-09 | 312 | D | 0 | 1 | P3MK11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review, interviews with Certified Nursing Assistants (CNAs) #1 and #2 and the Director of Nursing (DON), and observation the facility failed to provide facial grooming for 1 of 3 residents observed for Activities of Daily Living (ADLs). Resident #57 was observed with a long strand of facial hair for all days of the survey. The findings included: Resident #57 was admitted to the facility 6/9/16 with [DIAGNOSES REDACTED]. Observation of Resident #57 on 3/7/17 at approximately 12:17 PM revealed s/he had a strand of hair on his/her chin -- about 1 - 2 inches long. Observation of Resident #57 on 3/8/17 at approximately 9:17AM revealed that s/he had the same long hair on his/her chin. The hair had not been clipped. Review of the Quarterly Minimum Data Set (MDS) assessment dated [DATE] for Resident #57 on 2/8/17 at approximately 2:57 PM revealed that the resident required extensive one-person physical assistance for personal hygiene. Observation of Resident #57 on 3/9/17 at approximately 8:49 AM revealed that the strand of facial hair had not been removed. Interview with CNA #1 on 3/9/17 at approximately 11:40 AMM revealed the resident never refuses ADL care. The CNA stated s/he would meet the resident twice a day for grooming. S/he revealed that she had never helped the resident clip facial hair, but if s/he had noticed facial hair on the resident, s/he would assist in removing it with resident permission. The CNA then confirmed that facial hair was present on the resident and stated s/he had not noticed it earlier. Interview with CNA #2 on 3/9/17 at approximately 11:53 PM revealed the CNA would assist with grooming whenever the resident needed grooming. S/he revealed that facial hair would be removed as soon as it was noticed. Review of Policy for Quality of Life / Dignity on 3/9/17 at approximately 12:17 PM revealed that, Residents shall be groomed as they wish to be groomed (hair styles, nails, facial hair, etc.). Interview with … | 2020-09-01 |
| 3619 | 3619 | EMERITUS AT GREENVILLE | 425373 | 1306 PELHAM RD | GREENVILLE | SC | 29615 | 2017-03-09 | 323 | D | 0 | 1 | P3MK11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interviews, record review and review of the facility's Incident/Accident Reporting Process, the facility failed to put interventions in place to prevent injury from falls for 1 of 3 sampled residents reviewed for falls/accidents. Resident #133 admitted with high risk for falls without appropriate interventions in place and no interventions after a fall with injuries. The findings included: The facility admitted Resident #133 with [DIAGNOSES REDACTED]. Random observation on 3/07/17 at approximately 11:29 AM revealed resident in dining area. Resident #133 was observed with bruising, scarring to middle of forehead, down to nose, side of face and redden area to left hand. An interview on 3/07/17 at approximately 12:14 with Licensed Practical Nurse (LPN) #3, revealed the resident had a fall on 3/03/17 and sustained bruises to face and left hand. A review of the medical record on 3/08/17 at approximately 3:19 PM revealed a nursing assessment dated [DATE] that indicated the resident was a high risk for falls. A review of the incident report dated 3/03/17 indicated the resident had an unwitnessed fall and that the resident had Cut/Laceration, Scrape/Abrasion to finger, left forearm, left hand, nose and other part of forehead. The incident report further indicated the resident fell in activity room at 7 PM and was found laying face down on floor. There was no documentation on the incident report to indicate if other residents were present or if staff attempted to interview other residents to determine what occurred. There was no documentation to indicate interventions were in place prior to or after the fall. Review of an admission care plan initiated on 3/02/17 indicated under falls section for resident to have call light in reach and encourage resident to use call light. The 5 day admission Minimum Data Set (MDS) indicated the resident was severely impaired cognitively and never/rarely made decisions. A review of the facility's… | 2020-09-01 |
| 3620 | 3620 | EMERITUS AT GREENVILLE | 425373 | 1306 PELHAM RD | GREENVILLE | SC | 29615 | 2017-03-09 | 372 | F | 0 | 1 | P3MK11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation and interview with the Dining Services Director, the facility failed to properly dispose of waste in 1 of 1 grease containers. During all days of survey, the bin containing recycled grease was noted to have a large, slippery, [MEDICATION NAME] puddle around it. The findings included: Observation of the grease container on 3/7/17 at approximately 3:40 PM revealed there was a [MEDICATION NAME], slippery substance around the base of the container. Observation of the grease container on 3/8/17 at approximately 11:48 AM revealed there was a [MEDICATION NAME], slippery substance around the base of the container. Interview with the Dining Services Director on 3/8/17 at approximately 2:19 PM confirmed that a [MEDICATION NAME], slippery substance was around the base of the grease container. S/he stated maintenance would hose it down later that day. Observation of the grease container on 3/9/17 at approximately 8:45 AM revealed a slippery, [MEDICATION NAME] substance was around the base of the container. Interview with the Dining Services Director on 3/9/17 revealed that there were two grease recycling bins for the fryer. An old one on the left and a new one on the right. S/he believes the old grease container is leaking but wants to check the new one as well. At time of exit, there was no documentation provided that indicated the facility was making efforts to replace the grease container prior to the survey | 2020-09-01 |
