cms_SC
Data source: Big Local News · About: big-local-datasette
110 rows where "filedate" is on date 2016-06-01
This data as json, copyable, CSV (advanced)
Suggested facets: facility_name, facility_id, address, city, zip, inspection_date, scope_severity, complaint, standard, eventid, inspection_date (date), filedate (date)
| Link | rowid ▼ | facility_name | facility_id | address | city | state | zip | inspection_date | deficiency_tag | scope_severity | complaint | standard | eventid | inspection_text | filedate |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 8195 | 8195 | CHERAW HEALTHCARE | 425005 | 400 MOFFAT ROAD | CHERAW | SC | 29520 | 2013-06-12 | 281 | D | 1 | 0 | YGJV11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the complaint inspection, based on interviews, record reviews and facility policy review, the facility failed to provide the correct insulin coverage for 1 of 4 residents reviewed for insulin administration. Resident #1 did not receive the correct insulin coverage for 3 elevated blood sugar readings during the month of February 2013. The findings included: Resident #1 was admitted to the facility with [DIAGNOSES REDACTED]. A review of the quarterly assessment dated [DATE] revealed that Resident #1 was coded as having a short-term and long-term memory problems with severely impaired cognitive skill for daily decision-making. The MDS (material data set) also coded the resident as needing a one-person assist for ADL (activity of daily living) care. The resident height was documented at 59 inches with a weight of 106 pounds. A review of the closed record on 6/12/13 at 9:15 AM revealed that Resident #1 received sliding scale [MEDICATION NAME] for blood sugars beyond the parameters set by the physician. The physicians order for the sliding scale parameters were as follows: for blood sugars above 200 milligrams/deciliter (mg/dl) give 2 units of [MEDICATION NAME]; above 250 mg/dl give 4 units of [MEDICATION NAME]; above 300 mg/dl give 6 units of [MEDICATION NAME]; above 350 mg/dl 8 units of [MEDICATION NAME]; above 400 mg/dl give 10 units of [MEDICATION NAME]. A review of the MAR (medication administration record) for February 2013 revealed blood glucose readings with incorrect insulin coverage based on the physicians orders: 2/11/13 at 9 PM blood glucose level=362, the resident received 6 units of [MEDICATION NAME] 2/12/13 at 9 PM blood glucose level=377, the resident received 6 units of [MEDICATION NAME] 2/16/13 at 9 PM blood glucose level=377, the resident received 6 units of [MEDICATION NAME] The blood glucose levels were above the 350 mg/dl level and the resident should have received 8 units of [MEDICATION NAME] instead of the 6 u… | 2016-06-01 |
| 8196 | 8196 | HEARTLAND OF COLUMBIA REHAB AND NURSING CENTER | 425008 | 2601 FOREST DRIVE | COLUMBIA | SC | 29204 | 2013-02-21 | 329 | D | 0 | 1 | CSJ811 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the Complaint and Recertification Survey, based on limited record review and interviews, the facility nursing staff failed to appropriately document behaviors for Resident #13 (1 of 16 sampled residents reviewed with psychoactive medications) relative to the administration of one time doses of Intramuscular (IM) [MEDICATION NAME] and [MEDICATION NAME] along with PRN (As Needed) doses of [MEDICATION NAME]. Resident #13 did not receive [MEDICATION NAME] as ordered x 2 doses after an ordered increase in dosage. The findings included: The facility admitted Resident #13 with [DIAGNOSES REDACTED]. While in the facility, Resident #13 was diagnosed with [REDACTED]. Resident #13 was discharged home from the facility on 12/19/12. The closed chart was reviewed. Record review on 2/20/12 revealed a Physician's Telephone Order dated 11/22/12 at 1:00 PM which stated [MEDICATION NAME] 5 mg/ml (milliliter) IM now. The indication for the use of the [MEDICATION NAME] was documented on the order as having been for agitation. Review of the November 2012 Medication Administration Record [REDACTED]. Review of facility Progress Notes revealed a note dated 11/22/12 at 1:42 PM which stated, Resident is alert, responsive and up in w/c (wheelchair) at this time. No adverse reactions to medications, no c/o (complaints of) pain or distress noted on shift. Tx (Treatment) completed with no complications noted. No falls noted on shift. Peg tube patent, flushing and running at this time. VS (Vital Signs) 111/57, 98.7, 80, 20. RP (Responsible Party) notified of new order: [MEDICATION NAME] 5 mg/ml IM now, RE: agitation. There were no Progress Notes prior to this entry that documented any behaviors the resident was exhibiting, the severity of behavior, or an escalation in behaviors to indicate a need for the [MEDICATION NAME]. There was no documentation of any other interventions that had been attempted prior to the administration of the [MEDICATION NAME]. The re… | 2016-06-01 |
| 8197 | 8197 | HEARTLAND OF COLUMBIA REHAB AND NURSING CENTER | 425008 | 2601 FOREST DRIVE | COLUMBIA | SC | 29204 | 2013-02-21 | 371 | E | 0 | 1 | CSJ811 | On days of the survey, based on observation, interviews and review of facility policy, the facility failed to ensure food was prepared, distributed and served under sanitary conditions, kitchen staff were not wearing proper hair restraints and food was not served at the correct temperature. The findings included: On all days of the survey Food Service Worker #1 did not use a beard protector. Food Service Worker #2 was observed wearing a ball cap but hair was touching below the collar and not restrained. Interviews on 2/9/13 at approximately 11:00 AM and again on 2/21/13 at approximately 8:39 AM with the Operations Manager, verified no proper hair restraints were used. Steam table temperatures of the lunch meal on 2/20/13 at approximately 12:10 PM by Food Service Worker #1 revealed Macaroni Salad , the menu alternate, was at 51 degrees Fahrenheit. An interview with Food Service Worker #1 verified that the Macaroni Salad, the menu alternate, was not 41 degrees Fahrenheit. He/she stated the Macaroni Salad was just put in the refrigerator. | 2016-06-01 |
| 8198 | 8198 | FAITH HEALTHCARE CENTER | 425009 | 617 WEST MARION STREET | FLORENCE | SC | 29501 | 2012-08-22 | 174 | E | 0 | 1 | RTYQ11 | On the days of the survey, based on the Group Meeting concerns and interviews, the facility failed to provide a portable phone that would function adequately throughout the building or in the 3 of 3 nursing unit halls . The findings included: During the Resident Group Meeting on 8/21/12 at 3:30pm, 2 of 3 Residents who attended the meeting voiced concerns related to portable phone usage. The facility had portable phones on all 3 nursing units. The Resident's stated the Staff bring the portable phone to you, but it will not work everywhere in the building. During an interview with Gwendolyn Turner, Social Worker (SW) on 8/22/12 at 9:45am, Surveyor reviewed the Resident's concerns discussed at the Group Meeting. The SW was not aware that the portable phones would not work throughout the building. During an interview with the SW on 8/22/12 at 2:30pm, the SW verified that the portable phones on all 3 nursing units worked half way down the hall then would shut off. The SW stated the Administrator verified the portable phones did not work in all areas of the building and was working on replacing the portable phones at this time. Review of the Resident Concern/Grievance Response Form, on 8/22/12 at 2:45pm, verified The facility replaced all cordless phones at each nurses station for the residents to use when in room. | 2016-06-01 |
| 8199 | 8199 | FAITH HEALTHCARE CENTER | 425009 | 617 WEST MARION STREET | FLORENCE | SC | 29501 | 2012-08-22 | 253 | E | 0 | 1 | RTYQ11 | On the days of the survey based on observations, the facility failed to provide housekeeping and maintenance services to maintain a sanitary, orderly, and comfortable interior for 3 of 4 Units reviewed. Stained/soiled tablecloths and chairs were noted on the Skilled Wing, C-Wing, and AB Wing dining areas. Stained and soiled shower stalls/equipment were noted on 1 of 3 Units with showers. The findings included: On 8/21/12 at 3:30 PM, observation of the Restorative Dining Area on the C-Wing revealed tablecloths with stains and food particles. At 3:45 PM, observation of the C-Wing dining area revealed three stained upright chairs and two stained tablecloths. Observation of the AB Hall revealed two stained upright burgundy chairs noted in the small TV/Dining area. Observation of the Skilled Dining Room revealed three stained upright chairs and eight stained tablecloths. During initial tour on 8/20/12, observation of the Skilled Unit revealed a shower room on the West Hall that contained a shower trolley. Lifting the shower trolley pad, small particles of debris and a small cotton pad was observed. A purple/teal colored shower curtain was torn and the plastic liner was noted with several tears. The shower trolley was observed again on 8/22/12. On 8/22/12 at 2:30 PM, during environmental rounds with the Administrator, he confirmed the condition of the trolley and the torn shower curtain. During and interview with the Administrator on 8/22/12, it was revealed that Housekeeping was responsible for cleaning the shower trolleys weekly and that the Certified Nursing Assistants were to clean them after every use. During the interview with the Administrator on 8/22/12, it was also revealed that the Dietary Supervisor was to change tablecloths twice a week and as needed. | 2016-06-01 |
| 8200 | 8200 | FAITH HEALTHCARE CENTER | 425009 | 617 WEST MARION STREET | FLORENCE | SC | 29501 | 2012-08-22 | 279 | E | 0 | 1 | RTYQ11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on record reviews, the facility failed to ensure that comprehensive care plans were developed for residents with tracheostomies related to type and size of cannulas needed, availability of back-up [MEDICAL CONDITION], and emergency procedures in the event of decannulation for 2 of 2 residents reviewed who had tracheostomies (#2 and #13). The findings included: Review of the plans of care for resident #2 and resident #13 revealed that their [MEDICAL CONDITION] status was included in various problems, however, the care plans did not address what types of cannulas the residents required, the size needed, the location of emergency replacement cannulas, or emergency procedures to be used in the event of decannulation. Cross refer to F-328. | 2016-06-01 |
| 8201 | 8201 | FAITH HEALTHCARE CENTER | 425009 | 617 WEST MARION STREET | FLORENCE | SC | 29501 | 2012-08-22 | 281 | D | 0 | 1 | RTYQ11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on record review, interview, and review of the FSBS/SS(Fingerstick Blood Sugar/Sliding Scale) Tool, the facility failed to ensure services provided by the facility met professional standards of quality. Sliding scale insulin was not given as ordered for 1 of 3 residents receiving sliding scale insulin.(Resident #18) The findings included: The facility admitted Resident #18 with [DIAGNOSES REDACTED]. Record review on 8/22/12 revealed the resident had an order for [REDACTED]. On 8/22/12, during an interview with LPN(Licensed Practical Nurse)#3, she stated that due to the resident receiving a scheduled PM dose of [MEDICATION NAME] at 5:00 PM, that was probably why the sliding scale insulin was not given. During an interview with the Unit Manager for C-Hall on 8/22/12, she stated that due to the PM scheduled dose of insulin that was probably why nurses did not give the coverage. There was no evidence presented that the resident's physician was contacted to clarify the order. On 7/24/12, blood sugars had been added to the facilitys Quality Assurance due to multiple holes, incorrect dosages, orders without parameters. On 7/25/12, Unit Managers, DON(Director of Nursing), and ADON(Assistant Director of Nursing) were inserviced on blood sugar policy and audit tools. Audit tools were put into place and to be done daily per Unit Managers/ADON/DON, and week-end supervisor. An audit for this resident was not presented during the survey and no evidence was presented that the Unit Manager had recognized a problem with the resident not receiving the sliding scale coverage. The Unit Manager stated that the audit tool indicated the same as the resident's MAR. | 2016-06-01 |
| 8202 | 8202 | FAITH HEALTHCARE CENTER | 425009 | 617 WEST MARION STREET | FLORENCE | SC | 29501 | 2012-08-22 | 314 | E | 0 | 1 | RTYQ11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on record review and observation, the facility failed to ensure that residents having pressure ulcers received necessary treatment and services to promote healing for 2 of 5 residents reviewed for pressure ulcers (#2 and #15). Resident #2 had the wrong treatment to his wound on 8/21/12. Resident #15 showed signs of decline in his wound that were not communicated to his physician for possible change of treatment. The findings included: Resident #2 entered the facility with a pressure ulcer on his upper left back, over the scapula. Licensed Practical Nurse (LPN) #2 did wound care to the ulcer on 8/21/12 at approximately 3:30 PM. She was assisted by the RN Unit Manager. LPN #2 stated the treatment included cleansing the pressure ulcer with wound cleanser, applying Hydrogel, and then covering the area with [MEDICATION NAME] dressing. The Unit Manager left the resident's room to check the treatment order and returned saying that was the treatment ordered by the physician. LPN #2 provided the wound care with appropriate technique. Review of the medical record revealed that on 8/7/12, the physician changed the treatment order from Hydrogel once a day to: Cleanse (L) upper back (with) wound cleanser, apply wet to dry dressing BID (twice a day). Review of the Treatment Record for August 2012 showed the treatment ordered on [DATE] was not started until 8/21/12 at 8 PM. Resident #15 arrived at the facility with a pressure ulcer on his left outer ankle, a Stage II. the admitting nurse's note stated it measured 2.5 by 2.5 centimeters (cm) and had yellow drainage. The wound bed had slough and beefy red tissue. Review of the medical record revealed the resident had a number of comorbidities and behaviors that compromised his ability to heal. Review of the Nurse's Notes (NN) and Wound Management Program Weekly Wound Documentation (WWD) revealed the following information: NN, 6/13/12, left ankle, Stage II, 2 by 2.4 cm with slo… | 2016-06-01 |
| 8203 | 8203 | FAITH HEALTHCARE CENTER | 425009 | 617 WEST MARION STREET | FLORENCE | SC | 29501 | 2012-08-22 | 328 | E | 0 | 1 | RTYQ11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on record reviews, observations, interviews, and review of facility policies and procedures, the facility failed to ensure that residents with tracheostomies had appropriate equipment and emergencies procedures in place in the event of decannulation for 2 of 2 residents observed with tracheostomies (#2 and #13). The findings included: Resident #2 arrived at the facility with a #10 cuffless [MEDICAL CONDITION]. He had had his [MEDICAL CONDITION] since 1998. The information about type and size of the [MEDICAL CONDITION] was documented on the hospital transfer forms at his admission in April 2012 and on his return from a hospital stay at the end of July 2012. The information was also included in the admitting nurse's note, and randomly throughout the nurses' notes by one particular nurse. It was not included in the physician's orders [REDACTED]. An observation of the resident's room at approximately 4:55 PM, in the company of a CNA revealed no evidence of a back-up [MEDICAL CONDITION]. At 5 PM, Licensed Practical Nurse (LPN) #3 was asked to show where the back up [MEDICAL CONDITION] was located. She stated that she had to call the Security Officer to unlock the storage room on the D wing. LPN #3 was asked if there was a back-up [MEDICAL CONDITION] in the resident's room, and she stated there was not. A search of the supply room revealed no back-up [MEDICAL CONDITION] for the resident. Only disposable inner cannulas in size 6 were noted. At 5:07 PM, LPN #3 returned to Unit C and in response to the question of what size tube was required, browsed through the resident's chart looking for the size and type of his [MEDICAL CONDITION]. LPN #3 paged the Unit Manager (UM) for Units AB and C. The RN UM responded to the page at 5:17 PM. Both she and LPN #3 searched the resident's room for the back-up [MEDICAL CONDITION]. At 5:30 PM, the RN UM was still looking. At 5:45 PM, the RN UM stated there was no back-up [MEDICAL CON… | 2016-06-01 |
| 8204 | 8204 | FAITH HEALTHCARE CENTER | 425009 | 617 WEST MARION STREET | FLORENCE | SC | 29501 | 2012-08-22 | 431 | D | 0 | 1 | RTYQ11 | On the days of the survey, based on observation, review of the facility policy Drug and Biological Storage and interview, the facility failed to store drugs in locked compartments. A package of Methotrexate was noted within the pages of the Medication Administration Record(MAR) on the Skilled Unit. The findings included: On 8/21/12 after observing a tube flush at 5:35 PM, this surveyor exited the room to observe the MAR . Within the pages of the MAR a small plastic bag containing 32 Methotrexate 2.5 milligrams pills was discovered. After the Unit Manager exited the room, she was shown the bag containing the Methotrexate. She stated at that time that she had not placed the bag within the pages of the MAR and she did not know who had placed the bag there. She stated that when a drug is received from the pharmacy, it was to be locked up for safety. Cognitively impaired mobile residents were noted on the Unit. Review of the facility policy titled Drug and Biological Storage revealed drugs were to be stored in an appropriately lighted, locked storage area accessible to authorized personnel only. | 2016-06-01 |
| 8205 | 8205 | FAITH HEALTHCARE CENTER | 425009 | 617 WEST MARION STREET | FLORENCE | SC | 29501 | 2012-08-22 | 441 | D | 0 | 1 | RTYQ11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on observation and review of facility policy Procedure for Clean Dressing Change, the facility failed to provide a safe, sanitary environment to help prevent the development and transmission of disease and infection. Inappropriate infection control practices were noted during and after observing wound care. (Resident #8). The findings included: The facility admitted Resident #8 with [DIAGNOSES REDACTED]. During observation of pressure sore treatment on 8/21/12 at 10:50 AM, Licensed Practical Nurse(LPN)#2 was observed after donning gloves to cleanse the wound; dry the wound; place a dry 4 X 4 in the wound; place 4 x 4's over the area; tear several strips of tape from a roll and place them over the 4 x 4's. After washing her hands and exiting the room, LPN #2 was followed to the treatment cart. After opening the treatment care, LPN #2 was asked if the resident had a drawer specific for his supplies in which she stated no. After describing the treatment to LPN #2, she stated that she would dispose of the tape. Review of the facility policy titledProcedure for Clean Dressing Change, revealed the following: 12. Clean wound as ordered .;13. Screen the wound and determine if the treatment continues to be appropriate; 14. Remove gloves and wash hands; 15. Apply new gloves; 16. Dress as ordered .17. Remove gloves and wash hands. | 2016-06-01 |
| 8206 | 8206 | FAITH HEALTHCARE CENTER | 425009 | 617 WEST MARION STREET | FLORENCE | SC | 29501 | 2012-08-22 | 496 | D | 0 | 1 | RTYQ11 | On the days of the survey, based on review of employee files and interview, the facility failed to ensure that information was obtained from every State Certified Nursing Assistant (CNA) Registry before allowing an individual to serve as a nurse aide for 1 of 1 CNA hired who was certified in another state. The findings included: Review of five employee files, three of whom were CNAs, hired in the past four months, revealed one of the CNAs hired was also certified in the state of Georgia. The facility was unable to show evidence that the Georgia state registry was contacted for information prior to allowing the CNA to work with residents at the facility. An interview with the facility's Human Resources manager on 8/21/12 at 10:15 AM confirmed this finding. | 2016-06-01 |
| 8207 | 8207 | FAITH HEALTHCARE CENTER | 425009 | 617 WEST MARION STREET | FLORENCE | SC | 29501 | 2012-08-22 | 514 | D | 0 | 1 | RTYQ11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on record reviews and interviews, the facility failed to maintain clinical records on each resident in accordance with accepted professional standards and practices that are complete and accurately documented for 3 of 13 sampled residents' records reviewed. Residents #1, #3, and #4 Cumulative physician's orders [REDACTED]. The findings included: The facility admitted Resident #3 with [DIAGNOSES REDACTED]. Record review on 08-21-12 at 11:50 AM of the Cumulative physician's orders [REDACTED]. During an interview on 08-22-12 at 8:55 AM with the Director of Nursing, after record review, verified the above as noted and revealed the Unit Manager had been responsible to ensure the July Cumulative physician's orders [REDACTED]. Resident #4 had [DIAGNOSES REDACTED]. During a record review on 8/21/12 at 10:40am, the cumulative Physician Orders revealed 2 different sacral wound treatments listed below: - Clean left buttock with wound cleanser/pack lightly with [MEDICATION NAME] Calcium Alginate/apply skin prep to wound edges/cover with gauze and secure with tape/change every 2-3 days and as needed for drainage. - Cleanse area on coccyx with wound cleanser/wipe dry/apply hydrogel and cover with stratsorb dressing twice daily until healed (Stage II)/Medispetic to surround area. During a record review on 8/21/12 at 10:42am, the Report of Consultation for 6/25/12 report stated, change left buttock treatment to: thin layer of hydrogel, pack lightly with damp saline gauze, cover with dry gauze, secure with tape and change twice daily. During an interview on 8/21/12 at 12:45am, Licensed Practical Nurse #4 verified the dated 8/1/12 cumulative physician's orders [REDACTED]. on the Treatment Administration Record for the order. The facility admitted Resident #1 with [DIAGNOSES REDACTED]. Record review on 8/21/12 revealed a diet was not listed on the current cumulative orders for August 2012. | 2016-06-01 |
