cms_SC
Data source: Big Local News · About: big-local-datasette
41 rows where "inspection_date" is on date 2017-04-21
This data as json, copyable, CSV (advanced)
| Link | rowid ▼ | facility_name | facility_id | address | city | state | zip | inspection_date | deficiency_tag | scope_severity | complaint | standard | eventid | inspection_text | filedate |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2250 | 2250 | MAGNOLIA MANOR - ROCK HILL | 425165 | 127 MURRAH DR | ROCK HILL | SC | 29732 | 2017-04-21 | 156 | B | 0 | 1 | 9IUY11 | Based on record review and interviews, one of three residents (Resident #11) reviewed for Medicare notices of non-coverage was not notified in writing following a telephone notification. The findings included: On 4/21/17 at 08:30 AM, review of Resident #11's Medicare Determination on Continued Stay-Skilled Nursing/Facility form revealed D. This is to confirm that you were advised of the noncoverage of the services under Medicare by telephone on 11/8/16. The Beneficiary's name was written on the bottom of form with the signature of the Administrative Officer. The CMS -NOMNC Form was also not signed by the beneficiary. At the bottom of Form CMS -NOMNC, a signed and witnessed handwritten notation stated, 11/18/16 at 3:06 PM Spoke with (family member) concerning (Resident #11). I let her(him) know that she(he) will be moved off of Medicare because she(he) met her(his) goals and prior level of function. She(He) has the right to appeal and gave her(him) the number. On 4/21/17 at 8:49 AM, the Business Office Manager verified that a letter had not been sent to Resident #11 following the telephone notification of Medicare non-coverage. The Business Office Manager said,; Normally we talk to resident or family. With reference to S&C-09-20: Residents or their legal representative must sign notices to verify receipt; however, if the resident is unable to receive the notice and the resident's legal representative is unavailable, the SNF (Skilled Nursing Facility) provider may contact the legal representative and inform him/her by phone .must immediately follow up .with a written notice. The date of telephone contact is considered to be the date the telephone notice was given as long as it is not disputed by the beneficiary. | 2020-09-01 |
| 2251 | 2251 | MAGNOLIA MANOR - ROCK HILL | 425165 | 127 MURRAH DR | ROCK HILL | SC | 29732 | 2017-04-21 | 157 | E | 0 | 1 | 9IUY11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record reviews and interviews, the facility failed to notify family members of significant changes in residents' medical conditions requiring physician intervention for 2 of 2 sampled residents reviewed for notification. Residents #82 and #113 had multiple changes in condition and/or medication/treatment without evidence of family notification. The findings included: The facility admitted Resident #82 with [DIAGNOSES REDACTED]. Review of physician's orders [REDACTED]. On 2-3-17, Resident #82 had a positive chest x-ray and was placed on [MEDICATION NAME] 500 mg (milligrams) one tab(let) PO (by mouth) daily x 10 days for pneumonia. There was no evidence in the record that the family had been notified of the resident's change of condition or new antibiotic therapy treatment. On 2-3-17, a Physician's Telephone Order was noted for Urine for U/A (Urinalysis) (with) reflex (to be picked up on 2-6-17) related to falls. On 2-10-17, [MEDICATION NAME] 100 mg one tab every 12 hours X 7 days was started for treatment of [REDACTED]. There was no evidence in the record that the family had been notified of the resident's change of condition or new antibiotic therapy treatment. On 3-27-17, the physician/extender ordered [MEDICATION NAME] 15 ml (milliliters) PO every 8 hours x 7 days for cough and [MEDICATION NAME] 2 sprays in each nostril daily x 30 days for rhinitis. There was no evidence in the record that the family had been notified of the resident's change of condition requiring new medication for a respiratory condition. The facility sent Resident #82 to the emergency room (ER) for evaluation after s/he sustained a fall on 4-14-17. The resident returned with an order for [REDACTED]. During an interview at 10 AM on 4-20-17, Registered Nurse (RN) #1 stated that if nurses notified the family of changes, it should be documented in the medical record, specifically in the Nurse's Notes. At 2:30 PM, RN #1 reviewed the record and verified that there wa… | 2020-09-01 |
| 2252 | 2252 | MAGNOLIA MANOR - ROCK HILL | 425165 | 127 MURRAH DR | ROCK HILL | SC | 29732 | 2017-04-21 | 167 | C | 0 | 1 | 9IUY11 | Based on observations and interviews, the facility failed to ensure results of the most recent and past three years of survey results were readily available for resident/family and visitor review on 3 of 3 units. The findings included: No survey results or sign where the survey could be located was observed during the initial tour on 4/17/17 at 10:44 AM, on 4/18/17 and 4/19/17 throughout the day, and upon leaving the facility at the end of the day on 4/19/17. On 4/19/17, when asked where the survey results could be located, the receptionist retrieved them from a bookshelf next to her/his desk behind the business office door. During an interview on 4/19/17 at approximately 5:30 PM concerning the survey results, the Administrator stated; The survey results are kept on a bookshelf beside the receptionist's desk. The Administrator verified the survey results from the last 3 years were not accessible and that only the 1 year was available. The Administrator said, They're in my office. | 2020-09-01 |
| 2253 | 2253 | MAGNOLIA MANOR - ROCK HILL | 425165 | 127 MURRAH DR | ROCK HILL | SC | 29732 | 2017-04-21 | 241 | E | 0 | 1 | 9IUY11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations, interviews, and record reviews, the facility failed to treat residents with respect and dignity. The facility did not ensure that the manner of care and the environment in which it was provided either maintained or enhanced each resident's quality of life by recognizing their individuality while protecting and promoting their rights for 8 out of 10 residents reviewed for dignity. The Findings included: Review of Medical record on 4/19/17 revealed Resident #27 was originally admitted to facility in (MONTH) 2007 with the [DIAGNOSES REDACTED]. Observations on 4/17/17 at 2:20 PM and 4/19/17 at 12:30 PM revealed that Resident #27 was sitting in a geri-recliner wearing a pair of white socks on which her/his first initial and last name were written in large block letters with black ink, clearly visible to other residents, visitors and staff. RN #3 verified during observation/interview on 4/20/17 at 11:35 AM that Resident #27 was wearing a pair of white socks which had her/his first initial and last name written in block letters in black ink that was clearly visible and that she/he had facial hair that had not been removed during AM care. Review of the medical record on 4/21/17 at 3:00 PM revealed Resident #173 was admitted to facility on 4/7/2017 with [DIAGNOSES REDACTED]. Observation on 4/20/17 at 8:20 AM revealed that the room door was open for Resident #173 and s/he was lying in bed with urinary catheter drainage bag secured to bedframe without a privacy cover, clearly visible to other residents, visitors and staff who pass by the room. At 9:10 AM on 4-20-17, Resident #82 was noted to have a half-empty carton of milk left on her/his tray from breakfast. No glass was available for the milk and no straw had been opened and placed in the container. When asked, the resident stated s/he had not been offered nor did s/he receive a glass for her/his milk. S/he stated, I drink from the carton after I use it for my cereal. On 4-19-1… | 2020-09-01 |
| 2254 | 2254 | MAGNOLIA MANOR - ROCK HILL | 425165 | 127 MURRAH DR | ROCK HILL | SC | 29732 | 2017-04-21 | 242 | D | 0 | 1 | 9IUY11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, the facility failed to honor resident choices for frequency and type of bath/shower choice for one of three residents. Resident #172 had no opportunity to choose the number of showers per week. The findings included: The facility admitted Resident #172 with a [DIAGNOSES REDACTED]. Interview with Resident #172 on 4/17/17 at 2:59 PM revealed the resident did not get to choose the frequency or type of bath or shower. Resident #172 stated, They do showers twice a week .If at home I would bathe 4 times a week. During an interview on 4/20/17 at 5:42 PM, Certified Nurse Assistant #5 stated that the bathing schedule was set up by the room. And that it was assumed that the resident's preference was for a shower. If the resident refused a shower they were offered a bed bath. During an interview on 4/20/17 at 5:48 PM, when asked about bathing choices, the Admissions Director when asked about bathing choices stated, Social Services does the initial history that includes a question about bathing preferences. When residents are admitted , there is a predetermined shower schedule based on room assignment. On 4/20/17 at 6:05 PM, Licensed Practical Nurse #4 said that at one time the resident said he/she wanted showers 2 times a week, then 4 times a week and then changed back to 2 times a week. There was no evidence of this noted on the Nurse's Notes or the Care Plan. On 4/20/17 at 8:55 AM, review of the Social Service Admission Evaluation Form noted that the resident's ability to Choose between a tub bath, shower, bed bath or sponge bath was coded 1- very important and shower was circled. There was no reference to choices related to frequency of bathing. Review of the Point Care History revealed that the resident received a partial bed bath 5 times and a complete bed bath 5 times since admission on 3/3/1/17. A shower was only recorded once during the 19 day period since admission. Review of Nurse's Notes on 4/20/17 at 9:1… | 2020-09-01 |