| 3621 | 3621 | EMERITUS AT GREENVILLE | 425373 | 1306 PELHAM RD | GREENVILLE | SC | 29615 | 2017-03-09 | 411 | D | 0 | 1 | P3MK11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, record review and interviews, the facility failed to provide routine dental services for 1 of 1 sampled resident reviewed for dental services. Resident #16 was observed with missing and cracked/broken teeth with no documentation of dental services being offered/provided. The findings included: Based on observation on 3/08/17 at approximately 11:46 AM, Resident #16 was observed in room in bed with broken and missing teeth. A review of the medical record on 3/08/17 at approximately 12:52 AM revealed there was no documentation to indicate a dental consultation referral was done. During an interview with the Director of Nursing (DON), the DON confirmed no dental consult/referral was made. The DON provided a nursing assessment dated [DATE] that indicated the resident's oral status was natural and broken teeth. The assessment did not address the resident's missing teeth. The DON stated he/she would check to see if there was any documentation to indicate if a dental consult referral was made or documentation to indicate the family was notified of services. The DON further stated the resident had not expressed any dental pain and the facility does not have a dental contract. An interview on 3/09/17 at approximately 10:56 AM with Licensed Practical Nurse #3 revealed the facility does not have a contract with a dental office and the family would have to make a preference for dental services. LPN #3 stated the DON was still checking to see if the facility addressed the broken/missing teeth with the resident's responsible party. | 2020-09-01 |
| 3622 | 3622 | EMERITUS AT GREENVILLE | 425373 | 1306 PELHAM RD | GREENVILLE | SC | 29615 | 2017-03-09 | 456 | D | 0 | 1 | P3MK11 | Based on interviews and observations, the facility failed to ensure that 1 of 28 sampled residents beds were functioning properly. Res #127's mechanical bed in room 165A would not go down when pressing bed control button. The findings included: During individual interview on 3/07/17 at approximately 3:17 PM with Resident #127, the resident stated his/her bed was not working appropriately. The resident stated he/she was not able to get the bed to go down when operating the bed. Resident #127 stated he/she had informed the facility of the bed not working. The resident was observed informing a therapist that the bed was not working earlier during the morning. The therapist attempted to address the problem. A random observation on 3/08/17 at approximately 9:39 AM revealed the resident's medical bed in room 165A would go up but once up it would not go back down. The observation was confirmed by Licensed Practical Nurse (LPN #3). LPN #3 attempted to get the bed to go down several times while the surveyor was present and the bed would not go down after being raised. A few minutes later, an admissions staff member stated the bed was unplugged and that was why it would not go down. A random observation of the mechanical bed in room 165A on 3/09/17 at approximately 9:28 AM revealed the bed would go up but still would not go down when pressing the the bed control button. An observation and interview on 3/09/17 at approximately 9:32 AM with LPN #3 confirmed the findings that the mechanical bed would on go up when the up button was pressed but would not go down when the down button was pressed. LPN #3 then physically pressed down on the bed in order to get the bed to go down when the down bed control button was pressed. LPN #3 then proceeded to notify the maintenance staff that the resident's bed was not working properly. | 2020-09-01 |
| 3623 | 3623 | EMERITUS AT GREENVILLE | 425373 | 1306 PELHAM RD | GREENVILLE | SC | 29615 | 2017-03-09 | 460 | E | 0 | 1 | P3MK11 | Based on observation and interview, the facility failed to ensure that resident rooms were equipped to provide full visual privacy for the residents in 17 of 28 resident rooms. The privacy curtains were not long enough to fully extend around the window beds in all the semi-private rooms. The findings included: During observation of semi-private resident rooms 160, 162, 163, 164 and 170 on 3/8/2017 beginning at 8:52 AM, it was observed that the rooms were not equipped to provide full visual privacy. Full visual privacy means that residents have a means of completely withdrawing from public view while occupying their bed. The privacy curtain for all of the beds on the window side of the room was not long enough to fully extend around the bed. During a tour of all the semi-private rooms with the Maintenance Director (with the Director of Nursing, and the Assistant Executive Director also present) on 3/9/2017 at 1:27 PM, the Maintenance Director confirmed that the privacy curtains did not fully extend around the window beds and did not provide full visual privacy for residents in window beds. | 2020-09-01 |
