cms_SC: 8841
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 |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
8841 | AGAPE REHABILITATION OF CONWAY | 425391 | 2320 HIGHWAY 378 | CONWAY | SC | 29527 | 2012-12-03 | 157 | G | 1 | 0 | 2MGS11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On days of the complaint inspection, based on record review and interviews, the physician was not notified of a skin tear to Resident #3's left arm or Resident #1's change in condition. The findings included: Cross refers to F-323 as it relates to the failure of the facility to notify the physician of a skin tear to Resident #3's left arm on 09/14/2012. Cross refers to F-329 as it relates to the family of Resident #1 calling Emergency Medical Services (EMS) on 11/03/2012, EMS found 4 [MEDICATION NAME] Patches on the resident. The resident was found with decreased respirations and a blood glucose of 36. [MEDICATION NAME] and [MEDICATION NAME] were administered by EMS and the resident's vital signs improved and s/he became alert and oriented before arrival at the emergency room . Review of the closed medical record revealed [MEDICATION NAME] Patch(s) 25 micrograms was applied to Resident #1's chest upper left and upper right on 10/27/2012 and 10/30/2012 with no documentation that the [MEDICATION NAME] Patches were removed. On 11/02/2012 a [MEDICATION NAME] Patch was applied to Resident #1's chest upper left. The facility admitted Resident #3 from home with hospice care, for short term respite. In an interview with Certified Nurse Aide #1 s/he stated that the resident was injured during incontinent care sometime before midnight on 09/14/2012. Review of the resident's closed medical record showed no assessment or description of the injury and the physician was not notified of the injury from 09/14/2012 until the resident was discharged on [DATE]. Review of the facility investigation included a Resident Incident Report that indicated the incident date was 9-15-12 at 0335. The Narrative of incident and description of injuries stated, Call to room . observed skin tear to bilateral forearms. No other injury noted tx (treatment) in place. Hospice and family notified . Record review on 11/18/2012 revealed Nurse's Note from 09/14/2012 - 09/17/2012 the 9/14/2012 note at 0335 stated, Pt (patient) received skin tear to bilateral hands/forearm hospice nurse notified and husband notified. There was no other documentation regarding the skin tear to Resident #3's arm until 09/16/2012 at 2130 (9:30 PM) .Bilateral [MEDICATION NAME] intact on both arms . On 09/17/2012 at 1230 the Nurse's Note stated, Pt. (patient) D/C'd (discharged ) home per husband/hospice request . All meds given to husband . 1:00 PM Pt's husband notified Administrator that he chose to have the ambulance go ahead and take her/him to the hospital for evaluation of skin tears to arms prior to going home. Husband encouraged to keep us posted on her status. Review of Resident #3's hospital discharge summary dated 09/21/2012 indicated, .Hospital course: . 7. [MEDICAL CONDITION] of the arm. The patient was found to have old pieces of paper wrapped around her/his arms on admission. Wound care removed the tape, however, s/he did suffer some skin breakdown during the process. Wound care was consulted and they have dressing the wounds with petroleum gauze . Her/his left arm [MEDICAL CONDITION] is greater than her right. S/he is on [MEDICATION NAME] 100 twice a day . Resident #1 was admitted to the facility with [DIAGNOSES REDACTED]. Review of the EMS Incident Report dated 11/03/2012 stated, .Upon arrival found . patient lying in bed . Nurse staff stated that patient eyes rolled back into his head and s/he has not been able to talk today . Review of the 11/03/2012 Daily Skilled Nurse's Note dated 0900 stated, Resident eating breakfast in bed. AM medications administered. Alert but confused. SR (side rails) x 2. Bed in lowest position. Wound Vac intact. Foley cath intact draining amber urine. Will continue to monitor. There was no other documentation regarding Resident #1, the arrival of EMS or notification of the physician regarding a change in condition. In an interview with the surveyor on 11/18/2012 the Administrator confirmed there was no documentation related to the incident. S/he stated that the nurse working that day no longer worked at the facility. | 2015-12-01 |