| 2255 | 2255 | MAGNOLIA MANOR - ROCK HILL | 425165 | 127 MURRAH DR | ROCK HILL | SC | 29732 | 2017-04-21 | 247 | D | 0 | 1 | 9IUY11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview, record review, and review of the facility's policy entitled Room Changes/Transfers within the Facility, the facility failed to ensure Resident # 111 and/or responsible party was notified of a room change. 1 of 4 sampled residents reviewed for Admission, Transfer and Discharge Review. The findings included: The facility admitted Resident # 111 with [DIAGNOSES REDACTED]. During stage 1 interview with Resident#111 on 4/17/17 at 2:20 PM revealed, the question was asked to Resident #111 Were you given notice before a room change or a change in roommate? The resident stated No. They told him he was transferring to a new room during the transfer. A review of the medical record of the Quarterly Minimum Data Set ((MDS) dated [DATE] indicated the resident was alert and interview-able with a Brief Interview Mental Status (BIMS) score of 8. Further record review on 4/20/17 at 10:17 AM revealed Social Review conducted on 5/29/17 resident was in room [ROOM NUMBER]B. The quarterly social review assessment conducted on 8/23/16 revealed resident is in room [ROOM NUMBER]. Further record review of the social services progress notes revealed no documentation of the resident and/or responsible party notified of a room change. An interview on 4/20/17 at approximately 10:25 AM with the Social Services Director (SSD), revealed there was no discussion with the resident or the family about the room change. The SSD confirmed there was no documentation of a discussion with the resident and/or responsible party about a room change. The SSD further stated Resident #111 was an overlook. Review of the facility's policy entitled Room Changes/Transfers within the Facility on 4/20/17 at 10:53 AM revealed the following: Procedures: 4. Written notice of all room transfers, utilizing current forms, Room Change Notification form will be provided to the patient/resident or his/her qualified legal representative before the anticipated transfer. | 2020-09-01 |
| 2256 | 2256 | MAGNOLIA MANOR - ROCK HILL | 425165 | 127 MURRAH DR | ROCK HILL | SC | 29732 | 2017-04-21 | 248 | D | 0 | 1 | 9IUY11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, the facility failed to provide individual activities based on an assessment of resident interests for 1 of 3 sampled residents reviewed for activities. The findings included: The facility admitted Resident #172 on 3/3/1/17, with [DIAGNOSES REDACTED]. During an interview, Resident #172 responded No to the following questions: 1) Do you participate in the activity programs ? 2) Do the activities meet your interests? 3) Are the Activities provided as often as you would like, including on weekends and evenings? During the interview, Resident #172 stated I have not heard of any activities. Do you people know that I am a quad? On 04/20/2017 at 10:23 AM, review revealed no Activity Assessment present in the medical record. On 4/20/17 at 10:26 AM, The Activities Director verified that no Activity Assessment had been completed. S/He said, I have not got to him/her yet. I have 7 days to do this and I must have overlooked it. Further, s/he said, My assistant is now the Social Services Assistant and s/he did all the Activity Assessments. A review of the Individual Resident Daily Participation Record showed the resident had active participation in Current Events/News from 4/2-4/16/17. The Activity Director said, This means that the resident watches the news on TV in his/her room. Chat and Reality marked completed daily during 4/2-4/16/17, The Activity Director stated s/he did that activity daily with all residents. She was the only activities employee in facility with a census of 103. On 4/20/17 at approximately 11:00 AM review of the Multiple Data System (MDS) Admission Assement completed on 4/07/17, Resident #172 had a BIMs score of 13. | 2020-09-01 |
| 2257 | 2257 | MAGNOLIA MANOR - ROCK HILL | 425165 | 127 MURRAH DR | ROCK HILL | SC | 29732 | 2017-04-21 | 253 | E | 0 | 1 | 9IUY11 | Based on observation and interview, the facility failed to maintain a sanitary and functional environment for residents on 3 of 3 units. Concerns were identified with damaged and /or cleanliness of walls, floors, ceilings, furniture, lights and patient care equipment. Repeated concerns were also identified with odors in various locations in the facility. The findings included: 1.Unit 1: Room 103 - On 4-18-17 at 11:45 a.m., the surface of the closets were noted to be deeply marred and the bottom of the closet of Resident #82 had the surface missing. There was damage noted to the drywall near the foot of the bed for Resident #82. Near the bathroom, there were multiple scrapes along the wall. In the bathroom there were areas of torn drywall around the baseboard and brown substance built up around the base of the commode. Room 104 - On 4-17-17 at 2:25 p.m., the drywall between the door to the bedroom and door to the bathroom had multiple torn areas; the bathroom door had multiple deep scrapes from the bottom of the door up to the door handle. Room 106 - On 4-18-17 at 10:30 a.m. the HVAC unit on the wall was noted to be cracked; the sink in the bathroom was cracked. Room 108 - On 4-18-17 at 11:59 a.m., the back of Resident #152's wheelchair was noted to have torn areas on the surface. Near the head of the bed there were holes in dry wall. There were multiple areas on the furniture where the finish had scraped off. There was a tear in the dry wall on the wall near the bathroom. Inside the bathroom there was a large crack in right front corner of the sink. There was an unlabeled toothbrush holder on the back of the sink. There was a large gash in wood covering 1/2 the surface of the door, near the bottom. Room 110 - On 4-17-17 at 4:31 p.m., there was dry wall damage noted at the head of the bed, holes in ceiling at the head of the bed near the window, and marred surfaces on the bedroom furniture. The bathroom door had damage to the outside, facing the bedroom. Dry wall damage was noted on the wall around the bathroom do… | 2020-09-01 |
| 2258 | 2258 | MAGNOLIA MANOR - ROCK HILL | 425165 | 127 MURRAH DR | ROCK HILL | SC | 29732 | 2017-04-21 | 272 | D | 0 | 1 | 9IUY11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview, the facility failed to accurately and completely assess 1 of 3 sampled residents reviewed for Activities. The Activity Assessment for Resident #172 was not completed. The findings included: The facility admitted Resident #172 on 3/3/1/17, with [DIAGNOSES REDACTED]. On 04/20/2017 at 10:23 AM, review revealed no Activity Assessment present in the medical record. On 4/20/17 at 10:26 AM, The Activities Director verified that no Activity Assessment had been completed. S/He said, I have not got to him/her yet. I have 7 days to do this and I must have overlooked it. Further, s/he said, My assistant is now the Social Services Assistant and s/he did all the Activity Assessments. . | 2020-09-01 |
| 2259 | 2259 | MAGNOLIA MANOR - ROCK HILL | 425165 | 127 MURRAH DR | ROCK HILL | SC | 29732 | 2017-04-21 | 278 | E | 0 | 1 | 9IUY11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to assure that 1 of 3 residents reviewed for range of motion, 1 of 2 residents reviewed for urinary incontinence, 2 of 5 residents reviewed for unnecessary medications and 1 of 2 residents reviewed for pressure ulcers received accurate assessments. The Findings included: Review of Medical record on conducted on 4/19/17 revealed that the facility originally admitted Resident #27 to the facility in (MONTH) 2007 with the [DIAGNOSES REDACTED]. Record Review of Resident #27's Annual Comprehensive Minimum Data Set (MDS) assessment with Assessment Reference Date (ARD) of 9/25/2016 on 4/19/17 revealed Section G (Functional Status) items G0400A (Functional Range of Motion (FROM) limitation in upper extremity) was coded 0=no impairment and G0400B (FROM limitation in lower extremity) was coded 2=impairment on both sides. Further review of medical record revealed that there was no supportive documentation for the dates of 9/19/16-9/25/16 to compare with the coding on the MDS with ARD of 9/25/16. When MDS Nurse #2 was asked during interview on 4/20/17 at 9:55 AM where the documentation was located that supported the coding of FROM of upper and lower extremities for Annual comprehensive MDS with ARD 9/25/16, s/he replied that she would pull that information from the thinned medical records; however, the information was not provided prior to the end of the survey. Further review Resident #27's Quarterly MDS assessment with ARD of 3/28/17 revealed Section G (Functional Status) items G0400A (FROM limitation in upper extremity) was coded 2=impairment on both sides and G0400B (FROM limitation in lower extremity) was coded as 0=no impairment. Additional review of supportive documentation revealed Nursing Data Collection Tool completed on 3/22/17 indicating on page 3 of 6 that Functional Limitation in ROM of upper extremity is checked no and lower extremity is checked as impairment on one sid… | 2020-09-01 |