| 3624 | 3624 | EMERITUS AT GREENVILLE | 425373 | 1306 PELHAM RD | GREENVILLE | SC | 29615 | 2017-03-09 | 514 | D | 0 | 1 | P3MK11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview, the facility failed to maintain the medical records on each resident to be accurately documented and complete. Resident #57 had inconsistencies in physical functioning and Resident #16 failed to have a report from a podiatry visit readily accessible for review and follow-up. The findings included: Resident #57 was admitted to the facility on [DATE] with [DIAGNOSES REDACTED]. Review of weekly / monthly nursing summaries for the past 90 days on 3/9/17 at approximately 10:32 AM revealed inconsistencies in assessments of physical functioning for Resident #57. On 3/4/17 the resident was assessed as requiring extensive assistance for bed mobility, requiring extensive assistance from one person for eating, and being totally dependent for bathing. On 3/7/17 the resident was assessed as requiring limited assistance for bed mobility, requiring only setup and supervision for eating, and requiring extensive assistance for bathing. On 2/4/17 the resident was assessed as requiring limited assistance for bed mobility, limited assistance for transfers, and requiring no assistance and only supervision for eating. On 2/11/17 the resident was assessed as being totally dependent for bed mobility, totally dependent for transfers, and limited assistance for eating. Interview with Licensed [MEDICATION NAME] Nurse (LPN) #3 on 3/9/17 at approximately 11:58 AM revealed that Resident #57 has had no real decline in physical functioning. S/he confirmed that s/he would code Resident #57 as requiring no supervision for eating. S/he then confirmed that s/he had written the assessment that coded Resident #57 as requiring extensive assistance from one person for eating. LPN #3 stated the resident sometimes leans and needs assistance staying upright during dining. Interview with the Director of Nursing (DON) on 3/9/17 at approximately 12:30 PM revealed that the Certified Nursing Assistants report physical functioning to nurses who fill out… | 2020-09-01 |
| 3972 | 3972 | PRESBYTERIAN HOME OF SOUTH CAROLINA-COLUMBIA | 425396 | 700 DAVEGA DRIVE | LEXINGTON | SC | 29073 | 2017-03-09 | 157 | D | 0 | 1 | BULT11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview, the facility failed to notify the resident's physician of a significant change in physical status for 1 of 1 sampled resident reviewed for hospice. The facility failed to notify the physician of Resident #27's abnormal glucose levels. The findings included: The facility admitted Resident #27 with [DIAGNOSES REDACTED]. Record review on 03/08/2017 at 3:00 PM revealed a physicians order for finger stick-monitoring of blood glucose for suspected hypo or [MEDICAL CONDITION] with a protocol to call the physician if the residents blood glucose is less than 70 or greater than 250. Review of the residents Medication Administration Record [REDACTED]. Review of the resident's clinical progress notes revealed no evidence of notification of the physician. Interview on 03/08/2017, the Director of Nursing (DON) stated that s/he could not find documentation of physician notification. | 2020-09-01 |
| 3973 | 3973 | PRESBYTERIAN HOME OF SOUTH CAROLINA-COLUMBIA | 425396 | 700 DAVEGA DRIVE | LEXINGTON | SC | 29073 | 2017-03-09 | 282 | D | 0 | 1 | BULT11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review, interview and review of facility policy, the facility failed to ensure that the Care Plan was followed for 1 of 1 resident sampled for Nutrition. The Care Plan was not followed for Resident #19 related to monitoring and interventions for lack of regular bowel movements. The findings include: The facility admitted Resident #19 with [DIAGNOSES REDACTED]. Review of the Nurse's Notes on 03/07/17 at 3:21 pm revealed that on 03/02/17 Resident #19 was given Milk of Magnesia (MOM) due to no bowel movements for 6 days. Further review of the bowel movement monitoring documentation revealed that Resident #19 did not have a bowel movement on 02/25-28/17 and 03/01/17, 5 consecutive days. Review of the Care Plan revealed that Resident #19 had an issue with the potential for constipation. The goal for Resident #19 was to have regular bowel movements (BM) at least every 3 days through next review. The interventions included: monitoring of bowel patterns and administration of medication or treatments for constipation. Review of the facility's Bowel/Constipation - Clinical Protocol revealed if no BM in last 3 days residents should be given 30 cc (cubic centimeters) of Milk of Magnesia along with additional measures as indicated. In an interview on 03/09/17 at 10:12 am the Director of Nursing (DON) stated that s/he runs a report each day to track resident bowel movements. The DON attempted to locate documentation of additional bowel movements for Resident #19 but was unable to do so. | 2020-09-01 |
| 3974 | 3974 | PRESBYTERIAN HOME OF SOUTH CAROLINA-COLUMBIA | 425396 | 700 DAVEGA DRIVE | LEXINGTON | SC | 29073 | 2017-03-09 | 309 | E | 0 | 1 | BULT11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview, the facility failed to provide the necessary care and services to attain or maintain the highest practicable physical, mental and psychosocial well-being for 1 of 1 sampled resident reviewed for nutrition and 1 of 1 sampled resident reviewed for hospice. The facility failed to intervene when Resident #19 had no bowel movement for 5 days. The facility failed to monitor pain and coordinate care with hospice for Resident #27. The findings included: The facility admitted Resident #27 with [DIAGNOSES REDACTED]. Review of hospice social services notes revealed no evidence of documentation that hospice was invited to the facility care plan meeting for Resident #27. Social service notes revealed one entry dated 02/22/2017 that indicated the hospice staff did not attend that care plan meeting because the facility failed to notify hospice. During an interview on 03/08/2017 at 3:20 PM, Registered Nurse (RN) #1 verified that hospice did not attend Resident #27's care plan meeting. RN #1 stated that the facility does not require hospice to attend the care plan meetings or to review or sign the residents care plan. RN #1 verified that there was no evidence of documentation that hospice reviewed the residents care plan or that the facility reviewed the residents hospice care plan. Review of the resident's Medication Administration Record (MAR) revealed an order for [REDACTED]. with at protocol to Monitor pain and follow up in 60 minutes. Review of the MAR and clinical notes revealed that when the resident reported pain on the following dates: 1/3/17, 1/4/17, 1/6/17, 1/8/17, 1/12/117, 1/13/17, 1/14/17, 1/18/17, 1/22/17, 1/24/17, 1/26/17, 1/27/17, 1/30/17, 1/31/17, 2/3/17, 2/5/17, 2/6/17, 2/8/17, 2/11/17, 2/14/17, 2/15/17, 2/17/17, 2/20/17, 2/21/17, 2/24/17, 2/25/17, 3/2/17, 3/5/17, 3/6/17, and 3/7/17, there was no evidence of documentation for follow up in 60 minutes when the resident did and did not receive pain medicat… | 2020-09-01 |