| 8208 | 8208 | WHITE OAK MANOR - SPARTANBURG | 425024 | 295 EAST PEARL STREET | SPARTANBURG | SC | 29303 | 2012-05-16 | 224 | D | 0 | 1 | YFIO11 | On the days of the survey, based on observations, interviews and review of the Resident Council Minutes, the facility failed to meet the needs of a resident timely as evidenced during a random observation of neglect when a resident requested the facility staff to toilet her. Three of 7 residents in a group interview, monthly Resident Council Minutes, and this random observation made during the survey, indicated there was a concern with a delay in response to meet resident needs, timely. The findings included: A random observation on 5/15/12 at approximately 3:25 PM on Unit 1 revealed a resident seated in a reclined chair near the nurse's station with two licensed nurses and 2 CNA's standing or seated around the nurse's station. The resident seated in the reclined chair stated, I need to go to the bathroom. No staff member positioned at the nurse's station responded to the resident. The resident in the reclined chair repeated the statement, I need to go to the bathroom. The facility staff at the desk continued to work without acknowledging the resident's request or that the resident had spoken. The surveyor informed Licensed Practical Nurse (LPN) #1 at the desk that the resident stated she needed to go to the bathroom. LPN #1 asked the resident what she said and the resident repeated, I need to go to the bathroom. LPN #1 asked a Certified Nursing Assistant (CNA), also at the nurse's station, to assist the resident. The CNA walked past the resident, down the hall, then returned after a short period of time. The CNA then took the resident to her room and returned to the nurse's station after a brief period of time. At that time the CNA that was asked by LPN#1 to assist the resident with her request of toileting was observed going down a different hallway away from the resident's room. This surveyor again approached LPN #1 and asked if the services requested by the resident had been provided since the CNA that removed the resident was observed leaving the area. LPN #1 stated she would find out. An interview on 5/15/1… | 2016-06-01 |
| 8209 | 8209 | WHITE OAK MANOR - SPARTANBURG | 425024 | 295 EAST PEARL STREET | SPARTANBURG | SC | 29303 | 2012-05-16 | 250 | D | 0 | 1 | YFIO11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on record review and interview, the facility failed to provide medically related social services for a resident with an uncertain discharge. Resident #25 was noted with inconsistent documentation for discharge planning. (1 of 3 closed charts reviewed) The finding included: The facility admitted Resident #25 on 3/12/12 with [DIAGNOSES REDACTED]. Record review revealed an Admission MDS (Minimum Data Set) dated 3/19/12 that indicated the resident had short and long term memory problem with cognitive impairments. Review the care plan with an identified problem date of 3/21/12 indicated the resident discharge plan was uncertain at that time but resident may remain in facility long term care related to dementia. Review of an Admissions Coordinator note dated 3/12/12 indicated spouse and other members of the family hoped for resident to return to the home environment. A Social Services note dated 3/20/12 indicated resident was new admission to facility with uncertain discharge plan. The Social Services note further indicated the resident had Dementia and was not aware of his circumstance. A Social Services note dated 3/27/12 indicated resident had problems related to uncertain discharge date . A care plan with an identified problem date of 4/08/12 indicated the resident required use of restraints related to unassisted transfer attempted/poor safety awareness. A Social Services note dated 4/10/12 indicated resident had problem with uncertain discharge date and Dementia. The Social Services note further indicated the resident had Dementia and was not aware of his circumstance. A Social Services noted dated 4/24/12 indicated the resident had problems with an uncertain discharge. There were no further Social Services notes related to discharge planning. A Licensed Nurse note dated 4/27/12 indicated the resident was to go to an Assistive Living Facility on Monday (4/30/12). An interview on 5/16/12 at approximately 10:30 A… | 2016-06-01 |
| 8210 | 8210 | WHITE OAK MANOR - SPARTANBURG | 425024 | 295 EAST PEARL STREET | SPARTANBURG | SC | 29303 | 2012-05-16 | 441 | D | 0 | 1 | YFIO11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on observation, interview, and review of the facility provided policy on Hand Hygiene, the facility failed to maintain a sanitary environment. Following a [DEVICE] flush the nurse failed to wash her hands prior to touching another resident. ( 1 of 3 gastric tube flushes observed for infection control practices - Resident #4.) The findings included: The facility admitted Resident #4 with [DIAGNOSES REDACTED]. After observing a tube flush treatment on 5/15/12 at 12:15 PM, LPN # 3 took a plastic bag of trash to the soiled utility room on 400 Unit. The nurse placed the bag of trash into a trash barrel, replaced the lid on the barrel, and exited the room. She proceeded down the hall to the laundry, entered and placed the other plastic bag of soiled linen into the receptacle for soiled linen. The nurse exited the laundry area and started down the hall. A resident said something and the nurse entered the resident 's room, walked over to the resident, placing her hands on the resident's shoulder and wheelchair. The nurse had not washed her hands prior to leaving the soiled utility room or laundry room, prior to touching the resident During an interview with the ADON ( Assistant Director of Nursing) on 5/16/12 at 9:10 AM, The ADON confirmed the nurse should have washed her hands before leaving the soiled utility room and before leaving the laundry. Additionally, the nurse should have washed her hands before direct contact with the resident. Review of the facility's policy on Hand Hygiene documented Hand Hygiene should be done: before and after direct resident contact and after contact or handling of soiled linens or equipment. | 2016-06-01 |
| 8211 | 8211 | CHESTER NURSING CENTER | 425061 | 1 MEDICAL PARK DRIVE | CHESTER | SC | 29706 | 2012-05-03 | 223 | L | 0 | 1 | WII411 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** July 17, 2012 - Ammended to reflect change of original Scope and Severity Lowered to K and lowered Scope and Severity to E On the days of the Recertification and Extended Survey, based on observations, record review, and interviews, the facility failed to ensure the staff monitored visitors/sitters interactions with residents to ensure the safety and well being of residents in the facility. Resident #18 was allegedly verbally abused by Resident #11's visitor/sitter. The findings included: Cross refers to F-226 as it relates to the failure of the facility to follow policy to identify abuse and neglect, report allegations of abuse/neglect as well as protect residents from further abuse/neglect once an allegation was reported. Cross refers to F-490 as it related to the failure of the facility Administration to provide the necessary oversight to ensure policies and procedures related to protecting residents from abuse/neglect by reporting and intervening to prevent further abuse/neglect was implemented properly. The Administration was not aware paid sitters were operating in the building and the facility had no policies in place to ensure sitters were aware of facility policies and procedures and met regulatory requirements. Cross refers to F-520 as it relates to the failure of the facility to be aware that paid sitters were operating in the building and the facility had no policies in place to ensure sitters were aware of facility policies and procedures. The facility admitted Resident #18 with [DIAGNOSES REDACTED]. Record review revealed an Annual MDS (Minimum Data Set) dated 6/17/11 that indicated the resident had a BIMS (Brief Interview for Mental Status) of 3 indicating she was cognitively impaired. Review of the MDS dated [DATE] indicated Resident #18 had long and short-term memory with severe cognitive impairment in daily living skills. The MDS further indicated the resident had the ability to respond adequately to simple direction; no beh… | 2016-06-01 |
| 8212 | 8212 | CHESTER NURSING CENTER | 425061 | 1 MEDICAL PARK DRIVE | CHESTER | SC | 29706 | 2012-05-03 | 225 | L | 0 | 1 | WII411 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** July 17, 2012 - Ammended to reflect change to original Scope and Severity to J and lowered Scope and Severity to D On the days of the Recertification and Extended survey, based on record reviews, interviews and incident logs, the facility failed to ensure that all alleged violations involving mistreatment, neglect, or abuse, were reported immediately to the administrator of the facility and to other officials in accordance with State law through established procedures (including to the State survey and certification agency). Application of heat by a licensed staff member to the leg of Resident #11, 1 of 3 residents reviewed for heat treatments, was applied improperly and not monitored resulting in a second degree burn to the resident. The incident was not reported as possible neglect to the State Agency. The findings included: Cross refers to F-226 as it relates to the failure of the facility to follow policy to identify neglect, report allegations of neglect as well as protect residents from further neglect once an allegation was reported. Cross Refers to F-281 as it relates to the failure of the facility Nursing staff to verify the physician's orders [REDACTED]. The failure placed Resident #11 at risk of serious harm. Cross Refers to F-323 as it relates to the failure of the facility to provide necessary care for Resident #11 when a licensed staff member used a microwave to heat a compress and placed the heated compress directly on the resident's leg without using a barrier between the resident's leg and the compress. This action resulted in a second degree burn to the resident's leg. Cross Refers to F-490 as it relates to the failure of the Administrator to ensure the facility was administered in a manner that enabled it to use its resources effectively and efficiently to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident. The administrator was aware that a licensed nurse used a microw… | 2016-06-01 |
| 8213 | 8213 | CHESTER NURSING CENTER | 425061 | 1 MEDICAL PARK DRIVE | CHESTER | SC | 29706 | 2012-05-03 | 226 | L | 0 | 1 | WII411 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** July 17, 2012 - Ammended to reflect change to original Scope and Severity to K and lowered Scope and Severity to E On the days of the Recertification and Extended survey, based on interviews, record reviews, and review of the facility Abuse and Neglect Policy the facility failed to follow its policies and procedures that prohibit mistreatment, neglect, and abuse of residents. The facility staff failed to report neglect involving Resident #11 who suffered a burn related to a heat treatment which was applied incorrectly. The incident was not investigated and reported to the State Agency. The facility staff failed to respond when a sitter for Resident #11 yelled at her roommate Resident #18; multiple staff members were observed by the surveyor standing by when the incident occurred. The findings included: Cross Refers to F-223 as it relates to the failure of the facility to ensure that staff monitored visitors/sitters interactions with residents to ensure the residents safety and well being in the facility. Resident #18 was allegedly verbally abused by Resident #11's visitor/sitter. Cross Refers to F-225 as it relates to the failure of the facility to report and thoroughly investigate an incident in the facility as possible neglect due to a nurse's inappropriate approach to applying heat to Resident #11's leg that resulted in a burn. Cross Refers to F-281 as it relates to the failure of the facility Nursing staff to verify the physician's orders [REDACTED]. The failure placed Resident #11 at risk of serious harm. Cross Refers to F-323 as it relates to the failure of the facility to provide necessary care for Resident #11. The resident was burned when a nurse used a microwave to heat a compress and placed it directly on the resident's leg without using an appropriate barrier between the resident's leg and the heated compress. This action resulted in a second degree burn to the resident's leg. Cross Refers to F-490 as it relates to the failure of … | 2016-06-01 |
| 8214 | 8214 | CHESTER NURSING CENTER | 425061 | 1 MEDICAL PARK DRIVE | CHESTER | SC | 29706 | 2012-05-03 | 242 | E | 0 | 1 | WII411 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on group interview and review of the facility's menus, the facility failed to plan a menu that residents did not feel was repetitive. (i.e. tomato soup and green beans served frequently). Five of 5 group members stated food preferences are not honored. Resident #8's food choices were not honored during two meal observations The findings included: Based on concerns expressed during the group interview of repeatedly receiving tomato soup and green beans, the facility's menus were reviewed for repetitiveness. On 5/1/12, review of the 3 week CMRC (Chester Regional Medical Center) Menus revealed the Sunday evening meal for weeks #1, 2 and 3 was tomato soup, saltine crackers, grilled cheese, banana foster bread pudding. The Wednesday evening meal for weeks #1, 2, and 3 was fried chicken, macaroni and cheese, seasoned greens, cornbread, carmelicious brownies. The Friday lunch meal for weeks #1, 2, and 3 was chicken wings, baked fries, walking salad, wheat dinner roll. The Friday evening meal for weeks 1, 2, and 3 was crusted/breaded fish with tartar sauce, half baked potato, cole slaw, hush puppies, cornbread, lemon coconut cake. For week # 3, supper on Wednesday, Thursday, and Saturday and the week 1 Sunday lunch, (which follows week 3 Saturday) green beans were served. An interview was conducted on 5/2/12, at approximately 10:00am, with the Food Service Director (FSD) and the Registered Dietitian (RD). The surveyor reviewed the above information with the FSD and RD. The FSD and RD acknowledged that the menus were written in such a way that single food items (tomato soup, green beans) and entire meals were being duplicated repeatedly throughout the menu. The facility admitted Resident #8 on 4/20/10 and readmitted the resident on 2/06/12 with [DIAGNOSES REDACTED]. Record review revealed a Quarterly MDS (Minimum Data Set) dated 4/10/12 which indicated the resident had a Brief Interview Mental Status (BIMS) score of 15… | 2016-06-01 |
| 8215 | 8215 | CHESTER NURSING CENTER | 425061 | 1 MEDICAL PARK DRIVE | CHESTER | SC | 29706 | 2012-05-03 | 281 | J | 0 | 1 | WII411 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the Recertification and Extended survey, based on observations, interviews, record reviews and review of the facility's policies entitled Applying A Warm Compress Or Soak and Standing Orders for Chester Regional Nursing Center, and the facility Event Report, the facility failed to provide services that met professional standards of quality for 3 of 16 sampled residents reviewed for professional standards of care. Resident #11 received a burn due to improper application by a licensed staff member, failure to monitor the heat treatment, and failure to consistently assess and monitor healing of the burn, Resident #16 with a low body temperature reading had no recheck of temperature delaying treatment, and the facility allowed untrained Licensed Practical Nurses (LPN) to administer medications through a Peripherally Inserted Central Catheter (PICC) or did not have a Registered Nurse present in the facility during the medication administration via the PICC line for Resident #1. The findings included: Cross Refer to F323 as it relates to a licensed staff member applying heat improperly to Resident #11 resulting in a second degree burn to the resident's leg. The facility admitted Resident #11 with [DIAGNOSES REDACTED]. On 5/1/2012 at 3:40 PM, during review of the medical chart for Resident #11, a telephone order dated 3/11/12 indicated that the resident had an order for [REDACTED]. The Nurse's Notes (NN) dated 3/8/12 indicated that the resident had complained of left knee pain and a pain medication was given. On 3/11/12 the NN again indicated that the resident had left knee pain and the physician was in the facility and ordered heat to the knee every shift. The NN contained no documentation related to clarifying the order for moist or dry heat. The Treatment Record indicated that heat was applied to the resident's knee every shift as ordered until it was discontinued on 3/27/11. The NN for 3/27/12 at 11:00 AM revealed that the facilit… | 2016-06-01 |
| 8216 | 8216 | CHESTER NURSING CENTER | 425061 | 1 MEDICAL PARK DRIVE | CHESTER | SC | 29706 | 2012-05-03 | 314 | D | 0 | 1 | WII411 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the Recertification and Extended survey, based on observations, interviews and review of the facility's policy entitled Aseptic Technique For Changing Dressings, the facility failed to provide necessary treatment and services to promote healing and prevent infection for 1 of 2 residents observed for Pressure Ulcer Treatment. Licensed Practical Nurse (LPN) #1 failed to properly cleanse the pressure area for Resident #2. The findings included: The facility admitted Resident #2 with [DIAGNOSES REDACTED]. On 5/1/2012 at 11:50 AM, during observation of a Pressure Ulcer treatment for [REDACTED].#1 used a saline soaked 4X4 to cleanse the wound. The LPN patted the wound bed and the peri-wound area multiple times using the same 4X4 and the same area of the 4X4. LPN #1 then, using a new 4X4, patted the wound bed and peri-wound area multiple times with the same side of the 4X4 to dry the wound before applying the new dressing. On 5/15/12 at 5:15 PM, during an interview with LPN #1, the surveyor reviewed her observations on the wound care. The LPN did not disagree with the surveyors observations. Review of the facility's police entitled Aseptic Technique For Changing Dressings revealed .Work from center outward in small [MEDICAL CONDITION], using a clean gauze for each stroke . | 2016-06-01 |
| 8217 | 8217 | CHESTER NURSING CENTER | 425061 | 1 MEDICAL PARK DRIVE | CHESTER | SC | 29706 | 2012-05-03 | 315 | D | 0 | 1 | WII411 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the Recertification and Extended survey, based on observation, interviews and review of the facility's policy entitled Catheter Care, the facility failed to ensure that a resident who is incontinent of bladder receives appropriate treatment and services to prevent urinary tract infections and to restore as much normal bladder function as possible for 1 of 1 resident reviewed with a Foley Catheter. Licensed Practical Nurse (LPN) #3 failed to properly cleanse Resident #8's labia, meatus and tubing during catheter care. LPN #3 also failed to wash her hands and change gloves properly during and after the procedure. The findings included: The facility admitted Resident #8 on 4/20/2011 and readmitted her on 2/6/12 with [DIAGNOSES REDACTED]. On 5/1/2012 at 3:05 PM, during observation of catheter care for Resident #8, LPN #3 assembled supplies on the resident's bedside table, washed her hands and gloved. She removed the resident's brief, then LPN #3 removed her gloves, washed her hands and put on clean gloves. LPN #3 placed a towel under the resident and assisted her into position. LPN #3 then removed her gloves and put on new gloves without washing her hands. After wetting a wash cloth, LPN #3 spread the resident's labia slightly without exposing the urinary meatus. LPN #3 wiped the edge of each side of the resident's labia and down the center, not reaching the meatus, using a new cloth for each wipe. LPN #3 then grasp the catheter tubing at the point where it met the labia and wiped the tubing one time. The LPN wiped the resident front to back on the exterior center of the labia three times and again grasp the tubing at the exterior of the labia and wiped it one time with the same area of the cloth. She then used a towel to pat the area dry. Without removing her gloves or washing her hands, LPN #3 assisted the resident to her right side, removed the towel, opened the resident's closet, took a new brief from the closet and assisted a … | 2016-06-01 |
| 8218 | 8218 | CHESTER NURSING CENTER | 425061 | 1 MEDICAL PARK DRIVE | CHESTER | SC | 29706 | 2012-05-03 | 323 | J | 0 | 1 | WII411 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the Recertification and Extended survey, based on observations, interviews, record reviews and review of the facility's policy's entitled Applying A Warm Compress or Soak, Event Report, and Abuse and Neglect, the facility failed to ensure that the resident environment remains as free of accident hazards as is possible; and each resident receives adequate supervision and assistance devices to prevent accidents for 1 of 1 resident reviewed for burns. Resident #11 received a burn when a heat treatment was administered incorrectly and not monitored during the treatment. In addition 3 of 4 units were noted to have high hot water temperatures and one of 4 units was noted to have low cool water temperatures. The findings included: Cross Refer to F281 as it relates to the facility failure to ensure resident treatments were performed safely and failure to consistently assess and monitor progress should any harm occur. The facility admitted Resident #11 on 11/18/2011 with [DIAGNOSES REDACTED]. Review of Resident #11's medical record revealed a facility's Event Report that indicated on 3/27/12 at 10:30 AM the nurse was called to resident's room by (CNA), observed red area with two intact blisters to lt (left) knee. Also on mattress beside resident was a biohazard bag with two washclothes (sic) inside and a pillowcase covering it. Resident currently has tx (treatment) of heat to lt knee q (every) shift. Called 11p-7a nurse on duty last night, ask her how she did heat tx. to resident's knee. She stated 'I wet two washclothes (sic), put them in microwave for 2 minutes then put inside a biohazard bag and wrapped a pillowcase around it and laid it on resident's knee'. Further documentation reviewed at the facility did indicate the LPN did not check the progress of the treatment after she became busy with other tasks. In an interview on 5/2/12 at 9:05 AM with the Assistant Director of Nursing (ADON), she stated that the facility uses moist heat… | 2016-06-01 |
