cms_SC: 985

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.

Data source: Big Local News · About: big-local-datasette

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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
985	PRUITTHEALTH- BAMBERG	425104	439 NORTH STREET	BAMBERG	SC	29003	2018-09-20	686	E	0	1	F5OV11	NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observations, record reviews, and interviews, the facility failed to provide care and services to prevent development of pressure ulcers in high risk residents and promote healing of existing pressure ulcers for 3 of 8 residents reviewed with pressure ulcers. Residents #68, #29, and #26 were not turned and positioned every 2 hours per physician's orders [REDACTED]. In addition, the nurse failed to cleanse the scissors prior to cutting a dressing to be used as wound packing on a stage 4 pressure ulcer for Resident #68. The findings included: The facility admitted Resident #26 with [DIAGNOSES REDACTED]. Review of the 7-10-18 Quarterly Minimum Data Set (MDS) Assessment MDS on 9/10/18 at 10:15 PM revealed that the resident was totally dependent on staff for bed mobility. Record review on 9/19/18 at 1:26 PM revealed physician's orders [REDACTED]. Review of the Care Plan on 9/19/18 at 3:01 PM revealed interventions for decreased mobility included turning and positioning every 2 hours. Multiple observations revealed Resident #26 positioned on his/her back with the head of the bed elevated at least 30 degrees (on 9/09/18 at 10:28 AM, 12:15 PM, and 2:12 PM; on 9/10/18 at 8:43 AM, 9:30 AM, 11:03 AM, 12:37 AM, 2:16 PM, and 4:02 PM; on 9/18/18 at 9:31 AM, 11 AM, 12:31 PM, 2:15 PM, and 4:18 PM), indicating s/he had not been turned and positioned every 2 hours. During all observations, a positioning wedge was noted on the bedside table. No pillows or positioning devices were noted in the bed with the resident. During an observation and interview on 9/19/18 at 8:36 AM, the Director of Nurses (DON) verified that the resident was positioned on his/her back. S/he stated, He (she) should be turned every 2 hours and the wedge used for positioning. The facility admitted Resident #29 with [DIAGNOSES REDACTED]. Review of the 7-13-18 Quarterly Minimum Data Set (MDS) Assessment MDS on 9/10/18 at 9:25 PM revealed that the resident required extensive assistance of 2 staff members for bed mobility. A 11-5-17 significant change in status assessment noted the resident with a stage 3 pressure ulcer. Record review on 9/18/18 at 10:12 AM revealed physician's orders [REDACTED]. Review of the Medication Administration Record [REDACTED]. Review of the Care Plan on 9/18/18 at 12:47 PM revealed interventions for decreased mobility and skin breakdown included turning and positioning every 2 hours. Multiple observations revealed Resident #29 positioned on his/her back with the head of the bed elevated at least 30 degrees (on 9/09/18 at 11:48 AM, 1:55 PM, and 3:59 PM; on 9/10/18 at 8:24 AM, 9:45 AM, 11:13 AM, and 12:47 PM; on 9/18/18 at 9:25 AM, 11:04 AM, 12:05 PM, 2:10 PM, 2:25 PM and 4:13 PM), indicating s/he had not been turned and positioned every 2 hours. No pillows or positioning devices were noted in the bed with the resident except to prop up [MEDICAL CONDITION] right arm. During an interview and observation on 9/19/18 at 8:43 AM, the DON verified the resident's positioning. S/he stated that the resident should be turned and positioned every 2 hours. The facility admitted Resident #68 with [DIAGNOSES REDACTED]. Review of the 8-16-18 Quarterly Minimum Data Set (MDS) Assessment MDS on 9/10/18 at 7:21 PM revealed that the resident required extensive assistance of staff for bed mobility and had a stage 4 pressure ulcer. Record review on 9/18/18 at 3:21 PM revealed physician's orders [REDACTED]. Review of the Care Plan on 09/19/18 at 8:50 PM revealed interventions for decreased mobility and skin breakdown included a turning and positioning program. During an interview on 9/09/18 at 2:36 PM, Resident #68's family asked, When does that (positioning) wedge go on? We never see it used. (Resident #68) is always on her (his) back when we're here. Multiple observations revealed Resident #68 positioned on his/her back with the head of the bed elevated at least 30 degrees (on 9/09/18 at 10:36 AM, 12:24, 2:19 PM, and 4:17 PM; on 9/18/18 at 9:32 AM, 11:30 AM, 2:17 PM, and 5:47 PM), indicating s/he had not been turned and positioned every 2 hours. During all observations, a positioning wedge was noted in the chair. No pillows or positioning devices were noted in the bed with the resident. During an interview on 9/19/18 at 9:23 AM, the DON stated, They should turn her (him) every 2 hours and use the wedge. During observation of the stage 4 sacral pressure ulcer treatment on 9/18/18 at 11:30 AM, Licensed Practical Nurse #5 removed a pair of scissors from her/his pocket and cut the silver alginate dressing with which the wound was to be packed. Before application, the surveyor stopped the nurse and asked about cleansing the implement. The nurse stated s/he had cleaned it earlier with a Clorox Wipe. The Lippincott Procedures for alginate dressing application provided by the facility at 10:23 AM on 9-20-18 stated to Cut the dressing to the size of the wound using sterile scissors .	2020-09-01