cms_SC: 3665

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
3665 OPUS POST ACUTE REHABILITATION 425379 300 AGAPE DRIVE WEST COLUMBIA SC 29169 2017-06-28 157 E 1 0 0BFI11 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** > Based on record review and interview the facility failed to immediately notify the resident's family of resident's peripheral intravenous central catheter (PICC) line complications or notify physician of medication parameters for 1 of 3 residents reviewed for PICC lines and 1 of 3 residents reviewed for medications. Resident #1 had problems with PICC line being clogged, removed, and or dislodged. No evidence the resident's family was notified of resident changes. Resident #3 was given medication ordered not to give and to notify physician if pulse rate below [AGE]. The findings included: The facility admitted resident #1 with [DIAGNOSES REDACTED]. Review of the medical record revealed Nurses Notes from 2/17/17-3/15/17. Resident received [MEDICATION NAME] and [MEDICATION NAME] via double Lumen PICC line to right upper arm for an infected blood clot in the lung. admitted for short term rehab Alert and oriented x 2 (times 2). Nurses' Notes: 2/22/17 at 5:31 PM Nurse entered room to unhook antibiotic and observed blood up the IV tubing. PICC line would not flush. Medical Doctor (MD) notified, orders to send to emergency room (ER) to replace PICC line. Hospital called and stated they could not get the PICC line replaced tonight but would call with a time in the morning. Hospital placed an IV in left (L) antecubital. MD notified of this. 2/24/17 resident receiving intravenous (IV) antibiotics via PICC. (No documentation of PICC replacement or family notification). 2/26/17 8:23 AM: Nurse in to check on IV antibiotic and noted IV not on pole. Resident had the IV bag in the bed and s/he had clamped the bag her/himself. Patient educated. IV hung for medication to finish so second antibiotic could be hung. (Family Responsible Party (RP) not notified.) 2/28/17 (Two days later) Son called to discuss resident refusing therapy and discharge plans. 3/1/17- Weekly Skill review: Resident noted to have been non-compliant one time during the week with IV antibiotic by clamping off the line. Education completed on benefits vs risk of receiving antibiotics. 3/2/2017 Nurse reported resident had suicidal thoughts, voiced to three staff members. Nurse Practitioner (NP) called. Patient transferred to Baptist Hospital for Evaluation. Returned to facility at 11:46 PM. Resident voiced no [MEDICAL CONDITION]. Resident rested in bed throughout the night. (No documentation RP notified) 3/4/17 Resident received IV antibiotics via INT in right hand. Resident returned from hospital after pulling PICC line out during day shift. Hospital unable to replace PICC due to radiology services not available on weekends, INT placed instead. (No documentation RP notified resident had pulled out PICC line or hospital transfer.) 3/5/17 Resident removed INT to right hand. Resident has had 4 PICC lines placed. Resident follows up with hospital on [DATE] for replacement of PICC line. 3/6/17 Spoke to nurse at Dr.'s office about ordered lab work that was due this morning.Informed nurse that patient had pulled out both PICC line and INT. No access present at this time for antibiotic (ABT) therapy. 3/8/2017 Weekly Skilled Review: Resident went to Dr. who ordered CT scan to determine if s/he still needs antibiotic. Instructed the facility to place resident on [MEDICATION NAME] for [MEDICAL CONDITIONS] discovered in facility today before appointment. 3/9/17 Resident allowed nurse to administer half of her/his ABT via INT access then took them down her/himself and refused the rest of the medication. MD and family notified. 3/10/17 9:00 AM: Patient transported to hospital to get PICC line replaced. INT to left hand pulled. Returned to facility shortly after 2:00 PM. Single Lumen PICC noted to Left forearm. Dressing intact and dry. 2:00 PM [MEDICATION NAME] hung at time of return. Patient noted up at nurse's station 40 minutes later. Patient had removed ABT bag from pole and rolled himself up to the nurses station for a cup of coffee. 3/15/17 at 8:43 PM: Patient had an appointment this morning with Dr. with infectious control. Dr.'s office called stating they were sending the patient to the emergency room . As of 3/15/17 at 8:45 pm. Patient has not returned to OPUS. No update on patient status. In an interview with the surveyor on 6/27/16 at 11:55 AM the Director of Nursing stated S/He kept pulling out PICC line. We did some education with her/him and s/he would be in agreement. We tried to make sure s/he got his antibiotics. We notified her/his family and her/his son tried to talk to her/him about it. Resident #1 repeatedly removed IV access, either PICC line or INT. S/he removed or cut off infusing IV antibiotics. The resident was sent to the hospital on four different occasions due to lack of venous access. There was no evidence the resident's family/RP was notified each time the resident had changes or hospital transfers. Review of Resident #5's Medication Administration Record [REDACTED]. The resident was administered the medication on 5/28/17 at 1700 with a pulse of 55. There was no documentation on the Medication Administration Record [REDACTED]. Review of the Nurses' Notes dated 5/28/17 at 6:36 PM revealed Resident #5's daughter called the nurses' station stating that the resident needed to be transferred out to the emergency department immediately for difficulty breathing. The nurse asked the resident if s/he would like to go to the emergency room like his/her daughter wanted. Resident #5 said no, I'm okay, just needed to sit up. The nurse called the physician and informed him/her of the situation and s/he said it is okay to send the resident out on the basis that the family wanted him/her to go. Review of the resident's Transfer Form dated 5/28/17 revealed the resident was transferred to the hospital related to respiratory distress. In an interview with the surveyor on 6/27/17 at approximately 3:20 PM, the Director of Nursing stated the resident's [MED] should have been held and the physician notified on 5/28/17 when his/her pulse was 55. There was no documentation that the resident's physician was notified per the order. 2020-09-01