cms_SC: 8265

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
8265 HEARTLAND HEALTH AND REHABILITATION CARE CENTER-HA 425289 1800 EAGLE LANDING BLVD HANAHAN SC 29406 2016-03-02 315 D 0 1 3A0811 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview the facility failed to provide appropriate treatment and services to restore as much normal Bladder function as possible for Resident #71, 1 of 3 sampled residents reviewed for Urinary incontinence. Resident #71 had a decline in Bladder function with new no interventions implemented to restore or maintain Bladder function. The findings included: The facility admitted resident #71 with [DIAGNOSES REDACTED]. Record review of the Minimum Data Set (MDS) - Version 3.0 on 3/1/2016 at approximately 12:38 PM revealed an Admission MDS dated [DATE] that indicated the resident was not having any urinary incontinence. The MDS also indicated that a trial of a toileting program had not been attempted. Review of the Quarterly MDS, dated [DATE], on 3/1/2016 at approximately 12:38 PM indicated that the resident was always incontinent of the Bladder with no episodes of continent voiding. In addition, the 2/8/2016 MDS indicated that a trial of a toileting program had not been attempted. Both MDS assessments revealed that the resident had a BIMS (Brief Interview for Mental Status) score of 14, indicating the resident was cognitively intact. Record review of the Patient Admission/Readmission Screen dated 10/30/2015 on 3/1/2016 at 3:39 PM revealed that the resident did not have Bladder incontinence. Record review of the Patient Admission/Readmission Screen dated 1/6/2016 on 3/1/2016 at approximately 3:39 PM revealed that the resident did have Bladder incontinence. In addition, the Patient Admission/Readmission Screen read If Bladder Incontinence is checked, initiate bladder diary, complete Urinary Incontinence & Indwelling Catheter Assessment in 72 hrs. and initiate toileting program UNLESS patient is terminally ill, has intractable pain OR is comatose. There was no documentation in the medical record that any further Bladder assessments or a toileting program had been done. Review of the Comprehensive Care Plan on 3/1/2016 at approximately 1:04 PM revealed that the Comprehensive Care Plan had not been reviewed or revised to indicate the resident had a decline in Bladder function and was having Urinary incontinence. The Comprehensive Care Plan revealed a focus area that the resident was At risk for Urinary incontinence r/t (related to) decreased mobility. The focus area was initiated on 11/11/2015 and last revised on 11/23/2015. During an interview with Registered Nurse (RN) #4 on 3/1/2016 at approximately 1:04 PM, RN #4 confirmed that the resident was assessed as always continent of the Bladder on the Admission MDS and always incontinent of the Bladder on the Quarterly MDS. RN #4 also stated that the resident was having frequent episodes of high blood sugars and declining health status which were likely causing the increased Urinary incontinence. RN #4 stated the staff were toileting the resident more frequently. The Comprehensive Care Plan was reviewed with RN #4 and RN #4 confirmed the Comprehensive Care Plan had not been reviewed and revised related to the resident's decline in Bladder function. RN #4 confirmed that the Comprehensive Care Plan had not been revised to include more frequent toileting. In addition, RN #4 stated the Comprehensive Care Plan should have been revised related to the resident's decline in bladder function. During an interview with Registered Nurse (RN) #3 on 3/1/2016 at approximately 4:15 PM, RN #3 stated that a Urinary Incontinence Assessment had not been done after the Bladder incontinence was noted on the 1/6/2016 Patient Admission/Readmission Screen . In addition, RN #3 stated that the resident did not participate in a toileting program. During an interview with Certified Nursing Assistant (CNA) #3 on 3/2/2016 at 11:50 AM, CNA #3 stated she/he had been caring for the resident since his/her admission to the facility. CNA #3 stated that the resident was continent and able to use a urinal for toileting when he/she first came into the facility. CNA #3 stated the resident was no longer able to use the urinal and was usually incontinent of the Bladder 3-4 times during her/his shift. CNA #3 also stated the resident was able to tell her/him when he/she was wet and needed incontinence care, but could no longer call her/him before an incontinent episode. CNA #3 stated she checked the resident at least every 2 hours for toileting and incontinence checks. 2016-06-01