ORDERS:
CONSENT ORDER AND AGREEMENT
FINDINGS OF FACT
1. Rebecca Laughter (Licensee) has been the holder of a license to operate Oakridge
Community Care Home No. 1 (facility) issued by the South Carolina Department of Health and
Environmental Control (Department) pursuant to Section 44-7-110 et seq. South Carolina Code
of Laws (1976) (as amended).
2. The Department notified the facility by letter dated August 25, 1998 (see Attachment A),
that it had determined it was appropriate to impose a $6,500.00 monetary penalty. The letter was
received by the Licensee on August 27, 1998.
3. The Licensee notified the Department by letter dated September 21, 1998 (Attachment B),
that she was appealing the Department's decision to impose a monetary penalty.
4. The Licensee contested some of the violations included in Attachment A.
Oakridge Community Care Home No. 1
Page Two
THEREFORE, IT IS AGREED
1. In consideration of the above, the Department agrees to suspend $ 5,500.00 of the
$6,500.00 monetary penalty assessed against Oakridge Community Care Home No. 1. Therefore,
the current penalty amount due and payable to the Department is $1,000.00 (synopsis attached).
2. The Licensee agrees to pay this $1,000.00 penalty within ten days of receipt of this
executed Consent Order.
3. It is understood by the Licensee that Section 44-7-320 (D) of the S.C. Code of Laws states
that "Failure to pay a penalty within thirty days is grounds for suspension, revocation, or denial
of a renewal of a license. No license may be issued, reissued, or renewed until all penalties
finally assessed against a person or facility have been paid."
4. If repeat violations of those sections noted in Attachment A are noted during subsequent
inspections by the Department during the twelve month period following execution of this
Consent Order, the Department may require payment of all or part of the suspended portion of
the assessed penalty and/or may impose a penalty in accordance with Section 103 D., R 61-84,
and the Licensee shall immediately pay to the Department the assessed penalty.
5. The Department in no way waives its authority to enforce, by imposing penalties or
otherwise, all statutory and regulatory requirements applicable to the licensure of Oakridge
Community Care Home No.1.
Page Three
Oakridge Community Care Home No.1
6. The Licensee, or her designee, shall take immediate steps to correct all violations noted in
Attachment A and all violations noted by the Department in previous inspections. The Licensee
will establish procedures to ensure that violations in Attachment A and similar violations of R
61-84, Standards for Licensing Community Residential Care Facilities, do not occur in the
future.
7. It is further agreed that future violations or repeat violations of the regulations or
applicable licensing statutes may result in the imposition of penalties or revocation of the license
to operate Oakridge Community Care Home No. 1, pursuant to Section 44-7-320 of the South
Carolina Code of Laws (1976) (as amended), and the facility administrator has been informed of
these potential actions.
AND IT IS SO ORDERED
APPROVED:
January 13, 1999
John D. Geathers Date
Administrative Law Judge
WE CONSENT:
Jerry L. Paul, Director Date
Health Licensing Section
Josephine Patton, DHEC Attorney Date
Rebecca Laughter, Administrator/Licensee Date
Oakridge Community Care Home No. 1
Richard H. Rhodes, Attorney Date
South Carolina Department of Health and Environmental Control
HEALTH LICENSING SECTION
Summary of Violations (Basis for Imposing Penalties)
| Oakridge Community Care Home #1 |
CRCF
|
38
|
| (Facility) |
(Type of Facility)
|
(Number of Beds)
|
| Date
Cited |
R61-84
Section |
Class |
Description of Violation
|
Penalty
Range |
Penalty
Imposed |
Penalty
Called in
per Consent
Order |
Penalty
Held in
Abeyance |
| 8/12/97 |
204.B.4 |
III |
Last TB test documented for one staff member was
dated 7/19/96. |
0 |
|
|
|
| 7/14/98 |
204.B.4 |
III |
2 of 6 staff personnel records reviewed did not contain
documentation of an annual TB skin test. |
$100-500 |
$100 |
0 |
$100 |
| 8/12/97 |
207.C.2 |
II |
There was no documentation of a current electrical
inspection. |
$100-500 |
|
|
|
| 7/14/98 |
207.C1,2 |
II |
There was no documentation of current heating and
electrical inspections. Documents observed on May 22
and 23 indicated repair of equipment. It did not address
the operating condition of the systems. |
$200-1000 |
$200 |
$100 |
$100 |
| 8/12/97 |
209.B.1 |
II |
2 of 5 resident records reviewed contained fee
agreements which did not contain the signature of the
sponsor or representative. |
$100-500 |
|
|
|
| 7/14/98 |
209.B.1 |
II |
Update of current charges for a resident was not signed
by resident's responsible party. |
$200-1000 |
$200 |
0 |
$200 |
| 8/12/97 |
307 |
II |
Last date of a rabies vaccination for a collie dog present
at the facility was 4/12/96. Annual shots are required. |
$100-500 |
|
|
|
| 7/14/98 |
307 |
II |
Two small 3-4 week old kittens were observed outside
on the porch of the facility. There was no
documentation available to indicate that these kittens
had been examined by a veterinarian. Food and water
bowls were not provided. |
$200-1000 |
$200 |
0 |
$200 |
| 8/16/96 |
402.E,D |
II |
The facility did not follow its emergency medical care
procedures by failing to call the resident's physician
when the resident asked for medical help. Please
respond to this violation within 15 days of receipt of
this report. |
$100-500 |
|
|
|
| 7/14/98 |
402.E |
II |
On July 14, 1998, a resident was not taken to a
scheduled doctor's appointment due to lack of staff.
