cms_SC: 8242
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 8242 | THE METHODIST OAKS | 425131 | 151 LOVELY DRIVE | ORANGEBURG | SC | 29115 | 2012-02-29 | 280 | E | 0 | 1 | 5WM211 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on record review and interview, the facility failed to review and revise care plans for 4 of 13 resident care plans reviewed. The facility failed to revise the CNA (Certified Nurses Aide) care plan to reflect implemented interventions to prevent falls for Resident #6, failed to update the comprehensive care plan to reflect a fall for Resident #6, failed to update the comprehensive care plan for Resident #5 to reflect implemented interventions to prevent falls, and failed to revise the care plans for Resident #9 and Resident #13 to reflect treated infections. The findings included: The facility admitted Resident #6 on 12/11/07 with [DIAGNOSES REDACTED]. Review of the Nurse's Notes dated 8/22/11 at 5:55 PM indicated Resident #6 sustained a fall to the floor after rolling out of bed. Review of the fall data provided by the facility entitled Falls Screened by Therapy PAR (Patients at Risk) committee revealed that recommendations following the fall included, Recommend resident not be left alone for meals. Further review of the Nurse's Notes dated 11/18/11 at 11:05 AM indicated Resident #6 was found on the floor in front of the wheelchair. The notation stated, Res (resident) appeared to have slide (sic) out of w/c. Record review indicated Resident #6 sustained a [MEDICAL CONDITION] tibia and fibula as a result of the incident. Review of the Therapy Screen dated 11/22/11 indicated interventions included recommend checking regularly for repositioning needs and Recommend Hoyer lift transfer to protect fx. Review of the Falls Screened by Therapy PAR committee data revealed Recommend not leaving resident alone but in-sight of caregivers to identify repositioning needs .Recommend also Hoyer transfers were recommended interventions to prevent further falls. Review of the Nurse's Notes dated 1/07/12 at 8:30 AM indicated, CNA was transferring res from wheelchair to bed when Res slipped and slid to ground on top of CNA. The Therapy Screen following the incident indicated, Recommend Hoyer transfer. Review of Resident #6's comprehensive care plan revealed the fall on 1/07/12 was not documented and was not included under the problem area entitled Falls. Review of Resident #6's KARDEX contained in the CNA Notebook revealed the recommendations following the falls on 8/22/11 and 11/18/11 were not documented on the KARDEX. These recommended interventions included not leaving the resident alone for meals, checking regularly for need of repositioning, and use of Hoyer lift for transfers. Further review indicated the KARDEX form indicated transfer assistance for Resident #6 was Assist of 1. During an interview on 2/29/12 at approximately 3:00 PM, CNA #3 was asked how CNA staff know what type of assistive device or assistance a resident requires for transfers. CNA #3 stated that this information is documented on the CNA KARDEX located in a notebook at the Nurse's Station. CNA #3 reviewed the KARDEX with the surveyor and confirmed that Assist of 1 was documented under Transfer assistance. CNA #3 stated that Resident #6 was to be transferred using a Hoyer lift and referred to a pink, laminated page in the resident's section of the notebook which contained this information. This signage contained no date to indicate when this information was included in the CNA Notebook. During an interview on 2/29/12 at approximately 11:10 AM, the Director of Nursing (DON) and MDS Coordinator were asked to review Resident #6's KARDEX. Both staff members confirmed that the KARDEX indicated Resident #6 was a transfer assist of 1. In addition, both staff members confirmed that the KARDEX did not include information that Resident #6 was not to be left alone for meals, should be checked frequently for repositioning needs, and should be transferred via a Hoyer lift. The DON and MDS Coordinator were asked to review the page in the CNA Notebook which indicated Resident #6 was to be transferred via a Hoyer lift. When asked when this information was included in the CNA Notebook, the DON stated that this information was included after the fall on 1/07/12 but was not included prior to this incident. During an interview on 2/29/12 at approximately 2:45 PM, the MDS Coordinator was questioned about the process for updating care plans. The MDS Coordinator indicated that information is obtained from physician's orders [REDACTED]. The MDS Coordinator indicated that both the comprehensive care plans and CNA care plans are updated using this information. Resident #5 was re-admitted on [DATE] with [DIAGNOSES REDACTED]. Record review on 2/27/12 at approximately 2:15pm indicated the resident had fallen on 1/3/12, 1/4/12, 1/6/12, 1/10/12, and 1/30/12. Review of the current Care Plan revealed that it did not reflect that the falls had occurred or the interventions that were put into place to prevent further falls. Resident #9 was re-admitted [DATE] with [DIAGNOSES REDACTED]. Record review on 2/28/12 at approximately 10:10am revealed a physician's orders [REDACTED]. A second physician's orders [REDACTED]. Review of current Care Plan revealed that it did not reflect the infection or the interventions put into place. Resident #13 was admitted on [DATE] with [DIAGNOSES REDACTED]. Record review on 2/28/12 at approximately 4:10pm revealed a physician's orders [REDACTED]. A second physician's orders [REDACTED]. A third physician's orders [REDACTED]. Review of the current Care Plan revealed that it did not reflect the infections or the interventions put into place. Interview on 2/29/12 at approximately 11:10am with the MDS Coordinator and Director of Nursing indicated that the above three Care Plans had not been updated to reflect the changes in the residents status or the interventions put into place to correct or prevent future occurrences. | 2016-06-01 |