cms_SC: 7987

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
7987 PRUITTHEALTH BAMBERG 425104 439 NORTH STREET BAMBERG SC 29003 2012-08-01 318 D 0 1 WJTJ11 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on observation, record review, and interview, the facility failed to give appropriate treatment and services to prevent further decrease in range of motion to 1 of 2 sampled residents with contratures. The facility failed to provide range of motion and positioning to Resident #1 to prevent further contracture and to prevent skin breakdown. The findings included: Resident #1 was admitted with bilateral upper and lower extremity contractures and multiple pressure wounds. Observation on 7/30/12 at 12:55PM revealed the resident lying in bed, right leg severely contracted toward buttock, and prevalon boots on both feet. A Hospice Certified Nursing Assistant (CNA) completed his bed bath, positioned the resident on his back, and elevated the head and foot of the bed. There were no positioning devices or pillows noted in place. At 1:55PM and 3:40PM the resident was observed in the same position and continued without positioning devices or pillows. At 4:45PM, the resident was observed in bed with a pillow behind his back propping him toward his left side. However there were no positioning devices or pillows between his knees, between his right leg and buttock, or at his right arm contracture. On 7/31/12 at 8:45AM, Resident #1 was observed on his back with the head of the bed elevated. A pillow was observed on top of the resident. No other positioning devices were observed. Observation and interview conducted during wound treatment on 7/31/12 at 9:15AM revealed a stage II pressure ulcer at the resident's right elbow, not previously noted with a current treatment order. The wound care nurse stated, It opens and has healed several times. Record review on 7/31/12 at 1:40PM revealed physician's orders [REDACTED]. Documentation of Wound Observation and assessment dated [DATE] stated R elbow has abrasion where res.(resident) scrubs about in bed with elbow. The Documentation of Wound Observation and assessment dated [DATE] stated Res. uses elbow to scoot self slightly in bed. Will be difficult to heal and remain healed. On 7/31/12 at 2:30PM, record review revealed Interdisciplinary Referral to Rehab Screening form dated 4/19/12 for Range of motion/contractures B (bilateral) lower ext/ (extremities). Rehab Screening Results and Recommendations signed 4/23/12 recommended Pt (patient) was on hospice prior to admission to facility. Due to current end of life status no skilled physical therapy needs at this time. An Interdisciplinary Referral to Rehab Screening form dated 5/11/12 referring the resident to rehab for Range of motion/contractures Rehab Screening Results and Recommendations signed 5/11/12 stated Eval (evaluation) completed for measurement of LE (left extremity) contracture - nursing staff to continue with routine ROM (range of motion)/ positioning. An undated Interdisciplinary Referral to Rehab Screening without a complaint checked for referral had a Rehab Screening Results and Recommendations signed 5/11/12 that stated Nursing staff to perform gentle PROM (passive range of motion) with ADLs (activities of daily living) per OT (Occupational Therapy) inservice - position with pillows as needed for comfort. An interview on 7/31/12 at 4:20PM with the Director of Rehab revealed that the resident had been evaluated for PT (Physical Therapy) and OT and that his contractures were too severe for therapy. She stated that an inservice was conducted with all staff for ROM during ADLs concerning this specific resident. Record review 7/31/12 at 4:25PM revealed the Plan of Care for PT and OT noted the resident's Rehab Potential as poor. OT evaluated the resident to require total care for ADLs. PT measured the resident's contractures revealing that his R knee - 120 decrees full knee ext with fairly fixed contracture. Record review and interview with the Director of Nursing (DON) on 7/31/12 at 5:00PM revealed CNA Care Interventions Record Form with no evidence of instruction for any ROM to be provided during care. Observation and interview on 7/31/12 at 4:30PM with the 100 Hall Unit Manager (UM) confirmed the resident's positioning without pillows/devices. She stated that position changes were to take place every two hours to include pillows and devices. The 100 Hall UM confirmed the severity of the contractures and named devices that could be used with nursing discretion for positioning and wound prevention. 2016-09-01