cms_SC: 10201

In collaboration with The Seattle Times, Big Local News is providing full-text nursing home deficiencies from Centers for Medicare & Medicaid Services (CMS). These files contain the full narrative details of each nursing home deficiency cited regulators. The files include deficiencies from Standard Surveys (routine inspections) and from Complaint Surveys. Complete data begins January 2011 (although some earlier inspections do show up). Individual states are provides as CSV files. A very large (4.5GB) national file is also provided as a zipped archive. New data will be updated on a monthly basis. For additional documentation, please see the README.

Data source: Big Local News · About: big-local-datasette

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rowid facility_name facility_id address city state zip inspection_date deficiency_tag scope_severity complaint standard eventid inspection_text filedate
10201 ELLEN SAGAR NURSING HOME 425012 1817 JONESVILLE HIGHWAY UNION SC 29379 2010-09-15 322 D     A4CW11 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on observation, interviews, and review of the facility's policies entitled "Gastrostomy Tube Check List" and "Procedure for Cleaning 60 cc (cubic centimeters) Syringes Used for Resident Feeding", the facility failed to utilize universal precautions and clean technique when flushing the Gastrostomy (G-) Tube and when cleaning and storing the piston syringes and gravity set for 2 of 3 residents observed for Gastrostomy Tube flushes. The findings included: The facility admitted Resident #5 on 7/17/09 with [DIAGNOSES REDACTED]. On 9/14/10 at approximately 12:33 PM, Licensed Practical Nurse (LPN) #6 was observed by two surveyors providing a Gastrostomy Tube flush before and after medication administration without washing her hands prior to initiating the procedure. LPN #6 opened the Medication cart, retrieved a bottle of liquid Tylenol from the drawer and poured 20 milliliters (ml) of Tylenol into a medication cup. LPN #6 proceeded to the resident's room, knocked, entered the room and filled the 2 empty medicine cups with 30 ml of water from the sink and placed all 3 medicine cups on the over-bed table. She then closed the door, opened a plastic bag and placed it on the foot of the bed and donned a pair of non-sterile gloves. LPN #6 proceeded to check for and replace residual, checked for placement of the [DEVICE], and administered the 30 ml flush, the medication and ended with another 30 ml flush. Upon completion of the procedure, the piston syringe was rinsed and placed wet, back into the bag. Review of the "Gastrostomy Tube Check List" provided by the facility on 9-14-10 revealed "2. Placement check: Check placement before flushes,...Gather supplies..., Explain procedure to Resident, Provide Privacy, Wash Hands, (apply) Non-sterile gloves, ..." The facility admitted Resident #3 on 4-8-01 with [DIAGNOSES REDACTED]. Prior to observation of a Gastrostomy (G-) feeding and flush on 9-14-10 beginning at 9:55 AM, two Certified Nursing Assistants exited the resident's room after completing AM care, including incontinent care. Registered Nurse (RN) #1 proceeded to prepare the resident for a gravity feeding. She checked placement using a 60 cc (cubic centimeter) piston syringe and then infused 30 cc of water via gravity through the barrel of the syringe. The RN then connected the gravity feeding tubing to the [DEVICE] and set the clamp so as to infuse it slowly. She then took apart the piston syringe and placed it in the sink. She removed the gloves she had used during the procedure, rinsed the syringe with water, placed the piston in the barrel of the syringe, and stored it together, wet, in its original packaging. At 10:30 AM, RN #1 disconnected the gravity feeding set and hung the capped tubing on the feeding pole. She neglected to rinse out the feeding set, allowing feeding to remain in the tubing and bottom of the bag. When asked if this was how the set was stored until the next feeding, the RN replied, "Yes." The nurse completed the water flush via gravity using the barrel of the feeding syringe. After completing the procedure, RN #1 again placed the piston and barrel of the feeding syringe into the sink. She removed the gloves she had used during the procedure, rinsed the syringe with water, placed the piston in the barrel of the syringe, and stored it together, wet, in its original packaging. RN #1 verified that this was the procedure she always followed. During an interview on 9-15-10 at 10 AM, the Director of Nurses stated that the facility policy did not address handling of the piston syringe or gravity feeding set. She stated that the syringe should not have been placed in the sink and that the feeding should have been rinsed out of the gravity set and not allowed to remain until the next feeding time. On 9-15-10 at 1 PM, RN #1 verified the procedure as above noted. During an interview on 9-15-10 at 12:05 PM, the Administrator stated there was no evidence on file that RN #1 had been trained on the proper procedure for [DEVICE] feeding/flush. Review of the facility's policy entitled "Gastrostomy Tube Checklist" on 9-15-10 revealed no reference to cleansing or storage of the piston syringe or gravity feeding set. Review of the Infection Control Manual on 9-15-10 revealed a policy entitled "Procedure for Cleaning 60 cc Syringes Used for Resident Feeding" which stated: "...3. The syringe is washed and cleaned thoroughly with dispenser soap and water and rinsed well in hot water subsequent to use. Be sure not to place the syringe in the sink. 4. The syringe is stored separate (barrel and syringe) on a clean paper towel and covered with a clean towel and allowed to air dry...7. Syringes used for tube feeding are cared for in the same manner as described above..." 2014-03-01