Pruitthealth- Moncks Corner

Inspectors wroteBased on review of facility policy, record review, and interview, the facility failed to obtain a physician order for advance directives for Resident (R)11, for 1 of 1 residents reviewed for advance directives.

Inspectors wroteBased on review of facility policy, observation, record review and interview, the facility failed to ensure Resident (R)1 was free from misappropriation of a narcotic medication for 1 of 1 residents reviewed for misappropriation.

Inspectors wroteBased on interview, record review, and facility policy the facility failed to ensure that Resident (R)1, a resident diagnosed with dementia, was free from neglect by failing to provide necessary care and services to prevent R1 from eloping from the facility which had the potential for serious bodily harm. On [DATE] at approximately 8:00 PM, R1 was found in the parking lot of the facility near a major U.S. Highway (Highway 17) by staff after they were unable to locate the resident for bedtime. On [DATE] at 5:51 PM, the Administrator was notified that the failure to ensure Resident (R)1 was free from neglect, which resulted in a successful elopement on [DATE] at approximately 8:00 PM, constituted Immediate Jeopardy (IJ) at F600. [...]

Inspectors wroteBased on interview, record review, and review of the facility policy, the facility failed to ensure that adequate supervision was in place to prevent Resident (R)1 from eloping from the facility. Specifically, on 10/02/24 at approximately 8:00 PM, R1 was found in the parking lot of the facility near a major U.S. Highway (Highway 17), by staff after they were unable to locate the resident for bedtime. On 10/04/24 at 5:51 PM, the Administrator was notified that the failure to ensure Resident (R)1 was free from neglect, which resulted in a successful elopement on 10/02/24 at approximately 8:00 PM, constituted Immediate Jeopardy (IJ) at F689. On 10/04/24 at 5:51 PM, the survey team provided the Administrator with a copy of the CMS IJ Template and informed the facility IJ existed as of 10/02/24, when a resident successfully eloped from the facility through the front door. [...]

Inspectors wroteBased on review of facility policy, observation, record review, and interview, the facility failed to ensure 11 of 76 residents, Residents (R)4, R5, R6, R7, R8, R9, R10, R11, R12, R13, and R14, received their physician ordered medications. On 08/27/24 at 5:40 PM, the State Agency (SA) determined that the facility's non-compliance with one or more federal health, safety, and/or quality regulations could cause serious harm. On 08/28/24 at 9:10 AM, the survey team provided the Administrator with a copy of the CMS Immediate Jeopardy (IJ) Template, informing the facility IJ existed as of 08/22/24. The IJ was related to 42 CFR 483.25 - Residents are free of Significant Medication Errors. On 08/28/24, the facility provided an acceptable IJ Removal Plan. [...]

Inspectors wroteBased on record reviews and interviews, the facility failed to have a system in place to ensure every employed nurse aide had a completed performance review every 12 months. The facility further failed to ensure each nurse aide received the required 12 hours of inservice based on the outcome of the performance reviews.

Inspectors wroteBased on observation, record review, interview, review of facility policy, and manufacturer labeling, the facility failed to assure that medications were properly stored for 1 of 20 residents, 1 of 2 medication rooms and 2 of 2 treatment carts.

Inspectors wroteBased on review of facility policy, record review, observations, and interviews, the facility failed to maintain the dignity of Resident (R)40, for 1 of 2 residents reviewed for dignity. Specifically, R40's nose hairs failed to be trimmed.

Inspectors wroteBased on record review and interview, the facility failed to ensure Resident (R)8, with a diagnoses of post traumatic stress disorder and bipolar disorder, was referred and screened for possible needed services, utilizing the PASARR Level II screening and evaluation tool for 1 of 3 residents reviewed for PASARR Level II.

Inspectors wroteBased on observations, interviews, and record review, the facility failed to update Resident (R)677's Care Plan related to oxygen use and pain management for 1 of 5 residents reviewed. Furthermore, the facility failed to accurately reflect R31's advance directives in the Care Plan for 1 of 3 residents reviewed for Advance Directives.

Inspectors wroteBased on review of the facility policy, observation, record review, and interviews, the facility failed to ensure proper hand washing during wound care for Resident (R)13. Furthermore the facility failed to properly clean the wounds and additionally failed to ensure resident privacy before providing wound care for 1 of 1 resident observed for wound care.

Inspectors wroteBased on review of the facility policy, observation, and interview, the facility failed to follow a procedure during catheter care to prevent infections for Resident (R)13, for 1 of 1 residents reviewed for catheter care.

Inspectors wroteBased on review of facility policy, observations, interviews, and record review, the facility failed to establish a physician order related to oxygen use for Resident (R)677, for 1 of 5 residents reviewed.

Inspectors wroteBased on observation, record review, and interview, the facility failed to assure that a medication prescribed to Resident (R)38 for a fecal impaction, was being administered according to physician orders for 1 of 3 residents reviewed for hospitalization.

Inspectors wroteBased on observation, interview, facility policy review, and glucometer manufacturer recommendations, the facility failed to assure that proper infection control practices were being followed regarding glucometer cleaning for 1 of 3 residents, (Resident (R)42) observed for finger stick blood sugar testing during medication pass administration.

Inspectors wroteBased on record reviews and interviews, the facility failed to designate a licensed nurse to serve as a charge nurse on each tour of duty.

Inspectors wroteBased on observations, interviews, record reviews and review of facility policy, the facility failed to implement care plan interventions, for 1 of 3 residents, to prevent accidents/hazards for Resident (R)1. Specifically, the facility failed to ensure fall mats were in place.

Inspectors wroteBased on interviews, record review, and policy review, the facility failed to ensure a safe environment for 1 Resident (R)77) of 3 residents reviewed for accidents. Specifically, R77 ingested unsecured medications of another resident, risperidone (antipsychotic), buspirone (anti-anxiety), and gabapentin (anti-convulsant), which were left unsupervised on the top of the medication cart. The practice of lack of supervision of residents, and unsecured medications resulted in the resident experiencing a medical emergency that required the resident to be transferred to the emergency room (ER).

Inspectors wroteBased on interview, record review, review of the Centers for Disease and Prevention (CDC) guidelines, and facility policy review, the facility failed to ensure that 2 Residents (R)1 and R84) of 5 residents sampled for immunization reviews, were offered, and given the option to receive or decline pneumonia vaccine.