| 2260 | 2260 | MAGNOLIA MANOR - ROCK HILL | 425165 | 127 MURRAH DR | ROCK HILL | SC | 29732 | 2017-04-21 | 279 | E | 0 | 1 | 9IUY11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview, the facility failed to ensure Care Plans accurately reflected resident's needs and concerns for 4 of 28 sampled residents reviewed for Care Plan (Residents #8, 3, 113). Resident #8 had no Care Plan for oral status. Resident #3 had no Care Plan for therapy treatment. Resident #113 had no Care Plan for [MEDICAL TREATMENT], Pacemaker, [MEDICAL CONDITION], Anticoagulant, and disease specific goals and interventions. The findings included: The facility admitted Resident #8 with [DIAGNOSES REDACTED]. The Nursing Data Collection Tool dated 1-24-17 was reviewed on 4-19-17 at 3:02 p.m. and revealed the resident's oral status to be all teeth missing, no dentures (edentulous). During an interview 1123 on 4-20-17, the MDS Nurse #2 indicated that if the resident's oral status did not trigger on her/his admission assessment, it would not be captured on the Care Plan. The Nursing Data Collection Tool was reviewed with MDS Nurses #1 and #2, and it was determined that the assessment had been coded inaccurately. They stated that if the assessment had been coded accurately, the problem area would have been transcribed to the Care Plan. The facility admitted Resident #3 with [DIAGNOSES REDACTED]. Record review on 4-20-17 at 9:22 a.m. indicated that the physician had ordered Occupational Therapy on 3-2-17 and discontinued it on 4-12-17, with recommendation to have the Resident up in the chair daily as tolerated for socialization and leisure pursuits. Occupational Therapy Progress and Discharge Summary indicated that therapy was working on goals for Resident #3 to maintain positioning while in a high-back reclined chair with a seat cushion. Review of the Care Plan on 4-19-17 at 4:45 p.m. revealed no indication of the start of therapy, goals for therapy treatment or approaches for staff with regard to resident positioning. During an interview at 8:57 a.m. on 4-20-17, in the presence of MDS Nurse #1, MDS Nurse #2 stated, Residen… | 2020-09-01 |
| 2261 | 2261 | MAGNOLIA MANOR - ROCK HILL | 425165 | 127 MURRAH DR | ROCK HILL | SC | 29732 | 2017-04-21 | 280 | E | 0 | 1 | 9IUY11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interviews, the facility failed to facilitate the participation of a nurse aide with responsibility for the resident and the attending physician during interdisciplinary care planning for 21 of 28 sampled residents (#150, #58, #73, #167, #161, #49, #113, #82, #5, #45, #47, #60, #66, #76, #77, #148, #100, #164, #30, #8 and #3) reviewed for care plans. The facility further failed to facilitate resident or family participation for the interdisciplinary care plan meetings for 4 of 28 residents reviewed for care plans (#8, #49, #82 and #113). Finally, the facility failed to update the care plan to reflect current status for 2 of 2 residents reviewed for pressure ulcers (#49 and #90). The findings included: During interview on 4/20/17 at 9:45 AM, Social Services Director revealed that s/he was responsible for inviting people to the interdisciplinary care plan meeting. When asked if the primary care physician and a C.N.[NAME] with responsibility for the resident were invited to the interdisciplinary care plan meeting, s/he revealed that they were not. When asked how the information discussed in the interdisciplinary care plan meetings are communicated to the resident's primary care physician, s/he stated that the Doctor is made aware of any changes with the residents through the communication book and that s/he reviews the orders every month, if any major issues are identified, then they are reported to doctor as appropriate; however, there was no formal communication to physician regarding routine information discussed during the interdisciplinary care plan meeting. Review of 3/8/17 Care Conference documentation for Resident #150 on 4/19/17 at 10 AM reflected that there was no participation of Certified Nursing Assistant (C.N.[NAME]) or Primary Care Physician (PCP). Review of 4/20/17 Care Conference documentation for Resident #58 on 4/20/17 at 11 AM reflected that there was no participation of Certified Nursing Assistant … | 2020-09-01 |
| 2262 | 2262 | MAGNOLIA MANOR - ROCK HILL | 425165 | 127 MURRAH DR | ROCK HILL | SC | 29732 | 2017-04-21 | 281 | D | 0 | 1 | 9IUY11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview, the facility-failed to develop an interim care plan on admission for one of one sampled resident reviewed for [MEDICAL TREATMENT]. There was no evidence of assessment and care planning sufficient to meet the needs of newly admitted Resident #113. The findings included: The facility admitted Resident #113 with [DIAGNOSES REDACTED]. Record review at 9:41 AM on 4-19-17 revealed that the resident had been re-admitted to the facility on [DATE] following hospitalization for [DIAGNOSES REDACTED] and [MEDICAL CONDITIONS]. Review of physician's orders [REDACTED].#113 was admitted on [MEDICAL TREATMENT], Eliquis (anticoagulant) for [MEDICAL CONDITION] Fibrillation, and [MEDICATION NAME] (antibiotic) for [MEDICAL CONDITION]. Contact isolation was implemented on admission. The resident was also admitted with treatments to the sacrum and left shin. Record review at 12:50 PM on 4-19-17 revealed an Interim Care Plan that was blank except for one 3-15-17 reference: L(ef)t leg swelling-warm to touch-ABT (antibiotic) Bactrim DS x 10 days. The Interim Care Plan sections Pressure Ulcer Risk, Pain, Dehydration Risk, Fracture, Nutrition, Diabetic Alert, Infection Alert, Fall Risk, and Toileting were left blank. There was no mention of the amount of assistance needed with activities of daily living, [MEDICAL TREATMENT], use of an anticoagulant, pacemaker, or isolation for [MEDICAL CONDITION] infection. During an interview on 4-19-17 at 2:04 PM, Registered Nurse #1 stated that the admitting nurse or the Unit Manager was responsible for completing the Interim Plan of Care. S/he reviewed and verified that the only entry on the plan was in reference to the leg [MEDICAL CONDITION]. | 2020-09-01 |
| 2263 | 2263 | MAGNOLIA MANOR - ROCK HILL | 425165 | 127 MURRAH DR | ROCK HILL | SC | 29732 | 2017-04-21 | 309 | D | 0 | 1 | 9IUY11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record reviews and interviews, the facility failed to adjust medication times for one of one sampled resident reviewed for [MEDICAL TREATMENT] (Resident #113). In addition, the facility failed to obtain a physician's orders [REDACTED].#90). The findings included: The facility admitted Resident #113 with [DIAGNOSES REDACTED]. Record review at 9:41 AM on 4-19-17 revealed that the resident had been re-admitted to the facility on [DATE] following hospitalization for [DIAGNOSES REDACTED] and [MEDICAL CONDITIONS]. Review of physician's orders [REDACTED]. There were no explanations documented in the record. On 3-17-17, the 8 AM doses of Eliquis, [MEDICATION NAME] and the 9 AM and 1 PM doses of [MEDICATION NAME] were circled. On 3-27-17, the 8 AM doses of Eliquis and [MEDICATION NAME], and the 9 AM dose of [MEDICATION NAME] were circled. On 3-31-17, the 8 AM doses of Eliquis, Bactrim DS, and [MEDICATION NAME], and the 9 AM dose of [MEDICATION NAME] were circled. On 4-3-17, the 8 AM doses of Eliquis, Bactrim DS, Renavite, [MEDICATION NAME], Acidophilus, [MEDICATION NAME], and Vitamin C, and the 8 AM and 12 PM doses of [MEDICATION NAME] were circled. On 4-10-17, the 8 AM doses of Bactrim DS, Acidophilus, [MEDICATION NAME], and Vitamin C, and the 12 PM dose of [MEDICATION NAME] were circled. During an interview on 4-19-17 at 2:04 PM, Registered Nurse (RN) #1 reviewed the MARs and verified that the resident had not received the medications as ordered. S/he stated the dates of omission were all [MEDICAL TREATMENT] days but that the reason should be documented. When asked if the medication regimen had been reviewed and adjusted to accommodate the [MEDICAL TREATMENT] schedule, RN #1 stated, No. The facility admitted Resident #90 with the [DIAGNOSES REDACTED]. Review of the medical record for Resident #90 on 4/21/17 at 2:42 revealed a Physician's Telephone Order dated 2/28/17 for U/A C&S R/T increased confusion TORB: MD#1 with corresponding urine cu… | 2020-09-01 |
| 2264 | 2264 | MAGNOLIA MANOR - ROCK HILL | 425165 | 127 MURRAH DR | ROCK HILL | SC | 29732 | 2017-04-21 | 314 | E | 0 | 1 | 9IUY11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, record review, and interview, the facility failed to provide intervention for pressure ulcer prevention as ordered and/or care planned for 2 of 3 residents reviewed for pressure ulcers. Residents #49 and #90 were observed without heel protectors in place. The findings included: The facility admitted Resident #49 with [DIAGNOSES REDACTED]. Review of the 11-17-16 Quarterly and 2-15-17 Annual Minimum Data Set Assessments on 4-21-17 at 10:41 AM revealed that the resident was coded at risk for pressure ulcer development. Record review at 9:17 AM on 4-21-17 revealed a 1-6-17 physician's orders [REDACTED]. Review of the Weekly Skin Integrity Reviews and Wound Treatment & Progress Record revealed that the resident had a history of [REDACTED]. Multiple observations (on 4/19/17 at 9:41 AM, 4/19/17 at 5:46 PM, 4/20/17 at 8:45 AM, 4/21/17 at 8:45 AM, and 4/21/17 at 10:37 AM) revealed Resident #49 in bed on his/her back without the heel lift boots in place as ordered. Review of the 2-11-17 Braden Scale for Predicting Pressure Sore Risk reviewed on 4-21-17 at 1:20 PM revealed that Resident #49 had a score of 16 with a total score of 18 or below considered at risk. Review of Nurse's Notes and Treatment Administration Records for 2/17 through 4/17 at 9:50 AM on 4-21-17 revealed no references to refusal of the ordered treatment. Review of the Care Plan at approximately 11 AM on 4-21-17 revealed that the facility had assessed the resident to be at risk for further skin impairment related to positioning and [MEDICAL CONDITION]. Approaches/interventions did not include application of the heel lifters. During an interview and observation at 10:37 AM on 4-21-17, Licensed Practical Nurse (LPN) #2 verified that the heel lifter was not in place as ordered. The nurse located the equipment in the closet. The resident stated s/he thought s/he did not need it because s/he had no current skin problem on the foot. The LPN told the resident s/he should… | 2020-09-01 |