| 3975 | 3975 | PRESBYTERIAN HOME OF SOUTH CAROLINA-COLUMBIA | 425396 | 700 DAVEGA DRIVE | LEXINGTON | SC | 29073 | 2017-03-09 | 332 | D | 0 | 1 | BULT11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, record review, and interview, the facility failed to maintain a medication rate of less than 5%. There were 3 errors out of 29 opportunities for error, resulting in a medication error rate of 10.3%. The findings included: Error #1 and #2 On 3/7/17 at approximately 9:45 AM, during observation of Resident #77's medication administration on Unit 2, Licensed Practical Nurse (LPN) #1 was observed to take the residents blood pressure (BP) which read 111/53. LPN #1 then administered Resident #77's medication without physician ordered Metroprolol 100 milligram (mg.) and [MEDICATION NAME] 40 mg. LPN #1 stated to Resident #77, Your blood pressure is low so you won't be receiving your heart medication. LPN then disposed of the [MEDICATION NAME] and Metroprolol into the medication cart disposal. LPN #1 then addressed the facility Nurse Practitioner in the hall regarding another medication Resident #77 requested. LPN #1 did not mention Resident #77's low BP or the withholding of their medication. LPN #1 then recorded in the Medication Administration Record [REDACTED]. LPN #1 was asked where the physicians order states to hold the resident medication for a BP of 111/53. LPN #1 stated, It is facility policy and standard order protocol to not give residents medication for a systolic BP below 120. LPN #1 was then asked if s/he was going to contact the physician. LPN #1 stated, Maybe I need to. On 3/7/17 at approximately 10:15 AM, during an interview with the Director of Nursing (DON), Resident 77's physician's orders [REDACTED]. The DON was asked for the resident standard order protocol and the facility policy for the administration of BP medications. The DON stated that BP medication orders are resident specific and there was not a standard order protocol for Resident #77. The DON verified Resident #77 did not have an order to hold medication for a low BP and indicated the LPN should have contacted the physician regarding the holding of… | 2020-09-01 |
| 3976 | 3976 | PRESBYTERIAN HOME OF SOUTH CAROLINA-COLUMBIA | 425396 | 700 DAVEGA DRIVE | LEXINGTON | SC | 29073 | 2017-03-09 | 333 | E | 0 | 1 | BULT11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, record review, and interview, the facility failed to administer medication resulting in significant medication errors for 1 of 2 residents reviewed for blood pressure (BP) medication administration. Resident #77 did not receive physician ordered BP medications. The findings included: The facility admitted Resident #77 with [DIAGNOSES REDACTED]. On 3/7/17 at approximately 9:45 AM, during observation of Resident #77's medication administration on Unit 2, Licensed Practical Nurse (LPN) #1 was observed to take the residents blood pressure (BP) which read 111/53. LPN #1 then administered Resident #77's medication without physician ordered Metroprolol 100 milligram (mg.) and [MEDICATION NAME] 40 mg. LPN #1 stated to Resident #77, Your blood pressure is low so you won't be receiving your heart medication. LPN then disposed of the [MEDICATION NAME] and Metroprolol into the medication cart disposal. LPN #1 then addressed the facility Nurse Practitioner in the hall regarding another medication Resident #77 requested. LPN #1 did not mention Resident #77's low BP or the withholding of their medication. LPN #1 then recorded in the Medication Administration Record [REDACTED]. LPN #1 was asked where the physicians order states to hold the resident medication for a BP of 111/53. LPN #1 stated, It is facility policy and standard order protocol to not give residents medication for a systolic BP below 120. LPN #1 was then asked if s/he was going to contact the physician. LPN #1 stated, Maybe I need to. On 3/7/17 at approximately 10:15 AM, during an interview with the Director of Nursing (DON), Resident 77's physician's orders [REDACTED]. The DON was asked for the resident standard order protocol and the facility policy for the administration of BP medications. The DON stated that BP medication orders are resident specific and there was not a standard order protocol for Resident #77. The DON verified Resident #77 did not have an order to ho… | 2020-09-01 |
