cms_SC: 1858

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.

This data as json, copyable

rowid facility_name facility_id address city state zip inspection_date deficiency_tag scope_severity complaint standard eventid inspection_text filedate
1858 PRUITTHEALTH-AIKEN 425145 830 LAURENS STREET NORTH AIKEN SC 29801 2018-08-30 688 E 0 1 H9EX11 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations, record reviews, and interviews, the facility failed to provide on-going care and services to prevent further decline in existing contractures for 4 of 4 sampled residents reviewed with limited range of motion (ROM). Residents #18, #19, #115, and #120 had no evidence of provision of ROM, restorative services, and/or splinting to prevent further decline. The findings included: The facility admitted Resident #18 with [DIAGNOSES REDACTED]. Review of the 6-12-18 Quarterly Minimum Data Set (MDS) Assessment on 8/29/18 at 10:57 PM revealed that the resident had functional impairment of one upper and both lower extremities. No ROM or Restorative services were noted as provided. No behaviors were noted. Initial observation on 8/27/18 at 11:34 AM and throughout the survey revealed left upper extremity contractures with a soft elbow splint but no device or handroll in place for the hand/wrist. Review of the Care Plan on 8/30/18 at 8:02 AM revealed no reference to contractures or planned interventions to maintain or improve ROM. Nor did the plan address any concern related to refusal of care. During an interview on 8-30-18, Registered Nurse #1 verified that the Care Plan did not address the resident's contractures. Continued review of the medical record revealed no evidence of services provided to prevent further decline in ROM. During an interview at 4:08 PM on 8/29/18, when asked about ROM, Resident #18 stated,I don't get any exercises. During an interview on 8/29/18 at 6:01 PM, the Consultant Administrator stated that Resident #18 was not on a restorative program. S/he reviewed the SMART charting and confirmed that it did not reflect provision of ROM. The facility admitted Resident #19 with [DIAGNOSES REDACTED]. Review of the 6-12-18 Quarterly MDS Assessment on 8/30/18 at 2:27 PM revealed that the resident had functional impairment of one upper and one lower extremity. No ROM or Restorative services were noted as provided. No behaviors were noted. Initial observation on 8/27/18 at 11:34 AM and throughout the survey revealed contractures of the right upper extremity with no splint or handroll in place. Review of the Care Plan on 8/30/18 at 2:57 PM revealed that interventions to address contractures included provision of ROM and devices as ordered. The plan did not address any concern related to refusal of care. Continued review of the medical record revealed no evidence of splint application or provision of ROM. Review of Occupational Therapy (OT) notes on 8/30/18 at 2:53 PM revealed that the resident was discharged with a splint on 1/18/18. During an interview on 8/30/18 at 3:17 PM, OT stated the resident had been discharged from therapy with a hand splint which s/he could not put on per self. When OT asked Resident #19 about the splint, the resident indicated the location and s/he found it in the top drawer of the bedside stand. The resident denied pain with use and OT stated the resident did not appear to have declined. During an interview on 8/29/18 at 6:01 PM, the Consultant Administrator stated that Resident #18 was not on a restorative program. S/he reviewed the SMART charting and confirmed that it did not reflect provision of ROM. The facility admitted Resident #115 with [DIAGNOSES REDACTED]. Review of the 7-24-18 Quarterly MDS Assessment on 8/29/18 at 11:46 AM revealed that the resident had functional impairment of bilateral upper and lower extremities. No ROM or Restorative services were noted as provided. No behaviors were noted. Initial observation on 08/27/18 at 11:30 AM through 8/29/18 during the survey revealed contractures of all extremities with only a left handroll in place. There were no other positioning devices or pillows to prevent further decline in contractures. Positioning was observed and confirmed with Licensed Practical Nurse #7 on 8/27/18 at 4:53 PM. Continued review of the medical record revealed no evidence of services provided to prevent further decline in ROM. Review of the Care Plan on 8/29/18 at 12:08 PM revealed that interventions to address contractures included provision of ROM and devices as ordered. The plan did not address any concern related to refusal of care. During an interview on 8/29/18 at 6:01 PM, the Consultant Administrator stated that Resident #18 was not on a restorative program. S/he reviewed the SMART charting and confirmed that it did not reflect provision of ROM. During an interview on 8/30/18 at 3:41 PM, the OT and Rehab Director stated they treated Resident #115 in 1/18. S/he was discharged with orders to wear soft elbow splints and palmar supports or rolled washcloths in the hands. They stated they saw the resident today and (s)he did not have elbow splints on but had washcloths in his (her) hands. They stated the resident needed splints to maintain current ROM so (s)he doesn't get worse. They noted that Physical Therapy also saw the resident in (MONTH) and that soft splints were to be used for the knees. These were also not observed to be in place and were still recommended. The facility admitted Resident #120 with [DIAGNOSES REDACTED]. Initial observation on 08/27/18 at 11:30 AM and throughout the survey revealed contractures of both upper extremities with no splints or handrolls in place. Review of the MDS Assessments on 8/29/18 at 3:09 PM revealed that the 12-12-17 Annual assessment noted ROM impaired in one upper and 2 lower extremities and the 7-31-18 Quarterly assessment noted impairment in both upper and lower extremities. No ROM, restorative services, or therapy was coded. No behaviors were noted. During an interview on 8/29/18 at 5:13 PM with the 3 MDS coordinators, Licensed Practical Nurse #4 verified the coding for the 12/17 and 2/18 assessments indicated ROM was impaired in one upper extremity. The assessments completed in 5/18 and 7/18 indicated ROM was impaired in both upper extremities. When asked what had been implemented to prevent any further decline, they researched and found that OT completed an evaluation only on 4/12/18 with no new recommendations made. Review of the Care Plan on 8/29/18 at 3:48 PM revealed that interventions to address contractures included provision of ROM with ADL (activities of daily living) care and devices as ordered. The plan did not address any concern related to refusal of care. During an interview on 8/29/18 at 4:50 PM, when asked about the location of ROM documentation, RN #2 s/he would need to find the CNA (Certified Nursing Assistant) Book or get the SMART charting. During an interview on 8/29/18 at 6:01 PM, the Consultant Administrator stated that Resident #18 was not on a restorative program. S/he reviewed the SMART charting and confirmed that it did not reflect provision of ROM. During an interview on 8/30/18 at 4:01 PM, the OT and Rehab Director stated that Resident #120 had last had therapy in (YEAR) and had been discharged with a left palmar splint to maintain ROM. The resident had refused a right upper extremity because s/he uses the TV remote, call bell, and bed control with that hand. The therapists stated they had looked at the resident that day and s/he had not had a decline on the left side. OT stated that the resident needed to keep it elevated for [MEDICAL CONDITION] and that the resident does want the splint. 2020-09-01