| 2265 | 2265 | MAGNOLIA MANOR - ROCK HILL | 425165 | 127 MURRAH DR | ROCK HILL | SC | 29732 | 2017-04-21 | 315 | E | 0 | 1 | 9IUY11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview, Resident #178 was admitted with an indwelling urinary catheter and the facility failed to implement interventions for indwelling urinary catheter care and/or management upon admission. Indwelling urinary catheter care was not provided for first 8 days of Resident stay for one of one residents reviewed for urinary tract infection. The Findings included: Review of the medical record on 4/21/17 at 3:00 PM revealed Resident #173 was admitted to facility on 4/7/2017 with [DIAGNOSES REDACTED]. Review of Daily Skilled Nurse's Note for the dates 4/7/17, 4/8/17, 4/9/17, 4/10/17, 4/11/17, 4/12/17, and 4/15/17 revealed that a foley (indwelling urinary) catheter was in place. Further review revealed that Admission Physician order [REDACTED]. Additionally, Physician Telephone Order dated 4/15/17 stated: foley catheter care every shift. Change foley catheter every month 18 Fr (French) /30 cc (cubic centimeter) TORB (Telephone Order Received By) (Family Nurse Practitioner) FNP #1/ (Licensed Practical Nurse) LPN #5. Review of the Treatment Administration Record (TAR) for (MONTH) (YEAR) revealed that foley (indwelling urinary) catheter care was not provided until 4/15/2017 during 7am-7pm shift. During interview on 4/21/17 at 4:00 PM, Director of Nursing (DON) verified that there was no order addressing presence of and/or care for a foley (indwelling urinary) catheter written upon admission to facility on 4/7/2017. Additionally, DON verified that there was no documentation in the medical record that reflected foley (indwelling urinary) catheter care had been provided to Resident #173 until a physician telephone order was written to initiate foley (indwelling urinary) catheter care every shift that was transcribed onto the TAR and first initialed by nurse as completed on 7am-7pm shift on 4/15/2017. | 2020-09-01 |
| 2266 | 2266 | MAGNOLIA MANOR - ROCK HILL | 425165 | 127 MURRAH DR | ROCK HILL | SC | 29732 | 2017-04-21 | 318 | D | 0 | 1 | 9IUY11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview, the facility failed to provide Range of Motion (ROM) to prevent further decrease in range of motion for Resident # 60, 1 of 3 residents reviewed for range of motion. The findings included: The facility admitted Resident #60 with [DIAGNOSES REDACTED]. During the Stage 1 Staff Interview on 4/18/17 at 2:58 PM, the nurse stated resident could not open her left hand when prompted. Resident has no splint in place and not receiving (ROM). Review of the Comprehensive Minimal Data Set (MDS) on 4/20/17 at 5:13 PM revealed the Admission MDS dated [DATE] revealed Resident#60 required extensive to total assistance with all aspects of Activities of Daily Living and the resident was coded as having impairment on one side of the upper and lower body in ROM. Review of the quarterly MDS assessment dated [DATE] also revealed the resident was coded impairment one side of the upper and lower in ROM. Review of the Nurses Notes on 4/20/17 at 1:03 PM revealed no documentation of the resident receiving any range of motion. Review of the Care Plan on 4/20/17 at 12:17 PM revealed an Activities of Daily Living care plan with no interventions for decrease in ROM. During an interview on 4/20/17 at 2:42 PM with Certified Nurse Assistant #5 (CNA), the CNA explained the Activities of Daily Living for the resident that is provided in the morning included bathing, dressing, toileting, and transfer. There was no mention of providing ROM. | 2020-09-01 |
| 2267 | 2267 | MAGNOLIA MANOR - ROCK HILL | 425165 | 127 MURRAH DR | ROCK HILL | SC | 29732 | 2017-04-21 | 325 | D | 0 | 1 | 9IUY11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, record review, and interview, the facility failed to ensure Resident #148 maintained acceptable parameters of nutritional status such as body weight for 1 of 4 residents reviewed for Nutrition. Resident #148 had a significant weight loss. The findings included: The facility admitted Resident #148 with [DIAGNOSES REDACTED]. Review of the Admission Weights for Resident #148: Weight at Admission (12/14/2016): 140 Weight at 15 days after Adm. (12/29/2016): 155 (which is 15 lbs. more than at Adm. or a 10.7% gain) Weight at 30 days after Adm. (01/11/2017): 141 (which is 1 lbs. more than at Adm. or a .7% gain) Weight at 60 days after Adm. (02/11/2017): 129 (which is 11 lbs. less than at Adm. or a 7.9% loss) Review of the Nutritional evaluation dated 2/9/17 revealed resident had 8.3 % weight loss within 30 days but he/she continued to lose weight with no interventions in place to prevent further weight loss or to stabilize weight. During an interview on 04/20/17 at 11:51 AM with the Certified Dietary Manager (CDM) confirmed the weight loss. CDM reviewed the Physician order [REDACTED]. CDM also stated Resident # 148 should have been placed on a supplement. | 2020-09-01 |
| 2268 | 2268 | MAGNOLIA MANOR - ROCK HILL | 425165 | 127 MURRAH DR | ROCK HILL | SC | 29732 | 2017-04-21 | 328 | D | 0 | 1 | 9IUY11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and review of facility policies entitled [MEDICAL CONDITION] Care and Tracheal Suctioning, the facility failed to follow procedures to ensure infection prevention for one of one sampled resident reviewed for [MEDICAL CONDITION] care and suctioning (Resident #161). The findings included: The facility admitted Resident #161 with [DIAGNOSES REDACTED]. During observation of [MEDICAL CONDITION] care and suctioning at 11 AM on 4-19-17, Registered Nurse (RN) #2 failed to follow procedures to ensure prevention of infection. Prior to the procedure, the nurse did not apply personal protective equipment (PPE). During the trach(eostomy) care, RN #2 opened [MEDICAL CONDITION] kit and placed the sterile drape on the overbed table. After opening and placing the sterile disposable inner cannula on the drape, s/he applied sterile gloves. S/he then placed the stoma dressing on the drape and opened and poured Normal Saline into the tray. With the left hand, RN #2 removed [MEDICAL CONDITION] (humidified oxygen). S/he removed the inner cannula and dressing/drain sponge with the left hand and placed them in the waste receptacle. With the right hand, the nurse wiped the outer cannula/flanges with moist normal saline gauze and used a cotton-tipped applicator with Normal Saline to cleanse around the stoma. During this procedure, s/he secured the [MEDICAL CONDITION] with her/his left hand. S/he dried the outer cannula/flanges with gauze. Then, securing the flange with the right hand, the nurse inserted the sterile disposable inner cannula with the left hand. S/he then applied the sterile drain sponge to the stoma site using both hands and replaced [MEDICAL CONDITION]. The resident began to cough up a large amount of sputum from the [MEDICAL CONDITION]. RN #2 obtained 4x4 gauze from the dresser, opened them, and, using both hands, wiped the inside of [MEDICAL CONDITION] and the outer trach. S/he removed the gloves and checked the reside… | 2020-09-01 |
| 2269 | 2269 | MAGNOLIA MANOR - ROCK HILL | 425165 | 127 MURRAH DR | ROCK HILL | SC | 29732 | 2017-04-21 | 329 | E | 0 | 1 | 9IUY11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview, the facility failed to ensure that the medication regimen was adequately monitored for 2 of 6 sampled residents reviewed for unnecessary medication. Finger stick blood sugar (FSBS) tests were omitted multiple times for Resident #113 without documented reasons. Staff did not rotate [MEDICATION NAME] application sites per manufacturer's recommendation for Resident #30. The findings included: The facility readmitted Resident #113 with [DIAGNOSES REDACTED].diff.). Record review at 10:57 AM on 4-19-17 revealed physician's orders [REDACTED]. Special Instructions: Greater than 350 less than 70 contact MD. Review of the 3-17 Medication Administration Record (MAR) revealed that the FSBS had not been completed as ordered on the following dates/times since admission on 3-15-17: - 3-17-17 4 PM - 3-19-17 6 AM - 3-20-17 4 PM - 3-22-17 4 PM - 3-26-17 4 PM - 3-29-17 4 PM - 3-30-17 4 PM Review of the MAR and Nurse's Notes at 1:11 PM on 4-19-17 revealed no documented reasons for omission. During an interview on 4-19-17 at 2:04 PM, Registered Nurse #1 reviewed the medical record and verified that the blood sugar results nor reasons for omission were documented. S/he stated the FSBS results or reasons for omission should be noted on the MAR. The facility admitted Resident #30 with [DIAGNOSES REDACTED]. Record review on 4/20/2017 at 10:07 AM, revealed a physician's orders [REDACTED]. Review of the (Medication Administration Record) MAR on 4/19/2017 at 10:07 revealed no site numbers recorded. The MAR had daily abbreviations (with no key to explain them) to indicate placement site. There was a body grid in the MAR that indicated patch placement sites for 11/1/16 -11/31/16, no current grid available. On 4/20/2017 at 2:30 PM, Licensed Practical Nurse (LPN) verified that the grid was not current. LPN #5 said, The way they are supposed to use the grid is, if today is the 20th day of the month, then they are supposed to rotate the s… | 2020-09-01 |
