The Hughey Law Firm has successfully pursued claims against this facility.

Every day, individuals entrust the care of their elderly loved ones to nursing homes across the nation. In the United States,  an estimated 1.4 to 1.5 million individuals live in nursing homes. How do you know if the facility you’re considering for your loved one is a safe and quality place? One of the ways is to find the health and safety reports from the facility’s annual inspection. Read on for more information about NHC Healthcare – Garden City from the nursing home abuse attorneys at Hughey Law Firm.

About NHC Healthcare – Garden City

NHC Healthcare – Garden City is a 148-bed facility in Garden City, South Carolina serving both long-term patients as well as short-term rehabilitation patients. It is owned by a for-profit corporation and accepts Medicare and Medicaid. The facility is rated in terms of staffing. In spite of having more residents than the national and state average, the facility employs close to the average number of licensed staff including registered nurses and physical therapists per resident.

The quality of care that residents receive is also ranked, based on 16 quality measures. For short-term patients, the quality measures include the:

  • Percentage of residents who were re-hospitalized after nursing home admission;
  • Percentage of residents who had an outpatient emergency department visit;
  • Percentage of residents who were given an antipsychotic medication for the first time;
  • Percentage of residents with new or worsened pressure ulcers (bedsores);
  • Percentage of residents who improved their ability to move around independently;
  • Percentage of residents who received a flu shot;
  • Percentage of residents who received a pneumonia vaccine;
  • Percentage of residents who were assessed and had functional goals included in their care plan;
  • Rate of short-stay patients who were able to return home and to their community;
  • Rate of potentially preventable hospitalizations within 30 days after returning home; and
  • Medicare spending per beneficiary.

For long-term patients, the rating is listed as average, and quality measures include:

  • Number of hospitalizations per 1,000 resident days;
  • Number of outpatient emergency department visits per 1,000 resident days;
  • Percentage of residents receiving an antipsychotic medication;
  • Percentage of residents experiencing one or more falls resulting in major injury;
  • Percentage of high-risk patients with pressure ulcers;
  • Percentage of residents with a urinary tract infection;
  • Percentage of residents whose ability to move independently worsened;
  • Percentage of residents whose need for help with daily activities increased;
  • Percentage of residents who received a flu shot;
  • Percentage of residents who lost control of their bowels or bladder;
  • Percentage of residents who lost too much weight;
  • Percentage of residents who have symptoms of depression; and
  • Percentage of residents receiving anti-anxiety or hypnotic medication.

March 2016 Inspection

In March 2016, the U.S. Department of Health and Human Services (HHS) conducted a health inspection at the facility. HHS found that the facility had EIGHT DEFICIENCIES during that inspection, each of which caused no actual harm but presented a risk for more than minimal harm to residents, with some of those deficiencies being widespread.

January 2017 Inspection

In January 2017, HHS’s annual inspection of the facility uncovered two deficiencies:

  1. Failure to conduct initial and periodic assessments of each resident’s functional capacity. Inspectors found that the facility failed to properly document issues such as incontinence and the presence of pressure ulcers during periodic assessments of two residents.
  2. Failure to allow the resident to participate in planning or revision of the resident’s care plan. In one circumstance, HHS discovered that the facility kept two care plans on a resident’s door, one stating that a use of a personal alarm due to the resident’s propensity for falling was indicated, while the other record did not. Additional record-keeping inconsistencies were found with another patient who also was at risk for falling and had a moderate cognitive impairment. A third resident, at risk for falling, was found to have inconsistent instructions in their care plan regarding their need for assistance with mobility and toileting.

For these deficiencies, staff was instructed to update the care plans for these residents to ensure that the plans provided clear instructions for fall prevention.

April 2018 Inspection

The April 2018, an HHS inspection again yielded two deficiencies:

  1. Failure to ensure medication error rates are not 5 percent or greater. Based on observations, record reviews, and interviews with staff, the inspection revealed that the facility had a medication error rate of 10.7 percent, which translated to three errors. The errors included failing to dispense the entire dose of two different medications one resident needed, who required that medicines be mixed into applesauce to be consumed. The facility committed another of the errors by dispensing medication well before a meal when the prescription directions ordered that it be taken with food.
  2. Failure to safeguard resident-identifiable information and/or maintain medical records on each resident in accordance with accepted professional standards. The relevant errors included one charting record for a resident that actually belonged to another resident, and two cases where information about a patient whose health was declining was not properly recorded in the resident’s chart and physicians or family members were not notified in a timely manner about these health declines.