| 8219 | 8219 | CHESTER NURSING CENTER | 425061 | 1 MEDICAL PARK DRIVE | CHESTER | SC | 29706 | 2012-05-03 | 363 | F | 0 | 1 | WII411 | On the days of the survey, based on observation, interview, and review of the menus, the facility failed to serve the menu as written. The menu stated 6 ounces (oz) of chili and 3 oz or 4 oz of mashed potatoes was to be served. The staff served 4 oz of chili and 2 and 2/3 oz of mashed potatoes. The findings included: Observation on 5/1/12, at approximately 11:40am revealed Cook #1 serving 4 oz of chili and 2 2/3 oz of mashed potatoes for all diet types. The State Agency surveyor and Cook #1 checked the ladle and scoops sizes together and confirmed that a 4 oz ladle was being used to portion the chili and a #12 (2 2/3 oz) scoop was being used to portion the mashed potatoes. This surveyor then asked the Registered Dietitian (RD) to provide the surveyor with the menu the staff was using to determine the portion sizes to be served. The RD and surveyor reviewed the menu together and verified that all diet types were to receive 6 oz of chili, Pureed diets were to receive 4 oz of mashed potatoes, and all other diet types were to receive 3 oz of mashed potatoes. The RD and Cook #1 confirmed that the required amount of chili and mashed potatoes were not being served at that time. | 2016-06-01 |
| 8220 | 8220 | CHESTER NURSING CENTER | 425061 | 1 MEDICAL PARK DRIVE | CHESTER | SC | 29706 | 2012-05-03 | 367 | D | 0 | 1 | WII411 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on observation, interview, and record review, the facility failed to provide a mechanical soft diet as prescribed by the physician for 1 of 3 residents with physician ordered mechanically altered diets. (Resident #1) The findings included: Resident #1 was admitted on [DATE] with [DIAGNOSES REDACTED]. Record review on 4/30/12, at approximately 12:15pm revealed a physician's orders [REDACTED]. Observations on 4/30/12 at approximately 12:30pm revealed Resident #1 eating a lunch of pureed pimento cheese, pureed cottage cheese, pureed fruit, soup, ice cream, and tea. Observation on 4/30/12 at approximately 5:00pm revealed the resident eating a supper of pureed meatloaf, mashed potatoes, pureed broccoli, pureed pineapple upside down cake, and tea. Observations on 5/1/12 at approximately 12:15pm revealed the resident eating a lunch of pureed chili, mashed potatoes, and tea. Review of the tray card for each meal indicated that the resident should receive a pureed diet. Interview with the Registered Dietitian on 5/1/12 at approximately 3:15pm confirmed that the physician's orders [REDACTED]. The RD confirmed that a pureed diet was not the same texture as a Soft diet and the resident was not receiving the appropriate textured diet. | 2016-06-01 |
| 8221 | 8221 | CHESTER NURSING CENTER | 425061 | 1 MEDICAL PARK DRIVE | CHESTER | SC | 29706 | 2012-05-03 | 371 | E | 0 | 1 | WII411 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on observation and interview, the facility failed to store and prepare food under sanitary conditions as evidenced by lids off trash cans, food stored in opened bags in bins without covers, food not covered in the freezer, hand sink without a pedal trash can available, and tiles missing around a drain in the floor. The findings included: Observations on 4/30/12 at approximately 10:30am revealed lids off the trash cans in the dishroom, which was not being used at the time. Lids off the trash cans by both coolers. In the freezer were open boxes of breaded meat, chicken, and ravioli. There was a bin containing an open bag of flour with no lid. Under a prep table there was a bin containing an open bag of rice with no lid and a bin with an open bag of flour with no lid. The hand sink by the trayline had no trash can with a foot pedal available. Under the raw meat prep table was a drain where there were no tiles for approximately 8 inches around the drain exposing a porous surface and impeding free flow of liquids to the drain. Observations on 5/1/12 at approximately 11:50am revealed that the above findings continued to be in existence with the addition of an observation of staff washing their hands at the hand sink and having to open the lid of a trash can with their clean hands to dispose of used paper towels. Observations on 5/2/12 at approximately 10:00am with the Food Service Director and the Registered Dietitian revealed that the above findings continued to exist. Interviews with the Food Service Director and the Registered Dietitian confirmed that the trash can should be covered at all times, food in bins should not be stored in open bags and the bins should be covered, the food in the freezer should be tightly covered, there should be a trash can with a foot pedal at the hand sink, and the surface area around the drain should be of a non porous surface to allow free flow of liquids into the drain. Observatio… | 2016-06-01 |
| 8222 | 8222 | CHESTER NURSING CENTER | 425061 | 1 MEDICAL PARK DRIVE | CHESTER | SC | 29706 | 2012-05-03 | 441 | E | 0 | 1 | WII411 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the Recertification and Extended survey, based on observations and interviews, the facility failed to maintain an Infection Control Program designed to provide a safe, sanitary and comfortable environment and to help prevent the development and transmission of disease and infection. Licensed Practical Nurse (LPN) #2 failed to wash/sanitize her hands during observation of medication pass. LPN #1 and LPN #2 failed to properly clean and store tube flush syringes after the procedures were completed for Resident #2 and #3. (2 of 2 tube flushes observed.) The findings included: The facility admitted Resident #3 with [DIAGNOSES REDACTED]. On 5/1/2012 at 12:45 PM, during an observation of Resident #3's tube flush, LPN #2 completed the flush, rinsed the plunger and barrel of the syringe and placed the syringe into a measuring container which contained water standing in the bottom of the container. The syringe was placed in a way that the tip of the syringe and the rubber gasket of the plunger was standing in water. On 5/1/2012 at 4:00 PM the surveyors observations were reviewed with LPN #2. She did not dispute the observations. The facility admitted Resident #2 with [DIAGNOSES REDACTED]. On 5/1/12 at 12:55 PM, during an observation of Resident #2's Tube Flush, LPN #1 aspirated stomach contents to check for tube placement before instilling the prescribed amount of water. While instilling the water, water and stomach contents backed up into the syringe barrel. LPN #1 reinserted the contents of the syringe. After the treatment, LPN #1 disconnected the syringe, placed it tip side down on the barrel and rubber side down on the plunger into a measuring container without washing and drying the syringe. At 5:15 PM on 5/1/12, the surveyor reviewed her observations with LPN #1. The LPN Stated that she did remember not washing the syringe or the barrel before placing it in the container. On 5/1/2012 at 8:00 AM, during observations of medication pa… | 2016-06-01 |
| 8223 | 8223 | CHESTER NURSING CENTER | 425061 | 1 MEDICAL PARK DRIVE | CHESTER | SC | 29706 | 2012-05-03 | 490 | L | 0 | 1 | WII411 | July 17, 2012 - Ammended to reflect changes to the original Scope and Severity to K and lowered Scope and Severity to E. On the days of the Recertification and Extended survey, based on record reviews, interviews and review of facility policy and procedures related to providing heat treatments, the facility administration failed to effectively and efficiently utilize resources to prevent one of one sampled resident from harm due to inappropriate application of a warm compress treatment. The facility failed to obtain clarification orders related on how to apply heat to a resident and failed to monitor the treatment which resulted in a burn to a resident. The facility failed to complete a thorough investigation of the burn incident and failed to report the injury as neglect to the State survey and certification agency. In addition the facility failed to develop policies on using paid sitters in the facility and were unaware of sitters currently working in the facility at the time of survey. The findings included: Cross Refers to F-223 as it relates to the failure of the facility to ensure that staff monitored visitors/sitters interactions with residents to ensure the residents safety and well being in the facility. Cross Refers to F-225 as it relates to the facility's failure to report an allegation of neglect to the State survey and certification agency. Cross Refers to F-226 as it relates to the facility's failure to ensure that staff was adequately trained to define, recognize and report allegations of abuse/neglect. Cross Refers to F-281 as it relates to the facility's failure to ensure that the licensed staff received adequate training to request clarification orders on applying a warm compress treatment and the monitoring of the treatment to prevent injury. Cross Refers to F-323 as it relates to the facility failure to prevent accidents and hazards for a resident that was burned during a warm compress treatment. Cross Refers to F-520 as it relates to the facility's failure to ensure each resident receiving wa… | 2016-06-01 |
| 8224 | 8224 | CHESTER NURSING CENTER | 425061 | 1 MEDICAL PARK DRIVE | CHESTER | SC | 29706 | 2012-05-03 | 520 | L | 0 | 1 | WII411 | July 17, 2012 - Ammended to reflect changes to the original Scope and Severity to K and lowered Scope and Severity to E. On the days of the Recertification and Extended survey, based on record reviews and interviews, the facility failed to develop, implement and monitor an action plan for identified concerns related to a nurse placing a hot compress in a microwave, placing it on a resident's skin without monitoring progression of the treatment and resulting in a second degree burn to the resident. The injury noted on 3/27/12 and no review of current policy or re-education was provided to nursing staff to prevent further injuries related to heat treatments. The facility staff failed to recognize verbal abuse and failed to act to protect the resident at the time the abuse took place. In addition, the facility failed to have any policies on using paid sitters in the facility and were unaware of sitters currently working in the facility at the time of survey. The findings included: Cross Refers to F-223 as it relates to the facility's failure to recognize verbal abuse, protect the resident abused, and have policies in place for paid sitters in the facility. Cross Refers to F-225 as it relates to the facility's failure to report an allegation of neglect to the State survey and certification agency. Cross Refers to F-226 as it relates to the facility's failure to ensure that staff was adequately trained to define, recognize and report allegations of abuse/neglect. Cross Refers to F-281 as it relates to the facility's failure to ensure that the licensed staff received adequate training to request clarification orders on applying a warm compress treatment and the monitoring of the treatment to prevent injury. Cross Refers to F-323 as it relates to the facility failure to prevent accidents and hazards for a resident that was burned during a warm compress treatment. Cross Refers to F-490 as it relates to the failure of the facility's Administration to provide the necessary oversight to ensure policies and procedures relate… | 2016-06-01 |
| 8225 | 8225 | MAGNOLIA MANOR - SPARTANBURG | 425091 | 375 SERPENTINE DRIVE | SPARTANBURG | SC | 29305 | 2012-04-18 | 252 | E | 0 | 1 | KT9K11 | On the days of the survey, based on random observations and interview, the facility failed to provide a clean homelike environment as evidenced by the strong smell of urine within the facility during the days of the survey. The findings included: Upon entering the facility on 4/16/12 at 10:30 AM, strong urine odors were detected from the entrance, Units 1,2,and 3, including the elevator. These urine odors remained through out the 3 days of the survey. The District Housekeeping Manager confirmed there were some odors. He stated, We have some challenging residents, and this is an old building. The Maintenance Supervisor also acknowledged the urine odors. On initial tour of the facility on 4/16/12 at approximately 10:30 AM a strong urine odor was noted on the hall for rooms 101 to 122. The strong urine odors remained through out the day. At approximately 11:15 AM, housekeeping staff was observed mopping with bucket of dark water in room 122. On 4/16/12 at approximately 1:30 PM a strong urine smell was still noted near rooms 101 to 113. On 4/17/12 though out the day (approximately 9 AM to 5 PM) , urine odors were evident near room 114 through 122. On 4/18/12 at approximately 9:50 AM staff was over-heard reminding housekeeping staff to use fresh water when mopping. On 4/16/12 upon entering the facility, a strong urine odor was noted in the entry way. As the elevator was entered to go to the conference room, a strong urine odor was also noted in the elevator. Each time during the survey when the elevator was used, a strong urine odor remained. During random observations on 4/16/12 through 4/18/12 strong urine odors were noted when entering the front main entrance to the facility and on Unit 3. During an observation on 4/16/12 at 10:35am, there were strong urine odors on Unit 3 which were remained present at 6:00pm. During an observation on 4/16/12 at 4:35pm, there were strong urine odors in the room of Resident #10. During an observation on 4/17/12 at 8:30am, strong urine odors were present on Unit 3. During an observa… | 2016-06-01 |
| 8226 | 8226 | MAGNOLIA MANOR - SPARTANBURG | 425091 | 375 SERPENTINE DRIVE | SPARTANBURG | SC | 29305 | 2012-04-18 | 284 | D | 0 | 1 | KT9K11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on closed record review and interview, the facility failed to provide evidence of post discharge planning for 1 of 2 sampled residents discharged home. Resident #16 had no documented discharge planning to ensure individual needs were addressed. The finding included: The facility admitted Resident #16 on 11/14/11 with [DIAGNOSES REDACTED]. Record review on 4/17/12 at approximately 1:55 PM revealed an Admission MDS (Minimum Data Set)dated 11/29/11 that indicated the resident was severely impaired cognitively in daily decision making skills. There was no documented discharge planning to ensure the resident's needs were addressed after discharge from the facility. Further record review revealed Social Services Progress Notes dated 11/29/11 that resident was receiving supervised visits with family while at the facility. Social Services Progress Notes dated 12/01/12 and 12/30/12 revealed a supervised visit between resident and family took place while the resident was in the facility. An undated discharge summary indicated resident was discharged home with family. There was no documentation related to which family member the resident was discharged with (especially since resident was receiving supervised family visits while in the facility). An interview on 4/17/12 at approximately 3:15 PM with the Social Services Director (SSD) confirmed the finding that there was no post discharge planning documentation. The SSD stated discharge planning was done but could not find the documentation. An interview on 4/17/12 at approximately 3:45 PM with the Medical Records Director confirmed there was no documentation related to post discharge planning. | 2016-06-01 |
| 8227 | 8227 | MAGNOLIA MANOR - SPARTANBURG | 425091 | 375 SERPENTINE DRIVE | SPARTANBURG | SC | 29305 | 2012-04-18 | 312 | E | 0 | 1 | KT9K11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on observations, record review and interviews, the facility failed to provide grooming and personal hygiene care for 1 of 1 sampled diabetic residents reviewed for finger nail care concerns and random observations of other residents in need of fingernail care. Resident #8 was observed on 2 days of the survey with long, jagged nails with a black substance under the finger nails. The findings included: The facility admitted Resident #8 on 11/28/11 with [DIAGNOSES REDACTED]. During initial tour on 4/16/12, observation revealed the resident seated in his room with long, jagged finger nails and a dark substance under the finger nails. A later observation on 4/16/12 at approximately 1:35 PM revealed no change had occurred in the condition of the resident's fingernails. An interview on 4/17/12 at approximately 8:48 AM with Licensed Practical Nurse (LPN) #2 revealed the Certified Nursing Aides (CNAs) were responsible for cutting resident finger nails. When asked about who was responsible for cutting diabetic resident finger nails, LPN #2 stated nurses. When asked if there was a finger nail care schedule for diabetic residents, LPN #2 stated there was no schedule. An interview on 4/17/12 at approximately 8:50 AM with the Assistant Director of Nursing (ADON) revealed the CNAs were to keep the nurses informed of residents needing nail care. The ADON then observed and confirmed resident 8's fingernails to be long, jagged with a dark substance under the finger nails. The ADON stated there was no documentation to indicate when Resident #8 last had finger nail and that Resident # 8 sometimes refused finger nail care. There was no documentation to indicate resident refused finger nail care. The ADON then referred this Surveyor to LPN #3 for information related to finger nail care for Resident #8. An interview on 4/17/12 at approximately 9 AM with LPN #3 revealed diabetic residents finger nails are cut as they grow. On 4/16/12… | 2016-06-01 |
| 8228 | 8228 | MAGNOLIA MANOR - SPARTANBURG | 425091 | 375 SERPENTINE DRIVE | SPARTANBURG | SC | 29305 | 2012-04-18 | 314 | E | 0 | 1 | KT9K11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey based on observations, interviews and review of the facility's policy entitled Application of Dressing-Absorption Dressing on pressure ulcer care, the facility failed to assure that 2 of 2 sampled residents observed for wound care received treatment to promote healing and infection. The Unit #3 Manager did not properly wash her hands during wound care for Resident #10. For Resident #1 Licensed Practical Nurse #1 did not properly clean one wound, did not clean another wound, and failed to use proper hand washing technique. The findings included: The facility admitted Resident #10 on 12/12/11 with [DIAGNOSES REDACTED]. During wound care observation on 4/16/12 at 3:15pm, the Unit Manager completed wound care but failed to wash her hands prior to leaving the Resident's room. The Unit Manager used hand sanitizer before and after the wound care treatment. However, after completing wound care, the Unit Manager replaced items on the Resident's overbed table, raised the Resident's head of the bed, and repositioned the Resident to ensure the Resident was comfortable. The Unit Manager did not wash her hands before exiting the room. She then walked down the hall and placed treatment supplies in the treatment cart next to the nurse's station and then recorded the treatment in the Treatment Administration Record next to the sink. The Unit Manager then washed her hands at the sink behind the nurse's station. During an interview on 4/18/12 at 11:50am, the Unit Manager confirmed that she had left the Resident's room after completing the treatment, replaced supplies in the Treatment Cart, signed off the order in the Treatment Administration Record and then washed her hands. During an interview on 4/18/12 at 12:00 noon, the Staff Development Coordinator also confirmed that the Unit Manager did not wash her hands before leaving the Resident's room. and that the SDC had already told the Unit Manager she should have washed her hands prior… | 2016-06-01 |
| 8229 | 8229 | MAGNOLIA MANOR - SPARTANBURG | 425091 | 375 SERPENTINE DRIVE | SPARTANBURG | SC | 29305 | 2012-04-18 | 425 | E | 0 | 1 | KT9K11 | On the days of the survey, based on observation, interview, and the Drug Facts and Comparisons book (updated monthly), the facility failed to follow a procedure to ensure that expired medications were removed from medication storage in the Unit 3 medication storage area. The findings included: On 4/18/12 at 11:49 AM, observation of the Unit 3 Medication Room refrigerator revealed one 5 milliliter (ml) vial (50 tests) Tuberculin Purified Protein Derivative (PPD), (Mantoux), Tubersol, opened with a puncture date of 3/10/12. The Drug Facts and Comparisons book, page 2001, states (in reference to Tuberculin Purified Protein Derivative): Discard vials in use for more than 30 days because of possible oxidation and degradation that may affect potency. During an interview on 4/18/12 at 11:57 AM, Licensed Practical Nurse (LPN) #5 confirmed the puncture date (3/10/12) and stated that a punctured vial of PPD should not be kept longer than 30 days --- then toss it. | 2016-06-01 |
| 8230 | 8230 | MAGNOLIA MANOR - SPARTANBURG | 425091 | 375 SERPENTINE DRIVE | SPARTANBURG | SC | 29305 | 2012-04-18 | 441 | D | 0 | 1 | KT9K11 | On the days of the survey, based on observation record review and interview, the facility failed to maintain a sanitary environment to help prevent the transmission of disease and infection related to the cleaning of glucometers used between residents. The findings included: On 4/17/12 at 3:48 PM Licensed Practical Nurse (LPN) #4 was observed to perform a fingerstick blood sugar (FSBS) test on Resident A. Prior to the procedure, LPN #4 cleaned the glucometer with an alcohol wipe and after the procedure she cleaned the glucometer with an alcohol wipe. Review of the facility's policy entitled Performing a Blood Glucose Test revealed under Step 1: Clean glucometer with purple top wipe and after the FSBS test under Step 6: Clean glucometer with purple top wipe. Purple top wipes come from a container with a purple top and the wipes contain chlorine. During an interview on 4/17/12 at 4:33 PM, LPN #4 was asked to state the procedure for for doing a FSBS. She stated: Clean the meter with an alcohol wipe. Do the FSBS. Remove the test strip from the glucometer. Clean the glucometer with an alcohol wipe. When asked about the use of the wipes in the purple top container, LPN #4 stated that they were used to clean equipment and that she did not use them to clean glucometers. Further review revealed that on 3/12/12, the facility had an in-service on glucometers which included cleaning the meters with chlorine wipes. LPN #4 is a PRN (as needed) nurse and review of the IN-SERVICE ATTENDANCE RECORD SIGNATURE SHEET revealed that she was not present for the in-service. | 2016-06-01 |