| 2270 | 2270 | MAGNOLIA MANOR - ROCK HILL | 425165 | 127 MURRAH DR | ROCK HILL | SC | 29732 | 2017-04-21 | 356 | C | 0 | 1 | 9IUY11 | Based on record review and interviews, the facility failed to have the daily nurse staffing information posted in a location visible to both residents and visitors for the first 3 days of the survey on three of three nursing units. Inability to access daily nurse staffing information had the potential to affect all residents and visitors who desired to obtain this information. The findings included: During each of the first three days of the survey, observations upon entry to the facility revealed that the daily nurse staffing information was not posted in a location that was visible to both residents and visitors. During an interview with Administrator on 4/19/17 at 12:15 PM, when asked where the daily nurse staffing posting was located, the Administrator stated that it was usually located in a notebook resting on the hand railing on the wall under the bulletin board that displayed current open positions. Administrator then verified during the interview, that there currently was no notebook in that location. At 12:30 PM on 4/19/17, the Staffing Coordinator presented the surveyor with a black notebook that contained the daily nurse staffing information, at which time the surveyor requested that the Staffing Coordinator return the book to where it is typically kept, and the Staffing Coordinator stated that s/he would put it there right now. Approximately 30 minutes later, the surveyor observed that there was no notebook located on or near the hand railing under the bulletin board that displayed current open positions which was verified by the Clinical Nursing Consultant on 4/19/17 at 1:00 PM. During interview with DON and Clinical Nursing Consultant on 4/19/17 at 1:03 PM Director of Nursing (DON) contacted the Staffing Coordinator via telephone and inquired where the notebook containing current daily nurse staffing info (specifically for current date 4/19/17) was located. DON reported to surveyor that the notebook was located on top of the mail box. Observation on 4/19/17 at 1:04 PM revealed that a black note book… | 2020-09-01 |
| 2271 | 2271 | MAGNOLIA MANOR - ROCK HILL | 425165 | 127 MURRAH DR | ROCK HILL | SC | 29732 | 2017-04-21 | 371 | F | 0 | 1 | 9IUY11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview and review of the facility policy, Nutrition Policies and Procedures, the facility failed to maintain sanitary conditions for 1 of 1 kitchen reviewed and had the potential to impact 97 of 97 residents with ordered diets. Dietary staff failed to secure facial hair when entering and exiting the food preparation area, dispose of expired food items, properly label and date stored items. The findings included: On 4-17-17 at approximately 10:49 a.m., an initial tour of the facility's kitchen with the Assistant Kitchen Manager revealed: Walk-in refrigerator: 1. (10) Rotted bell peppers, with soft, brown and black areas 2. (6) Head of lettuce rotted, with wet, brown areas 3. (28) Pint sized cartons of whole milk with expiration date of 4/16/17 Walk-in freezer: 4. (1) Vanilla Bettercreme ice cream, 9 pounds, Frozen, Use By 3 [DATE] - stored on the floor The following items were noted to be opened, undated and unlabeled outside of their original packaging: 5. (5) 32 ounce bags of freezer burned broccoli, undated 6. (1) 32 ounce bag of cauliflower, undated 7. (5) 32 ounce bags of battered sweet corn nuggets, undated 8. (5) 48 ounce bags of yellow squash, undated 9. (3) 32 ounce bags of chopped spinach, undated 10. (2) Bags of hash browns, undated, unlabeled 11. (1) Bag of catfish nuggets, undated, unlabeled 12. (2) Bags of croissants, undated, unlabeled 13. (1) Bag of French fries, undated, unlabeled 14. (2) Bags of French toast, undated, unlabeled 15. (3) Bags of Pancakes, undated, unlabeled 16. (1) Bag of riblets, dated 3/1/17, freezer burned 17. (1) 2.5 pound bag of shrimp, undated 18. (1) Bag of pepperoni, undated, unlabeled 19. (1) Bag of crinkled fries, opened and undated 20. (1) Bag of plain omelets, opened and undated 21. (1) Bag of sugar cookies, opened and undated 22. (2) Chicken patties opened and undated 23. (1) Bag of fish filets, opened and undated 24. (1) Bag of carrots opened, undated, freezer burned In th… | 2020-09-01 |
| 2272 | 2272 | MAGNOLIA MANOR - ROCK HILL | 425165 | 127 MURRAH DR | ROCK HILL | SC | 29732 | 2017-04-21 | 372 | D | 0 | 1 | 9IUY11 | Based on observation and review of the U.S. Food Code, Section 5-521.113, the facility failed to dispose of garbage and refuse properly for 1 of 1 dumpster reviewed for garbage disposal. One of one dumpster's lids were opened with garbage and debris visible. The findings included: On 4-17-17 at approximately 1:16 pm, an observation was made by two surveyors that the facility's dumpster, located outside behind the dietary department was noted to have the side door ajar, with bags of garbage and debris inside the containers. There were three cats observed near the dumpster. Policies concerning trash disposal were requested but were not provided. The U.S. Food Code, Section 5-521.113, states, Receptacles and waste handling units for refuse and returnables shall be kept covered. | 2020-09-01 |
| 2273 | 2273 | MAGNOLIA MANOR - ROCK HILL | 425165 | 127 MURRAH DR | ROCK HILL | SC | 29732 | 2017-04-21 | 428 | E | 0 | 1 | 9IUY11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview, the Registered Pharmacist (RPH) did not identify irregularity related to Exelon patch not rotated for Resident #30, 1 of 1 resident reviewed with Exelon patch. The findings included: The facility admitted Resident #30 with [DIAGNOSES REDACTED]. Record review on 4/20/2017 at 10:07 AM, revealed a physician's orders [REDACTED]. Review of the (Medication Administration Record) MAR indicated [REDACTED]. The MAR indicated [REDACTED]. There was a body grid in the MAR indicated [REDACTED]. On 4/20/2017 at 2:30 PM, Licensed Practical Nurse (LPN) verified that the grid was not current. LPN #5 said, The way they are supposed to use the grid is, if today is the 20th day of the month, then they are supposed to rotate the site indicated for the 20th day of the month. On 4/20/2017 at approximately 3:00 PM, LPN #2 also verified that the grid in the MAR indicated [REDACTED]. She knew the patch was supposed to be moved daily. The same documentation was on MAR for the months of (MONTH) to (MONTH) (YEAR). Review of the MAR for the 4/1/17 through 4/14/17 revealed that the initials LC (left chest?) were noted on 4-1, 4-4, and 4-10-17. The initials RC(right chest?) were noted on 4-3 and 4-7. From 4/15 through 4/20/17 the patch was placed on LC on 4-15, 4-18, 4-20 and the patch was placed on RC on 4-17 and 4-19. Manufacturer's Recommendations for Exelon Patches state: It is recommended that the site of patch application be changed daily to avoid potential irritation, although consecutive patches can be applied to the same anatomic site (e.g., another spot on the upper back). The same site should not be used within 14 days. On 4/20/2017 at approximately 3:00 PM a review of the RPh monthly documentation of the Pharmacy Progress Notes for Resident #30 revealed that the RPh conducted review with no irregularity documented related to the Exelon patch with the same pattern of patch application reviewed from (MONTH) to (MONTH) of (YEAR… | 2020-09-01 |
| 2274 | 2274 | MAGNOLIA MANOR - ROCK HILL | 425165 | 127 MURRAH DR | ROCK HILL | SC | 29732 | 2017-04-21 | 441 | E | 0 | 1 | 9IUY11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations, interviews, and review of both medical records and facility policies, the facility failed to follow procedures to prevent transmission of communicable diseases and infection for one of one resident reviewed on isolation and one of one resident reviewed for tracheostomy. The Findings included: Review of the medical record on 4/21/17 at 3:00 PM revealed Resident #173 was admitted to facility on 4/7/2017 with [DIAGNOSES REDACTED]. Further review revealed that on 4/15/17 Resident #173 was placed on isolation related to Urine Culture results that indicated >100,000 colony-forming units (cfu)/ mL (milliliter) of [MEDICATION NAME] Resistant [MEDICATION NAME] (VRE) During interview on 4/17/17 at 11:03 AM, RN #1 verified that Resident #173 was on contact isolation due to [MEDICATION NAME] Resistant [MEDICATION NAME] (VRE) identified on urine culture results that were received this weekend. Review of Infection Prevention and Control Policy and procedure on 4/20/17 at 10:30 AM revealed that for any resident under Contact Isolation gloves should be worn when having prolonged contact with surfaces in the resident's room that may have a concentration of organisms, such as bedrails, commode chairs, etc. After care rendered, staff should remove gloves before leaving the resident's environment and wash hands immediately with an antimicrobial agent or waterless antiseptic agent, if running water is not available. Observation on 4/20/17 at 8:50 AM revealed C.N.[NAME] #3, C.N.A #4 and LPN #6 in Resident #173's room not wearing any personal protective equipment (PPE). C.N.[NAME] #3 was standing and leaning against bedrail while feeding Resident #173. C.N.[NAME] #3 was then observed leaving Resident #173's room without washing her/his hands and left to enter other resident's rooms. LPN #6 did not don PPE to administer medications to Resident #173. During interview, C.N.[NAME] #3 stated that they only have to dress out when doing care. LPN #6… | 2020-09-01 |
| 2275 | 2275 | MAGNOLIA MANOR - ROCK HILL | 425165 | 127 MURRAH DR | ROCK HILL | SC | 29732 | 2017-04-21 | 463 | E | 0 | 1 | 9IUY11 | Based on observation and interview, the facility failed to provide adequate access of communication to nursing staff by having call lights in Rooms #32 and #16 not functioning for 3 days of the survey on 1 of 3 units toured. The findings included: An observation was made on 4-18-17 at 2:54 p.m. in Room 16 that the call light was not operational. The button was pressed twice and had no sound or light to indicate functioning. An observation was made on 4-18-17 at 8:23 a.m. in Room 32 that the call light was not operational. During the environmental tour on 4-20-17 at 6:50 p.m. with the Maintenance Manager and Housekeeping Supervisor, the above concerns were brought to their attention and confirmed that the affected rooms had been without functioning call lights for 3 days of the survey. | 2020-09-01 |
