cms_SC: 6004
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 6004 | PALMETTO HEALTH TUOMEY SUBACUTE SKILLED CARE | 425346 | 129 N WASHINGTON ST | SUMTER | SC | 29150 | 2016-02-19 | 155 | D | 0 | 1 | UXVO11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review, interview and review of the facility policy titled, Advance Directives/Advance Health Care Planning Documents, and General guidelines for Do Not Resuscitate Orders, Futility and Decisions to Forego or Withdraw Life-Sustaining Services, the facility failed to ensure 1 of 16 residents reviewed for Advance Directives were afforded the opportunity to formulate their own Advance Directives. No documentation could be found in the medical records to ensure Resident #78's repsonsible party was afforded the opportunity to formulate advanced directives. The findings included: The facility admitted Resident #78 with [DIAGNOSES REDACTED]. Review on 2/18/2016 at approximately 4:00 PM of the medical record for Resident # 78 revealed a form titled, Certification of Patient's Inability to Consent to Health Care Decisions. The form was signed by two physicians and stated he/she did not have the ability to make his/her own health care decisions. Further review of the medical record on 2/18/2016 at approximately 4:00 PM revealed a physician's order for a DNR status dated 2/15/2016. Review on 2/19/2016 at approximately 8:15 AM of a,Palliative Care Narrative Note, (no signature) dated 2/15/2016 at 10:45 AM states, asked pt (patient) if he/she would want to be resuscitated if his/her heart stopped and he/she was not breathing. Pt said he/she would NOT want to be brought back, he/she requested DNR. NP (Nurse Practitioner) notified, order for DNR written. No documentation/signatures could be found in Resident #78's medical record to ensure these were the wishes of resident #78 and his/her Responsible Party/Family. No documentation could be found in Resident #78's medical record that the physician had discussed the code status with the Responsible Party/Family. Review on 2/19/2015 at approximately 9:20 AM of the facility policy titled, Advance Directives/Advance Health Care Planning Documents, states under section X11, Definition, under C. states, Advance Directives, means a written document used to record and communicate a person's wishes regarding future medical care. Review on 2/19/2016 at approximately 9:30 AM of the facility policy titled, General Guidelines for Do Not Resuscitate Orders, Futility and Decisions to Forego or Withdraw Life-Sustaining Services, under Section III, C. states, DNR Discussion:, Initiation of discussions concerning DNR status is appropriate and standard medical practice when the attending physician, with a reasonable degree of medical certainty, has determined that the patient has a terminal condition , is irreversibly comatose or in the process of dying for which resuscitation measures would probably be unsuccessful and would only serve to prolong the process of dying or promote suffering. Number 1. The attending physician plays the major role in discussing DNR decisions with the patient or the patient's surrogate decision maker. When a patient is unable to consent, the name of the surrogate decision maker is documented in the medical record . Number 2. states, The attending physician and patient (or surrogate decision makers) should have a discussion concerning [DIAGNOSES REDACTED]. | 2018-07-01 |