| 8231 | 8231 | WINDSOR MANOR | 425114 | 5583 SUMMERTON HIGHWAY | MANNING | SC | 29102 | 2013-06-06 | 272 | E | 1 | 0 | 43K911 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on record review, interview and review of the facility provided policy for restraints, the facility failed to accurately and timely assess Resident # 51 related to the the use of restraints. (1 of 4 sampled residents reviewed for fall assessments and 1 of 3 sampled residents reviewed for restraint assessments) The findings included: Resident # 51 was admitted on [DATE]. A siderail assessment was completed on 12/18/12 for the resident who had a known history of falls and behaviors. The siderail assessment deemed the resident required the use of siderails for turning and positioning. It also documented the resident was at great risk for falls from the bed, required assistance to turn and move and the resident was unable to use the call system. On 12/19/12 a order was received for a low bed as the resident was unsafely crawling over the siderails. A new assessment was not completed. On 3/27/13, the siderails were reassessed and the assessment stated quarterly review- no changes. However, the siderails had been discontinued once the low bed was put in place on 12/20/12. The inaccurate assessment was verified by the Minimum Data Set Coordinator (MDS) on 6/6/13 who stated, I missed it. On 6/5/13 at 1:41 PM, during an interview with the MDS Coordinator, s/he stated that restraint assessments are only completed for comprehensive assessments by him/her. S/he was unsure as to who completed the quarterly assessments. However, no restraint assessment for any device documented as having been used was located in the medical record. On 6/5/13 at 1:58 PM, the MDS Coordinator stated no assessment was located and the chart has not been thinned. At approximately 4:40 PM, assorted pages from a thinned record were located in a file cabinet but did not include any assessments related to the use of restraints including a gerichair with a table, broda chair, lap belt, soft waist restraint, abdominal binder or leg restraint. One asses… | 2016-06-01 |
| 8232 | 8232 | WINDSOR MANOR | 425114 | 5583 SUMMERTON HIGHWAY | MANNING | SC | 29102 | 2013-06-06 | 280 | E | 1 | 0 | 43K911 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on record review and interview, the facility failed to review and revise the plan of care for Resident # 51 related to repeat falls and multiple use of restraints. The plan of care did not accurately reflect the interventions used. (1 of 4 sampled residents reviewed for falls and 1 of 3 sampled residents reviewed for restraints and the revision of the plan of care. ) The findings included: Resident # 51 was admitted to the facility on [DATE]. Record review on the days of the survey revealed the resident had multiple falls, with and without injury, and multiple restraint devices had been attempted. On 6/5/13, review of the two careplan's (Admission and quarterly) completed for the resident revealed the following concerns: Padded siderails that were discontinued on 12/12/12 continued to be listed on the plan of care Provide Broda chair for locomotion (discontinued 5/15/13), remained on the careplan The use of a Geri chair with a table (12/20/12), abdominal binder (12/23/12), reclining chair (12/19/12), Broda chair with leg restraints (discontinued 1/28/13 ) were not noted on the careplan. The residents unsafe behaviors of climbing over the siderails, sliding under the waist restraint and trying to slide the restraint over his/her head were not addressed. The last fall recorded on the careplan provided for review on 6/5/13 was 5/1/13 which stated send to ER (emergency room ) for evaluation as ordered Record review indicated the resident either fell or was found on the floor on 5/18,5/20,5/27/13. There was repeated documentation of the resident pulling out or otherwise tampering with his/her feeding tube. The concern nor preventives measures were not included on the plan of care for the feeding tube. The resident was assessed as being unable to use the call light system and was documented as having severe cognitive impairment with a BIMS (Brief Interview Mental Status) of 5. However, careplan approaches included t… | 2016-06-01 |
| 8233 | 8233 | WINDSOR MANOR | 425114 | 5583 SUMMERTON HIGHWAY | MANNING | SC | 29102 | 2013-06-06 | 490 | E | 1 | 0 | 43K911 | On the days of the survey, based on record review and interview, the facility failed to be administered in way that effectively and efficiently enabled the residents to attain or maintain the highest practicable physical, mental and social well-being of each resident. Facility Administration failed to identify the use of multiple restraints without assessments, continued use of restraint as the resident demonstrated unsafe behaviors, the use of restraints without an order, and a careplan that did not accurately reflect the resident for Resident # 51. Additionally, the facility Administration failed to identify the lack of a documented and active grievance policy and failed to identify Licensed Practical Nurses were required to have advanced documented training prior to changing gastrostomy tubes. The findings included: A pattern of concerns was identified for Resident # 51 during chart review on the days of the survey. Included in the concerns were the the use of multiple restraints without assessments, continued use of restraints as the resident demonstrated unsafe behaviors, the use of restraints without an order, and a careplan that did not accurately reflect Resident # 51. Additionally, the facility Administration failed to identify the lack of a documented active grievance policy. When interviewed on 6/6/13, the Administrator stated s/he did not find it unusual that the facility had not had any grievances since the arrival of the new social services representative or since the last survey. The Administrator later confirmed a resident had expressed concern related to missing money and s/he replaced the missing money. However, there was no documentation to show the concern, the investigation or the resolution. When the Administrator conducted the personnel evaluation of the social services representative in December 2012, s/he did not identify the lack of documented grievances. The facility administration was unaware and failed to develop a program to assure Licensed Practical Nurses were aware not to change n… | 2016-06-01 |
| 8234 | 8234 | KINGSTREE NURSING FACILITY | 425117 | 401 NELSON BOULEVARD | KINGSTREE | SC | 29556 | 2013-06-07 | 280 | E | 1 | 0 | 8GKN11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the recertification and complaint surveys, based on record review and interviews, the facility failed to ensure that the care plan was reviewed and accurately updated to concur with physician's orders [REDACTED]. The facility failed to update the care plan for Resident #20 to consistently provide interventions to minimize injury in the event of falls. The findings included: On 9-19-12, an Initial 24 Hour Report was received by the State Agency related to an injury of unknown origin or possible abuse. Resident #20 sustained a hematoma to the right forehead, right side of the head, and behind the right ear, which had been reported to facility staff by a Hospice Certified Nursing Assistant (CNA) at 8 AM that morning. The physician and family were notified and the resident was sent to the hospital for evaluation and treatment. An investigation was begun and the Kingstree Police Department was notified. Review of the facility's Five-Day Follow-Up Report dated 10-1-12 revealed that the Hospice CNA noted blood in the resident's hair on 9-19-12 while in the shower. S/he noted a bruise and notified Licensed Practical Nurse (LPN) #1 who checked the resident and found her/him with a second area of bruising as well. The physician and family were notified in a timely manner and the resident was transported to the emergency room for evaluation. An investigation was conducted immediately including staff and resident interviews. No blood was found in the shower or resident's room. No falls were reported or heard on the 11-7 shift on 9-18-12. At change of shift, neither the 11-7 nor 7-3 CNA noted any injury. The 7-3 nurse (LPN #1) and CNA #1 observed the resident being ambulated to the shower with no evidence of injury. Facility staff was unaware of any injury until the Hospice CNA called for the nurse's assistance related to a [MEDICAL CONDITION] and hematoma. During interviews, the Hospice CNA denied any occurrence in the shower. The facility… | 2016-06-01 |
| 8235 | 8235 | KINGSTREE NURSING FACILITY | 425117 | 401 NELSON BOULEVARD | KINGSTREE | SC | 29556 | 2013-06-07 | 309 | E | 1 | 0 | 8GKN11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the recertification and complaint surveys, based on record review and interviews, the facility failed to provide evidence of consistent and coordinated care and services to one of two sampled residents reviewed for provision of Hospice services. Hospice and the facility failed to adequately communicate to develop a fully integrated plan of care so as to consistently provide needed services for Resident # 20. Although Hospice provided services in the home prior to Resident #20's skilled nursing facility admission, the initial assessment and interdisciplinary care plan failed to reflect known behaviors, thus limiting the extent to which a comprehensive care plan could be developed to address these behaviors and maintain the safety of the resident to the extent possible. There was no evidence of a collaborative care plan meeting until 7-3-12, almost two months after the resident was admitted to the skilled facility. The findings included: Record review on 5-3-13 revealed that the facility admitted Resident #20 on 5-7-12 with [DIAGNOSES REDACTED]. Review of Hospice information revealed that the initial referral/coverage date was 12-13-11, approximately five months prior to the nursing home admission. The primary coverage [DIAGNOSES REDACTED]. The most recent Hospice care plan included provision of aide services four times per week and nursing services twice weekly. Renew of the biweekly care plans revealed that Hospice had been kept updated by the facility on the resident's condition. However, there was no evidence of Hospice communication with the facility regarding pre-admission concerns/problems dealt with in the home environment. Review of March, 2012 Hospice certification documentation faxed to the State Agency on 6-6-13 revealed information that was not reflected in the Admission Assessment or Care Plan or in subsequent interdisciplinary Plans of Care: Functional Limitations noted moderate assistance required for feeding, toi… | 2016-06-01 |
| 8236 | 8236 | KINGSTREE NURSING FACILITY | 425117 | 401 NELSON BOULEVARD | KINGSTREE | SC | 29556 | 2013-06-07 | 323 | E | 1 | 0 | 8GKN11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the recertification and complaint surveys, based on record review and interviews, the facility failed to ensure that one of four residents reviewed for falls received adequate supervision to prevent accidents and provide devices to minimize injury in the event of falls. Facility staff were aware that a Hospice Certified Nursing Assistant (CNA) ambulated Resident #20 to the shower without a helmet in place as ordered and care planned, though the resident had a documented history of multiple falls and agitation/behaviors related to pacing and being combative/slapping staff when attempts were made to redirect the resident. While in the shower, the resident sustained [REDACTED]. Although facility staff were aware of the fact that the resident was ambulating without the helmet in place to minimize injury in the event of falls, they failed to intervene to ensure that the physician's orders [REDACTED]. The findings included: On 9-19-12, an Initial 24 Hour Report was received by the State Agency related to an injury of unknown origin or possible abuse. Resident #20 sustained a hematoma to the right forehead, right side of the head, and behind the right ear, which had been reported by a Hospice Certified Nursing Assistant (CNA) at 8 AM that morning. The physician and family were notified and the resident was sent to the hospital for evaluation and treatment. An investigation was begun and the Kingstree Police Department was notified. Review of the facility's Five-Day Follow-Up Report dated 10-1-12 revealed that the Hospice CNA noted blood in the resident's hair on 9-19-12 while in the shower. S/he noted a bruise and notified Licensed Practical Nurse (LPN) #1 who checked the resident and found her/him with a second area of bruising as well. The physician and family were notified and the resident was transported to the emergency room for evaluation. An investigation was conducted immediately including staff and resident interviews. No blo… | 2016-06-01 |
| 8237 | 8237 | INMAN HEALTHCARE | 425122 | 51 N MAIN ST | INMAN | SC | 29349 | 2012-11-07 | 333 | D | 0 | 1 | YTDP11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on observations, record review, interview and the Drug Facts and Comparisons book (updated monthly), the facility failed to ensure that a resident observed during medication pass (Resident A) was free of a significant medication error. The findings included: On 11/6/12 at 8:30 AM, during observation of medication pass, Licensed Practical Nurse (LPN) #1 was observed to administer one [MEDICATION NAME] 5 milligram (mg) tablet and 5 other medications to Resident A. Review of the current physician's orders [REDACTED]. During an interview on 11/6/12 at 8:46 AM, LPN #1 was asked about the resident's respiration rate. She stated that she had not taken it and that she would go back and check the resident's respiration now. The resident's respiration rate was found to be 18. The Drug Facts and Comparisons book (updated monthly), page 793, states (in a black box warning) concerning [MEDICATION NAME] use: Respiratory depression is the chief hazard associated with [MEDICATION NAME] administration. | 2016-06-01 |
| 8238 | 8238 | INMAN HEALTHCARE | 425122 | 51 N MAIN ST | INMAN | SC | 29349 | 2012-11-07 | 371 | E | 0 | 1 | YTDP11 | On the days of the survey, based on random observations of the kitchen and interview, staff were observed with no beard constraint in place, hair not completely covered by a hair restraint, and using serving gloves to move soiled carts, open drawers, and retrieve supplies from the supply room without washing hands or changing gloves while serving food on the tray line. The findings included: During random observation of the kitchen area on 11/6/12, the cook was observed serving food with hair net not completely restraining hair. The CDM (Certified Dietary Manager) did not have a beard restraint on to cover facial hair around mouth and chin. The cook was observed to move a serving cart near the steam table with serving glove and then with the same glove picked up a piece of bread and placed it on a plate to be served to a resident. Later, the cook retrieved Styrofoam products from the storage area and served the tray with the same gloves. A storage drawer was also opened with the serving glove to obtain a serving utensil. Each time the staff member continued using the same gloves to serve plates of food. On 11/7/12 these areas were discussed with the CDM. He was not aware he needed to wear a beard protector while around the food . The kitchen staff were not aware that they needed to wash hands and change gloves if they handled anything else other than the food. | 2016-06-01 |
| 8239 | 8239 | INMAN HEALTHCARE | 425122 | 51 N MAIN ST | INMAN | SC | 29349 | 2012-11-07 | 425 | D | 0 | 1 | YTDP11 | On the days of the survey, based on observations, interview, and the Drug Facts and Comparisons book (updated monthly), the facility failed to follow a procedure to ensure that expired medications were removed from medication storage in the facility's medication refrigerator at the facility's nurses station. The findings included: On 11/6/12 at 11:44 AM, observation of the facility's medication storage refrigerator revealed one 1 milliliter (ml) vial (10 tests) Tuberculin Purified Protein Derivative (PPD), Diluted/Aplisol, 5 TU (tuberculin units)/0.1 ml, opened, with a puncture date of 10/1/12. The Drug Facts and Comparisons book (updated monthly), page 2001, states (in reference to Tuberculin Purified Protein Derivative): Discard vials in use for more than 30 days because of possible oxidation and degradation that may affect potency. During an interview on 11/6/12 at 12:03 PM, Licensed Practical Nurse (LPN) #1 confirmed the puncture date (10/1/12) and stated that night shift medication nurses are responsible for checking the medication refrigerator and medication storage cabinets for expired products. She was not sure if there is a set schedule. | 2016-06-01 |
| 8240 | 8240 | INMAN HEALTHCARE | 425122 | 51 N MAIN ST | INMAN | SC | 29349 | 2012-11-07 | 441 | D | 0 | 1 | YTDP11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on an observation of a wound treatment and interview, the nurse did not provide a safe, sanitary environment to prevent the development and transmission of disease or infection by not washing and or sanitizing his/her hands between changing soiled gloves and applying clean gloves. Resident # 2's brief also touched the clean wound bed. ( 1 of 1 sampled residents observed for wound care.) The findings included: The facility admitted Resident # 2 on 5/21/10 with a [DIAGNOSES REDACTED].# 1 (Licensed Practical Nurse) was observed to change his/her gloves eight times during 2 wound treatments without washing or sanitizing his/her hands between removing soiled gloves and applying clean gloves. The resident's brief also touched the clean wound bed during the treatment. After the treatment was completed, the LPN was asked if this was her normal procedure for changing gloves during wound care. She said ,No. I usually wash my hands or use hand sanitizer each time I change my gloves. I was nervous today. He/she also stated that the brief should have been more secure so as not to touch the wound. | 2016-06-01 |
| 8241 | 8241 | THE METHODIST OAKS | 425131 | 151 LOVELY DRIVE | ORANGEBURG | SC | 29115 | 2012-02-29 | 225 | D | 0 | 1 | 5WM211 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey based on interview and record review, the facility failed to report an injury of unknown origin to the appropriate State agency for 1 of 1 sampled residents reviewed with an injury of unknown origin. (Resident #5) The findings included: Resident #5 was re-admitted on [DATE] with [DIAGNOSES REDACTED]. Record review on 2/27/12 at approximately 2:15pm revealed a nursing note dated 1/3/12 which indicated that the resident was seated in wheelchair in doorway of room with skin tears to arms, knot noted on back of head - sent to ER (emergency room ). Review of Incident report on 2/28/12 at approximately 10:30am indicated that a nurse and CNA (Certified Nursing Assistant) entered room after a loud noise was heard. When asked what had happened, the resident stated he was trying to go downstairs to put out the fire. The incident report did not indicate where in the room the resident was located when found. Review of the resident's most recent Minimal Data Set of 2/14/12 indicated a BIMS (Brief Interview for Mental Status) of 7. A BIMS score of 0-7 indicates severe cognitive impairment. Interview on 2/28/12 with the Administrator indicated that the incident had not been reported any State agency. Communication with the Bureau of Certification Compliant Intake Officer verified that the incident had not been reported to the agency. Based on the information in the nursing notes and the incident report, the occurrence met the definition of an injury of unknown origin. Therefore, it should have been reported to the appropriate State agency within 24 hours of its occurrence and a further investigation should have occurred and been documented. | 2016-06-01 |
| 8242 | 8242 | THE METHODIST OAKS | 425131 | 151 LOVELY DRIVE | ORANGEBURG | SC | 29115 | 2012-02-29 | 280 | E | 0 | 1 | 5WM211 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on record review and interview, the facility failed to review and revise care plans for 4 of 13 resident care plans reviewed. The facility failed to revise the CNA (Certified Nurses Aide) care plan to reflect implemented interventions to prevent falls for Resident #6, failed to update the comprehensive care plan to reflect a fall for Resident #6, failed to update the comprehensive care plan for Resident #5 to reflect implemented interventions to prevent falls, and failed to revise the care plans for Resident #9 and Resident #13 to reflect treated infections. The findings included: The facility admitted Resident #6 on 12/11/07 with [DIAGNOSES REDACTED]. Review of the Nurse's Notes dated 8/22/11 at 5:55 PM indicated Resident #6 sustained a fall to the floor after rolling out of bed. Review of the fall data provided by the facility entitled Falls Screened by Therapy PAR (Patients at Risk) committee revealed that recommendations following the fall included, Recommend resident not be left alone for meals. Further review of the Nurse's Notes dated 11/18/11 at 11:05 AM indicated Resident #6 was found on the floor in front of the wheelchair. The notation stated, Res (resident) appeared to have slide (sic) out of w/c. Record review indicated Resident #6 sustained a [MEDICAL CONDITION] tibia and fibula as a result of the incident. Review of the Therapy Screen dated 11/22/11 indicated interventions included recommend checking regularly for repositioning needs and Recommend Hoyer lift transfer to protect fx. Review of the Falls Screened by Therapy PAR committee data revealed Recommend not leaving resident alone but in-sight of caregivers to identify repositioning needs .Recommend also Hoyer transfers were recommended interventions to prevent further falls. Review of the Nurse's Notes dated 1/07/12 at 8:30 AM indicated, CNA was transferring res from wheelchair to bed when Res slipped and slid to ground on top of CNA. The T… | 2016-06-01 |