| 3977 | 3977 | PRESBYTERIAN HOME OF SOUTH CAROLINA-COLUMBIA | 425396 | 700 DAVEGA DRIVE | LEXINGTON | SC | 29073 | 2017-03-09 | 371 | F | 0 | 1 | BULT11 | Based on observation, interview, and review of facility policies, the facility failed to prepare, distribute, and serve food under sanitary conditions for 2 of 2 kitchens reviewed and has the potential to affect 16 of 16 residents with ordered diets as evidenced by failing to do the following: Disposing of expired food items, cleaning pans and scoops. The findings included: On 3-6-17 at approximately 2:42 PM, an initial tour of the Main and Health Care kitchens with the Executive Chef revealed: Main kitchen area: 1.) (9) Full pans and (7) Half pans were stacked wet 2.) Scoops were lying in the flour and sugar bins with ingredients on the handles 3.) (13) 8 ounce Imperial Dairy Drink Nectar Consistency with a use by date of 1/19/17 4.) (32) 8 ounce Imperial Dairy Drink with a use by date of 2/17/17 Main kitchen walk-in refrigerator: 1.) (36) Green peppers in a bin on the storage rack were discolored and had a black and white fuzzy substance growing on them The Health Care kitchen: Dry Storage cabinet above counter: 1.) (1) 7 and 1/4 ounce can of tomato soup low sodium with an expiration date 11/29/16 2.) (2) 7 and 1/4 ounce cans of tomato soup low sodium with an expiration date 3/3/17 3.) (1) 7 and 1/4 ounce can of mushroom soup with an expiration date of 12/8/16 Following the initial tour observations of the Main and Health Care kitchens the Executive Chef verified the above 8 findings. Review of the facility policy Food and Supply Storage, states under procedure bullet #1, Most products contain an expiration date. The words sell by, best -by, enjoy-by, or use-by, should proceed the date. The sell-by, date is the last date that the food can be sold or consumed; do not sell products in retail areas or place on patient trays/resident plates past the date on the product. Foods past the use by, sell by, best -by, or enjoy-by date should be discarded. Also, the policy Storage of Pots, Dishes, Flatware, Utensils states under bullet #1, Air dry all food contact surfaces, including pots, dishes, flatware, and utensils be… | 2020-09-01 |
| 3978 | 3978 | PRESBYTERIAN HOME OF SOUTH CAROLINA-COLUMBIA | 425396 | 700 DAVEGA DRIVE | LEXINGTON | SC | 29073 | 2017-03-09 | 431 | E | 0 | 1 | BULT11 | Based on observations, interview, review of the manufactures recommendations and facility policy, the facility failed to follow a procedure to ensure that medication was stored at proper temperatures in accordance with manufacture specifications in 1 of 1 medication storage room reviewed. Tuberculin Purified Protein Derivative, (Mantoux) (PPD) (Tubersol), insulin, and Flor-Lorazapam were stored at a temperature below manufacture specifications. The findings included: On 3/7/17 at 1:55 PM, an observation of the Unit 2 medication storage room refrigerator with Licensed Practical Nurse (LPN) #1 revealed an internal temperature thermometer that read 32 degrees of Fahrenheit and the contents of the refrigerator were: 1.) (1) Unopened Levemir Flex insulin pen, Lot #FZF0477 2.) (1) Unopened vial of Novolog mix 70/30, 100 unit, Lot # FZF0470 3.) (1) Unopened Novolog FlexPen, Lot # FZF0531 4.) (1) Unopened vial Humolog, 100 units, Lot #C 3A 5.) (1) Unopened vial Novolin R, 100 units, Lot #FZF0075 6.) (1) Unopened vial Novolin R, 100 unit, Lot #FZF0546 7.) (1) Vial Novolin R, 100 unit, Lot #FZF0219 8.) (2) Vials Tubersol PPD, 10 tests, Lot #C5035AA (1) unopened 9.) (31) Unopened doses of Flor-Lorazapam 2 mg./ml. Lot # 018 Following the observation LPN #1 verified the internal temperature thermometer of the refrigerator read 32 degrees of Fahrenheit and the contents of the refrigerator. On 3/7/17 at 2:00 PM, a review of the Refrigerator Temperature Log posted on the refrigerator door with LPN #1 revealed a recording of 33 degrees of Fahrenheit on (MONTH) 6, (YEAR). Also, the log had instructions stating, Refrigerator must be kept between: 33-40 degrees. Following the observation of the log, LPN#1 verified the temperature recording of 33 degrees of Fahrenheit on (MONTH) 6, (YEAR). LPN #1 then stated s/he did not know the correct temperature for the storage of medications PPD, insulin or Flor-Ativan. After review of the box manufacture instructions for Novolin R and Tubersol PPD with LPN #1, s/he indicated that the internal t… | 2020-09-01 |
| 5769 | 5769 | COVENANT TOWERS HEALTHCARE CENTER | 425382 | 5001 LITTLE RIVER ROAD | MYRTLE BEACH | SC | 29577 | 2017-03-09 | 156 | B | 0 | 1 | NH9U11 | Based on record review and interview the facility failed to issue a required CMS form or 1 of 5 CMS (Centers for Medicare and Medicaid) approved denial letters for Resident #17 with ending coverage of Medicare part A with days remaining and remained in the facility for 1 of 3 residents reviewed for Liability Notices. The findings included: The facility admitted Resident #17 for Rehabilitation/Therapy Services. Review on 3/9/2017 at approximately 3:54 PM of a form titled, Notice of Medicare Non-Coverage, revealed that current services will end on 11/10/2016 and was signed on 11/07/2017 by the resident's responsible party. Per the Social Services Director Resident #17 had days remaining and was going to remain a resident in the facility. Further review on 3/9/2017 at approximately 4:00 PM of the medical record for Resident #17 revealed no CMS form nor 1 of 5 CMS approved denial letters had been issued. During an interview on 3/9/2017 at approximately 4:00 PM with the Billing Manager, he/she stated, I was filling in for the Social Worker and I forgot to issue the CMS or any of the 1 of 5 CMS approved denial letters. | 2018-10-01 |