Per resident, staff did not take her because the facility
would have been understaffed. (Inspectors observed
resident and staff getting into a truck upon arrival to
facility.) |
$200-1000 |
$200 |
$100 |
$100 |
| 7/14/98 |
404.A |
I |
Staff notified three of the inspectors on this date that a
14-year-old boy is the only staff on duty on 3rd shift. |
$200-1000 |
$1000 |
0 |
$1000 |
| 2/11/98 |
505.C |
I |
A resident record did not contain documentation of
notes of observation. |
$200-1000 |
|
|
|
| 7/14/98 |
505.C |
I |
There was no documentation in a resident's medical
record that treatments ordered by a physician had been
administered. However, staff documented that
Duoderm had been applied. The inspectors observed an
open wound on the large toe of the right food which
was exuding pus and blood and several flies were
observed on the wound. Resident stated that toe had
not been cleaned and/or the dressing changed in several
days. |
$500-2000 |
$500 |
$100 |
$400 |
| 6/12/97 |
505.E
903 |
I
I |
The only documentation observed in a resident record
of an elopement from the facility was the treatment
report from the emergency room. |
$200-1000 |
|
|
|
| 2/11/98 |
505.E
505.C |
I
I |
A resident record reviewed did not contain
documentation of notes of observations or symptoms
and other indications of illness or injury, i.e., no
documentation which described the deterioration in the
resident's condition. |
$500-2000 |
|
|
|
| 7/14/98 |
505.E |
I |
For a resident admitted May 7, 1998 and discharged
June 16, 1998 (after hospital stay from June 8th thru
June 16th), there were no notes of observation of
illness/injuries. |
$1000-5000 |
|
|
|
| 8/12/97 |
506.A.4 |
II |
2 of 5 resident records reviewed did not contain a care
plan which described social activities for the individual. |
$100-500 |
|
|
|
| 2/11/98 |
506 |
II |
A resident record reviewed did not contain
documentation of a care plan which had been revised as
needed. Staff indicated to both inspectors that this
resident needs total care, i.e., dressing, bathing and
feeding. Resident was observed in a hospital bed with
both side rails in use and an alternating pressure pump. |
$200-1000 |
|
|
|
| 7/14/98 |
506.A |
II |
For four of four resident records reviewed, care plans
did not address activities suitable or desirable for
residents. |
$500-2000 |
$500 |
$100 |
$400 |
| 8/12/97 |
601.B.1 |
I |
The required staff ratio of 1:10 was not maintained the
day of this survey. Upon entry to this facility at 9:30
a.m., one cook and one staff person were present for 34
residents. |
$200-1000 |
|
|
|
| 2/11/98 |
601.B.1 |
I |
At least one staff member for each 10 residents or
portion thereof was not on duty. Two staff of the 4 on
duty traveled to Oakridge Community Care Home #2
with the inspectors at 11:50 a.m. |
$500-2000 |
|
|
|
| 7/14/98 |
601.B.1 |
I |
Only three staff members were present on duty. The
other staff person was acting in place of the
administrator who was absent. |
$1000-5000 |
$1000 |
$200 |
$800 |
| 7/25/97 |
801 |
II |
One AC unit in the facility was not operable. |
$100-500 |
|
|
|
| 8/12/97 |
801 |
II |
a. There was molding missing from the steps adjacent
to the sitting area.
b. A double paned window (the outside window) had
broken and numerous pieces of broken glass were
observed in the track.
c. Chairs and recliners (vinyl) in the sitting room were
ripped and torn.
d. Chipped tile was observed on the laundry in the
bathroom between resident rooms #6 and #8.