| 8243 | 8243 | THE METHODIST OAKS | 425131 | 151 LOVELY DRIVE | ORANGEBURG | SC | 29115 | 2012-02-29 | 315 | D | 0 | 1 | 5WM211 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on observations, interview and review of the facility's policy Catheter Care, the facility failed to ensure that 1 of 3 residents received appropriate catheter care. For Resident #3, Certified Nurse Assistant (CNA) failed to separate and cleanse the labia. The finding included: The facility admitted Resident #3 on 1-7-09 and was readmitted on [DATE] with [DIAGNOSES REDACTED]. On 2-29-12 at 11:38 AM, during an observation of Resident #3's Foley catheter care, CNA #4 anchored the catheter tubing at the urinary meatus with her left hand. She then used 3 sanitary swabs to wipe only the catheter tubing. The CNA did not separate the labia to assure thorough cleansing. On 2-29-12 at 11:49 AM, during an interview, CNA #4 verified she had only cleaned the catheter tubing. Review of the facility policy entitled Catheter Care states under Procedure, Female Residents: Spread the labia, using the first swab cleanse down the one side of the labia, second swab cleanse down the other side, use third swab, starting at the urinary meatus and clean down catheter tubing rotate swab and clean opposite side of the tubing. | 2016-06-01 |
| 8244 | 8244 | THE METHODIST OAKS | 425131 | 151 LOVELY DRIVE | ORANGEBURG | SC | 29115 | 2012-02-29 | 322 | D | 0 | 1 | 5WM211 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the Recertification Survey, based on observation, interview and record review, the facility failed to administer the amount of tube feeding formula and water flush as ordered for 5 feedings over a 2 day period for Resident #2, 1 of 2 residents sampled for Percutaneous Gastrostomy Tube (PEG) feedings. The findings included: The facility admitted Resident #2 on 12/13/11 with [DIAGNOSES REDACTED]. On 2/28/12 at 9:52 AM, Licensed Practical Nurse (LPN) #3 was observed administering the tube feeding and water flush to Resident #2. After checking the Medication Administration Record, [REDACTED]. After washing her hands, donning gloves and verifying placement, the LPN flushed the PEG tube with 30 ml of water. She poured 60 ml of Glucerna 1.5 into the syringe and allowed to flow via gravity. She then poured an additional 60 ml into the syringe and allowed to flow, added an additional 5 ml of formula then followed with an additional 30 ml of water to flush the tube. Record review on 2/28/12 at 3:40 PM revealed a Physician's Telephone Order dated 1/31/12 that read Per Dietary Rec(ommendation) - (Change) TF (tube feeding) to bolus 1 can Glucerna 1.5 @ (at) 9A, 1P and 6P and follow with 125 cc (cubic centimeters) H2O (water) flush. Further review revealed the order had been carried over to the February 1-29 monthly physician's orders [REDACTED]. During an interview on 2/28/12 at 4:45 PM, LPN #3 confirmed that she had given a total of 125 ml of tube feeding and a total of 60 ml of water to flush. After reviewing the MAR indicated [REDACTED]. | 2016-06-01 |
| 8245 | 8245 | THE METHODIST OAKS | 425131 | 151 LOVELY DRIVE | ORANGEBURG | SC | 29115 | 2012-02-29 | 369 | D | 0 | 1 | 5WM211 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on record review and observation, the facility failed to provide adaptive feeding equipment for 1 of 1 sampled residents with orders for adaptive equipment. The facility did not provide Resident #6 with the angled spoon per physician's orders [REDACTED]. The findings included: The facility admitted Resident #6 on 12/10/07 with [DIAGNOSES REDACTED]. Review of the February 2012 physician's orders [REDACTED]. Further record review revealed a Physician's Telephone Order dated 5/23/11 for an angled spoon. Review of the Nutrition Risk assessment dated [DATE] indicated an angled spoon was listed as an adaptive device to be used for Resident #6. Observation of the lunch meal on 2/28/12 at approximately 12:30 PM and the dinner meal on 2/28/12 at approximately 5:45 PM revealed Resident #6 sitting at a table eating in the dining room. Observation indicated that Resident #6 was provided a built-up fork for both meals. This was the only eating utensil provided by staff for both of the meals. Review of the dietary tray card revealed a photo of adaptive equipment which did not include an adaptive spoon. On 2/29/12 at approximately 4:00 PM, the Certified Dietary Manager (CDM) reviewed the dietary card and order for angled spoon. The CDM confirmed that the dietary card did not correctly indicate that the angled spoon was to be provided. | 2016-06-01 |
| 8246 | 8246 | THE METHODIST OAKS | 425131 | 151 LOVELY DRIVE | ORANGEBURG | SC | 29115 | 2012-02-29 | 425 | D | 0 | 1 | 5WM211 | On the days of the survey, based on observation and interview, the facility failed to follow a procedure to ensure that expired medications were not stored in 1 of 3 medication rooms. The findings include: On 2/27/12 at approximately 10:45 AM, inspection of the Riverside (D Wing) medication room refrigerator revealed the following: -One opened vial of Novolog Insulin 100 U (units)/1 ml (milliliter), Lot AZF0366, Prescription 848, dispensed 1-19-12 and belonging to Resident A had not been labelled as to the date it was opened. -One opened vial of Novolog Insulin 100 U/1 ml, Lot AZF0333, Prescription 976, dispensed 12/15/11 and belonging to Resident B had not been labelled as to the date opened. These findings were verified by LPN (Licensed Practical Nurse # 2) who stated that they should have been dated when opened. The manufacturer, Novo Nordisk, states in the package insert that Novolog Insulin should be discarded 28 days after opening. | 2016-06-01 |
| 8247 | 8247 | THE METHODIST OAKS | 425131 | 151 LOVELY DRIVE | ORANGEBURG | SC | 29115 | 2012-02-29 | 441 | E | 0 | 1 | 5WM211 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the Recertification Survey, based on observations, interviews and record review, the facility failed to implement all components of the infection control program. The facility failed to have a process to comply with State Laws and Regulations for reporting communicable diseases and outbreaks and failed to monitor that staff observed transmission based precautions. The facility also failed to ensure that expired instant hand sanitizers were not being stored in 2 of 3 medication rooms and were not being used during patient care on 3 of 6 medication carts. The findings included: Review of the facility's Policy and Procedure Manual revealed no list of Reportable Conditions or communicable diseases to be reported in accordance with State Laws and Regulations. During an interview on [DATE] at approximately 11:30 AM, the Infection Control Nurse stated she didn't know where the list might be. She stated she hadn't seen one and did not know what conditions or communicable diseases were reportable. Review of the infection surveillance logs indicated the facility had 4 ESBL (Extended-Spectrum Beta-Lactamase) infections in the month of January, 2012. The Infection Preventionist was not able to state whether that would constitute an outbreak of a communicable disease and stated she would have to research it. On [DATE] during initial tour, Resident #11 was noted to be on transmission-based precautions. Licensed Practical Nurse (LPN) #3 stated the resident was on contact isolation. Record Review on [DATE] at approximately 10:30 AM revealed the resident had a Culture and Sensitivity on [DATE] which was positive for [DIAGNOSES REDACTED] Pneumoniae ESBL and antibiotic therapy and isolation precautions were ordered on [DATE] when the results were received. At 6:15 PM on [DATE], Certified Nursing Assistant (CNA) #2 was observed delivering the evening meal in the resident's room without donning any PPE (Personal Protective Equipment) prior to enter… | 2016-06-01 |
| 8248 | 8248 | THE METHODIST OAKS | 425131 | 151 LOVELY DRIVE | ORANGEBURG | SC | 29115 | 2012-02-29 | 502 | D | 0 | 1 | 5WM211 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on observation and interview, the facility failed to follow a procedure to ensure that expired laboratory products were not stored in 1 of 3 medication rooms. The findings include: On [DATE] at approximately 10:30 AM, inspection of the Piedmont (A Wing) medication room revealed the following: -Fourteen packages of BBL Culture Swab Collection and Transport System, Lot 029H43 L.YPT233, expiration ,[DATE] were found in a plastic biohazard bag located in the 2nd drawer from the right side of a storage cabinet. This finding was verified by LPN (Licensed Practical Nurse) #1 on [DATE] at approximately 11:35 AM. | 2016-06-01 |
| 8249 | 8249 | THE METHODIST OAKS | 425131 | 151 LOVELY DRIVE | ORANGEBURG | SC | 29115 | 2012-02-29 | 520 | F | 0 | 1 | 5WM211 | On the days of the survey, based on an interview with the Administrator and Infection Control Preventionist, the facility's Quality Assurance Committee failed to monitor the effect of implemented changes and making needed revisions to the action plans. The findings included: Interview on 2/29/12 at approximately 10:00am with the Administrator and Infection Control Preventionist concerning the facility Quality Assurance Program revealed that the committee was actively addressing concerns in the area of Falls, Weight Loss, Infections, Skin Tears, Medications among others. However, the committee was reviewing the concerns on a case by case basis. The committee had not developed a formal system wide plan of action addressing monitoring of the interventions put into place and the effectiveness of those interventions in relation to the operation of the facility and how it could benefit all who reside within the facility. The Infection Control Preventionist stated We don't connect the dots. | 2016-06-01 |
| 8250 | 8250 | SOUTHLAND HEALTH CARE CENTER | 425157 | 722 SOUTH DARGAN STREET | FLORENCE | SC | 29506 | 2012-05-30 | 241 | D | 0 | 1 | ZD5411 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on observations and interview, the facility failed to promote care in a manner that enhances each resident's dignity for 1 of 3 residents reviewed with catheters. The facility failed to provide a cover for Resident #2's catheter bag. The findings included: The facility admitted Resident #2 on 4/05/07 with [DIAGNOSES REDACTED]. Review of the medical record on 5/29/12 revealed a physician's orders [REDACTED]. During the Initial Tour of the unit on 5/29/12 at approximately 11:35 AM, the resident's door was open, and the resident's Foley catheter bag was observed hanging on the side of the bed facing/nearest the door. The catheter bag was observed to contain a small amount of urine, and the bag was uncovered. These findings remained the same during observations of the resident's catheter bag on 5/29/12 at approximately 2:15 PM, 5:20 PM, 6:00 PM and on 5/30/12 at approximately 9:15 AM and 11:45 AM. The resident's door was open and the catheter bag was hanging in the same location during these observations. During an interview with Licensed Practical Nurse (LPN) #2 on 5/30/12 at approximately 11:45 AM, the surveyor asked LPN #2 to view the resident's room from the hallway and to observe if anything would be noticeable to visitors or anyone walking past the room. At that time, LPN #2 stated that the catheter bag was uncovered and should have a cover. When asked if staff had access to catheter bag covers, LPN #2 stated that the covers were available in the unit's supply room. | 2016-06-01 |
| 8251 | 8251 | SOUTHLAND HEALTH CARE CENTER | 425157 | 722 SOUTH DARGAN STREET | FLORENCE | SC | 29506 | 2012-05-30 | 431 | E | 0 | 1 | ZD5411 | On the days of the survey, based on observation and interview, the facility failed to ensure that the drugs used in the facility were labeled in accordance with currently accepted professional principles, which included the expiration date. Three of four medication carts contained medications repackaged by the pharmacy without expiration dates. The findings included: On 05/29/12 at approximately 3:50 pm on the South Unit in medication cart #2, three repackaged medications were noted without expiration dates on the labels. During an interview with Licensed Practical Nurse #1 at the time of the findings, she confirmed no expiration dates were found on the labels. She stated that the medications had been supplied by Hospice. On 05/30/12 at approximately 10:50 am on the North Unit in medication cart #1, and cart # 2 one repackaged medication was found in each cart without an expiration date on the label. During an interview with the Assistant Director of Nurses (ADON) at the time of the finding, she confirmed no expiration date was on the label. She also stated that the medications been supplied by Hospice. | 2016-06-01 |
| 8252 | 8252 | AGAPE REHABILITATION OF ROCK HILL | 425159 | 159 SEDGEWOOD DR | ROCK HILL | SC | 29732 | 2013-06-18 | 282 | E | 1 | 0 | B96711 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the day of the complaint inspection, based on record review, observation and interview, the facility failed to ensure that each resident care plan was followed. The facility failed to follow care planned safety devices to prevent fall for 4 of 5 residents reviewed for falls (Resident #4, #5, #6 and #7). The findings included: Resident #4 was admitted to the facility on [DATE] for rehabilitation after having a hip repair. Review of the Discharge Summary from the hospital revealed Resident #4 was admitted to the hospital on [DATE] for a left [MEDICAL CONDITION] after s/he fell . Review of Resident #4's Fall Risk assessment dated [DATE] revealed the resident had a total score of 14. The Fall Risk Assessment form indicated that a total score above 10 represents high risk for falls. Review of Resident #4's Interim Care Plan revealed the resident was at risk for falls and bed/chair alarms were used as an intervention. Review of the Care Plan revealed a risk for falls was identified as a problem area. Interventions and approaches were listed on the care plan and included to ensure any safety devices ordered were in place and functioning properly every shift. Review of Resident #4's Treatment Record for June 2013 revealed Bed alarm to bed (clip) and Clip alarm to chair. The alarms were not signed for on the 7 AM - 7 PM shift for 6/10/13 when reviewed at 5:05 PM. On 6/10/13 at approximately 4:05 PM Resident #4 was observed to stand up from her wheelchair across from the nurse's station and fall. The surveyor informed Registered Nurse (RN) #2 and Certified Nurse Aide (CNA) #3 at the nurse's station that the resident had fallen. Resident #4 was noted to have a clip alarm dangling from her/his clothing but no alarm was sounding. During interview on 6/10/13 at approximately 4:19 PM RN #2 stated that Resident #4's alarm was not turned on. During interview on 6/10/13 at approximately 4:22 PM CNA #3 stated that if the alarm was turned on it would have sou… | 2016-06-01 |
| 8253 | 8253 | AGAPE REHABILITATION OF ROCK HILL | 425159 | 159 SEDGEWOOD DR | ROCK HILL | SC | 29732 | 2013-06-18 | 309 | G | 1 | 0 | B96711 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the day of the complaint inspection, based on record review and interview, the facility failed to provide the necessary care and services to maintain the highest practicable physical well-being. Resident #1 was found on the floor beside her/his bed with the bed alarm sounding. The x-ray's obtained related to the fall were reported to a nurse as negative for a fracture, the x-ray's in fact showed a fractured wrist and hip. The facility failed to timely address Resident #1's injury. The findings included: Review of the facility investigation summary stated that a nurse received a verbal negative x-ray result called in to her/him for Resident #1. Because s/he received a negative verbal report, s/he did not thoroughly read the written reports when they arrived, instead placing them in the physician's box for review. Review of Resident #1's Nurse's Notes from 5/4/13 through 5/6/13 revealed the following: 5/4/13 8:00 AM indicated the resident was observed lying on his/her right side on the floor in his/her room beside the bed and the bed alarm was sounding. The nurse assessed the resident for injuries and noted the resident cried when moving his/her upper and lower right extremities. A new order for x-ray of the right side was received. 12:00 PM x-ray of resident's right side and the resident was medicated for pain. 3:00 PM x-ray results were back and no fracture was noted to the right side, the resident was medicated for pain. 10:00 PM Resident #1 was medicated for pain to the right side of the body. Tender to touch or move. 5/5/13 4:00 AM attempted to give [MEDICATION NAME] but refused to take. Appears in much pain during ADL's. 6:00 PM Resident in bed resting with eye's closed. Rt (right) side tender to touch. Pt (patient) medicated x 2 @ 7:00 AM and 2:00 PM with some effectiveness. Pt is unable to mover his/her (RLE) right lower extremities without having pain. 5/5/ - 5/6/13 at 8:00 PM medicated for pain and at 1:45 AM the doctor notified of… | 2016-06-01 |
| 8254 | 8254 | AGAPE REHABILITATION OF ROCK HILL | 425159 | 159 SEDGEWOOD DR | ROCK HILL | SC | 29732 | 2013-06-18 | 328 | G | 1 | 0 | B96711 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the complaint inspection, based on record review and interviews, the facility failed to ensure that one of one sampled residents reviewed with a [MEDICAL CONDITION] received appropriate care and services. The facility failed to implement interventions timely to prevent dislodgement of the [MEDICAL CONDITION] cannula for Resident #7. The findings included; The facility admitted /readmitted Resident #7 with [DIAGNOSES REDACTED]. Review of the Minimum Data Set assessment dated [DATE] revealed the resident had short and long term memory problems. Review of the hospital Discharge Summary dated 4/23/13 revealed Resident #7 initially was treated at the hospital for a decline in mental status. Imaging on day 2 demonstrated an increase in ventricular size ([DIAGNOSES REDACTED]), and the resident was transferred for neurosurgical care. The resident underwent [REDACTED]. The resident required reintubation within 48 hours for hypoxic [MEDICAL CONDITION] and [DIAGNOSES REDACTED], and subsequently required a [MEDICAL CONDITION] on 4/2/13. According to the summary, On date of discharge, (Resident #7) is alert [MEDICAL CONDITION]. (S/he) is able to speak a few words and follow commands with the LUE (left upper extremity). (S/he) has an old right [MEDICAL CONDITION] as well as facial weakness.[MEDICAL CONDITION] in place with no plans to decannulate given poor functional status and mental status . Review of nursing facility documentation revealed a Daily Skilled Nurse's Note dated 4/26/13 at 10:00 PM, which included information that the suction catheter would not go into [MEDICAL CONDITION] the inner or outer cannula with resistance met at every attempt. Noted [MEDICAL CONDITION] turned to the R(ight) side instead of forward, this was different from 2 days ago. Outer cannula head or neck plate was not flush to the skin and outer cannula was showing protruding out of the [MEDICAL CONDITION] opening in a R(ight) direction instead of straight out.… | 2016-06-01 |
| 8255 | 8255 | FLORENCE REHAB & NURSING CENTER | 425163 | 133 WEST CLARKE ROAD | FLORENCE | SC | 29501 | 2013-06-06 | 271 | D | 1 | 0 | ZP2D11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the day of the Complaint Inspection, based on record review and review of the facility's policy entitled [MEDICAL CONDITION], BILEVEL AND NPPV (Continuous Positive Airway Pressure, Bilevel Positive Airway Pressure or [MEDICAL CONDITION] and Non Invasive Positive Pressure Ventilation), the facility failed to obtain an admission order and/or prescription for [MEDICAL CONDITION], including the settings, for Resident #4, 1 of 2 residents reviewed with a [MEDICAL CONDITION] or [MEDICAL CONDITION]. The findings included: The facility admitted Resident #4 with [DIAGNOSES REDACTED]. On 6/6/13 at 3:02 PM, review of the Discharge Summary from the hospital revealed the statement S/he is to wear the [MEDICAL CONDITION] if s/he gets in trouble in the daytime. The summary also stated s/he had been ordered for [MEDICAL CONDITION] and the settings of it. The settings were not listed on the discharge summary. Review of the Physicians Orders and Telephone Orders on 6/6/13 at 3:42 PM revealed there were no orders written for administration of the [MEDICAL CONDITION] or the settings. On 6/6/13 at 3:37 PM, review of the admission care plan dated 3/20/13 revealed Potential for Resp (Respiratory) Complications Related to [MEDICAL CONDITION] and [MEDICAL CONDITION] Fibrosis and being Oxygen (O2) dependent was identified as a problem area. Interventions and approaches included give oxygen as ordered; elevate HOB (head of bed); assess for wheezing, SOB (shortness of breath), congestion; break tasks down into small segments; encourage rest periods; serve diet as ordered; vital signs routinely or as ordered; and O2 SATS (saturations) every shift. The care plan did not include any interventions related to the [MEDICAL CONDITION]. Review of the facility's policy, [MEDICAL CONDITION], BILEVEL AND NPPV, revealed Admission Criteria .2. A prescription for the device with the settings. The policy further stated Physician Responsibilities .3. Provide a written, signed physic… | 2016-06-01 |
| 8256 | 8256 | FLORENCE REHAB & NURSING CENTER | 425163 | 133 WEST CLARKE ROAD | FLORENCE | SC | 29501 | 2013-06-06 | 323 | D | 1 | 0 | ZP2D11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the day of the Complaint Inspection, based on observation, interview, and record review, the facility failed to ensure that a wheel chair alarm was in use as ordered for Resident #2, 1 of 6 residents reviewed with chair and/or bed alarms. The findings included: The facility admitted Resident #2 with [DIAGNOSES REDACTED]. On 6/6/13 at approximately 11:25 AM, during initial tour, Resident #2 was observed in his/her room sitting in his/her wheel chair with oxygen infusing via nasal cannula. The resident was observed again on at 2:30 PM and at 4:16 PM. No alarm was observed on the resident's wheel chair during any of the observations. At 1:54 PM, record review revealed an order dated 5/27/13 for a wheel chair alarm with an order to check function every shift. Further review of the record on 6/6/13 at 2:21 PM revealed a Nurse's Note dated 5/24/13 at 1:15 AM that stated Resident heard hollering out. Went to room (and) found resident sitting on floor in front of w/c (wheel chair). Review of the care plan dated 5/29/13 at 4:10 PM on 6/6/13 revealed the intervention W/C alarm. Check function Q (every) shift . At approximately 4:15 PM on 6/6/13, review of the Treatment Administration Record (TAR) revealed the treatment W/C alarm (check) function q (every) shift had been signed as completed for the 7-3 shift on 6/6/13. During an interview at 4:16 PM, Licensed Practical Nurse #1 confirmed that s/he had signed the MAR on 6/6/13 as having checked the function of the wheel chair alarm. S/he further confirmed that the wheel chair alarm was not on the resident's chair and was unable to locate an alarm in the resident's room. The resident stated at that time if there's an alarm on this chair, I don't know about it. | 2016-06-01 |