| 5770 | 5770 | COVENANT TOWERS HEALTHCARE CENTER | 425382 | 5001 LITTLE RIVER ROAD | MYRTLE BEACH | SC | 29577 | 2017-03-09 | 157 | E | 0 | 1 | NH9U11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review, interview and review of the facility policy titled Procedure for Notification of Changes in Resident Status or Resident Emergency,the facility failed to notify the resident's responsible party and/or interested family member with a change in condition. Resident #38's pressure ulcer worsened and Resident #22 with a change in skin condition.(1 of 4 reviewed with a pressure ulcer and 1 of 1 with a change in skin condition) In addition, the physician was not notified of Resident #13's refusal of medications.(1 of 5 reviewed for unnecessary medications) The findings included: The facility admitted Resident #38 with [DIAGNOSES REDACTED]. Review of the medical record on 3/8/17 revealed a physician's order to cleanse the coccyx wound with Normal Saline, apply skin prep to the periwound and cover with an Allevyn AG Classic 3 x 3 dressing every three days. Review of the nurse's notes revealed on 2/23/17 a Stage 3 pressure ulcer to the coccyx with slough measuring 1 centimeter(cm) x .5 cm x .2 cm was observed. Further review of the nurse's notes revealed there was no notification to the responsible party and/or interested family member. During an interview with the Director of Nursing on 3/8/17 at 4:14 PM, he/she stated there was no notification documented the Responsible Party or interested family member was notified of the pressure ulcer. He/she continued by stating it was his/her understanding the nurse who observed the area had shared this information in passing with the resident's family who visits daily. The facility admitted Resident #22 with [DIAGNOSES REDACTED]. Review of the medical record on 3/9/17 revealed Resident #22 rejected care and could be combative at times. Further review of the nurse's notes dated 12/2/16 revealed Resident #22 had an cracked open area in between the buttocks in which a cream was applied. No documentation was noted the responsible party and/or interested party member had been notified of the n… | 2018-10-01 |
| 5771 | 5771 | COVENANT TOWERS HEALTHCARE CENTER | 425382 | 5001 LITTLE RIVER ROAD | MYRTLE BEACH | SC | 29577 | 2017-03-09 | 247 | D | 0 | 1 | NH9U11 | Based on interviews and review of the facility policy entitled Change of Room or Roommate, the facility failed to provide advance notice of a room change for 2 of 2 residents reviewed for Admission, Transfer, Discharge. (Residents #31 and #15) The findings included: During a Resident interview, Resident #31 stated that he/she had changed rooms within the facility and was given no advance notice prior to the room change. During a Family interview, a family representative of Resident #15 stated that Resident #15 had been moved to a different room, and the family member was given no advance notice prior to the room change. On 3/9/17 at approximately 10:00 AM, Licensed Practical Nurse (LPN) #2 provided documentation indicating Resident #31 and Resident #15 changed rooms on 1/12/17. When asked for documentation indicating advance notice was given prior to the room changes, LPN #2 stated that there was no documentation related to the room changes. Review of the facility's policy entitled Change of Room or Roommate, indicated under Policy: In addition, the resident has a right to be informed in advance and in writing, to include the reason for the change, before the room or roommate in the facility is changed. Under Policy Explanation and Compliance Guidelines, #3 stated, The Social Service designee or Licensed Nurse should inform the resident's sponsor/family in advance of a change in the resident's room or roommate. During an interview on 3/9/17 at approximately 3:45 PM, the Social Services Director and Director of Nursing (DON) confirmed that there was no documentation indicating Resident #31 or the family member of Resident #15 was given advance notice of the room changes. | 2018-10-01 |
| 5772 | 5772 | COVENANT TOWERS HEALTHCARE CENTER | 425382 | 5001 LITTLE RIVER ROAD | MYRTLE BEACH | SC | 29577 | 2017-03-09 | 272 | D | 0 | 1 | NH9U11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record reviews and interviews, the facility failed to comprehensively assess Resident #25 for the existence of bilateral heel pressure ulcers resulting in delayed treatment for 1 of 4 reviewed with pressure ulcers. The findings included: The facility admitted Resident #25 with [DIAGNOSES REDACTED]. Gangrene of Right Great Toe, Smoker and [MEDICAL CONDITION]. Review on 3/8/2017 at approximately 9:28 AM of the medical record for Resident #25 revealed a form titled, Admission Evaluation and Interim Care Plan. under section E, Braden Scale for Predicting Pressure Ulcers is scored with an 18 which indicates Resident #25 is at risk for developing pressure ulcers. According to the assessment on the admission evaluation and interim care plan form, Resident #25 was admitted with bruising of the right antecubital and the left and right wrists. He/she also had a scabbed abrasion on the right knee, and ulceration on the bottom of the right great toe measuring 3.5 centimeters x 3.0 centimeters x 0.1 centimeters. No mention was made of any pressure ulcers of the bilateral heels until 12/13/2016 and Resident # 25 was admitted to the facility on 12/1/2016. Further review on 3/8/2017 at approximately 9:30 AM of the the medical record revealed, Daily Skilled Nurse's Notes. The nurse's note dated 12/13/2016 under skin states, open lesion to the right great toe and no open areas were mentioned of the bilateral heels. Review of the nurse's note dated 12/14/2016 under skin states, open [MEDICAL CONDITION] to bilateral heels that are infected. Review on 3/8/2017 at approximately 9:40 AM of the, Weekly Skin Integrity Review, sheets revealed an assessment dated [DATE] indicated that Resident #25 had bruising only of his/her right great toe, right antecubital and the right knee. No other skin breakdown was documented at that time. Further review of the, Weekly Skin Integrity Review, on 3/8/2017 at approximately 9:45 AM revealed a second assessment dated [DATE… | 2018-10-01 |
