cms_SC: 8350

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
8350 AGAPE NURSING & REHAB CENTER 425379 300 AGAPE DRIVE WEST COLUMBIA SC 29169 2013-05-01 155 E 1 0 G3XH11 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the complaint inspection, based on record review and interview, the facility failed to provide the resident the right to formulate an advance directive. Resident's #1, #2 and #4 was not provided the right to formulate his/her advance directive on admission to the facility. The findings included: Resident #1 was admitted to the faciilty on 3/4/13. Review of the Daily Skilled Nurse's Note dated 3/4/13 at 4:30 PM revealed the resident arrived at the facility and was alert and oriented x 3. Review of the Authorization for Allow Natural Death Patient Without Ability to Consent was signed by Resident #1's Power Of Attorney on 3/4/13. The form was signed by the resident's Attending Physician on 3/11/13 and by the Concurring Physician on 3/13/13. Resident #1 was sent out and admitted to the hospital 3/12/13 and returned to the facility 3/16/13. Further review of the closed medical record revealed an order dated 3/4/13 DNR (Do Not Resucitate). The order was signed by the resident's Attending Physician on 3/11/13. During interview on 4/30/13 at approximately 2:30 pm the Admissions Coordinator stated that Resident #1 was alert and oriented when s/he was admitted to the facility on [DATE]. During interview on 5/1/13 at approximately 2:30 pm the Assistant Director of Nursing (ADON) stated that s/he completed the Authorization for Allow Natural Death Patient Without Ability to Consent for Resident #1. The ADON stated that Resident #1 was alert and oriented to self only at admssion. The ADON stated that two Physician signatures are required for a resident without the ability to consent. The ADON confirmed that the DNR order was written on 3/4/13 and signed by the Physician on 3/11/13. The ADON confirmed that the concurring Physician signature was not received until 3/13/13. The DNR order was obtained at the time of admission, before the resident was determined to not have the ability to consent by two physicians. The resident was assessed to be unable to make decisions but was educated on Advanced Directives on admission. The resident was not determined to be unable to consent until 3/13/13, however the resident was ordered a DNR before two physician's determined the resident was not able to make decisions. Both consent forms were signed on the same days by the family and the physician for both forms. The facility admitted resident #2 with [DIAGNOSES REDACTED]. Review of the medical record revealed a DNR (Do Not Resuscitate) code status on the admission orders [REDACTED]. The resident was coded to have long and short term memory loss with inability to make decisions regarding activities of daily living. Review of the Social Services Notes of 3/8/13 stated, _____(resident) was offered education on Advanced Directive at admission . Further review of the medical record revealed two Authorization for Allow Natural Death forms. One stated Patient with Ability to Consent and one stated Patient Without Ability to Consent. Both Authorizations were signed by the resident's family member on 3/6/13. Both were signed by the same physician on 3/11/13. A second physician's signature was dated 3/13/13 on the Patient Without Ability to Consent. The facility admitted resident #4 with [DIAGNOSES REDACTED]. Review of the medical record revealed the resident had an Interim (Admission) care plan dated 3/22/13 that stated the resident had an Advanced Directive for a Full Code. A physician's telephone order dated 3/24/13 stated DNR. Review of the Authorization for Allow Natural Death, Patient Without Ability to Consent revealed the form had been signed by the resident's representative.(Not dated when signed) The physician's signature was not signed until 4/1/13 with the second physician's signature not obtained until 4/5/13. Review of the Social Services Note dated 3/26/13 stated, ____ (resident) was offered education on Advanced Directives at admission. ____(resident) is a Full Code Resuscitate. The DNR order was written before two physician's had determined the resident was not able to consent. The resident's care plan and social services note stated the resident was a full code. There were no additional notes from social services to reflect any change in the code status. The care plan was not updated to depict a change in code status. The Director of Nursing and the Company Vice President of Compliance were interviewed by the surveyor on 5/1/13 at approximately 2:30 PM regarding the code status for resident # 4. They stated the resident was admitted without the attendance of family. Family came in that Sunday and requested DNR. The status wasn't; changed because we were waiting for the second physician's signature. The facility did not obtain the second physician's signature until 4/5/13, but had a physician's orders [REDACTED]. 2016-05-01