| 8257 | 8257 | SAINT MATTHEWS HEALTH CARE, LLC | 425170 | 601 DANTZLER STREET | SAINT MATTHEWS | SC | 29135 | 2012-04-11 | 281 | E | 0 | 1 | EZCC11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey based on record review and interview the facility failed to meet professional standards of quality related to repeatedly administering a medication that was documented on the resident 's list of allergies [REDACTED]. (One of 16 sampled resident's reviewed for professional standards.) The findings included: The facility readmitted Resident #4 on 10/11/11 with [DIAGNOSES REDACTED]. Record review on 4/9/12 revealed a allergy to [MEDICATION NAME] listed on the Medication Administration Record [REDACTED]. The hand written admission orders [REDACTED]. The Pharmacy Pre-Printed orders for November, December of 2011 and January, February, March and April 2012 had the allergies [REDACTED]. Registered Nurse #1 (RN) stated during an interview on 4/9/12 at 5:20 PM I am the one that does them and I just overlooked it. She also stated the Pharmacy put a semi colon behind the Tylenol so it looks like a separate allergy, but she is not allergic to Tylenol. The resident has a order dated 10/11/11 for Tylenol Extra Strength 500 mg (milligrams) two caplets by mouth twice a day. The MAR indicated [REDACTED]. The RN stated I crossed it (the [MEDICATION NAME]) off on the November, December and January orders but I didn't do it for February, March and April. I just dropped the ball, I guess. When ask if the other nurses signing the MAR brought it to her attention she stated no. The RN then stated: The nurses know this is not a true allergy. When ask what would happen if a new nurse was passing medication that was not familiar with this resident , she stated that could be a problem. The MAR's for February, March and April did not have [MEDICATION NAME] crossed out and the medication was signed as administered twice a day, every day. The January physician's orders [REDACTED]. | 2016-06-01 |
| 8258 | 8258 | SAINT MATTHEWS HEALTH CARE, LLC | 425170 | 601 DANTZLER STREET | SAINT MATTHEWS | SC | 29135 | 2012-04-11 | 371 | F | 0 | 1 | EZCC11 | On the days of the surveys, based on observations and interview, the facility failed to ensure that the insulated tops that cover the plates and foods served to resident's were used under sanitary conditions. The findings included: Observations on 4-10-2012 at 11:45 AM during preparation of the lunch meal revealed insulated covers stacked on a stainless steal counter near the tray line. Further observation of the insulated covers revealed dried- on white spots on the inside of the covers where there was potential for food contact. An interview with the District Manager of dietary services on 4-10-2012 confirmed this observation and he immediately began to sanitize the inside of the covers prior to utilization. He indicated that out of the approximately 150 insulted covers in kitchen inventory about one half were re-sanitized. When asked if the soiled covers would have been continued to be used if not identified by the survey process, he indicated a yes response. | 2016-06-01 |
| 8259 | 8259 | SAINT MATTHEWS HEALTH CARE, LLC | 425170 | 601 DANTZLER STREET | SAINT MATTHEWS | SC | 29135 | 2012-04-11 | 514 | E | 0 | 1 | EZCC11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey based on record review and interview the facility failed to assure that Resident # 4's medical record had accurately documented allergies [REDACTED]. Nursing staff administered the medication twice a day without questioning nor correcting the error. ( 1 of 16 sampled residents reviewed for accuracy of medical records.) The findings included: The facility readmitted Resident #4 on 10/11/11 with [DIAGNOSES REDACTED]. Record review on 4/9/12 revealed a allergy to [MEDICATION NAME] listed on the Medication Administration Record [REDACTED]. A typographical error had been made in November 2011 and was not corrected by either the nursing staff nor the pharmacy. | 2016-06-01 |
| 8260 | 8260 | HEARTLAND HEALTH AND REHABILITATION CARE CENTER-HA | 425289 | 1800 EAGLE LANDING BLVD | HANAHAN | SC | 29406 | 2016-03-02 | 164 | D | 0 | 1 | 3A0811 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview and review of the facility policy titled, Dressing Change: Nonsterile (Clean) and Sterile (Aseptic), the facility failed to provide privacy during a pressure ulcer treatment for 1 of 2 residents reviewed for pressure ulcers and 1 of 1 pressure ulcer treatments observed. Resident #164. The findings included: The facility admitted Resident #164 with [DIAGNOSES REDACTED]. An observation on 3/2/2016 at approximately 9:44 AM during a pressure ulcer treatment for [REDACTED].#164's bed. A staff member knocked on the door, and came over to the resident's bedside while the dressings were being changed on his/her coccyx. During an interview on 3/2/2016 at approximately 9:44 AM with Licensed Practical Nurse (LPN) #1 he/she confirmed that the privacy curtain was not pulled around Resident #164's bed during a dressing change to a pressure ulcer. LPN #1 stated, the privacy curtain should have been pulled and I should have asked the staff member to wait until the dressing was changed and the resident was covered. Review on 3/2/2016 at approximately 12:09 PM of the facility policy titled, Dressing Change: Nonsterile (Clean) and Sterile (Aseptic), revealed under, Procedure:, number 4. states, Introduce self, explain procedure and provide privacy. | 2016-06-01 |
| 8261 | 8261 | HEARTLAND HEALTH AND REHABILITATION CARE CENTER-HA | 425289 | 1800 EAGLE LANDING BLVD | HANAHAN | SC | 29406 | 2016-03-02 | 241 | E | 0 | 1 | 3A0811 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations and interviews, the facility failed to ensure staff knocked on residents doors prior to entering rooms, residents were covered after receiving treatments and each resident requiring assistance with eating were fed while seated at the table with other residents being fed. One of 2 sampled residents reviewed for dignity, 1 of 2 dining rooms observed, 1 of 2 units observed. The findings included: The facility admitted Resident #7 with [DIAGNOSES REDACTED]. During Stage I interview on 2/29/16 at approximately 11:15 AM, Resident #7 was being interviewed in his/her room with the door closed. One Certified Nursing Aide (CNA) knocked on the door once then peeped his/her head in the room without permission and closed the door. A few minutes later, another Certified Nursing Aide opened the door and entered the room without knocking. Resident #7 stated they do that all the time, after the second CNA entered the room without knocking. During random lunch meal observation on 2/29/16 at approximately 11:58 AM multiple residents were seated in the dining room. Two long tables were positioned vertically in the dining room as you entered and smaller tables were positioned around walls on each side of the dining room. The residents seated at the long tables were served and eating while the residents seated at the smaller tables were not served. At approximately 12:14 PM two tables with two residents noted with one staff member at each table feeding one resident while the other resident seated at the same table was not being fed or eating. Further observations revealed four staff members feeding residents without engaging in conversations with the resident. A random observation of lunch meals being delivered on the unit on 2/29/16 at approximately 1:03 PM revealed staff entering residents rooms without knocking. A random observation of breakfast delivery on 3/01/16 at approximately 9:07 AM revealed staff entering Rooms 305, 307 and 308 wit… | 2016-06-01 |
| 8262 | 8262 | HEARTLAND HEALTH AND REHABILITATION CARE CENTER-HA | 425289 | 1800 EAGLE LANDING BLVD | HANAHAN | SC | 29406 | 2016-03-02 | 242 | D | 0 | 1 | 3A0811 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview, the facility failed to ensure all residents were afforded the right to make choices about his/her life that are significant to the resident for 2 of 3 residents reviewed for choices. Resident #164's choices were not honored related to bathing, getting out of bed in the morning and going to bed at night and Resident #276's choice was not honored related to bathing. The findings included: The facility admitted Resident #164 with [DIAGNOSES REDACTED]. During an interview on 2/29/2016 at approximately 2:42 PM with Resident #164, he/she stated that he/she was not afforded the opportunity to choose when to get up in the morning, when to go to bed at night, or choices concerning when and what type of bath he/she received. The facility admitted Resident #276 with [DIAGNOSES REDACTED]. An interview on 3/1/2016 at approximately 12:30 PM with Resident #276's family member revealed that Resident #276 did not get bathed daily. Resident #276's family stated that he/she was used to bathing daily and it was Resident #276's preference to receive a bath daily. During an interview on 3/2/2016 at approximately 8:30 AM with the Administrator, he/she stated the he/she was not aware of any documentation or if any, where it would be documented and who was responsible for the documentation on resident choices. An interview on 3/2/2016 at approximately 9:05 AM with the Scheduler/Quality Assurance Coordinator revealed that he/she did not find out resident preferences concerning bathing, and getting up in the mornings and going to be at night. An interview on 3/2/2016 at approximately 9:10 AM with the Social Service worker #1 revealed that he/she too, did not know how the facility found out about resident preferences and choices. | 2016-06-01 |
| 8263 | 8263 | HEARTLAND HEALTH AND REHABILITATION CARE CENTER-HA | 425289 | 1800 EAGLE LANDING BLVD | HANAHAN | SC | 29406 | 2016-03-02 | 252 | D | 0 | 1 | 3A0811 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations, record reviews and interviews the facility failed to maintain a satisfactory environment for 1 of 1 resident sampled for a safe, clean, comfortable and homelike environment. The findings include: On 3/1/16 at approximately 2:28 PM a visit to the room of Resident #81 revealed a urine-like odor upon entry into the room, but lessened when near the area next to the window where Resident #81 was sleeping. Resident #81 was admitted to the facility and had a BIMS (Brief Interview for Mental Status) of 3 (0-7 = severe impairment) and had [DIAGNOSES REDACTED]. On 3/1/16 at approximately 3:09 PM a second visit to the room of Resident #81 revealed that a strong urine-like odor was originating from the area at/near the bed of Resident #146 which is located next to the door. In addition there were numerous (estimated 30 - 40) stuffed animals on the floor surrounding the bed. On 3/1/16 at approximately 3:17 PM CNA (Certified Nursing Assistant) # 1 and LPN (Licensed Practical Nurse) # 2 went with the Surveyor to the room of Resident #81. CNA # 1 stated that it did not smell good and that there was a strong urine-like odor originating near the bed of Resident #146. LPN # 2 stated that the room had been deep cleaned approximately 2 weeks ago. On 3/1/16 at approximately 3:37 PM the Surveyor informed the Administrator of the findings. The Administrator acknowledged awareness of odors and hoarding by Resident #146 and proceeded to investigate. On 03/1/16 at approximately 5:43 PM the Facility Regional Director stated that the bed of Resident #146 had been stripped, mattress changed and that stuffed animals were being evaluated. On 3/2/16 at approximately 9:20 AM a review of the Medical Record for Resident #146 revealed the following: Admission records from EMS and hospital referred to hoarding and insect infestation No reference by the Facility related to odors or hoarding ADL (Activities of Daily Living) self care deficit as evidenced by n… | 2016-06-01 |
| 8264 | 8264 | HEARTLAND HEALTH AND REHABILITATION CARE CENTER-HA | 425289 | 1800 EAGLE LANDING BLVD | HANAHAN | SC | 29406 | 2016-03-02 | 280 | D | 0 | 1 | 3A0811 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on Record review and interview the facility failed to review and revise the Comprehensive Care Plan for Resident #71, 1 of 3 sampled residents reviewed for urinary incontinence. The Comprehensive Care Plan was not reviewed and revised after the resident was assessed as having increased Urinary incontinence. The findings included: The facility admitted resident #71 with [DIAGNOSES REDACTED]. Record review of the Minimum Data Set (MDS) - Version 3.0 on 3/1/2016 at approximately 12:38 PM revealed an Admission MDS dated [DATE] that indicated the resident was not having any urinary incontinence. The MDS also indicated that a trial of a toileting program had not been attempted. Review of the Quarterly MDS, dated [DATE], on 3/1/2016 at approximately 12:38 PM indicated that the resident was always incontinent of the Bladder with no episodes of continent voiding. In addition, the 2/8/2016 MDS indicated that a trial of a toileting program had not been attempted. Both MDS assessments revealed that the resident had a BIMS (Brief Interview for Mental Status) score of 14, indicating the resident was cognitively intact. Record review of the Patient Admission/Readmission Screen dated 10/30/2015 on 3/1/2016 at 3:39 PM revealed that the resident did not have Bladder incontinence. Record review of the Patient Admission/Readmission Screen dated 1/6/2016 on 3/1/2016 at approximately 3:39 PM revealed that the resident did have Bladder incontinence. Review of the Comprehensive Care Plan on 3/1/2016 at approximately 1:04 PM revealed that the Comprehensive Care Plan had not been reviewed or revised to indicate the resident had a decline in Bladder function and was having Urinary incontinence. The Comprehensive Care Plan revealed a focus area that the resident was At risk for Urinary incontinence r/t (related to) decreased mobility. The focus area was initiated on 11/11/2015 and last revised on 11/23/2015. During an interview with Registered Nurse (RN) #4 on 3/1… | 2016-06-01 |
| 8265 | 8265 | HEARTLAND HEALTH AND REHABILITATION CARE CENTER-HA | 425289 | 1800 EAGLE LANDING BLVD | HANAHAN | SC | 29406 | 2016-03-02 | 315 | D | 0 | 1 | 3A0811 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview the facility failed to provide appropriate treatment and services to restore as much normal Bladder function as possible for Resident #71, 1 of 3 sampled residents reviewed for Urinary incontinence. Resident #71 had a decline in Bladder function with new no interventions implemented to restore or maintain Bladder function. The findings included: The facility admitted resident #71 with [DIAGNOSES REDACTED]. Record review of the Minimum Data Set (MDS) - Version 3.0 on 3/1/2016 at approximately 12:38 PM revealed an Admission MDS dated [DATE] that indicated the resident was not having any urinary incontinence. The MDS also indicated that a trial of a toileting program had not been attempted. Review of the Quarterly MDS, dated [DATE], on 3/1/2016 at approximately 12:38 PM indicated that the resident was always incontinent of the Bladder with no episodes of continent voiding. In addition, the 2/8/2016 MDS indicated that a trial of a toileting program had not been attempted. Both MDS assessments revealed that the resident had a BIMS (Brief Interview for Mental Status) score of 14, indicating the resident was cognitively intact. Record review of the Patient Admission/Readmission Screen dated 10/30/2015 on 3/1/2016 at 3:39 PM revealed that the resident did not have Bladder incontinence. Record review of the Patient Admission/Readmission Screen dated 1/6/2016 on 3/1/2016 at approximately 3:39 PM revealed that the resident did have Bladder incontinence. In addition, the Patient Admission/Readmission Screen read If Bladder Incontinence is checked, initiate bladder diary, complete Urinary Incontinence & Indwelling Catheter Assessment in 72 hrs. and initiate toileting program UNLESS patient is terminally ill, has intractable pain OR is comatose. There was no documentation in the medical record that any further Bladder assessments or a toileting program had been done. Review of the Comprehensive Care Plan on 3/1/2016 at … | 2016-06-01 |
| 8266 | 8266 | HEARTLAND HEALTH AND REHABILITATION CARE CENTER-HA | 425289 | 1800 EAGLE LANDING BLVD | HANAHAN | SC | 29406 | 2016-03-02 | 328 | D | 0 | 1 | 3A0811 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, record review and interview the facility failed to provide oxygen as ordered for Resident #273, 1 of 1 sampled resident reviewed for Respiratory Care. The facility did not set the resident's oxygen concentrator per the physician's orders [REDACTED]. The findings included: The facility admitted Resident #272 with [DIAGNOSES REDACTED]. Resident #273 was observed in bed on 1/29/2016 at 12:22 PM and 2:57 PM with oxygen infusing via nasal canula. On both observations the resident's oxygen concentrator was set at 2 liters. The resident was observed in bed on 3/1/2016 at 2:45 PM with oxygen infusing via nasal canula. The resident's oxygen concentrator was set at 2 liters. Record review of the physician's orders [REDACTED]. During an interview with Registered Nurse #3 on 3/1/2016 at 3:55 PM, the resident's orders were reviewed and RN #3 confirmed the resident's oxygen was ordered to be set at 3 liters. Immediately after review of the orders, Resident #273 was observed in bed with RN #3 present, who confirmed the resident's oxygen was set at 2 liters. RN #3 set the oxygen concentrator to 3 liters and checked the resident's oxygen level. The resident's oxygen level was within normal limits. | 2016-06-01 |
| 8267 | 8267 | HEARTLAND HEALTH AND REHABILITATION CARE CENTER-HA | 425289 | 1800 EAGLE LANDING BLVD | HANAHAN | SC | 29406 | 2016-03-02 | 431 | D | 0 | 1 | 3A0811 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations, record reviews, interviews and manufacturer package inserts and labeling the facility failed to assure that it was free of expired medication in 2 of 4 medication carts and that medications were stored correctly and securely in 2 of 2 medication rooms. The findings include: On [DATE] at approximately 9:52 AM the Unit 500 Medication Room door was found unlocked for approximately 10 minutes and the refrigerator contained one 6 ounce bottle, half full of Lido/Q-dry/MiAcid lot # 6ACZ W with an expiration date of [DATE] belonging to Resident # 53. These findings were verified on [DATE] at approximately 10:10 AM by LPN (Licensed Practical Nurse) # 1. On [DATE] at approximately 10:19 AM inspection of the Unit 100 Front Medication Cart was found to contain in the 3rd drawer one opened, in use bottle of Calcitonin-Salmon 200 Units/dose Nasal Spray by Apotex belonging to Resident # 72 lying on its side. The manufacturer labeling states: Store in use at room temperature .in an upright position. This finding was verified on [DATE] at approximately 10:25 AM by RN (Registered Nurse) # 1. On [DATE] at approximately 10:35 AM inspection of the Unit 100 Medication Room refrigerator revealed in the bottom drawer one opened, in use Novolog FlexPen by Novo-Nordisk belonging to Resident # 96. The manufacturer states: Don't store in use Novolog FlexPen in the refrigerator. This finding was verified by RN # 2 on [DATE] at approximately 10:43 AM. On [DATE] at approximately 2:31 PM inspection of the Magnolia Medication Cart 1 revealed one Levemir Flextouch, not in use belonging to Resident # 15 and labeled by the facility with an expiration date of [DATE]. This finding was verified by RN # 2 on [DATE] at approximately 2:35 PM. | 2016-06-01 |
| 8268 | 8268 | HEARTLAND HEALTH AND REHABILITATION CARE CENTER-HA | 425289 | 1800 EAGLE LANDING BLVD | HANAHAN | SC | 29406 | 2016-03-02 | 514 | D | 0 | 1 | 3A0811 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record reviews and interviews, the facility failed to maintain accurate documentation in the medical records for 2 of 16 sampled residents reviewed. Resident #7's medical record had documentation in the social services notes that were in reference to another resident. Resident #273 had blanks/missing documentation on the Treatment Administration Record Sheet (TARS). The findings included: The facility admitted Resident #7 with [DIAGNOSES REDACTED]. A review of the medical record on 3/01/16 at approximately 12:18 PM revealed a social services note dated 9/17/15 that indicated the resident and his/her sister requested to be prepared for discharge home. The social note further indicated that Resident #7 was using adaptive equipment to aid in dressing and needed assistance with a back brace; with another 2 weeks of rehab prior to discharge. A social services note dated 11/25/15 indicated there were no concerns at this time and there were no discharge plans due to physical care needs. There was no documentation to address the change in discharge planning from the 9/17/15 social services note to 11/25/15 social services note. During an interview on 3/02/16 at approximately 9:30 AM with Social Services Staff #1, after reviewing the 9/17/15 social services discharge note that indicated discharge plans were for Resident #7 to leave the facility after 2 weeks of rehab then reviewing the 11/25/15 social services note that indicated discharge was not the plan; the Social Services Staff #1 stated he/she was not sure if the information written on 9/17/15 was correct because there were no plans of discharge for Resident #7. An interview on 3/02/16 at approximately at 10:20 AM with Social Services Staff #1 revealed the 9/17/15 social services documentation should have been written in another resident's medical. The Social Services Staff #1 further stated the documentation was written on the wrong resident. The facility admitted Resident #272 with [D… | 2016-06-01 |