| 5773 | 5773 | COVENANT TOWERS HEALTHCARE CENTER | 425382 | 5001 LITTLE RIVER ROAD | MYRTLE BEACH | SC | 29577 | 2017-03-09 | 278 | D | 0 | 1 | NH9U11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview, the facility failed to accurately assess the rejection of care status of Resident #13 for 1 of 5 residents reviewed for unnecessary medications. The findings included: The facility admitted Resident#13 with [DIAGNOSES REDACTED]. On 3/8/17 at 12:59 PM, review of the Minimum Data Set (MDS) assessment dated [DATE], in Section E Behavior: E800 Rejection of care -Presence and Frequency coded 0 Behavior not exhibited. Review of the Medication Administration Records on 3/9/17 at 11:25 AM revealed that resident#13 refused [MEDICATION NAME] Nebulizer .083% on 1/7/17, 1/13/17, 1/19/17, 1/25/17, 1/26/17, 1/27/17, 1/28/17, 2/2/17, 2/3/17, 2/4/17, 2/7/17, 2/8/17, and 2/9/17. During an interview on 3/9/17 at 3:55 PM, the Director of Nursing (DON) stated Social Services coded that section on rejection of care. Social Services confirmed the inaccurate coding of rejection of care. Social Services stated it was a missed oversite. | 2018-10-01 |
| 5774 | 5774 | COVENANT TOWERS HEALTHCARE CENTER | 425382 | 5001 LITTLE RIVER ROAD | MYRTLE BEACH | SC | 29577 | 2017-03-09 | 280 | D | 0 | 1 | NH9U11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview, the facility failed to update Resident #22's care plan to reflect non-pharmacological interventions prior to administering a [MEDICAL CONDITION] medication.(1 of 5 reviewed for unnecessary medications) The findings included: The facility admitted Resident #22 with [DIAGNOSES REDACTED]. Review of the (MONTH) (YEAR) Medication Administration Record(MAR) on 3/9/17 revealed Resident #22 received [MEDICATION NAME] 50 milligrams(mgs) on 11/19/16 to assist with relaxation and [MEDICATION NAME] .5 mg on 11/16/16 for anxiety. Review of the (MONTH) (YEAR) MAR indicated [REDACTED]. [MEDICATION NAME] .5 mg was administered on 12/10/16 and 12/11/16 for pulling dressing off of wound(left lower extremity)/restlessness and messing with the dressing on the left lower extremity. Review of the resident's care plan for [MEDICAL CONDITION] Drug Use revealed there was no approach for non-pharmacological interventions to be attempted prior to administration of a [MEDICAL CONDITION]. On 3/9/17 at approximately 6:00 PM, the Director of Nursing reviewed the [MEDICAL CONDITION] Drug Use care plan for Resident #22 and confirmed there was no intervention listed to be tried prior to the administration of a [MEDICAL CONDITION] medication. | 2018-10-01 |
| 5775 | 5775 | COVENANT TOWERS HEALTHCARE CENTER | 425382 | 5001 LITTLE RIVER ROAD | MYRTLE BEACH | SC | 29577 | 2017-03-09 | 314 | E | 0 | 1 | NH9U11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview and review of the facility policy titled, Hand Washing and Use of Gloves, and Prevention and treatment of [REDACTED].#13 and failed to assess a pressure ulcer for Resident #38. The facility further failed to ensure Resident #25 did not acquire pressure ulcers after admission to the facility for 3 of 4 residents reviewed for pressure ulcers. The findings included: The facility admitted Resident #25 with [DIAGNOSES REDACTED]. Gangrene of Right Great Toe, Smoker and [MEDICAL CONDITION]. Review on 3/8/2017 at approximately 9:28 AM of the medical record for Resident #25 revealed an form titled, Admission Evaluation and Interim Care Plan. under section E, Braden Scale for Predicting Pressure Ulcers is scored with an 18 which indicates Resident #25 is at risk for developing pressure ulcers. According to the assessment on the admission evaluation and interim care plan form, Resident #25 was admitted with bruising of the right antecubital and the left and right wrists. He/she also had a scabbed abrasion on the right knee, and ulceration on the bottom of the right great toe measuring 3.5 centimeters x 3.0 centimeters x 0.1 centimeters. No mention was made of any pressure ulcers of the bilateral heels until 12/13/2016 and Resident # 25 was admitted to the facility on 12/1/2016. Further review on 3/8/2017 at approximately 9:30 AM of the the medical record revealed, Daily Skilled Nurse's Notes. The nurse's note dated 12/13/2016 under skin states, open lesion to the right great toe and no open areas were mention of the bilateral heels. Review of the nurse's note dated 12/14/2016 under skin states, open [MEDICAL CONDITION] to bilateral heels that are infected. Review on 3/8/2017 at approximately 9:45 AM of a form titled, Weekly Wound Evaluation and Tracking, measured the right heel on 12/13/2016 at 2.6 cm x 2 cm x 0.1 cm with purulent drainage. The left heel on 12/13/2016 was measured at 2.5 cm x 2.0 cm x 0.1 cm with purulent… | 2018-10-01 |
| 5776 | 5776 | COVENANT TOWERS HEALTHCARE CENTER | 425382 | 5001 LITTLE RIVER ROAD | MYRTLE BEACH | SC | 29577 | 2017-03-09 | 329 | D | 0 | 1 | NH9U11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview, the facility failed to provide non-pharmacological interventions prior to administering a [MEDICAL CONDITION] medication. Resident #22 received [MEDICATION NAME] and [MEDICATION NAME] without non-pharmacological interventions attempted.(1 of 5 residents reviewed for unnecessary medications) The findings included: The facility admitted Resident #22 with [DIAGNOSES REDACTED]. Review of the (MONTH) (YEAR) Medication Administration Record(MAR) on 3/9/17 revealed Resident #22 received [MEDICATION NAME] 50 milligrams(mgs) on 11/19/16 to assist with relaxation and [MEDICATION NAME] .5 mg on 11/16/16 for anxiety. Review of the (MONTH) (YEAR) MAR indicated [REDACTED]. [MEDICATION NAME] .5 mg was administered on 12/10/16 and 12/11/16 for pulling dressing off of wound(left lower extremity)/restlessness and messing with the dressing on the left lower extremity. Review of the nurse's notes revealed prior to the administration of the medications, no non-pharmacological intervention was documented. No documentation was provided during the survey related to any non-pharmacological attempts prior to the administration of medication. During an interview with Licensed Practical Nurse(LPN)#1 on 3/9/17 at 2:11 PM, he/she stated non-pharmacological interventions should be charted in the nurse's notes. No policy was presented during the survey related to non-pharmacological interventions prior to administration of a [MEDICAL CONDITION] medication. | 2018-10-01 |