June 2019 Inspection

The facility’s most recent health inspection, in June 2019, revealed four deficiencies:

  1. Failure to honor the resident’s right to a dignified existence, self-determination, communication. Based on a record review and interviews with staff and residents, HHS discovered that—on three separate occasions—a resident soiled themselves but staff failed to respond to the resident’s call light in a timely manner. The resident explained that sometimes staff takes a long time to answer call lights, and that twice the patient was unable to wait for a response. The third incident occurred as the resident was being transferred from their wheelchair to the toilet and was unable to wait until the transfer was complete.
  2. Failure to ensure each resident receives an accurate assessment. HHS’s review of the facility’s records revealed that the staff had failed to accurately code information for residents, including circumstances in which the residents were coded as being prescribed medications that they had not been prescribed, that a resident required a trunk restraint when they did not, and that a resident did not have pressure ulcers when they did.
  3. Failure to provide appropriate pressure ulcer care and prevent new ulcers from developing. The HHS inspection revealed that a resident had a pressure ulcer that was not properly documented. Upon discovering the pressure ulcer, the registered nurse who cleaned the resident’s wound used an improper procedure that could have resulted in contamination of the wound.
  4. Failure to provide and implement an infection prevention and control program. Two different nurses were observed dropping the residents’ medications onto a med tray and then picking them up with ungloved hands to administer to residents. The facility’s policy did not provide a policy for dealing with dropped medications.

The Importance of Nursing Home Inspections

Nursing homes require regular inspections to ensure the safety and well-being of residents, as well as to inform policy within the federal government on safety in the nation’s nursing homes. The inspections also provide the public with an unbiased glimpse into the day-to-day operations of the facility to help them to make informed decisions regarding their loved ones’ care.

However, the inspection process is not perfect for the following reasons:

  1. Predictability: Substandard facility operators often know when they’re going to be inspected and have the opportunity to “clean things up” before inspectors arrive, leading to inspection results that may not be as accurate as they would be if the inspections were conducted randomly. Federal guidelines no longer require state inspectors to provide the facility with written notice—which was formerly considered a way to make sure that key staff members were present to meet with inspectors—though some states still follow the policy of doing so. Even in states where the inspectors do not provide notice, operators can still guess as to when the facility will be inspected, as certifications only last 12 months and an inspection for re-certification must be conducted approximately 90 days before the certification’s expiration.
  2. Inefficiency: Many states do not have enough inspectors to conduct thorough inspections or spend an adequate amount of time at each facility. They also don’t have enough inspectors to provide appropriate follow-up with facilities that have major deficiencies.
  3. Paper compliance: Inspections rely heavily on records review, meaning that they don’t provide a complete picture of the day-to-day operations at the facility.
  4. Insensitivity to a diverse resident population: Not all facilities meet the same resident needs. Facilities providing specialized care, such as for dementia, often keep special needs patients on different floors from the rest of the resident population. The current survey forms don’t distinguish between care provided at specialized facilities versus facilities only focused on long or short-term general care.
  5. Lack of coordination between related monitoring processes: In some states, there is little coordination between inspections and monitoring or investigation of resident complaints, even though complaints present important information about the quality of care provided by the facility.

Other Resources for Evaluating Nursing Homes

When it comes to choosing a nursing home for your loved one, take these steps:

  • Consider what is important to you and to your loved one. Is it nursing care? Meals? The availability of services such as physical therapy, memory care, or hospice care? A religious connection? Identifying the qualities you’re seeking in a nursing home before you begin your search for a facility will help you narrow down your choices and can make the decision easier.
  • Talk to others to get suggestions or even references for nursing homes in your area. Family, friends, social workers, or religious groups can all be great resources when you’re seeking information about nursing homes.
  • After you’ve made a list of nursing homes that might be a good match for your loved one, call those facilities. Determine if they have availability, if there’s a waiting list, and the costs associated with the home.
  • Visit the facility. Some of the things you should look for include: Medicare/Medicaid certification, handicap access, residents who look like they’re well cared for, and warm interaction between the staff and residents.
  • Ask questions. Don’t be shy about asking staff about any strong odors, how long key staff members such as the director, head of nursing, head of social services, and head of kitchen staff have been working there. Strong odors and frequent turnover of key staff members can indicate a problem with the facility.
  • Visit again. Don’t call ahead and don’t visit on the same day of the week as you did before. Spot checking homes is a good way to see how they’re run when no one is expecting a guest who needs to be impressed.
  • Once you’ve selected a nursing home, be sure to read the contract for residency carefully. Ask questions if you don’t understand any of the contract provisions, and ask a trusted family member or friend to also look it over to see if anything about the contract seems unusual or unfair.

Hughey Law Firm: Our Nursing Home Neglect and Abuse Attorneys Are Here to Help You

If you believe your loved one has suffered abuse or neglect in NHC Healthcare – Garden City or at any other nursing home in South Carolina, contact us for information about your legal options. We’re available at (843) 881-8644 and through our online contact page.

Hughey Law Firm LLC
1311 Chuck Dawley Blvd. | Suite 201
Mt. Pleasant, SC 29464
Phone: 843-881-8644