cms_SC: 7255

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
7255 ROLLING GREEN VILLAGE 425160 1 HOKE SMITH BOULEVARD GREENVILLE SC 29615 2013-04-18 312 D 0 1 P9WS11 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on record review, review of facility policy for Skin Assessment Guidelines and interview, the facility failed to provide evidence that Resident A received the necessary services and assistance to maintain good nutrition. (1 of 2 sampled residents reviewed for assistance with Activities of Daily Living.) The facility failed to assure a resident was fully assessed for actual and potential skin disorders and appropriate treatment imitated on admission. Cross refer to F 309 as it relates to the failure of the facility to provide nutritional supplements as ordered. The findings included: Resident A was admitted to the facility with a known history of poor appetite. A closed record review on 4/15/13 revealed the resident was 71 inches tall and weighed 139 pounds on admission. The Dietary Assessment stated the resident's Ideal Body Weight was 155-189 pounds and noted the resident consumed 25% or less at meals. The initial careplan started on 4/1/13 identified the resident at risk for dehydration with a goal to consume adequate fluids, offer fluids between meals, An Occupational Therapy plan of care dated 4/2/13 stated the patient is able to manage a cup using no assistive feeding equipment requiring total assistance (100% assist) with initiation cue and 100% verbal instructions/cues. The patient is able to feed self after set-up utilizing regular utensils for 25% of meal requiring total assistance (100% assist) with initiation cue and 100% verbal instruction cues. A Speech Therapy Plan of Care dated 4/2/13 identified the resident as able to safely consume a regular diet with moderate impairment .requires thickened liquids; difficulty masticating foods and given 75% verbal instructions/cues. On 4/2/13 the speech therapist documented the resident had poor po (by mouth) intake with max(imum) cues. 4/3/13 .Resident refused all po intake .NP (Nurse Practitioner)notified of poor to no intake. 4/4/13 Patient required maximum cues to increase intake.Question impact of medications and or lack of nutrition as cause for decline in swallow function. Information on the assistance a resident requires (used by the nursing assistants) as a guide for care and titled: All About Me, stated the resident was a total assist at times for feeding. with verbal cues. Review of the clinical Notes Report revealed ongoing documentation of the residents poor appetite. On 4/2/13 at 3:46pm and 9:54pm the notes stated the Resident can feed self with set up- poor appetite . 4/3/13 Appetite is poor. today . appears to be weak. 4/4/13 Refused meal this shift. 4/4/13 Resident not eating/drinking well. Spoke with MD- new order for [MEDICATION NAME]. 4/4/13 10:44pm Resident did not eat any of his/her meal. 4/5/13 .is not eating or drinking well . Transferred to hospital. During an interview with the Unit Manager on 4/15/13 at 11:50 AM, s/he verified after reviewing the record, the ongoing documentation of the residents poor appetite. S/he did not dispute there was no documentation of alternative choices being offered, supplements or assistance being provided. There was no documented evidence the resident was receiving the assistance required as noted by the both the speech and occupational therapy assessments to consume sufficient nutrition. Additionally. on admission, nursing noted the presence of a Duoderm on the resident's buttock. There were no additional open areas documented. The dressing was not removed on admission and the area was not assessed, measured or evaluated for the proper treatment. On 4/15/13, during an interview with the Director of Nursing, s/he stated s/he would have expected the dressing to be removed, the area assessed and the physician contacted for orders for treatment. Post survey, the facility provided information that stated the dressing was not removed because it had been applied on the day of discharge and the area was going to be assessed by the wound nurse the following day. The resident was admitted on [DATE] at 6PM and the wound was assessed the following day at 11:51PM at which time the resident was noted to have two open areas. (An open area to the right buttock and an additional area to the left buttock) . Orders for treatment were documented as being written on 4/2/13 at 11:40 and 11:52pm. A copy of the facility provided Skin Assessment Guidelines states: Document on chart on the assessment, Describe (approx(imate) measure, color, shape open/closed). Chart location. Do not stage. Notify MD and Power of Attorney (POA) . Get an order for [REDACTED]. This is the written communication referral to the wound nurse. Implement treatment. Transcribe order. Order med(ication)/or treatment. Start treatment. Record. 2017-04-01