cms_SC: 10299
Data source: Big Local News · About: big-local-datasette
| rowid | facility_name | facility_id | address | city | state | zip | inspection_date | deficiency_tag | scope_severity | complaint | standard | eventid | inspection_text | filedate |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 10299 | WILDEWOOD DOWNS NURSING AND REHABILITATION CENTER | 425385 | 1215 WILDEWOOD DOWNS CIRCLE | COLUMBIA | SC | 29223 | 2010-09-20 | 323 | G | 9EZH11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the day of the survey, based on record reviews, the facility failed to ensure that residents received adequate supervision and assistance devices to prevent accidents for 2 of 2 residents reviewed who had repeated falls (#1 and #3). The findings included: Resident #1 with [DIAGNOSES REDACTED]. No fractures were diagnosed at the hospital. Resident #1 went to the facility for short term rehabilitation. Review of the admission nursing assessment showed a fall risk score of 20. A score above 10 indicated risk for falls. Review of the Resident Assessment Instrument (RAI) for 7/12/10 showed the resident had short and long term memory problems with moderately impaired decision making ability. The resident needed extensive assistance of one person for bed mobility, transfer, dressing, and bathing. She required total assistance for toilet use and hygiene. The resident was incontinent of bowel and bladder. A fall in the last 30 days was noted. Review of the Resident Assessment Protocol (RAP) noted revealed the resident was at risk for falls related to her history of falls. The note did not provide any history of the past falls. There was no evaluation of any pattern or triggers for the falls. Review of the plan of care dated 7/15/10 showed a problem of risk for falls with interventions of: gather information about past falls; keep call light in reach; anticipate and meet needs; provide safe environment; physical therapy evaluation and treatment; adaptive equipment as needed; and proper footwear. The resident fell three times while at the facility: 1. A Nurse's Note on 7/27/10 at 7 AM stated the resident was found lying on the floor in her bathroom. The resident could not explain how she got on the floor. A small skin tear on the left elbow resulted from the fall. There was no evidence the facility changed or added interventions to the resident's care plan after this fall. 2. On 7/28/10, at 7 PM, the Nurse ' s Note said her Certified Nursing Assistant (CNA) put the resident on the toilet. The CNA went to get a brief out of the closet. Resident #1 tried to get up alone and fell , hitting her right shoulder. The nurse's assessment showed a red area to the shoulder, and skin tears to the right wrist and left forearm. An orthopedic assessment and x-ray done on 8/6/10 showed a fractured distal right clavicle. There was no evidence the facility changed or added interventions to the resident's care plan after this fall. An interview with the CNA providing care to the resident on 7/28/10 revealed the resident had never tried to get up by herself before when in the CNA's care. The CNA said she found out from the nurse after the fall that the resident had fallen the day before while getting up unassisted. On 8/21/10, a Nurse's Note stated the resident was alert and oriented to herself. She was up at the bedside eating breakfast and took her morning medications. "... Informed pt to call for assistance daughter found up in BR (bathroom) had concerns of safety. ..." A personal safety alarm for the wheelchair was ordered that day. 3. The Nurse's Note on 8/22/10 at 12 PM stated a nursing assistant found the resident on the floor, lying by the bed. Skin tears to the left forearm and elbow were noted. The documentation in the Nurse's Notes, and the incident report, failed to say if the safety alarm was in use at the time of the fall. Review of the medical record revealed the resident was independent and wanted to do for herself. She also participated in therapy with improving functional status. The facility failed to use this information to adapt to the resident's changing status in an effort to prevent accidents. The resident was discharged home on[DATE]. Resident #3 with [DIAGNOSES REDACTED]. An admission nursing assessment for falls revealed a score of 22. Scores above 10 indicated a risk for falls. The facility physician's history and physical dated 7/22/10, the resident had had multiple falls. Review of the RAI of 7/25/10 showed the resident had short and long term memory problems with moderately impaired decision making ability. The resident needed extensive assistance of one person with bed mobility, transfer, dressing, hygiene, and bathing. He was incontinent of bowel and bladder. The RAI showed no falls. Review of the RAP notes of 7/28/10 showed the resident triggered for falls related to daily use of an antidepressant. Review of the care plan dated 8/3/10 revealed a problem of "high risk for falls related to Hx (history of) falls, decreased mobility." Interventions included: gather information on past falls; be sure call light is in reach; anticipate and meet needs; provide safe environment; physical therapy evaluation and treatment; adaptive equipment as needed; activities for diversion and strengthening; and appropriate footwear. The care plan showed no changes throughout the resident's stay. Review of the Nurse's Notes showed the resident had 11 falls without injury while at the facility: On 8/1/10, at 2 AM, the resident tried to get up and slid off the low bed. On 8/3/10, at 7:35 AM, the resident was found on the floor by his low bed. He was yelling for help and told the staff he was "trying to get up to go to therapy." On 8/9/10, at 5:20 AM, the resident was found lying on the floor with his head under the bed and his legs partially extended out on the right side. On 8/10/10 at 11:15 PM, the resident was found lying on the floor beside the bed with his head resting on the bed. On 8/14/10, at 4 AM, the resident was found lying on the floor beside his low bed with a pillow still under his head. On 8/15/10, at 10:45 PM, the resident rolled out of bed. On 8/18/10, at 4:30 AM, the resident was found on scooting on his stomach on the floor by his bed. He told the nurse "he crawled out of bed and couldn't bet back in." On 8/30/10, at 11:45 PM, the resident was found sitting on his buttocks with his back against the low bed. On 9/1/10, the resident was found on the floor in front of his wheelchair. He reported that he was trying to get something off his bedside table, leaned forward and fell . On 9/5/10, at 1:50 PM, the resident was found on the floor by his bed. "I was going to a meeting." On 9/6/10, at 3:40 AM, the resident was found on the floor by the bed. "I have to go to work." He also complained that the "bed is curved in the middle and it messed me up." The resident was discharged on [DATE]. Review of the medical record showed no evidence that the facility assessed the resident's falls in an attempt to find a pattern and possible triggers for the falls. The resident did have a bed in the low position but no other interventions were noted. | 2014-01-01 |