| 5777 | 5777 | COVENANT TOWERS HEALTHCARE CENTER | 425382 | 5001 LITTLE RIVER ROAD | MYRTLE BEACH | SC | 29577 | 2017-03-09 | 333 | D | 0 | 1 | NH9U11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations, record reviews and interview the facility failed to assure that it was free of a significant medication error based on 1 of 26 medications observed during medication pass. This error occurred when insulin was administered to Resident # 48 who was admitted by the facility on 3/6/17 with [DIAGNOSES REDACTED]. The findings include: During medication pass on 3/7/16 at approximately 11:39 AM LPN (Licensed Practical Nurse) # 1 administered 15 Units of Humalog Insulin using a Humalog Kwikpen to the right deltoid of Resident # 48, but did not prime the Humalog Kwikpen prior to administration of the insulin. When the dose was administered by LPN # 1, Resident 48 stated it hurt. On 03/7/2017 11:49 AM(NAME)LPN # 1 stated that he/she did not prime the Humalog Kwikpen before administering the insulin. LPN # 1 acknowledged that the resident stated that it hurt when the insulin was injected. The manufacturer's (Eli Lilly and Company) package insert states Prime before each injection. Priming your Pen means removing the air from the Needle and the Cartridge that may collect during normal use and ensure that the Pen is working correctly. If you do not prime before each injection, you may get too much or too little insulin. | 2018-10-01 |
| 5778 | 5778 | COVENANT TOWERS HEALTHCARE CENTER | 425382 | 5001 LITTLE RIVER ROAD | MYRTLE BEACH | SC | 29577 | 2017-03-09 | 371 | E | 0 | 1 | NH9U11 | Based on observations and review of the facility policy titled Date Marking Ready to Eat, TCS (Time, Temperature Control for Safety), the facility failed to follow proper sanitation and food handling practices for 1 of 1 kitchen reviewed. This has a potential for affecting all residents with prescribed diets, evidenced by following by the facility to do the following: walk in refrigerator, walk in freezer, and dry storage. The findings included: During the initial tour of the kitchen on 3/7/17 at 9:28 AM, in the walk in refrigerator part ricotta skin 48 ounces (oz.) expired 2/26/17 and Glenview Farm low-fat cottage cheese 5 pounds (lbs.) expired on 2/28/17. In the walk in freezer frozen French fries in a pan expired 3/5/17 and a pan of frozen veal expired on 2/27/17. The Dietary Director stated he/she have not had a chance to do the walk through to check the kitchen. At the time of the observation, the Dietary Director removed the items. Observation of the emergency storage area along with the Dietary Director revealed the following: Monarch Creamy Peanut Butter 5 lbs. expired 9/28/16. Review of the facility policy titled Date Marking Ready to Eat, TCS (Time, Temperature Control for Safety) revealed under the Instructions section the following: 6. Serve or discard refrigerated, ready -to-eat, TCS (Time, Temperature Control for Safety Foods). Monitoring: A designated employee will check refrigerators daily to verify that foods are dated marked and that foods exceeding the 7-day time period are not being used or stored. | 2018-10-01 |
| 5779 | 5779 | COVENANT TOWERS HEALTHCARE CENTER | 425382 | 5001 LITTLE RIVER ROAD | MYRTLE BEACH | SC | 29577 | 2017-03-09 | 456 | D | 0 | 1 | NH9U11 | Based on observation, interview and review of the facility policy titled, Lint Cleaning, the facility failed to ensure lint was removed from 2 of 2 clothes dryers to prevent an excessive amount of lint build up above the lint baskets and on the side walls of the dryers. The findings included. During an observation on 3/9/2017 at approximately 10:45 AM revealed an excessive amount of lint build up on the upper walls inside the dryers. Further observation on 3/9/2017 at approximately 10:50 AM revealed an excessive amount of lint on the top of the lint filter/baskets and on the wiring of the dryers. During an interview on 3/9/2017 at approximately 10:50 AM with a Laundry Worker confirmed the excessive amount of lint build up inside the dryers above the lint basket on the upper walls and on the wiring. Review on 3/9/2017 at approximately 1:40 PM of the facility policy titled, Lint Cleaning, states under Policy, 1. a. The laundry room supervisor is responsible to ensure that all procedures are followed. b. Lint cleaning shall be performed in the manner described in the procedures section below. 2. (i) Lint traps are to be cleaned and compartment to be swept out every 3 hours. (ii) Lint traps are located under the (2) dryer units. (iii) Remove the front cover, (iv) Using a broom, sweep lint out from cavity behind cover. (v) Visually inspect the entire area and as needed, use a stiff brush to remove any additional buildup of lint, (vi) Weekly Maintenance: Using a shop vacuum, remove any build up of lint from wiring connections located above the lint trap. | 2018-10-01 |
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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 );