| 8269 | 8269 | PRINCE GEORGE HEALTHCARE CENTER | 425295 | 901 MAPLE STREET | GEORGETOWN | SC | 29440 | 2012-07-25 | 318 | D | 0 | 1 | QHNN11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on record review and interview, the facility failed to ensure 1 of 1 sampled resident with limited range of motion received appropriate services to prevent further decline. Resident #3 did not receive Restorative Nursing as recommended by Occupational Therapy. The findings included: The facility admitted Resident #3 with [DIAGNOSES REDACTED]. Review of the Quarterly Minimum Data Set((MDS) dated [DATE] revealed the resident had range of motion limitations of the upper and lower extremities on one side. Review of the Occupational Discharge Note dated 6/22/12 revealed a recommendation for Restorative Nursing for left upper extremity range of motion and to continue with a rolled washcloth in the left hand at all times as tolerated except for patient care. Further review of the medical record revealed no restorative notes on the record. On 7/24/12 the Unit Manager was asked if she could locate documentation related to restorative services. The Unit Manager stated that Restorative Nursing had not been initiated. Further interview with Administrative Staff revealed that Restorative had not been started due to failure of therapy not initiating the paperwork. | 2016-06-01 |
| 8270 | 8270 | PRINCE GEORGE HEALTHCARE CENTER | 425295 | 901 MAPLE STREET | GEORGETOWN | SC | 29440 | 2012-07-25 | 325 | D | 0 | 1 | QHNN11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on observations, record review, and interview, the facility failed to maintain acceptable nutritional status as evidence by not following Physicians order for mighty shake to prevent weight loss for 1 of 5 residents reviewed for nutritional status (Resident #13). The findings included: The facility admitted Resident #13 with [DIAGNOSES REDACTED]. Review of the medical record on 7/23/12 at approximately 6 PM revealed Resident #13 was dependent on others for all ADL's (Activities of Daily Living) which includes eating. Reviewing the medical record for Resident #13 revealed a Physicians order for Mighty Shakes TID (Three times a day) with meals. Review of the Registered Dietitian Nutritional Care Monitoring Notes dated 6/7/12 revealed a problem of involuntary weight loss with a recommended intervention of Shake tid with meals. The RD documented the resident had an [MEDICATION NAME] level of 2.5. Observations of the lunch and supper meal on 7/24/12 revealed that Resident #13 did not receive a mighty shake with either meal. During an interview on 7/24/12 with the Unit Manager for [MEDICATION NAME], she verified that resident did not receive nutritional supplement with meal because the Physicians order for mighty shake for Resident #13 was never sent to Dietary for the weight loss intervention to be implemented. | 2016-06-01 |
| 8271 | 8271 | PRINCE GEORGE HEALTHCARE CENTER | 425295 | 901 MAPLE STREET | GEORGETOWN | SC | 29440 | 2012-07-25 | 367 | D | 0 | 1 | QHNN11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on record review, observations, and interviews, the facility failed to provide a physician ordered diet in the appropriate form for 1 of 2 residents reviewed receiving a Puree diet. Resident #3 continued to receive whole sandwiches after the diet was changed to pureed. The findings included: The facility admitted Resident #3 with [DIAGNOSES REDACTED]. Record review on 7/23/12 revealed a physician's orders [REDACTED]. During observation of the lunch meal on 7/24/12, a staff member delivering the tray was asked what diet the resident was receiving. The staff member stated that the resident was receiving a Puree diet. The staff member was asked if a whole sandwich was on a Puree diet and she stated that she did not think she would feed the sandwich to the resident. Observation of the evening meal revealed LPN(Licensed Practical Nurse)#2 feeding the resident. LPN #2 was asked what diet the resident was on and she responded after reading the tray card that she was on a Puree diet. LPN #2 confirmed a whole sandwich on the resident's tray. Review of the tray card revealed a sandwich was still listed. An interview with the Dietary Manager on 7/25/12 revealed that the sandwich had remained on the tray card after the diet change and that after it had been brought to her attention, it was removed. An interview with the Registered Dietician on 7/25/12 at 11:45 AM revealed that the sandwich was listed as a preference of the resident and when reviewing the resident's diet, she did not review the tray card for accuracy. | 2016-06-01 |
| 8272 | 8272 | PRINCE GEORGE HEALTHCARE CENTER | 425295 | 901 MAPLE STREET | GEORGETOWN | SC | 29440 | 2012-07-25 | 425 | D | 0 | 1 | QHNN11 | On the days of the survey, based on observation, manufacturer package insert, Facts and Comparisons (Updated Monthly) and interview, the facility failed to follow a procedure to ensure that expired medications were not stored in 1 of 3 medication rooms. The findings included: On 7/23/12 at approximately 1:10 PM, inspection of the Indigo Medication Room refrigerator revealed the following: Two opened vials of Tuberculin PPD (Purified Protein Derivative), 5 TU (Test Units)/0.1 ml (milliliter/vial, lots 3 and 7, labelled House Stock had not been labeled as to date opened. The manufacturer (JHD Pharmaceuticals) package insert and Facts and Comparision, page 2001 state, Discard vials in use for more than 30 days because of possible oxidation and degradation that may affect potency. This finding was verified by LPN (Licensed Practical Nurse #1 on 7/23/12 at approxiamtely 1:20 PM. | 2016-06-01 |
| 8273 | 8273 | CAPSTONE HEALTH & REHAB OF EASLEY | 425298 | 1850 CRESTVIEW ROAD | EASLEY | SC | 29642 | 2012-07-12 | 157 | G | 0 | 1 | PSVU11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on record review and interview, the facility failed to notify the physician timely for 1 of 9 residents reviewed with a change in their condition. The facility did not notify the physician when Resident #7, with history of respiratory distress, respiratory status changed. The findings included: The facility admitted resident #7 with [DIAGNOSES REDACTED]. Review of the nurses notes revealed the following documentation: 6/9/12 11:50 (no am or pm), Resident stated I don't feel well and I can't breathe. Resident also stated, Take me to the hospital! VS (vital signs) are as followed (sic): T (temperature) 99.6, P (pulse) 161, O2 (Oxygen) 51%, Resident diaphoretic and RR (Respirations) labored and uneven. Called on call NP (nurse Practitioner) ____ New order to send to ER. 6/12/12, 3:30 PM Resident returned to facility . The nurses notes throughout the resident stay described the resident's respirations as even and unlabored until 6/26/12. 6/26/12, 1230AM (late entry) Resp even and unlabored. 6/26/12, 3:00 AM (late entry) Resp shallow, lying in bed with eyes closed. Sleeping soundly, hard to arouse. O2 @ 2L (liters) NC (nasal cannula). There was no MD notification of shallow respirations or that the resident was difficult to arouse. 6/26/12, 640 AM (late entry) O2 88% inc. (increased) O2 to 3L, O2 increased to 92%. Informed on coming nurse of residents status. VS 156/70, 22, 91, 97.9. Will continue to monitor resident. There was no MD notification of the decreased oxygen saturation level or the decision to increase the oxygen flow rate for the resident with known [MEDICAL CONDITION]. 6/26/12, 8:15 (no am or pm) Resident noted to be diaphoretic, breathing labored, O2 Sat 83% on 3L/M,, increased O2 to 4L/M via N/C (nasal cannula) v/s 168/76 -92-29-98.8. Called NP (Nurse Practitioner) and spoke to her and she said to contact family and send out . The physician or nurse practitioner was not notified until 8:15 AM after … | 2016-06-01 |
| 8274 | 8274 | CAPSTONE HEALTH & REHAB OF EASLEY | 425298 | 1850 CRESTVIEW ROAD | EASLEY | SC | 29642 | 2012-07-12 | 328 | G | 0 | 1 | PSVU11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on record review, observations and interviews, the facility failed to provide appropriate services for 1 of 1 residents with acute change in respiratory status and 2 of 8 residents with oxygen concentrators. Resident #7 with known respiratory distress did not receive timely intervention for changes in her respiratory status. Resident #1 and one additional random resident did not have filters in place in their oxygen concentrators. The findings included: The facility admitted resident #7 with [DIAGNOSES REDACTED]. The resident had a history of [REDACTED]. On 6/26/12, the resident was noted to have shallow respirations and was difficult to arouse at 3:00 AM. There was no assessment done to check breath sounds or vital signs once the resident had been noted to be difficult to arouse and had shallow respirations. At 6:40 AM, the resident oxygen saturations were down to 88%, the nurse increased the oxygen flow and failed to notify the physician. There was no no documentation that an assessment had been done. The physician or nurse practitioner was not notified until 8:15 AM after the resident was noted to be diaphoretic and the resident's oxygen had again been increased for the second time to 4L/M. Review of the Resident's Physician orders revealed Oxygen was ordered at 2L/M. There was no Physician's order to increase the Oxygen rate for the resident with [MEDICAL CONDITION]. The resident was sent to the hospital and required intubation for respiratory distress. Review of Perry and Potter, Clinical Nursing Skills & Techniques, 7th Edition, Copyright 2010, Assessment of Signs and Symptoms Associated with [MEDICAL CONDITION] included: Apprehension, anxiety, behavioral changes, decreased level of consciousness, confusion, drowsiness, altered concentration, increased pulse rate and depth of respiration or irregular respiratory patterns, decreased lung sounds, adventitious lung sounds (e.g., crackle, wheezes), elevated … | 2016-06-01 |
| 8275 | 8275 | CAPSTONE HEALTH & REHAB OF EASLEY | 425298 | 1850 CRESTVIEW ROAD | EASLEY | SC | 29642 | 2012-07-12 | 425 | D | 0 | 1 | PSVU11 | On the days of the survey, based on observation and interview, the facility failed to follow a procedure to ensure expired medication/supplies were removed from available use. Three expired syringes containing .09 % sodium chloride were stored in a box mixed in with unexpired syringes in the medication room. The findings included: On 7/12/12 at 11:46 AM,a review of medications/supplies stored in the medication room revealed (3) three syringes of .09% sodium chloride that expired July 1, 2012. The syringes were stored within a box of 20 of unexpired syringes. Interview with the Assistant Director of Nursing on 7/12/12 at 12:28pm revealed the night shift nurses were responsible for checking for expired products. | 2016-06-01 |
| 8276 | 8276 | CAPSTONE HEALTH & REHAB OF EASLEY | 425298 | 1850 CRESTVIEW ROAD | EASLEY | SC | 29642 | 2012-07-12 | 514 | E | 0 | 1 | PSVU11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on record reviews and interviews, the facility failed to maintain clinical records in accordance with accepted professional standards and practice for 3 of 15 residents reviewed for accuracy and completeness of clinical records. (Residents #4, #7, and #13). Resident 4 and 13 had inaccurate cumulative month physician orders. Resident # 7's nursing documentation did not accurately reflect the resident's care. The findings included: The facility admitted Resident #13 with [DIAGNOSES REDACTED]. Record review on 7/12/12 at approximately 1:50 PM revealed a Physician's Telephone Order dated 6/26/12 which stated 1) (Increase) [MEDICATION NAME] to 0.100 mcg (micrograms) . Continued review revealed the order dated 6/26/12 for the increased dosage of [MEDICATION NAME] had not been carried over to the July 2012 cumulative Physician Orders; and the resident was still ordered to receive [MEDICATION NAME] 0.075 mcg daily. This was verified by Licensed Practical Nurse (LPN) #2. When asked how the monthly orders are compiled, LPN #2 stated that once an order is received by the Physician, the order is written, then the yellow copies go to Care Plans where the monthly Physician order [REDACTED]. Review of the July 2012 Medication Administration Record [REDACTED]. During an interview on 7/12/12 at 2:10 PM, the Health Information Manager was told of the concern about the inaccuracy of the cumulative July 2012 Physician order [REDACTED]. When asked how orders are carried over to the next month, she stated that the cumulative orders are printed out 7 days before the changeover (1st of the month). She stated once printed, the night nurse would check these for accuracy. Upon review of Resident #13's July cumulative Physician Orders, the Health Information Manager stated that the nurse checked the orders on 7/1/12 and indicated the signature next to the entry Above Orders Noted by:. She verified there was a blank in the signature/date … | 2016-06-01 |
| 8277 | 8277 | RICHARD M CAMPBELL VETERANS NURSING HOME | 425301 | 4605 BELTON HIGHWAY | ANDERSON | SC | 29621 | 2016-02-12 | 490 | J | 0 | 1 | 3WCN11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record reviews, interviews and review of the facility Abuse and Reporting Manual, the facility failed to be administered in a manner that enabled it to use its resources effectively and efficiently to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident. Administration failed to ensure that abuse policies were developed and/or implemented related to identification of abuse, investigation of allegations of abuse, protection of the resident, and screening of applicants prior to hire. Administration did not identify and address staff failure to follow established abuse policies related to identification of abuse and protection of Resident #62, one of two sampled residents reviewed for abuse. Administration failed to identify staff actions as abuse and failed to protect Resident #62 when accused employees were allowed to continue to work on the unit where s/he resided. On 2-10-2016 at 8:14 PM, the Administrator and Director of Nursing were notified that Immediate Jeopardy and /or Substandard Quality of Care existed in the facility as of 12/31/2015. The findings included: Cross Refer CFR 483.13(b), 483.13(c)(l)(i) Abuse, F-223 Related to the facility failure to prevent Resident # 62 from being physically abused by two employees on 12/31/15. The employees held the resident and performed incontinent care after the resident had repeatedly refused the care. Cross Refer CFR 483.13(c) F226 Related to facility failure to develop and/or implement policies on identification of abuse, investigation of abuse allegations, resident protection during investigation of allegations. Cross Refer CFR 483.15(g)(1) Provision of Medically related Social Services, F250 The facility failed to provide medically related social services for Resident # 62. Social Services failed to follow-up with the resident related to an incident of alleged abuse leaving the resident fearful of staff reprisal. The facility did n… | 2016-06-01 |
| 8278 | 8278 | PRUITTHEALTH ESTILL | 425315 | 252 LIBERTY STREET SOUTH | ESTILL | SC | 29918 | 2012-07-18 | 280 | D | 0 | 1 | 4SFT11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on observations, interviews and record review, the facility failed to update the care plan for 2 of 5 sampled residents receiving oxygen. Resident #4 was observed by staff changing the setting of liters on his concentrator and Resident #8 was not care planned for the use of oxygen. The findings included: The facility admitted Resident #4 with [DIAGNOSES REDACTED]. During an observation of Resident #4 on 7/16/12 at 3:55pm, the Resident's oxygen concentrator was set at 4 liters per minute via nasal cannula. During a record review on 7/16/12 at approximately 4:00pm, the Physician's Interim Orders dated 7/4/12 stated Oxygen at 2 liters per minute via nasal cannula continuously. During an observation on 7/17/12 at 10:27am, Resident #4's oxygen concentrator was set at 4 liters per minute via nasal cannula. During an interview with the Unit Manager #1 on 7/17/12 at 10:27am, she verified the oxygen order was for 2 liters per minute and the current setting on the oxygen concentrator was 4 liters per minute. The Unit Manager then stated, He messes with it. The Resident also stated that the Concentrator gets bumped. During a review of the Resident's Care Plan on 7/17/12 at 10:30am, no evidence was noted that the Care Plan addressed behaviors with readjusting of the oxygen concentrator machine. During an interview with the Unit Manager #1 on 7/17/12 at 10:30am, she confirmed that the Care Plan was not updated to reflect the Resident's behavior related to adjusting the flow on the oxygen concentrator. The facility admitted Resident #8 with [DIAGNOSES REDACTED]. During the days of the survey Resident #8 was observed wearing a oxygen tank. Review of the medical record on 7/16/12 at approximately 4:50 PM which revealed a physician's clarification order dated 6/29/12 for oxygen: O2 (oxygen) 2 l/m (liters per minute) via NC (Nasal Canula) to maintain sats (saturation levels) > (greater than) 92% Review of Resident #8's Care Pla… | 2016-06-01 |
| 8279 | 8279 | PRUITTHEALTH ESTILL | 425315 | 252 LIBERTY STREET SOUTH | ESTILL | SC | 29918 | 2012-07-18 | 328 | D | 0 | 1 | 4SFT11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on observations, record review and interview the facility failed to provide proper treatment and care for 2 of 5 sampled residents reviewed for oxygen administration. Resident #4's oxygen was observed being administered at 4 liters when there was a physician's orders [REDACTED]. Resident #8 portable oxygen tank was observed empty on separate occasions. The findings included: The facility admitted Resident #8 with [DIAGNOSES REDACTED]. During initial tour of the facility on 7/16/12 at approximately 1:30 PM, Resident #8 was observed wearing a portable oxygen tank. The surveyor observed the needle on the tank pointing to the red area which indicated needs refill. Review of the medical record on 7/16/12 at approximately 4:50 PM revealed a physician's orders [REDACTED].> (greater than) 92%. Review of the Daily Skilled Nurses Notes revealed on 6/27/12 at 7:55 PM .Resident yells I can't breathe O2 sats @ 93 on O2 via nasal canula. On 7/17/12 at approximately 10:45 AM, there was an observation of Resident #8's oxygen and the gauge was again pointing at the red area which indicated needs refill. During an interview Licensed Practical Nurse #1 verified that Resident #8 O2 tank was empty and needed to be replaced. The facility admitted Resident #4 with [DIAGNOSES REDACTED]. During a record review on 7/16/12 at approximately 4:00pm, the Physician's Interim Orders dated 7/4/12 verified the order for Oxygen at 2 liters per minute via nasal cannula continuously. During an observation on 7/16/12 at 3:55pm, Resident #4's oxygen concentrator was set at 4 liters per minute via nasal cannula. A second observation on 7/17/12 at 10:27am, revealed Resident #4's oxygen concentrator was set at 4 liters per minute via nasal cannula. During an interview with the Unit Manager #1 on 7/17/12 at 10:27am, she verified the oxygen order was for 2 liters per minute and the current setting on the oxygen concentrator was 4 liters per minute. Duri… | 2016-06-01 |
| 8280 | 8280 | NHC HEALTHCARE - LEXINGTON | 425333 | 2993 SUNSET BLVD | WEST COLUMBIA | SC | 29169 | 2012-04-18 | 309 | D | 0 | 1 | 98F911 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the Recertification Survey, based on record review, review of the Hospice contract, and interviews, the facility failed to provide documented evidence of hospice aide visits for 2 of 4 residents (Resident #4 and Resident #5) reviewed for hospice. The facility also failed to provide a current hospice treatment plan for Resident #4. The findings included: The facility admitted Resident #5 on [DATE] with [DIAGNOSES REDACTED]. Record review on [DATE] at approximately 11AM revealed Hospice orders for Resident #5. Review of the Hospice Care Plan noted that the Hospice aide was to visit 5 times a week to assist with personal care/ADL's/light housekeeping as needed within 60 day period of time. Further review of the Hospice record on [DATE] revealed no documentation of the Hospice aide visits or provision of planned care for Resident #5. On [DATE] at approximately 1:50 PM, a untitled document was located under the Hospice tab in the resident's medical record which revealed: The following forms need to be in the facility charts * Current Hospice Aide Care Plan and Weekly Progress Notes in separate notebook on each unit. Review of the Hospice contract on [DATE] at approximately 3:10 PM, under Section 5 A. Preparation and Maintenance of Records revealed: The facility shall prepare and maintain medical records for each Hospice patient receiving services pursuant to this Agreement. The medical records shall consist of progress notes and clinical notes describing all patient services and events .The Hospice PLAN OF CARE and other documentation must be maintained in the patient's medical record. On [DATE] at approximately 11:25 AM, during an interview with Registered Nurse (RN) #3, she verified there was no documentation of Hospice aide visits in the medical record or in a separate notebook on the unit. The Hospice aide notes were faxed to the facility on [DATE] at approximately 9:06 AM. During record review for Resident #4 on [DATE] at appro… | 2016-06-01 |
| 8281 | 8281 | NHC HEALTHCARE - LEXINGTON | 425333 | 2993 SUNSET BLVD | WEST COLUMBIA | SC | 29169 | 2012-04-18 | 314 | D | 0 | 1 | 98F911 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the Recertification Survey, based on observation, interviews and record review, the facility failed to provide necessary treatment and services to promote healing and prevent infection for Resident # 1, 1 of 2 residents reviewed for wound care. The findings included: The facility admitted Resident #1 on 7/8/10 with [DIAGNOSES REDACTED]. The resident was admitted to the hospital on [DATE] with [DIAGNOSES REDACTED]. On 4/18/12 at 10:18 AM, Registered Nurse (RN) #1 was observed performing wound care to Resident #1. After removing the soiled dressing, removing her gloves and donning clean gloves, RN #1 flushed the wound bed with normal saline which drained out of the wound to the peri-wound. RN #1 used a dry gauze to dry the contaminated normal saline from the peri-wound and then continued around the entire peri-wound with the same gauze. She applied the skin prep and the dressing to the wound. RN #1 did not clean the contaminated normal saline from the peri-wound. At 10:31 AM, RN #1, confirmed that the normal saline that had drained from the wound bed was contaminated and that she had wiped the entire peri-wound area with the same gauze used to dry the contaminated normal saline from the area below the wound. She verified that she should have discarded the gauze after drying the peri-wound of the contaminated normal saline and used a clean gauze and normal saline to clean the peri-wound. During an interview at 12:05 PM on 4/18/12, the Director of Nursing (DON) stated that ideally, the nurse would not have wiped the peri-wound with a contaminated gauze but once she did, she should have stopped the treatment and started over. The DON also verified that the facility's policy did not state how the wound or peri-wound should be cleaned but confirmed that a prudent nurse would have cleaned the peri-wound and that it should be cleaned from the edge of the wound outward. | 2016-06-01 |
