DHEC's Bureau of Healthcare Quality is responsible for licensing various healthcare facilities, activities, and professionals in South Carolina and for enforcing compliance with the applicable state regulations and statutes relating to these health care facilities, activities, and professionals to protect the health, safety, and welfare of the people of South Carolina. In addition, we investigate complaints and serious incidents.

Licensing Inspections

Here are key facts about DHEC's Healthcare Quality inspections:

• Inspectors are health care professionals.
• Inspections and/or investigations are unannounced.
• A report of visit (ROV) is left with the facility, activity, or professional after each inspection or investigation. An ROV includes a detailed description of the conditions, conduct or practices, if any, that were found to be in violation of statutory or regulatory requirements. Each individual inspection or investigation is not be construed as a check of every condition that may exist, nor does it relieve the licensee from the need to meet all applicable standards regulations and laws.
• If an applicable regulation and/or statute is not met, then the facility, activity, or professional must submit a plan of correction to DHEC.
• In some cases, a follow-up inspection is made to verify that violation(s) of applicable regulations and/or statutes are corrected.
• Consumers can use inspection reports to compare the performances of health care facilities, activities, and professionals.

Violations

Violations of the standards in S.C. regulations are generally classified as follows:

1. Class I violations are those that DHEC determines to present an imminent danger to the health, safety, or well-being of the persons in the facility, activity, or professional or a substantial probability that death or serious physical harm could result therefrom. A physical condition or one or more practices, means, methods or operations in use in a facility, activity, or professional may constitute such a violation.
2. Class II violations are those, other than Class I violations, that DHEC determines to have a negative impact on the health, safety or well-being of persons in the facility, activity, or professional.
3. Class III violations are those that are not classified as Class I or II in these regulations or those that are against the best practices as interpreted by DHEC.

Certification Inspections

DHEC's Bureau of Healthcare Quality is responsible for the licensure and regulation of health care providers that participate in federal Medicare or Medicaid programs. We routinely inspect these providers to ensure they are operating in compliance with applicable federal regulations and in a manner that protects the health and safety of their residents/patients/clients/individuals.

During a routine inspection DHEC staff observe, review a sampling of clinical records, policies and procedures, staffing reports and other relevant documents; and interview patients/residents, family members, staff, visitors, and/or volunteers. We may also investigate complaints during inspections.
If a violation of a regulation is found during an inspection or investigation, we document it on a form provided to the facility. The form is called the Statement of Deficiencies ( Form CMS-2567 ) for federal regulations. This form lists each deficiency and in many cases, the steps the health care provider is taking to correct the deficiencies.

Each regulation is assigned a tag number, followed by a summary of the requirement and details of why this requirement was not met. Each health care provider type has a different set of tags. When a regulation is cited as a deficiency it may also have a classification to indicate the severity of the deficiency.
Nursing home federal deficiencies are given a 'Scope and Severity' rating. Scope and Severity is a national system that rates the seriousness of deficiencies. It is used by all state survey agencies and the Centers for Medicare & Medicaid Services when conducting nursing home Medicare and Medicaid certification surveys. For each deficiency, the surveyor determines the level of harm to the resident(s) involved and the scope of the problem within the nursing home. The surveyor then assigns an alphabetical scope and severity value, A through L, to the deficiency.

• "A" is the least serious rating
• "L" is the most serious rating.

The scope and severity matrix is an integral part of how nursing home scores are calculated in the scoring system.