| 2276 | 2276 | MAGNOLIA MANOR - ROCK HILL | 425165 | 127 MURRAH DR | ROCK HILL | SC | 29732 | 2017-04-21 | 467 | E | 0 | 1 | 9IUY11 | Based on observation and interview, the facility failed to maintain proper ventilation for multiple rooms reviewed on 2 of 3 units (Units 2 and 3). The findings included: Proper ventilation to resident's restrooms were noted to be in disrepair in the following rooms reviewed: Unit 3: Room 2 - On 4-18-17 at 10:37 a.m. there were no ventilation sounds heard from the exhaust vent in the restroom. Room 3 - On 4-18-17 at 10:44 a.m. there were no ventilation sounds heard from the exhaust vent in the restroom. Room 8 - On 4-17-17 at 5:06 p.m. there were no ventilation sounds heard from the exhaust vent in the restroom. Unit 2 : Room 15 - On 4-18-17 at 2:24 p.m. there were no ventilation sounds heard from the exhaust vent in the restroom. Room 16 - On 4-18 at 2:54 p.m. there were no ventilation sounds heard from the exhaust vent in the restroom. Room 19 - On 4-18-17 at 3:02 p.m. there were no ventilation sounds heard from the exhaust vent in the restroom. Room 22 - on 4-18-17 at 3:11 p.m. there were no ventilation sounds heard from the exhaust vent in the restroom. Room 29 - On 4-18-17 at 10:33 a.m. there were no ventilation sounds from the exhaust vent in the restroom. These findings were reviewed and confirmed with the Maintenance Manager during the environmental tour at 6:50 p.m. on 4-20-17. S/he verified that the exhaust vents were not operational. | 2020-09-01 |
| 2277 | 2277 | MAGNOLIA MANOR - ROCK HILL | 425165 | 127 MURRAH DR | ROCK HILL | SC | 29732 | 2017-04-21 | 505 | E | 0 | 1 | 9IUY11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interviews, the facility failed to notify the physician in a timely manner of abnormal laboratory results requiring potential physician intervention as indicated for the residents' care for two of six sampled residents reviewed for unnecessary medication (Residents #8, #49). The findings included: The facility admitted Resident #49 with [DIAGNOSES REDACTED]. Record review at 9:17 AM on 4-21-17 revealed physician's orders [REDACTED]. Review of the lab reports revealed that the (MONTH) labs were drawn and reported on 8-11-16 with multiple abnormal results. There was no evidence in the medical record that the physician/extender was notified until the report was signed by the Nurse Practitioner on 8-15-16. Further review revealed that the (MONTH) labs were drawn and reported on 2-2-17 with multiple abnormal results. There was no evidence in the medical record that the physician/extender was notified until the report was signed by the Nurse Practitioner on 2-6-17. A HgbA1c and [MEDICATION NAME] were drawn and reported on 1-9-17 with multiple abnormal results. In this instance, there was no evidence of physician/extender notification at all. Additionally, a CBC, BMP (Basic Metabolic Panel), and HgbA1c were drawn and reported on 1-10-17 with multiple abnormal results. There was no evidence in the medical record that the physician/extender was notified until the report was signed by the Nurse Practitioner on 1-13-17. During an interview on 4-21-17 at 12:04 PM about the lab process, Licensed Practical Nurse (LPN) #2 stated, I enter the lab in the computer to be done. When results come back. if abnormal, we notify the doctor. S/he stated this would be found in the Nurse's Notes. The LPN reviewed the medical record and verified the dates the Nurse Practitioner signed the lab reports but was unable to locate any further information. S/he stated, The facility changed labs because we had problems with getting timely receipt of re… | 2020-09-01 |
| 3180 | 3180 | L.M.C.- EXTENDED CARE | 425321 | 815 OLD CHEROKEE ROAD | LEXINGTON | SC | 29072 | 2017-04-21 | 157 | E | 0 | 1 | ZZ1W11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on staff interview and clinical record review, the facility failed to notify the physician and responsible party of resident to resident physical and sexual altercations, in which R215 was the aggressor, for 6 of 57 stage 2 sampled residents (R) (R215, R405, R400, R236, R326, and R406). In addition, R215's responsible party was not notified of a new medication prescribed. These failures created the potential for a lack of physician intervention and family involvement and support when abuse incidents occurred. Findings include: Review of R215's Annual Minimum Data Set assessment (MDS) (a resident assessment tool), dated 1/20/17, revealed the resident was admitted to the facility on [DATE] with diagnosed including: [DIAGNOSES REDACTED]. The 1/20/17 MDS assessment revealed R215 was moderately cognitively impaired (Brief Interview for Mental Status (BIMS) score of 10 out of 15). Section E, Behavior, documented R215's physical and sexual behavioral symptoms directed toward others. Seven incidents of physical or sexual aggression, in which R215 was the aggressor, occurred between 8/7/16 and 4/19/17. R215 was physically or sexually aggressive towards R405, R236, R400, R326, R406 and an unidentified female resident. The facility failed to notify R215's physician and responsible party (RP) as well as the RP and physician for R405, R236, R400, R326, R406 of these incidents. 1) 8/7/16 Incident Between R215 and R405 Review of R215's nursing progress notes on 4/21/17 revealed on 8/7/16 at 6:23 p.m.Resident (R215) observed attempting to kiss R405. When stopped by this nurse R215 briefly became argumentative and made one attempt to repeat behavior. Residents were physically separated by this nurse . No documentation was found which indicated the RP or the physician of R215 were notified of the incident. R405's medical record was reviewed. No documentation was found which indicated the RP or physician for R405 were notified of the incident. 2) 8/21/16 … | 2020-09-01 |
| 3181 | 3181 | L.M.C.- EXTENDED CARE | 425321 | 815 OLD CHEROKEE ROAD | LEXINGTON | SC | 29072 | 2017-04-21 | 221 | D | 0 | 1 | ZZ1W11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations, interview, manufacturer guidelines, policy and procedure, and record review, the facility failed to ensure 3 of 57 stage 2 sampled residents (R) (R228, R323 and R197) were free from the use of restraints; the restraints were not applied according to manufacturer guidelines or the facility policy and procedure. Findings include: 1. Review of the Resident Face Sheet revealed R228 was admitted to the facility on [DATE] with a pertinent [DIAGNOSES REDACTED]. rising. The computerized physician order for [REDACTED]. Review of R228's quarterly Minimum Data Set ((MDS) dated [DATE], indicated R228 had short and long-term memory problems, was severely impaired and never/rarely made decisions related to cognitive skills for daily decision-making. R228 used a trunk restraint while seated in the chair or out of bed. The manufacturer's guidelines for the Economy Wheelchair Belt listed the following contraindications for use: Slides down in the wheelchair and is in a geri-chair or lounge chair. This device is intended for wheelchair use only. Review of the facility's policy Protective Device/Restraint Policy dated 9/16/15 indicated Physical Restraints are any manual method or physical or mechanical device, material, or equipment attached or adjacent to the resident's body that the individual cannot remove easily which restricts freedom of movement or normal access to one's body . Before a resident is restrained, the facility must demonstrate the presence of a specific medical symptom that would require the use of restraints, and how the use of restraints would treat the cause of the symptom . Appropriate exercise, therapeutic interventions . pillows, pads . often assist in achieving proper body position, balance and alignment, without the potential negative effects associated with restraint use. The procedures for this policy indicated . require a physician's order . medical condition requiring use . Nursing should ensure the restrain… | 2020-09-01 |
| 3182 | 3182 | L.M.C.- EXTENDED CARE | 425321 | 815 OLD CHEROKEE ROAD | LEXINGTON | SC | 29072 | 2017-04-21 | 225 | K | 0 | 1 | ZZ1W11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, record review, and policy review, the facility failed to report to the state survey agency and to the administrator incidents of potential abuse, thoroughly investigate incidents of resident to resident physical and sexual altercations/abuse perpetuated by resident (R) R215 and R369, and implement follow up interventions for 7 of 57 stage 2 sampled residents (R) (R37, R215, R405, R236, R400, R326, R406 and an unknown female resident). Additionally, a reported incident of staff to resident abuse towards R471 was not adequately investigated. Specifically: The facility failed to ensure aggressive behaviors of R215 towards other residents were thoroughly investigated by the facility, reported to the state survey agency and administrator, and sufficient interventions were implemented to keep the remaining 43 residents who resided on the secure unit safe from harm inflicted by R215. R215, who was cognitively impaired but at a higher cognitive level than the residents he targeted, exhibited aggressive physical behaviors towards residents on 3 occasions and sexually aggressive behaviors towards residents on 4 occasions between 8/7/16 and 4/19/17. The residents assaulted by R215 were R405, R236, R400, R326, R406 and an unknown female resident. Investigations into the incidents and protective measures to prevent recurrence were lacking creating an unsafe environment in the secure unit which perpetuating future incidents of abuse. The facility's failure to report, investigate, and implement interventions to prevent abuse was likely to cause serious injury, harm, impairment or death to a resident. Immediate Jeopardy was identified to have existed on 8/7/16 at 6:23 p.m. when R215 was first sexually aggressive towards R405. The administrator and director of nursing (DON) were informed of the Immediate Jeopardy on 4/21/17 at 2:42 p.m. An acceptable Allegation of Compliance (AoC) for removal was received on 4/21/17 and the im… | 2020-09-01 |
