cms_SC: 4365

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
4365 PRUITTHEALTH- BAMBERG 425104 439 NORTH STREET BAMBERG SC 29003 2016-07-15 274 D 0 1 2DDJ11 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review, interview, and review of the CMS ' s (Centers for Medicare/Medicaid) RAI (Resident Assessment Instrument) Version 3.0 Manual, the facility failed to identify a significant change and conduct a Significant Change in Status Assessment for Resident #67, 1 of 1 resident reviewed with a Significant change in condition. The findings included: The facility admitted Resident #67 with [DIAGNOSES REDACTED]. Resident #67 was re-admitted on [DATE] with additional [DIAGNOSES REDACTED]. At 9:20 AM on 07/14/2016, review of the MDS (Minimal Data Set) assessments revealed an Admission assessment dated [DATE] and a Quarterly assessment dated [DATE]. The assessments indicated a decline in cognition/ decision making with the BIMS (Brief Interview for Mental Status) score decreasing from a score of 13, cognitively intact, to a score of 11,moderately cognitively impaired. The assessment also indicated the resident declined from limited assistance to extensive assistance in eating, a decline in continence from frequently to always incontinent. In addition, the MDS coded the resident as having had a significant weight loss form 149 pounds to 120 pounds. Review of the 5/14/16 discharge summary indicated the [DIAGNOSES REDACTED]. Review of the RAI Manual, Chapter 2, page 2-21 revealed A SCSA (Significant Change in Status Assessment) is appropriate when: - There is a determination that a significant change (either improvement or decline) in a resident ' s condition from his/her baseline has occurred as indicated by comparison of the resident ' s current status to the most recent comprehensive assessment and any subsequent Quarterly assessments; and - The resident ' s condition is not expected to return to baseline within two weeks. In addition, the RAI manual defines a decline in status as a Decline in two or more of the following: - Resident ' s decision-making changes; - Presence of a resident mood item not previously reported by the resident or staff and/or an increase in the symptom frequency (PHQ-9(C)), e.g., increase in the number of areas where behavioral symptoms are coded as being present and/or the frequency of a symptom increases for items in Section [NAME] (Behavior); - Any decline in an ADL (Activity of Daily Living) physical functioning area where a resident is newly coded as Extensive assistance, Total dependence, or Activity did not occur since last assessment; - Resident ' s incontinence pattern changes or there was placement of an indwelling catheter; - Emergence of unplanned weight loss problem (5% change in 30 days or 10% change in 180 days); - Emergence of a new pressure ulcer at Stage II or higher or worsening in pressure ulcer status; - Resident begins to use trunk restraint or a chair that prevents rising when it was not used before; and/or - Overall deterioration of resident ' s condition. Further review of the Manual, Chapter 3, page 3-14 revealed a BIMS score of 13-15 was considered cognitively intact, a score of 8-12: moderately impaired cognition and a score of 0-7: severe impairment of cognition. During an interview at 07/14/2016 10:10:14 AM, the MDS Coordinator stated the system doesn't usually flag for a significant change for a 2 point decline in the BIMS score and that Dietary addressed the weight loss. The Coordinator stated s/he would look into the decline in ADLs. On 07/14/2016 at 12:52 PM, the MDS Coordinator confirmed the resident had declined in cognition, eating, and continence on the 6/6/16 Quarterly MDS assessment. The MDS Coordinator stated the weight loss was anticipated due to diuretic therapy and multiple medication changes for [MEDICAL CONDITION] and Diabetes Mellitus. In addition, the MDS Coordinator confirmed that a 2 point decline in cognition would constitute a significant decline if the change indicated the resident went from cognitively intact to moderately impaired and that was part of what would be at the discretion of the IDT (Interdisciplinary Team). The Coordinator indicated that the resident was sick on admission and sick after returning from the hospital so the IDT had not been able to determine what the resident's baseline was but when asked if the resident was the same person on the Quarterly assessment as he/she was at the time of the Comprehensive Assessment and formulation of the care plan, s/he confirmed the resident was not the same. The Coordinator confirmed a Significant Change in Status Assessment should have been conducted. 2020-02-01