e. Cracked wall plaster was observed on the wall
adjacent to the resident's bed in room #8.
f. There was no light cover for the fixture in the porch
sitting room.
g. The protective guard which surrounds the wood
stove was not secured to the floor.
h. The exit sign adjacent to room #1 was not
illuminated.
i. Peeling plaster was observed on the ceiling of room
#203.
j. Molding was missing from the stairs to the second
floor of the facility.
k. Improper window installation was observed in
resident room #6.
l. Rinse gauge to the dish machine was inoperable.
m. Large tears and cracks were observed on the kitchen
floor |
$200-1000 |
|
|
|
| 8/12/97
(Continued) |
801 |
II |
n. The ceiling in the kitchen area was in poor repair,
i.e., plaster peeling near hood; tar-like substance
dripping from ceiling.
o. Water damage was observed under the sink in
bathroom #1.
p. Filter in hood system was improperly installed. |
|
|
|
|
| 7/14/98 |
801 |
II |
A. "T" connections and ends of the sprinkler system
in rooms 6 and 202, and the sitting room had a
heavy build up of rust.
B. Chest of drawers were missing handles in rooms
202, 203, 204 and 205.
C. Floor linoleum was not joined and sealed in closets
in room 205, behind the door in room 202 and on
the common floor in rooms 203 and 204, causing
the uncoiled ends to curl up, exposing the sub
flooring.
D. Floor linoleum was damaged with missing
linoleum in rooms 203 and 204.
E. The light fixture in the north wing stairwell was
without a protective cover, and the hood in the
kitchen did not have a cover over the light.
F. There was a broken window with jagged edges in
room 203.
G. There was a hole in the wall approximately 6" x 1-1/2' behind the commode in room 1 bathroom
exposing the underpinning.
H. The commode seat in room 1 bathroom had worn
through the vinyl to the raw wood. |
$500-2000 |
$500 |
$100 |
$400 |
| 7/14/98
(continued) |
801 |
II |
I. The fire exit light on the west end of the building
was not illuminated.
J. The exit door on the west end of the building
would not self-latch. The latch was hanging
loosely at an angle secured partially by 1 screw. |
|
|
|
|
|
|
|
K. There was torn and missing vinyl on chair in the
living room.
L. Wood table surfaces were worn through to the raw
wood in the living and dining rooms.
M. There was damaged, missing and unglued toe mold
in the living and dining rooms on the west wing
hallway.
N. There was a missing brick on the bottom of the
exterior wall by the dining room.
O. The back of the wood steps on the east side of the
building were missing.
P. The ceiling was buckling, peeling in the living and
dining rooms and porch.
Q. The kitchen air conditioner is missing the front
cover, insulation, and is inoperative.
R. There was missing siding on the back of the house
by the porch.
-- The soap dispenser was not properly secured to the
wall in the women's restroom east wing.
-- The bottom medicine cabinet lock would not lock.
The lock was "frozen" in the open position. |
|
|
|
|
| 7/25/97 |
802.A |
II |
Flies were observed throughout the entire facility. Dead
flies and other insects were observed in all the window
sills in the facility. |
$100-500 |
|
|
|
| 8/12/97 |
802 |
II |
a. A soiled light cover was observed in the laundry
room.
b. Spider webs were observed in the window of the
laundry room and resident room #9.
c. A strong urine odor was observed in resident
rooms #2 and #6 and #20 and #203.
d. The beige recliner in the sitting room was soiled.
e. Dead flies and insects were observed in the
window sills throughout the facility; also in the
bathroom next to resident room #8.
f. The floor of the closet which contained a deep
freezer was soiled and contained an accumulation
of trash.
g. Urine was observed on the floor of resident room
#9.
h. The walls of resident room #9 were soiled.
i. Soiled bed linens were observed in room #205.
j. At least 10 cigarette butts were observed in the
trash can of room #204.
k. Debris was observed on the rails of numerous beds
throughout the facility.
l. Numerous stained box springs were observed in
resident rooms throughout the facility.
m. Food wrappers and dirty clothes were observed on
the floor of the closet in room #203. |
$200-1000 |
|
|
|
| 8/12/97
(continued) |
802 |
II |
n. Toxic agents were observed stored unsecured and
unattended in several locations, i.e., Wisk in
resident room #202, spray enamel, Decor and
Sudden Death (mice killer) in wooden cabinet on
the outside porch; Downy and Wind Fresh laundry
detergent in the laundry room. |
|
|
|
|
| 7/14/98 |
802.A |
II |
A. Toxic agents were stored unsecured and
unattended in the laundry room.