| 8282 | 8282 | NHC HEALTHCARE - LEXINGTON | 425333 | 2993 SUNSET BLVD | WEST COLUMBIA | SC | 29169 | 2012-04-18 | 323 | D | 0 | 1 | 98F911 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of survey, based on record review, observations and interviews, the facility failed to ensure that 1 of 2 sampled residents reviewed for exit seeking remained free from accident hazards as was possible by not assessing the placement of the Wanderguard and circulation as ordered by the physician for Resident #14. The findings included: The facility admitted Resident #14 on 11-2-11 with a [DIAGNOSES REDACTED]. During an observation of Resident #14 on 4-16-12 at approximately 5:05 PM, the resident was noted to be wearing a Wanderguard on her right ankle. Record review on 4-16-12 at approximately 5:10 PM, revealed that an elopement assessment had been completed on 1-2-12 and an order had been written on 1-3-12 as follows: Place Wanderguard to right ankle. Check placement every shift. Check circulation to right foot every shift. Upon review of Resident #14's Treatment Administration Record (TAR) for the month of April, there were no signatures located by the order on the TAR and no further documentation could be found in the chart indicating that the physicians order for every shift assessments for circulation and Wanderguard placement were being followed. During an interview on 4-17-12 at approximately 10:40 AM, Licensed Practical Nurse (LPN) #1 stated that the staff documented Wanderguard placement and circulation on the TAR's. The LPN reviewed the April TAR for Resident #14 and confirmed that the assessments for placement and circulation, had not been initiated as having been completed as ordered. There was no documented evidence the physician's orders [REDACTED]. | 2016-06-01 |
| 8283 | 8283 | NHC HEALTHCARE - LEXINGTON | 425333 | 2993 SUNSET BLVD | WEST COLUMBIA | SC | 29169 | 2012-04-18 | 328 | D | 0 | 1 | 98F911 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the Recertification Survey, based on observations, record review and interview, the facility failed to ensure that 1 of 6 sample residents received proper treatment and care for the use of oxygen. Resident #6's oxygen was not administered as ordered. The findings included: The facility admitted Resident #6 on 2/23/12 with [DIAGNOSES REDACTED]. During initial tour of the facility on 4/16/12 at approximately 9:55 AM, Resident #6 was observed sitting in his chair with his oxygen infusing at 2 liters per minute. On 4/16/12 at approximately 4:10 PM while conducting the Resident Interview, the surveyor again observed oxygen set at 2 liters. During the interview, Resident #6 stated that therapy puts his oxygen level on 2 liters and at night, when he wakes up, it's on 1 liter. On 4/16/12 at approximately 5:35 PM, the surveyor again observed the oxygen set at 2 liters. Review of the Admission Minimum Data Set with the Assessment Reference Date of 3/1/12 revealed, Section J Health Conditions (1100-1550) coded Resident #6 as having shortness of breath or trouble breathing with exertion (e.g., walking, bathing, transferring) and when lying flat. Record Review on 4/16/12 at approximately 3 PM, revealed a physician's orders [REDACTED].@ (at) 3 l (liters)/minute via N/C (Nasal Cannula) continuous. Review of the treatment record for 4/1/12-4/30/12 on 4/16/12 at approximately 3:15 PM revealed nurses' signatures documenting on both shifts that the resident's oxygen was at 3L/minute. Review of the Nurse's Notes revealed documentation of various dates and times of the resident's oxygen infusing at 2L/minute: 3/10/12/ 7A-7P: .O2 (Oxygen) sat checked 84% (percent) on room air-O2 replaced in nostrils by N/C at 2l/min. 3/10/12/11:30 PM: O2 at 2l/min via N/C 3/11/12/3:15 PM: O2 in progress @ 2l/min via N/C . 3/13/12/5:30 PM: .O2 in progress at 2l/min via N/C 3/15/12/7P-7A: . O2 on @ 2l/min via N/C . 3/24/12/1:00 PM: .O2 continue @ 2l/min . 4/4/12/11:30… | 2016-06-01 |
| 8284 | 8284 | MARTHA FRANKS BAPTIST RETIREMENT CENTER | 425334 | ONE MARTHA FRANKS DRIVE | LAURENS | SC | 29360 | 2012-02-08 | 280 | D | 0 | 1 | 6G5L11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey based on record review, observation, interviews and review of the facility's Wandering/Elopement Risk Policy, the facility failed to review and revise a care plan for 1 of 1 sampled resident with exit seeking behaviors. (Resident #13's care plan was not updated related to placement and location of wanderguard bracelet). The findings included: The facility admitted Resident #13 on 9/16/08 with diagnosed that included Altered Mental Status, [MEDICAL CONDITION], Hypertension and Dementia. Record review on 2/08/12 at approximately 11:30 AM revealed a Nurse's Note dated 10/31/11 that indicated resident was found outside Unit 2 by staff. The Nurse's Note further indicated the resident was not wearing a wanderguard bracelet and the writer immediately placed one on resident's left wrist. A Nurse's Note dated 12/15/11 indicated the resident tried to leave the facility several times. There was no documentation to indicate if the wanderguard was checked or located on the left wrist. Review of the facility's Wandering/Elopement Risk Policy indicated in #2 under procedure With each quarterly, annual, or significant change assessment, the Wandering/Elopement Risk Assessment is to be completed and the care plan revised/updated to reflect the current needs of the resident. An observation on 2/08/12 at 12:30 PM revealed the resident was in his room seated in a chair. There was no wanderguard located on the resident's left wrist. The resident's care plan, incorrectly dated as last reviewed 3/20/12, indicated the resident was at risk for elopement but stated the Resident will not wear a wanderguard; he will remove all that are applied. It had not been revised to reflect the resident was currently wearing a wanderguard or where it was located. Review of the MAR (Medication Administration Records) for November 2011, December 2011, January 2012 and February 2012 did not indicate the location of the wanderguard. An interview on 2/08/12 at … | 2016-06-01 |
| 8285 | 8285 | MARTHA FRANKS BAPTIST RETIREMENT CENTER | 425334 | ONE MARTHA FRANKS DRIVE | LAURENS | SC | 29360 | 2012-02-08 | 309 | D | 0 | 1 | 6G5L11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on record review and interview, intake and output was not recorded each shift per physician order [REDACTED]. The findings included: The facility admitted Resident # 1 on 2/08 and readmitted her on 3/18/10 with [DIAGNOSES REDACTED]. Record review on 2/7/12 revealed documentation of a recent UTI (Urinary Tract Infection) on 12/15/11 for which an antibiotic was ordered. The physician's orders [REDACTED]. The date beside the order was 12/14/10. The last documentation of I & O on the MAR (Medication Administration Record) was during October, 2011 with only initials but no actual amounts of intake or output. During an interview with the Unit Manager (Registered Nurse # 1), she reviewed the resident's record and thinned record. An order to check I & O q (every) shift was found dated 9/2/10. RN #1 continued to review the record but could not locate a discontinuation order for the I & O. She checked the MAR for February and found no documentation that I & O was being recorded. The nurse confirmed the staff were not recording intake and output on this resident per the physician's orders [REDACTED]. | 2016-06-01 |
| 8286 | 8286 | MARTHA FRANKS BAPTIST RETIREMENT CENTER | 425334 | ONE MARTHA FRANKS DRIVE | LAURENS | SC | 29360 | 2012-02-08 | 323 | G | 0 | 1 | 6G5L11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on observations, record reviews and interviews, the facility failed to ensure that 2 of 6 sampled residents reviewed for falls remained free from accident hazards by providing adequate supervision and assistance devices to prevent accidents. For Resident #1 the facility failed to implement interventions to prevent recurrence and reduce risk after a fall. Resident #8 sustained 3 falls resulting in a shoulder dislocation and tibial fracture on separate occasions resulting from failure of the facility to provide appropriate training, supervision, and/or changes in the care plan interventions to prevent recurrence. The findings included: The facility admitted Resident #8 on 06/12/06 with [DIAGNOSES REDACTED]. Record review on 02/07/12 at 3:30 PM revealed that an incident report was written on 12/31/11 at 10:10 PM which stated, Resident was laying on floor in front of recliner chair. Staff attempted to use the lift to transfer, no connection was made. Resident slide out of recliner onto floor. The documented equipment being used at the time of the incident was lift. Nurses Notes for 12/31/11 stated that Resident #8 was complaining of right knee pain, left and right ankle pain. Resident #8 was sent to the emergency room for evaluation. Nurses Notes on 1/1/12 at 3:40 AM revealed that Resident #8 returned from the emergency room with a [DIAGNOSES REDACTED]. The second incident report, for Resident #8, which was dated for 10/21/11 at 11:15 AM stated, staff getting res (resident) off toilet on stand-up lift. Res slid out sling lowered to floor by staff. C/O (complaints of) R (right) shoulder pain, cannot move R arm and c/o R knee to ankle pain can move R leg. The documented equipment being used at the time of the incident was a stand-up lift. Nurses Notes revealed Resident #8 was sent to the emergency roiagnom on [DATE] at 12:40 PM for evaluation of right shoulder and right knee pain. Nurses Notes revealed that Resident… | 2016-06-01 |
| 8287 | 8287 | MARTHA FRANKS BAPTIST RETIREMENT CENTER | 425334 | ONE MARTHA FRANKS DRIVE | LAURENS | SC | 29360 | 2012-02-08 | 371 | F | 0 | 1 | 6G5L11 | On the days of the survey, based on observations and interview, the facility failed to store, prepare, distribute and serve food under sanitary conditions. The facility freezer contained unlabeled/undated food. Kitchen equipment was observed soiled with dried food splatters or contained food debris, food items were not labelled nor dated, stored foods were improperly wrapped, The findings included: On 2/7/2012 at 9:20 AM, during tour of the facility's kitchen with the Dietary Manager, the Tilt Grill and the Deep Fryer contained a large amount of food debris and the oil was a dark color. A table top stand mixer had dried food splatters. The can opener attached to a counter had a black substance around the base where it was attached to the counter and in the area where the opening tip rested on the counter. The walk-in freezer had a large bag of breaded chicken strips which were taken out of the original box and had not been dated or labeled. The freezer also contained a frozen chicken which had been wrapped in aluminum foil and was partially exposed with no date. The Dietary Manager stated that the Tilt Grill and Deep Fryer were to be cleaned on the day of the tour. She removed the partially wrapped chicken from the freezer. As she removed the chicken, she stated they know they are not supposed to do that. On 2/8/2012 at 9:10 AM, during an additional tour with the Dietary Manager, the Deep Fryer was observed to contain a large amount of food debris and dark colored oil. The Tilt Grill had been cleaned. The mixer also continued to have dried splatters. The Dietary Manager stated that the Deep Fryer had been cleaned on 2/7/12 but had been used after the cleaning A cleaning schedule was requested but not provided prior to exiting the facility. | 2016-06-01 |
| 8288 | 8288 | MARTHA FRANKS BAPTIST RETIREMENT CENTER | 425334 | ONE MARTHA FRANKS DRIVE | LAURENS | SC | 29360 | 2012-02-08 | 425 | D | 0 | 1 | 6G5L11 | On the days of the survey, based on observations, interview, and the Drug Facts and Comparisons book (updated monthly), the facility failed to follow a procedure to ensure that expired medications were removed from medication storage in 2 of 3 medication rooms. The findings included: On 2/8/12 at 10:24 AM, observation of the 300 Unit medication room revealed one 1 milliliter (ml) vial (10 tests) Tuberculin Purified Protein Derivative, Diluted/Aplisol, opened with a puncture date of 1/2/12. The Drug Facts and Comparisons book, page 2001, states (in reference to Tuberculin Purified Protein Derivative): Discard vials in use for more than 30 days because of possible oxidation and degradation that may affect potency. During an interview on 2/8/12 at 10:38 AM, Licensed Practical Nurse (LPN) #1 revealed that the House Supervisor (LPN or Registered Nurse) spot checks the medication room periodically for expired medications, but there is no schedule. On 2/8/12 at 11:06 AM, observation of the 100 Unit medication room revealed one punch card of 30 tablets of Cetirizine HCl (hydrochloride) 10 mg (milligram), expired 1/31/12. During an interview on 2/8/12 at 11:33 AM, LPN #2 revealed that night shift nurses were responsible to check expiration dates on weekends and also periodically. She added that Pharmacy also comes once every couple of months and checks for expired medications. | 2016-06-01 |
| 8289 | 8289 | MARTHA FRANKS BAPTIST RETIREMENT CENTER | 425334 | ONE MARTHA FRANKS DRIVE | LAURENS | SC | 29360 | 2012-02-08 | 514 | D | 0 | 1 | 6G5L11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on record reviews and interviews, the facility failed to maintain clinical records on each resident in accordance with accepted professional standards and practices that were accurately documented for Resident #4, 1 of 10 residents reviewed for allergies. Resident #4 had allergies listed on admission records and the History and Physical which were not on the Physician order [REDACTED]. The findings included: The facility admitted Resident #4 on 4/19/2011 with [DIAGNOSES REDACTED]. The resident was found to be alert and orientated and scored a 14 on his BIMS.(Brief Interview for Mental Staus). On 2/7/2012 at 2:10 PM, during review of Resident #4's medical chart, allergy documentation was reviewed. A discharge form from a hospital dated 4/2/2011 stated that the resident was allergic to Latex and [MEDICATION NAME]. A facility History and Physical (H&P) dated 4/22/2011 and signed by the attending physician indicated allergies to Latex and [MEDICATION NAME]. Another H&P from a different hospital documented the resident's allergies as [MEDICATION NAME], Latex and Shellfish. A Patient Transfer form dated 12/24/2011 also listed the resident's allergies as [MEDICATION NAME], Latex and Shellfish. An Admission/Readmission Clinical Care assessment dated [DATE] indicated the allergies were Latex, Natural Rubber, [MEDICATION NAME] and Shellfish. An assessment dated [DATE] had the allergies documented as [MEDICATION NAME] and [MEDICATION NAME] and on 4/19/11 as Latex, [MEDICATION NAME] and [MEDICATION NAME]. The POF for 12/11, 1/12/and 2/12 contained documentation of Latex and Natural Rubber as the resident's allergies. The MAR's also contained the same allergy documentation. The MAR's and POFs revealed that the resident received [MEDICATION NAME] 20 milligrams once a day. On 2/7/2012 at 4:35 PM, vinyl gloves were observed being used by the staff and in the resident's room. On 2/8/2012 at 8?20 AM, during an interview with Re… | 2016-06-01 |
| 8290 | 8290 | C M TUCKER NURSING CARE CENTER / RODDEY | 425360 | 2200 HARDEN STREET | COLUMBIA | SC | 29203 | 2013-06-04 | 241 | D | 1 | 0 | QGG311 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the day of the complaint inspection, based on observation and interview, the facility failed to promote care for residents in a manner that maintains each resident's dignity. Resident #2 was observed receiving care in a manner that did not maintain the resident's dignity. The findings included: Resident #2 was observed during initial tour of the facility at approximately 2:30 PM. Resident #2 was standing in the doorway of the bathroom facing the open door to his/her room. Resident #2's pants were down and Certified Nurse Aide #1 was providing perineal care to the resident. Registered Nurse (RN) #1 confirmed the observation. RN #1 talked with the Unit Manager and stated that Resident #2 was completely exposed and that the door should have been closed. Review of Resident #2's medical record revealed the Quarterly Minimum (MDS) data set [DATE] coded the resident as requiring extensive assistance with one person physical assistance with toileting. Review of Resident #2's care plan revealed resident had a self care deficit and needed extensive assistance with toileting was identified as a problem area. Review of the facility's Policy and Procedure for Perineal Care revealed procedures included to provide privacy by closing the door, blinds, window and privacy curtain prior to starting the procedure to reduce apprehension and encourage cooperation and preserve dignity. | 2016-06-01 |
| 8291 | 8291 | EMERITUS AT GREENVILLE | 425373 | 1306 PELHAM RD | GREENVILLE | SC | 29615 | 2012-09-12 | 156 | C | 0 | 1 | FVQN11 | On the days of the survey, based on record review and interview, the facility failed to provide Skilled Nursing Facility Advanced Beneficiary Notice (SNFABN) Denial letters for 3 of 3 residents reviewed for Medicare beneficiary liability notices. The findings included: While Reviewing the Liability Notices and Beneficiary Appeal Rights on 9/12/12 at approximately 11 AM, the surveyor observed one form that was given to the three residents which was the CMS(Centers for Medicare/Medicaid) form which indicated the first day of Medicare non coverage for the residents. The residents reviewed did not exhaust their 100 days of medicare services. Issuing the Notice to Medicare Provider Non-coverage form CMS- to a resident only gives notice of his or her rights to a review of service termination. The facility did not provide the residents the SNFABN or a Denial letter to address liability for payment. During an interview with the Executive Director on 9/12/12 at 11:15 AM, he confirmed the surveyor findings and stated he was not aware of a SNFABN or Denial Letter. | 2016-06-01 |
| 8292 | 8292 | EMERITUS AT GREENVILLE | 425373 | 1306 PELHAM RD | GREENVILLE | SC | 29615 | 2012-09-12 | 225 | D | 0 | 1 | FVQN11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of survey, based on record review, interviews and review of the facility's Event Management Report, Investigating & (and) Reporting Policy and Event Management And Reporting Policy, the facility failed to report alleged violations involving mistreatment, neglect, or abuse, including injuries of unknown source and misappropriation of resident property are reported immediately to the administrator of the facility and to other officials in accordance with State law through established procedures (including to the State survey and certification agency). Resident #10, 1 of 1 resident with an injury of unknown origin, failed to have the injury reported by the facility to the appropriate state agency. The findings included: On 9/12/12 at 11:40 AM, during the record review for Resident #10, the Nurse's Notes contained documentation which stated on 6/24/12 at 11:30 AM .Upon inspection of pt (patient) there is a large discolored area to the L (left) ribcage area, baseball size .Area of unknown origin . Review of the resident's skin form stated the area was at the L (left) [MEDICATION NAME] area underarm and was Large baseball size discoloration to L underarm . The facility's Event Report Management-SNF form which was signed by the Director of Nursing (DON) stated Cause, if known, Unknown The DON added a statement to the back of the forms that the injury had occurred as the resident was being transferred as the DON had witnessed the resident being transferred by the staff lifting the resident with their arm/elbow lined up with the discolored area/hematoma. The statement also indicated that the staff transferred Resident #10 this way and held the resident tightly due to resisting care. The DON determined that the injury was from the staff transferring the resident. On 9/12 at 12:30 PM, during an interview with the DON, the DON stated that the staff should not have written Unknown. When asked if she had completed a 24 hour report and investiga… | 2016-06-01 |
| 8293 | 8293 | COVENANT TOWERS HEALTHCARE CENTER | 425382 | 5001 LITTLE RIVER ROAD | MYRTLE BEACH | SC | 29577 | 2013-01-23 | 156 | C | 0 | 1 | IOUH11 | On days of the survey, based on review of residents' funds and interview, the facility failed to complete 3 of 3 mandated Liability Notices: Skilled Nursing Facility Advanced Beneficiary Notices (SNFABN) for 3 of 3 residents. The findings included: On 1/23/13 at approximately 10:30 AM, review of 3 of 3 residents' funds revealed mandated Liability Notices had not been completed. During an interview on 1/23/13 at approximately 10:30 AM with the Director of Social Services/Activities, s/he confirmed the Skilled Nursing Facility Advanced Beneficiary Notices (SNFABN) were not completed. | 2016-06-01 |
| 8294 | 8294 | COVENANT TOWERS HEALTHCARE CENTER | 425382 | 5001 LITTLE RIVER ROAD | MYRTLE BEACH | SC | 29577 | 2013-01-23 | 425 | D | 0 | 1 | IOUH11 | On days of the survey, based on observation and interview, the facility failed to follow a procedure to ensure an expired medication was removed from 1 of 2 medication carts. The findings included: During the observation of medications in medication cart for Long Hall on 1/22/13 at approximately 12:30 PM the following medication was observed: Clonazepam (Klonopin) 1 mg (milligram), Manufactured by Actavis 8-13, Lot #891J11 C had expired on 1/17/13. During an interview on 1/22/13 at approximately 12:30 PM, Licensed Practical Nurse (LPN) #1 verified the expiration date of 1/17/13 and s/he stated No one is assigned to routinely check for expired medications. | 2016-06-01 |
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 );