cms_SC: 9381
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 |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
9381 | AGAPE REHABILITATION OF ROCK HILL | 425159 | 159 SEDGEWOOD DR | ROCK HILL | SC | 29732 | 2011-07-26 | 333 | D | 0 | 1 | HRMY11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** On the days of the survey, based on record review and interview, the facility failed to ensure that residents remained free from significant medication errors. Resident #3, one of fourteen residents reviewed for medications, did not receive [MEDICATION NAME] as ordered. The findings included: The facility admitted Resident #3 on 6/13/11 and readmitted him on 7/15/11 with [DIAGNOSES REDACTED]. Record review on 7/25/11 revealed cumulative physician's orders [REDACTED]. One entry revealed an order for [REDACTED]. The medication had been scheduled for 9:00 AM only. Review of Physician's Telephone Orders revealed an order dated 7/15/11 which said to "Hold [MEDICATION NAME] 20 mg". A subsequent Telephone Order dated 7/20/11 stated "PT (Patient) may start [MEDICATION NAME]". Review of the July 2011 Medication Record revealed an entry for "[MEDICATION NAME] 20 mg (1) PO Q 8 hrs, On hold per Pharmacy". The medication had been initialed as having been given once daily at 9:00 AM on 7/20, 7/21, 7/22, and 7/25 instead of every 8 hours as ordered. On 7/23 and 7/24, the nurse's initials had been circled for the 9:00 AM dose which indicated the resident had not received any [MEDICATION NAME] for those two days. Documented on the back of the Medication Record were entries for 7/23 and 7/24 which stated "[MEDICATION NAME] on hold, pharmacy". During an interview on 7/25/11 at 6:10 PM, Licensed Practical Nurse (LPN) #1 verified the above findings after reviewing the cumulative July physician's orders [REDACTED]. When asked what [MEDICATION NAME] was for, she stated that [MEDICATION NAME] was another name for [MEDICATION NAME] and that the resident used this medication to improve his [MEDICAL CONDITION] function. When asked if the medication had been on hold on 7/23 and 7/24, LPN #1 stated it hadn't, and that the medication had been available and in the medication cart at that time to be given. During an interview on 7/26/11 at approximately 2:00 PM, the resident's Physician stated the resident was taking [MEDICATION NAME] for [MEDICAL CONDITION] Hypertension. | 2015-05-01 |