cms_SC: 8359

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
8359 AGAPE NURSING & REHAB CENTER 425379 300 AGAPE DRIVE WEST COLUMBIA SC 29169 2013-05-30 325 E 1 0 FG7811 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the complaint inspection, based on record review, observation, and interviews, the facility failed to assess the nutritional needs of 3 of 11 residents with pressure sores. Resident #1 had numerous pressure sores with no assessment of the resident's nutritional needs to promote healing of the wounds. Resident #5 developed pressure sores in the facility and did not have an assessment of her/his nutritional needs to promote healing. Resident #7 was admitted with pressure sores and did not have a timely nutritional assessment. The findings included: The facility admitted Resident #1 with [DIAGNOSES REDACTED]. Review of the hospital Operative Report dated March 19, 2013 revealed under operative findings; S/he had a blister on her heel as well as a blister on the lateral . An Ace blister on the dorsum of the medial foot . I think these are all secondary to pressure from her [DIAGNOSES REDACTED] in the splint implants. The Initial Body assessment dated [DATE] indicated the right foot and leg to mid calf was in a soft cast. Nurse's Note for 3/27/13, 7 A--7 P stated, Resident had blood soaking through soft cast. Contacted orthopaedic surgeon for orders on how to change or add dressing to help with drainage. Surgeon appt. (appointment) made for today. Resident returned with plaster cast. There was no mention of the residents blisters or skin problems under the cast. An Orthopaedic Consultation dated 4/17/13 stated the fractures were not healed. Needs wound care for right heel ulcer (and left medial malleolus). A Pre-[MEDICATION NAME] was obtained on 4/24/13 to check the residents protein. The pre-[MEDICATION NAME] level was low at 6.2 milligrams per deciliter. Normal range was 17.0-34.0 mg/dl. Review of the body assessment of 5/19/13 revealed the resident had six (6) pressure areas in the area covered with a cast and over areas of hardware used to repair the residents fractures of her/his right leg. The wound measurements, length by width by depth: (1) Right inner calf 2.2 cm (centimeters) X 1.2 cm X 0.4 cm Stage III. (2) Right Upper ankle 2.4 X 1.2, Stage II. (3) Right Heel 4.6 X 4.1, unstageable. (4) Right outer ankle 2.4 X 2.2 X 0.5, Stage III. (5) Right upper foot 2.5 X 2.3, unstageable. (6) Right upper foot 1.8 X 1.5 unstageable. Review of the nutritional information revealed a Medical Nutrition Therapy assessment dated [DATE]. The nutritional assessment did not document the resident had pressure sores. There was no other assessment or Registered Dietician review of the dietary needs of the resident's pressure sores and the low pre-[MEDICATION NAME] level. There were no documented dietary interventions to promote healing of the wounds. The Registered Dietician was interviewed by the surveyor on 5/30/13 regarding the lack of nutritional assessments. The Dietician confirmed the resident should have been assessed, as soon as they were aware of the pressure sores. The facility admitted Resident #7 with [DIAGNOSES REDACTED]. Review of the Initial Body Assessment revealed an area on the resident's sacral area that measured 6.3 cm (centimeters) X 5.7 cms, Stage I. The right heel contained a blackened area of 1.2 cm X 0.9 cm. The resident was in the facility for five (5) days and discharged to the hospital, returning to the facility after a four day hospital stay. Review of the Hospital Transfer form dated 5/3/13, revealed the resident had a wound to her right labia, a wound to her left labia, a pressure sore to the gluteal fold. Review of the Skilled Nursing Weekly Skin Audit dated 5/13/13 revealed the resident had skin grafts and an open area to the coccyx. The wound measurements dated 5/19/13 stated the sacral wound was 7.5 cm X 8.4 cm. The area was unstageable. Review of the medical record for nutritional intervention revealed the resident had not been assessed for adequate nutrition to promote healing until 5/14/13. The RD was interviewed by the surveyor on 5/30/13 regarding the timeliness of the nutritional assessment. The RD stated, When a resident has wounds, nutritional assessment should be done right away. The facility admitted resident #5 with [DIAGNOSES REDACTED]. Review of the weekly Skin Assessments revealed on admission the resident had no pressure sores. On 5/3 and 5/10/13 there were no pressure sores. The Skin assessment dated [DATE] stated Sacrum, 1.5 cm x 0.8 cm x 0.5 cm, Stage II. On 5/24/13 the skin assessment stated Sacrum .4 cm x. 6 cm .05 cm, Stage II. Review of the Nutritional assessment dated [DATE], revealed the resident had no skin problems. The RD was interviewed by the surveyor on 5/30/13 at 8:15 AM related resident # 5's nutritional needs related to tube feedings and development of pressure sores. The RD stated, If a resident comes in with tube feeding, nursing would let me know within 2-3 days. I would evaluate. If resident develops wounds- I would make sure tube feeding met resident's needs. There was no nutritional assessment after the resident developed the pressure sore. 2016-05-01