cms_SC: 8540

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
8540 AGAPE REHABILITATION OF CONWAY 425391 2320 HIGHWAY 378 CONWAY SC 29527 2013-03-29 309 E 1 0 Y7B111 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the recertification and complaint survey, based on record reviews and interviews, the facility failed to ensure that residents received routine pain medication as ordered as part of a pain management program for 1 of 4 sampled residents reviewed for pain. Resident #94, a resident with chronic pain, did not receive [MEDICATION NAME] as ordered. The facility also failed to provide skin treatments as ordered for one of four residents reviewed for impaired skin integrity. Resident #94 was documented as having impaired skin integrity from the time of admission, but topical medications were not applied as ordered. The findings included: Review of the 2-12-13 and 2-19-13 Minimum Data Set (MDS) Assessments on 3-27-13 at 11:36 AM revealed that Resident # 94 had a BIMS (Brief Interview for Mental Status) score of 13, indicating s/he was cognitively intact. The resident required extensive to total care with all activities of daily living except eating. Range of motion was impaired in upper and lower extremities on one side. The resident was on scheduled pain medication and as needed medication was added on the second MDS. Occasional pain was noted at a rating of one to 3. Resident #94 was noted at risk for pressure ulcers and receiving skin ointment. [DIAGNOSES REDACTED]. S/he was admitted on transmission-based precautions and was receiving therapy. Review of the 2-26-13 Care Plan on 3-27-13 at 1 PM revealed that the potential for skin breakdown related to incontinence and impaired mobility for Resident #94 was addressed, in part, by approaches including checking the resident every two hours, applying 'barrier ointment, and treatments as ordered. The Interim Care Plan completed on admission also addressed skin integrity concerns. Record review on 3-27-13 at 12:34 PM revealed an admission 2-6-13 skin assessment noting a reddened area on the coccyx/sacral area. No other skin assessments were noted in the medical record. The Administrator and Assistant Director of Nurses (ADON) later presented skin assessments dated 2-13, 2-20, 2-27, 3-6, and 3-13-13, all noting a reddened sacral area. The skin audits for 2-13, 2-20 and 3-6-13 were noted as blanchable. One undated skin audit form noted an (unreadable) rash-Resident on .[MEDICATION NAME] Cream to area. 3-11-13 Therapy notes documented, Np (Nurse Practitioner) in with Pt. (patient) to observe mobility, stool, and red behind . Stools still loose. Red areas are yeast . Review of the hospital Discharge Summary on 3-27-13 at 1: 54 PM revealed transfer MEDICATION ORDERS FOR [REDACTED]. Review of the hand-written facility admission Physician' s Orders revealed that the transfer orders had been approved upon admission. Review of the Medication/Treatment Administration Records (MAR/TARs) at 5:25 PM on 3-27-13 revealed that [MEDICATION NAME] was not utilized to treat the reddened areas noted on the skin audits as ordered. The ointment/cream was only applied from 3-6 to 3-19-13 and was not noted as to the affected site. The [MEDICATION NAME] was not noted as utilized during the resident's stay. During an interview on 3-28-13 at 4:20 PM, the Director of Nurses (DON), ADON, and Corporate Consultant reviewed the MAR /TAR and verified the above. Further review of the hospital Discharge Summary on 3-27-13 at 1: 54 PM revealed transfer MEDICATION ORDERS FOR [REDACTED] and [MEDICATION NAME]/[MEDICATION NAME] 5mg /5OOmg one tab PO every 8 hours PRN. Review of the hand-written facility admission Physician' s Orders revealed that the transfer orders had been approved upon admission. The [MEDICATION NAME] was crossed off and a Telephone Order was noted on 2-7-13 to discontinue it. [MEDICATION NAME]/[MEDICATION NAME] 5mg/5OOmg one tab PO every 8 hours PRN was reordered on 2-27-13. Review of the 2-26-13 Care Plan on 3-27-13 at 1 PM revealed that Resident # 94 was also noted on the Care Plan as at risk for pain with approaches including administration of pain meds as ordered. The Interim Care Plan completed on admission also addressed pain concerns. Review of the Medication/Treatment Administration Records (MAR/TARs) at 5:25 PM on 3-27-13 revealed that the [MEDICATION NAME] had been administered once on 2-6-13 and twice on 2-7-13. Entries on the MAR indicated [REDACTED]. During an interview on 3-28-13 at 4:20 PM, the Director of Nurses (DON), ADON, and Corporate Consultant reviewed the MAR /TAR and verified the above. 2016-03-01