cms_SC: 6258
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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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 6258 | MAGNOLIA MANOR - GREENVILLE | 425090 | 411 ANSEL ST | GREENVILLE | SC | 29601 | 2014-06-19 | 274 | D | 0 | 1 | 336311 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the Recertification Survey, based on record reviews, interviews, and review of CMS's (Centers for Medicare & Medicaid Services) RAI (Resident Assessment Instrument) Version 3.0 Manual, the facility failed to conduct Significant Change in Status Assessments for Residents #4, #6, and #10, 3 of 3 residents reviewed with a significant change in status. The findings included: The facility admitted Resident #4 with [DIAGNOSES REDACTED]. On 6/17/14 at 2:34 PM, review of the Annual MDS (Minimal Data Set) dated 6/3/14 revealed Resident # 4 was coded as requiring extensive assistance with bed mobility, transfers and locomotion on and off the unit and for eating. Comparison to the previous Quarterly MDS assessment dated [DATE] indicated the resident had been coded as limited assistance for these aspects of ADLs (Activities of Daily Living) indicating the resident had experienced a decline. Further review revealed the resident had also experienced a decline in urinary and bowel continence and was newly coded as always incontinent where he/she had previously been coded as frequently incontinent. In addition, Resident #4 was coded as having verbal behaviors 1-3 days during the assessment period and other behaviors daily and had an unstageable pressure ulcer that were not present on the previous assessment. Review of the record revealed the resident's behaviors had began in April, 2014 and the Pressure ulcer onset date was 5/2/14. The facility admitted Resident #6 with [DIAGNOSES REDACTED]. On 6/17/14 at 3:00 PM, review of the Annual MDS (Minimal Data Set) dated 2/6/14 revealed Resident #4 was coded as requiring limited assistance with bed mobility. In addition, the resident was coded as having a poor appetite or overeating on 2-6 days during the assessment period resulting in a mood severity score of 1. Comparison to Quarterly MDS assessment dated [DATE] indicated the resident was newly coded as requiring extensive assistance for bed mobility and was coded as having an increase in the number and frequency of mood indicators resulting in a mood severity score of 5. Further review revealed the resident was coded as having a significant weight loss on the 5/8/14 quarterly assessment. During an interview on 6/18/14 at 9:10 AM, the MDS Coordinator confirmed the MDS dated [DATE] indicated Resident #4 had had a decline in behaviors, ADLs, urinary continence and a new pressure ulcer and verified that a Significant Change in Status Assessment (SCSA) should have been conducted in May, 2014. The MDS Coordinator also confirmed the decline in bed mobility and mood and the significant weight loss for Resident #6 and verified that a SCSA should have been done. A review of CMS's RAI Version 3.0 Manual, Chapter 2, page 2-20 revealed The SCSA (Significant Change in Status Assessment) is a comprehensive assessment for a resident that must be completed when the IDT (Interdisciplinary Team) has determined that a resident meets the significant change guidelines for either improvement or decline. In addition, the manual indicated, page 2-24, a SCSA would be appropriate for 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; 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 E (behavior); Any decline in an ADL 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. On 06/18/14 at approximately 9:00 AM, Resident #10's annual Minimum Data Set ((MDS) dated [DATE], documented that the resident showed an improvement after receiving therapy. The MDS quarterly dated 05/08/14 showed a decline from a 2 (improvement) to a 3 (decline) in both of the dressing and hygiene/bathing areas. Interview with the MDS coordinator at the time of findings verified that no significant change had been done as required. | 2018-04-01 |