cms_SC: 2773

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.

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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
2773 LAKE MARION NURSING FACILITY 425300 1527 URBANA ROAD SUMMERTON SC 29148 2019-11-04 849 D 0 1 09P711 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and staff interviews, the facility failed to properly communicate with hospice regarding code status for 1 of 1 resident (Resident #6). Specifically, the facilities records indicated a Full Code and the hospice records indicated a Do Not Resuscitate (DNR). The findings included: According to the Face Sheet, Resident #6 was admitted to the facility on [DATE]. [DIAGNOSES REDACTED]. According to the quarterly Minimum Data Set (MDS) assessment, dated 10/01/19, Resident #6 was unable to complete the Brief Interview of Mental Status (BIMS). She had a short term memory and long term memory problem. She required supervision to extensive assistance with all activities of daily living (ADL). Resident #6's clinical record was reviewed on 11/02/19 at 11:05 AM. The facility's chart had a code status of Full Code. This was signed on 10/04/18. The physician's orders [REDACTED]. Resident #6 was admitted to hospice on 01/22/19. The hospice chart had a code status of DNR. Registered Nurse (RN) #64 was interviewed on 11/02/19 at 11:21 AM. He said Resident #6 was a DNR and said she was on hospice. He did not assume someone was a DNR because they're on hospice. He said he would look in the chart, if he needed to know the code status for a resident. There was a form in the front of the chart that he would look at. According to Resident #6's care plan, the resident was receiving hospice services due to terminal stage of illness. Approaches included coordinating care and services with hospice provider. Unit Manager #114 was interviewed on 11/02/19 at 12:06 PM. She said the nurses would go to the hospice chart and look to see which code status a resident was. She said code status should be in both the hospice and facility charts and they should match. She said hospice would normally update the facility chart. She said the Social Services Director (SSD) was the one that goes over code status and would coordinate with hospice. She called the SSD on 11/02/19 at 12:09 PM. She said the resident's code status did not change to DNR when she went on hospice. She said the hospice chart was wrong. She remembered a conversation with the son, who was the Power of Attorney (POA), and the resident wanted to remain a full code to be around for her grandchildren. The SSD and Unit Manager looked at both charts. She confirmed the facility chart had a Full Code order and the hospice agency had a DNR order. She said the hospice order was signed by the daughter, who was not the PO[NAME] The SSD was not aware of the DNR order. She said they always called the family when something happened and the family always wants her sent out. She said the communication with the hospice agency was not good. They never informed her about the order, which they should have. The SSD said the nurses would go to the facility chart to look for code status and would not go to the hospice chart. RN #64 was interviewed on 11/02/19 at 12:32 PM. He said he would look in the facility's chart to determine a resident's code status. He would not look in the hospice chart. He does not assume a code status for anyone. He said he would always look at the chart to determine the resident's wishes. The SSD was interviewed on 11/03/19 at 3:48 PM. She confirmed that the communication from hospice was poor. She said they hardly ever talked to anyone. Sometimes hospice would come and no one knew they were there. She did not know the DNR order was in the hospice chart because no one told her. She did not know when that paperwork would have been placed in the chart. It was signed during her admission to hospice, but that didn't mean that was when it was placed in the chart. She was not sure why the hospice agency did not consult with the son, who was the PO[NAME] Unit Manager #114 was interviewed on 11/04/19 at 4:25 PM. She said the communication with paperwork being placed in the chart had not been good. The hospice agency did not tell them when they put something in the hospice chart. She said the hospice agency goes through the chart to ensure everything is in there. She thought it would be a good idea for them to start looking at the chart to ensure what was in there. She confirmed she was not aware of the DNR order in the hospice chart. She said when the hospice staff come, they are good about speaking with the facility staff. The Director of Nursing (DON) was interviewed on 11/04/19 at 5:21 PM. She said if the hospice agency obtained a DNR order, then they should have communicated that to the facility. She was not sure how the miscommunication happened. She said hospice should be communicating changes with the facility staff. 2020-09-01