| 3183 | 3183 | L.M.C.- EXTENDED CARE | 425321 | 815 OLD CHEROKEE ROAD | LEXINGTON | SC | 29072 | 2017-04-21 | 226 | K | 0 | 1 | ZZ1W11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, record review, policy review and interview, the facility failed to ensure the abuse policy and procedure was adequate, providing sufficient detail and direction to staff in the areas of reporting, investigating, and follow up in response to incidents of resident to resident abuse. The facility's current policies and procedures were insufficient in these areas. Staff failed to report and investigate 7 instances of resident to resident sexually or physically aggressive behaviors by resident (R) R215 towards 6 residents (R400, R406, R405, R236, R326, and one unknown female resident) and 1 incident of resident to resident physically aggressive behavior by R369 towards R37. All 8 instances took place in the secure unit where a total of 44 residents resided. In none of these 8 instances, was a report made to the state agency, a thorough investigation completed or sufficient interventions implemented to prevent recurrence. Additionally, R471 reported an allegation of abuse; a thorough investigation was not conducted. The facility's failure to ensure the abuse policy was adequate to prevent the occurrence of resident to resident abuse was determined to be likely to cause serious injury, harm, impairment, or death to a resident; thus, immediate jeopardy was identified on 4/21/17 at 2:42 p.m. All 43 residents who resided on the secure unit with R215 were at risk of abuse from R215 as well as other residents with allegations of abuse that might not be thoroughly investigated. The immediate jeopardy was determined to first exist on 8/7/16 at 6:23 p.m., when R215 was first sexually aggressive towards another resident on the secure unit. The facility's Administrator and Director of Nursing (DON) were informed of the immediate jeopardy on 4/21/17 at 2:42 p.m. An acceptable Allegation of Compliance (AoC) for removal was received, and approved, by the state survey agency on 4/21/17 at 6:20 p.m. Following removal of the immediate jeopardy… | 2020-09-01 |
| 3184 | 3184 | L.M.C.- EXTENDED CARE | 425321 | 815 OLD CHEROKEE ROAD | LEXINGTON | SC | 29072 | 2017-04-21 | 242 | D | 0 | 1 | ZZ1W11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, the facility failed to ensure the resident and/or representative were given a choice regarding the frequency of bathing for 2 of 57 stage 2 sampled residents (R) (R205 and R208). Findings include: 1. R205 was admitted to the facility on [DATE], with [DIAGNOSES REDACTED]. The 1/20/17 annual Minimum Data Set (MDS) assessment indicated the resident had a BIMs (brief interview for mental status) score of 15 out of 15 demonstrating no cognitive impairment; the resident was coded for receiving extensive assistance of one person for bathing. Review of the 2/14/17 care plan for continence indicated the resident experienced occasional episodes of urinary incontinence. The 2/14/17 care plan for Activities of Daily Living (ADLs) lacked approaches for the frequency of the resident's shower. Review of R205's shower sheets indicated the resident received 13 showers and 6 bed baths (19 bathing experiences) from 1/26/17 through 4/18/17 (11.5 weeks, or 83 days). During an interview on 4/18/17 at 10:40 a.m., resident 205 indicated I just need more showers. I am a lady and I like to be clean. The resident indicated she had told the staff before she wanted more showers. During an interview on 4/20/17 at 9:33 a.m., resident 205 indicated they give us a shower two times a week and I want a shower every day. 2. R208 was admitted to the facility on [DATE], with [DIAGNOSES REDACTED]. The 2/10/17 quarterly MDS assessment indicated the resident had short and long term memory problems, and was severely impaired with decision-making. The MDS indicated the resident had no behavior problems and was dependent on staff for her activities of daily living. The MDS indicated the resident was always incontinent of bowel and bladder. The 5/28/16 care plan for ADLs, with the target date of 6/10/17, lacked documentation of approaches for the frequency of the resident's bathing. Review of R208's facility's shower sheets from 1/1/17 through 4/18/… | 2020-09-01 |
| 3185 | 3185 | L.M.C.- EXTENDED CARE | 425321 | 815 OLD CHEROKEE ROAD | LEXINGTON | SC | 29072 | 2017-04-21 | 246 | D | 0 | 1 | ZZ1W11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, record review and staff interview, the facility failed to ensure 3 of 57 stage 2 sampled residents (R) (R147, R287 and R358) were provided with accommodations during meals related to dining room tables being too high. Findings include: 1. R147 had [DIAGNOSES REDACTED]. Review of the 1/6/17 quarterly Minimum Data Set (MDS) assessment demonstrated the resident was severely impaired in cognition. Coding on the 1/6/17 MDS indicated the resident required extensive, 1 person assist at meals. R358 had [DIAGNOSES REDACTED]. Review of the 3/10/17 annual MDS assessment demonstrated the resident was severely impaired in cognition. Coding on the 3/10/17 MDS indicated the resident required extensive, 1 person assist at meals. On 4/20/17 during the noon meal at 1:00 p.m., R147 and R358 were observed sitting in low geri-chairs being assisted by 2 CNAs in the Lexington dining room. Overbed tables were placed across the resident's chairs. There were a total of 5 adjustable tables with 1 empty adjustable table near where they were sitting, as well as an empty non-adjustable table. CNA5 was interviewed at this time and said, We use these tables because a regular table is too high for these low chairs. Further observation indicated there were five adjustable tables in the Lexington dining room, one which was empty. 2. R287 had [DIAGNOSES REDACTED]. Review of the 2/10/17 annual MDS assessment demonstrated the resident was severely impaired in cognition (Brief Interview for Mental Status score of 2 out of a possible 15). Coding on the 2/10/17 MDS indicated the resident required extensive, 1 person assist during meals. An observation on 4/20/17 at 12:45 p.m. revealed the resident was sitting in a low geri-chair. The height of the dining table came across the resident's chest. The resident was having difficulty seeing over her cups to see what kind of liquid was in them. During an interview on 4/20/17 at 12:50 p.m., CNA13 indicated the table wa… | 2020-09-01 |
| 3186 | 3186 | L.M.C.- EXTENDED CARE | 425321 | 815 OLD CHEROKEE ROAD | LEXINGTON | SC | 29072 | 2017-04-21 | 252 | E | 0 | 1 | ZZ1W11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation and staff interviews, the facility failed to provide a homelike environment during the meal service related to not removing dishes, silverware or glasses from trays and placing the tray in front of the residents for 2 of 9 dining rooms (Caughman and Lexington Units). Findings include: During the meal service in the Caughman dining room on 4/18/17 at 12:38 p.m., the Certified Nurse Aides (CNAs) were observed placing the residents' meal trays in front of them. The CNAs did not remove the dishes, glasses or silverware from the trays. The dining room tables did not have tablecloths or decorations on them. During the meal service in the Lexington dining room on 4/18/17 at 1:27 p.m., the CNAs were observed serving the residents' meals on trays and placing the trays in front of them. The tables were bare of tablecloths and/or decorations. During a meal observation in the Lexington dining room on 4/20/17 at 1:00 p.m., the CNAs were observed serving the residents' meals on trays and placing the trays in front of them. The tables remained void of tablecloths and/or decorations. During the exit conference on 4/21/17 beginning at 8:45 p.m., the Administrator indicated he had eaten off trays for [AGE] years and was never bothered by it. | 2020-09-01 |
| 3187 | 3187 | L.M.C.- EXTENDED CARE | 425321 | 815 OLD CHEROKEE ROAD | LEXINGTON | SC | 29072 | 2017-04-21 | 280 | D | 0 | 1 | ZZ1W11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on resident interview, staff interview, review of the facility's policy and procedure, and medical record review, the facility failed to ensure the staff developed and implemented a person-centered, comprehensive plan of care for 3 out of 57 stage 2 sampled residents (R) (R72, R400 and R228). Specifically, the facility did not revise R72's care plan for falls, R400's care plan for behaviors, or R228's care plan for mobility status and wandering behaviors. Findings Include: Review of the facility's Standard Policy/Procedure, No. 12-07 Subject: Fall Prevention Program, dated 2/26/16, indicated, Evaluating . The Falls Incident Report is completed by the nurse on the unit the fall occurred. It is important to collect the facts surrounding the fall at the time they occur. This nurse will initiate the Falls Event in the electronic health record. 3. An Acute Care Plan for falls will be initiated unless a care plan for falls is already in place. The current care plan would then be updated to reflect the fall. 1. Review of R72's Resident Face Sheet, printed on 4/21/17, indicated the facility admitted the resident on 1/14/10 with a re-admission on 2/1/17. R72 had [DIAGNOSES REDACTED]. Review of R72's quarterly Minimum Data Set (MDS), a comprehensive assessment completed by facility staff that drives the care planning process, with an assessment reference date (ARD) of 2/13/17, documented R72 had a Brief Interview for Mental Status (BIMS) score of 15/15 indicating no cognitive impairment. R72 exhibited verbal behavioral symptoms not directed toward others. R72 required extensive assistance of one for bed mobility, dressing, and toilet use and limited assistance of one for transfers. She was frequently incontinent of bladder and occasionally incontinent of bowel, and she was not on a toileting program. R72 also received a daily diuretic and antianxiety medication. Review of R72's Care Plan, dated 6/1/14 and last edited on 3/1/17, documented, Potent… | 2020-09-01 |
