cms_TN: 3324
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 |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
3324 | GOOD SAMARITAN SOCIETY - FAIRFIELD GLADE | 445506 | 100 SAMARITAN WAY | CROSSVILLE | TN | 38558 | 2019-11-14 | 655 | C | 0 | 1 | 69HQ11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on medical record review and interview the facility failed to provide evidence of documentation in the medical record indicating a Baseline Care Plan summary was given to the resident and/or resident representative for 6 Residents (#1, #16, #21, #22, #34, and #195) and failed to develop a Baseline Care Plan timely for 1 Resident (#16) of 6 residents reviewed for Baseline Care Plans. The findings include: Medical record review revealed Resident #1 was admitted to the facility on [DATE] with [DIAGNOSES REDACTED]. Medical record review of the Baseline Care Plan dated 11/1/19 revealed no documented evidence Resident #1 and/or the resident representative had received a summary of the Baseline Care Plan. Medical record review revealed Resident #16 was admitted to the facility on [DATE] with [DIAGNOSES REDACTED]. Medical record review of the Baseline Care Plan dated 5/21/19 revealed no documented evidence Resident #16 and/or the resident representative had received a summary of the Baseline Care Plan. Continued review revealed the Baseline Care Plan was dated 6 days after the admitted . Medical record review revealed Resident #21 was admitted to the facility on [DATE] with [DIAGNOSES REDACTED]. Medical record review of the Baseline Care Plan dated 10/24/18 revealed no documented evidence Resident #21 and/or the resident representative had received a summary of the Baseline Care Plan. Medical record review revealed Resident #22 was admitted to the facility on [DATE] with [DIAGNOSES REDACTED]. Medical record review of the Baseline Care Plan dated 9/23/19 revealed no documented evidence Resident #22 and/or the resident representative had received a summary of the Baseline Care Plan. Medical record review revealed Resident #34 was admitted to the facility on [DATE] with [DIAGNOSES REDACTED]. Medical record review of the Baseline Care Plan dated 10/14/19 revealed no documented evidence Resident #34 and/or the resident representative had received a summary of the Baseline Care Plan. Medical record review revealed Resident #195 was admitted to the facility on [DATE] with [DIAGNOSES REDACTED]. Medical record review of the Baseline Care Plan dated 11/8/19 revealed no documented evidence Resident #195 and/or the resident representative had received a summary of the Baseline Care Plan. Interview with the Director of Nursing (DON) on 11/14/19 at 9:36 AM, in the conference room, confirmed the facility did not have documented evidence in the medical record Resident #1, Resident #34, or Resident #195, or the resident representatives had received a summary of the Baseline Care plan. Interview with the DON on 11/14/19 at 1:37 PM, in the DON's office, confirmed the facility did not have documented evidence in the medical record Resident #16, Resident #21, or Resident #22 or the resident representatives had received a copy of the baseline care plan. Interview with the DON on 11/14/19 at 4:08 PM, in the conference room, confirmed the Baseline Care Plan had not been completed timely, within 48 hours of admission to the facility, for Resident #16. | 2020-09-01 |