Pruitthealth- Orangeburg

Inspectors wroteBased on record review and interview, the facility failed to ensure that a discharge Minimum Data Set (MDS) assessment was completed timely for one of 26 sample residents (Resident (R) 37) reviewed for MDS assessments. The failure to submit the discharge MDS did not allow for the closure of the residents' MDS cycle.

Inspectors wroteBased on observation, record review, interview, and facility policy review, the facility failed to ensure residents received alternative measures prior to the installation of side rails, and assessments were completed for the risk of entrapment for one of two residents (Resident (R) 235) reviewed for side rails of 26 sample residents. The lack of alternate side rail measures and proper assessment/consent could lead to potential restraint or side rail entrapment.

Inspectors wroteBased on observations and interviews, the facility failed to serve food at the appropriate/preferred temperature in 1 of 1 main kitchen.

Inspectors wroteBased on observations, interviews, and facility policy review, the facility failed to label and date foods, discard expired foods and failed to maintain a clean ice machine, in 1 of 1 main kitchen.

Inspectors wroteBased on review of facility policy, observations and interviews, the facility failed to ensure expired medications, and insulin pens were labeled and stored according to manufacturers recommendations in 2 of 4 medication carts and 1 of 2 treatment carts.

Inspectors wroteBased on observations, interviews, record review, and review of facility policy, the facility failed to ensure reasonable accommodations were provided to meet the needs and functional ability for 1 of 1 residents reviewed for accommodations of needs. Specifically, Resident (R)73's call light was observed out of reach and not accessible if the resident needed assistance.

Inspectors wroteBased on observations, interviews, record review, and review of facility policy, the facility failed to provide services to Resident (R)14, who was unable to carry out activities of daily living (ADL), necessary to maintain good grooming and personal hygiene for 1 of 3 residents reviewed for ADL care.

Inspectors wroteBased on observations, interviews, record review, and review of facility policy, the facility failed to provide Resident (R)14 with treatment to prevent further decrease in range of motion (ROM) for 1 of 1 residents reviewed for range of motion.

Inspectors wroteBased on review of facility policy, observations, and interviews, the facility failed to follow a procedure during Foley catheter care to decrease the likelihood of infection for Resident (R)70, for 1 of 1 residents observed for Foley catheter care.

Inspectors wroteBased on observation, interview and review of the facility policy, the facility failed to ensure expired food items were removed from the walk-in refrigerator and dented cans were removed from the dry storage for 1 of 1 main kitchen.

Inspectors wroteAmended 1/10/2022 Based on interviews and review of the daily postings for staffing, the facility failed to ensure a Registered Nurse was in the facility for 8 consecutive hours daily for multiple days from 9/17/2021 through 10/17/2021. The facility further failed to ensure the Director of Nursing did not serve as the charge nurse for 1 of 5 days of the survey. The facility had a census of 68 residents.

Inspectors wroteBased on observations, interviews, and the review of the facility's policy titled Infection Prevention and Control Policies and Procedures, the facility failed to ensure employees, vendors, and contractors were COVID-19 screened before entering the facility. The facility also failed to ensure staff practiced proper hand-washing prior to meal administration, for 2 of 2 meals observed. Findings Include: A review of the facility's s policy titled, Infection Prevention and Control Policies and Procedures under Procedure says the following: The facility will complete a Prevent COVID-19 Screening Checklist and/or COVID-19 Prevent Worksheet prior to entering facility, which includes vaccination history for employees, contracted staff, and consultant only. The facility will follow the screening process for signs and symptoms of COVID-19 and will restrict entry if concerns are identified. [...]

Inspectors wroteFindings: The facility admitted R18 on 02/18/2021 with diagnoses including, but not limited to, acute kidney failure, anorexia, depression, muscle weakness, pneumonia, dysphagia and aphasia, type 2 diabetes, dementia, severe protein-calorie malnutrition, and pulmonary embolism. During a meal observation on 10/20/21 at 1:05 PM, R18 approached a surveyor and said she wants to go to the bathroom. The surveyor passed the information on to a group of three CNAs that were close by. The CNAs kept talking among themselves and ignored the R18 request. At 1:08 PM, R18 repeated her request to go to the bathroom. CNA5 was asked if R18 has been taken to the bathroom and added she keep on saying she wants to go to the bathroom, perhaps she needs to be changed. CNA5 said in a loud voice in the hall, She is also incontinent then said to the resident (First name of the resident), go to your room. [...]

Inspectors wroteBased on observations, interviews and review of the facility guidance titled, Regulate Temperature in Nursing Homes, the facility failed to ensure the temperature in the resident room and hallways was maintained at 71 degrees Fahrenheit and not less on 3 of 3 units.

Inspectors wroteBased on record review and interviews, the facility failed to notify the Ombudsman when one (1) of one (1) resident discharged to the hospital. (Resident #36)

Inspectors wroteBased on observations, records review, and interviews, the facility failed to determine and complete a significant change in functional status assessment for Resident (R) 41. R41 had a significant decline in activities of daily living (ADLs).

Inspectors wroteBased on observations records review and interview the facility failed to provide the necessary care and services to ensure that R4 maintained activity of daily living (ADLs) abilities or received appropriate assistance with activities of daily living when needed for one of one sampled resident reviewed for ADLs.

Inspectors wroteBased on record reviews, interviews, and review of the facility policy titled, Weight Monitoring, the facility failed to provide interventions for Resident (R) 44 to promote weight maintenance or to decrease weight loss for 1 of 4 residents reviewed for Nutrition.

Inspectors wroteBased on observations, interview, and review of the facility policy titled, Medication Administration: General Guidelines, the facility failed to ensure a medication administration error rate of less than 5 percent during 2 out of 26 opportunities for error observed during medication administration.

Inspectors wroteBased on observation, interview and review of the Medication Administration Record for Resident (R)56, the facility failed to ensure a medication dosage and form was correct as ordered by the physician during med pass for 1 of 28 opportunities observed during medication administation.

Inspectors wroteBased on observations and interviews, the facility failed to maintain and ensure the call light system was properly working for one of 19 rooms reviewed for functioning call lights.

Inspectors wroteBased on observations and interviews, the facility failed to provide a functional, sanitary, and comfortable living environment for three of nineteen sample residents reviewed for the environment.