| 3188 | 3188 | L.M.C.- EXTENDED CARE | 425321 | 815 OLD CHEROKEE ROAD | LEXINGTON | SC | 29072 | 2017-04-21 | 323 | K | 0 | 1 | ZZ1W11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, record review, and policy review, the facility failed to provide adequate supervision and implement interventions to prevent resident to resident altercations and/or a fall for 8 of 57 stage 2 sampled residents (R) (R37, R72, R215, R405, R236, R400, R326, R406), an unknown female resident, and 43 residents residing on the secure unit with R215. Specifically, -The facility failed to ensure aggressive behaviors of R215 towards other residents were addressed and sufficient interventions were implemented to keep the remaining 43 residents who resided on the secure unit safe from harm inflicted by R215. R215, who was cognitively impaired yet at a higher cognitive level than his victims, exhibited aggressive physical behaviors towards residents on 3 occasions and sexually aggressive behaviors towards residents on 4 occasions between 8/7/16 and 4/19/17. The residents assaulted by R215 were R405, R236, R400, R326, R406 and an unknown female resident. The facility failed to notify R215's physician of the physically and sexually aggressive incidents; subsequently, there was a lack of physician response to the incidents. Investigations into the incidents and protective measures to prevent recurrence were lacking creating an unsafe environment in the secure unit. The facility's failure to provide supervision to keep residents safe from R215 was likely to cause serious injury, harm, impairment or death to a resident. Immediate Jeopardy was identified to have existed on 8/7/16 at 6:23 p.m. when R215 was first sexually aggressive towards R405. The administrator and director of nursing (DON) were informed of the Immediate Jeopardy on 4/21/17 at 2:42 p.m. An acceptable Allegation of Compliance (AoC) for removal was received on 4/21/17 and the immediate jeopardy was removed on 4/21/17 at 6:20 p.m. The scope and severity was lowered to a E, pattern at potential for more than minimal harm, once the immediate jeopardy was removed.… | 2020-09-01 |
| 3189 | 3189 | L.M.C.- EXTENDED CARE | 425321 | 815 OLD CHEROKEE ROAD | LEXINGTON | SC | 29072 | 2017-04-21 | 332 | D | 0 | 1 | ZZ1W11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, record review and interview, the facility failed to ensure medication errors were prevented for 2 of 27 medications observed being administered. Resident (R)7 did not receive the entire dose of medication ordered and staff did not ensure an injectable medication was given to the correct resident, R527. The facility medication error rate was 7.41 percent. Findings include: 1. Review of (MONTH) (YEAR)'s Physician order [REDACTED]. On 4/7/17, a physician order [REDACTED]. Observation on 4/20/17 at 8:44 a.m. revealed Licensed Practical Nurse (LPN)3 handed a prepared [MEDICATION NAME] nebulizer mouthpiece to R7, who slowly and weakly held it to his mouth. LPN3 informed him she would be back when it was completed and exited the room. At 8:46 a.m., R7 was observed with his eyes closed, no longer holding the nebulizer to his mouth and mist was observed continuing to come out of the mouth piece as it lay on the bed next to R7's thigh. LPN3 did not enter R7's room during the continuous observation. However, Registered Nurse (RN) 1 entered the room at 8:48 a.m. and stated she found the mouth piece lying on the bed; since he was finished with the medication, she turned the nebulizer off and put it back in the respiratory bag. Upon request, RN1 held it up, revealing there was still liquid medication remaining in the reservoir. RN1 exited R7's room [ROOM NUMBER] seconds later stating she had turned the nebulizer back on. After speaking with LPN3 in the hall, leaving R7 out of site, RN1 walked down the hallway away from R7's room. LPN3 continued to prepare medications for other residents out of sight of R7. The surveyor maintained continuous observation of R7 revealing he again was not holding the nebulizer to his mouth, as it was lying on the bed, still running with mist coming from the mouthpiece. Interview on 4/21/17 at 10:05 a.m. with Nurse Manager (NM)2, revealed, When the nebulizer is handed to the resident and they (nurses) see … | 2020-09-01 |
| 3190 | 3190 | L.M.C.- EXTENDED CARE | 425321 | 815 OLD CHEROKEE ROAD | LEXINGTON | SC | 29072 | 2017-04-21 | 431 | D | 0 | 1 | ZZ1W12 | Deficiency Text Not Available | 2020-09-01 |
| 3191 | 3191 | L.M.C.- EXTENDED CARE | 425321 | 815 OLD CHEROKEE ROAD | LEXINGTON | SC | 29072 | 2017-04-21 | 441 | E | 0 | 1 | ZZ1W11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview and policy review, the facility failed to maintain accepted infection control standards for 2 of 57 stage 2 sampled residents in 1 of 9 dining rooms (Resident (R)7 and R63). Specifically, the facility: -failed to ensure sanitation of nasal medication, -failed to ensure sanitation of respiratory equipment, and -failed to ensure staff handled clothing protectors properly. Findings Include: 1. Respiratory equipment During the initial tour on 4/18/17 at 10:15 a.m., the nebulized mist treatment (NMT) set-ups for R7 and R63 were observed still intact, with the masks and medication cups still attached to the tubing, contained in closed plastic bags. Condensation was noted in the medication cups. The NMT mouthpiece for R7 was observed to have dried brown residue on it. On 4/19/17 at 2:00 p.m., the NMT set-ups for R7 and R63 were observed still intact, with the masks and medication cups still attached to the tubing, contained in closed plastic bags. Condensation was noted in the medication cups. The NMT mouthpiece for R7 had dried brown residue on it. During an interview with the Respiratory Therapist Director (RTD) on 4/19/16 at 1:00 p.m., she stated the NMT set-ups were to be changed weekly and we follow the manufacturer's instructions for cleaning after use. According to the Air Care, NMT manufacturer's website, instructions for cleaning after each use were Rinse the mask or mouthpiece with warm water for at least half a minute. Shake off excess water and place parts on a clean towel for air-drying. Review of the Hand Held Nebulizer policy dated 5/12/11 indicated, in pertinent part, Step 13 following therapy, discard any residual medication and cover unit with dry plastic bag. Review of the Administration of Nebulized Solutions Policy revealed Step 14 clean nebulizer per manufacturer's instructions. 2. Nasal medication According to the undated admission face sheet, R7 was admitted to the facility on [DATE]. The face … | 2020-09-01 |
| 3192 | 3192 | L.M.C.- EXTENDED CARE | 425321 | 815 OLD CHEROKEE ROAD | LEXINGTON | SC | 29072 | 2017-04-21 | 490 | K | 0 | 1 | ZZ1W11 | Based on observations, interviews, record review, and policy review, the facility failed to ensure it was administered in a manner to ensure effective use of its resources to prevent abuse, investigate abuse, and promote a culture and environment free of abuse for 42 residents who lived on the secure unit (all residents on the secure unit except for resident (R) R369 and R215) and for 1 resident (R471) with a reported allegation of abuse. Specifically: The facility failed to ensure aggressive behaviors of R215 towards other residents were reported, investigated, and sufficient interventions were implemented to keep the additional 43 residents who resided on the secure unit safe from potential harm. R215 was found to have exhibited aggressive physical behaviors on 3 different occasions and sexual behaviors on 4 different occasions toward residents R400, R406, R405, R236, R326 and an unknown female resident. The facility's failure to be administered in an effective manner to keep residents safe from R215 was likely to cause serious injury, harm, impairment or death to a resident. Immediate Jeopardy was identified to have existed on 8/7/16 at 6:23 p.m. when R215 was first sexually aggressive towards R405. The facility's administrator and director of nursing (DON) were informed of the Immediate Jeopardy on 4/21/17 at 2:42 p.m. Findings include: 1. Job Descriptions According to the administrator's job description, dated 5/2014, under Miscellaneous it read .assure that all residents receive care in a manner and in an environment, that maintains or enhances their quality of life without abridging the safety and rights of other residents . According to the Director of Nursing's (DON) job description, dated 7/02, it stated under Major Duties and Responsibilities - Administrative Functions bullet 1.plan, develop, organize, implement, evaluate and direct the Nursing Services Department, as well as its programs and activities in accordance with current rules, regulations and guidelines that govern the long-term care facility… | 2020-09-01 |
Advanced export
JSON shape: default, array, newline-delimited
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 );