B. Flies were observed throughout the facility.
C. There was a build up of mildew on the wall and the
tub mat in the shower of room 8.
D. There was a strong urine odor in the shower and
room 8 on the west hall.
E. The furniture in the living room was soiled. |
$500-2000 |
$500 |
$100 |
$400 |
| 7/25/97 |
803 |
II |
A. There was no drain plug in the large dumpster.
B. All the yellow trash cans on the porch of the
facility were soiled, contained water and did not
have liners. |
$100-500 |
|
|
|
| 7/14/98 |
803.A |
II |
A. The lids to the dumpster were broken and missing.
There was no drain plug in the dumpster.
B. Uncovered trash cans were observed in the dining
room and on outside porch.
C. Trash was stored in the outside wood storage box. |
$200-1000 |
$200 |
0 |
$200 |
| 10/14/96 |
903
505.C,E |
I
I |
The administrator reported that a resident who had
taken medication intended for another resident had been
taken to the hospital by EMS after having cut herself
11/2/95 on her own fingernail. No incident report was
available regarding this incident and there was no
documentation available to describe when these stitches
had been removed, who provided the transportation to
the site where such treatment was rendered, nor of who
provided such treatment. |
$200-1000 |
|
|
|
| 2/11/98 |
903 |
I |
A resident record reviewed documented numerous falls
including a hip fracture (10/13/97). These documented
notes were primarily hospital entries. No incident
reports on this resident were available for review. |
$500-2000 |
|
|
|
| 7/14/98 |
903 |
I |
Resident care notes documented falls, hospitalization,
etc., yet there were no incident reports/notes which
indicated that residents' physicians and families were
notified. Also, there was no documentation of serious
illness and/or injuries resulting in hospitalization having
been reported to the Department. |
$1000-5000 |
$1000 |
$200 |
$800 |
| 7/25/97 |
1006.B.1 |
III |
A. A refrigerator (yellow) on the porch outside the
facility did not contain a thermometer.
B. Mayonnaise, bread and uncovered Blue Bonnet
sticks were observed in this refrigerator (yellow).
Please reference 1006.B.4.d. |
0 |
|
|
|
| 7/14/98 |
1006.B.1 |
III |
Personal items (e.g., comb, cigarettes, lotion, purse,
Listerine) were stored with food items in the kitchen. |
$100-500 |
$100 |
0 |
$100 |
| 7/25/97 |
1008.B.1 |
III |
The yellow refrigerator on the porch was heavily soiled
and covered inside with mold and mildew. |
0 |
|
|
|
|
|
|
Nonfood contact surfaces of utensils/equipment were
not thoroughly cleaned after use or cleaned at such
intervals as to maintain cleanliness and sanitary
conditions. For example:
a. soiled can opener holder
b. dust and grease buildup on hood system |
|
|
|
|
| 7/14/98 |
1008.B.1 |
III |
c. debris in utensil tray
d. food splatter in the microwave
e. soiled tray storing ice scoops
f. dust and debris accumulation in top of ice machine
g. debris on lower shelf of prep table
h. accumulated debris in victory cooler |
$100-500 |
$100 |
0 |
$100 |
| 8/6/97 |
2002 |
III |
Sprinkler system shall be inspected annually by a
certified sprinkler company. B3/SFPC
Hole in linen closet ceiling shall be repaired. C2/SBC
Electrical panel box shall be properly labeled.
EE7/NEC
Wire to water heater in upstairs closet shall be placed in
conduit. EE7/NEC
Clothing shall not be stored against water heater in
closet upstairs. F7/SFPC |
0 |
|
|
|
| 8/6/97
(continued) |
2002 |
III |
Fire drills shall be conducted quarterly per shift and
documentation kept on file. F7/SCRR
Curtains shall be treated annually for flame retardance
and documentation kept on file. F7/SCRR
Electrical inspections required annually by a certified
electrician. F7/SCDHEC |
|
|
|
|
| 7/14/98 |
2002 |
III |
A. The handle to the standpipe was not secured in
room 204.
B. There was a wash cloth covering the sprinkler head
in room 202. |
$100-500 |
$100 |
0 |
$100 |
| 7/25/97 |
2701.5 |
III |
A. Holes in the window screens were observed in the
small sitting area.
B. The large window screen in the dining area was not
flush in the track, i.e., non-intact. |
0 |
|
|
|
| 7/14/98 |
2701.5 |
III |
The window screen in room 203 was open to the
outside. |
$100-500 |
$100 |
0 |
$100 |
Totals $10,400-48,500 $6,500 $1,000 $5,500 |