cms_SC: 8195
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 |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
8195 | CHERAW HEALTHCARE | 425005 | 400 MOFFAT ROAD | CHERAW | SC | 29520 | 2013-06-12 | 281 | D | 1 | 0 | YGJV11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the complaint inspection, based on interviews, record reviews and facility policy review, the facility failed to provide the correct insulin coverage for 1 of 4 residents reviewed for insulin administration. Resident #1 did not receive the correct insulin coverage for 3 elevated blood sugar readings during the month of February 2013. The findings included: Resident #1 was admitted to the facility with [DIAGNOSES REDACTED]. A review of the quarterly assessment dated [DATE] revealed that Resident #1 was coded as having a short-term and long-term memory problems with severely impaired cognitive skill for daily decision-making. The MDS (material data set) also coded the resident as needing a one-person assist for ADL (activity of daily living) care. The resident height was documented at 59 inches with a weight of 106 pounds. A review of the closed record on 6/12/13 at 9:15 AM revealed that Resident #1 received sliding scale [MEDICATION NAME] for blood sugars beyond the parameters set by the physician. The physicians order for the sliding scale parameters were as follows: for blood sugars above 200 milligrams/deciliter (mg/dl) give 2 units of [MEDICATION NAME]; above 250 mg/dl give 4 units of [MEDICATION NAME]; above 300 mg/dl give 6 units of [MEDICATION NAME]; above 350 mg/dl 8 units of [MEDICATION NAME]; above 400 mg/dl give 10 units of [MEDICATION NAME]. A review of the MAR (medication administration record) for February 2013 revealed blood glucose readings with incorrect insulin coverage based on the physicians orders: 2/11/13 at 9 PM blood glucose level=362, the resident received 6 units of [MEDICATION NAME] 2/12/13 at 9 PM blood glucose level=377, the resident received 6 units of [MEDICATION NAME] 2/16/13 at 9 PM blood glucose level=377, the resident received 6 units of [MEDICATION NAME] The blood glucose levels were above the 350 mg/dl level and the resident should have received 8 units of [MEDICATION NAME] instead of the 6 units received. A review of the facility's policy for standing orders, provided by the DON (director of nursing) states, Follow sliding scale as ordered for blood sugars and was signed by the physician. A review of the Physician Notification Parameters, provided by the DON read -below 50 mg give [MEDICATION NAME] per protocol; above 250 follow sliding scale order, if MD ordered. An interview with the DON on 6/12/13 at 2:00 PM revealed that the nurses are expected to follow the parameters ordered by the physician when administering sliding scale insulin. If a resident is getting scheduled insulin there are no parameters, unless ordered by the physician. The nurses would track the blood sugar levels and call the physician if there was a problem/pattern or if the resident had a very high blood sugar then they would notify the physician. | 2016-06-01 |