cms_AK: 18

In collaboration with The Seattle Times, Big Local News is providing full-text nursing home deficiencies from Centers for Medicare & Medicaid Services (CMS). These files contain the full narrative details of each nursing home deficiency cited regulators. The files include deficiencies from Standard Surveys (routine inspections) and from Complaint Surveys. Complete data begins January 2011 (although some earlier inspections do show up). Individual states are provides as CSV files. A very large (4.5GB) national file is also provided as a zipped archive. New data will be updated on a monthly basis. For additional documentation, please see the README.

Data source: Big Local News · About: big-local-datasette

This data as json, copyable

rowid facility_name facility_id address city state zip inspection_date deficiency_tag scope_severity complaint standard eventid inspection_text filedate
18 KETCHIKAN MED CTR NEW HORIZONS TRANSITIONAL CARE 25010 3100 TONGASS AVENUE KETCHIKAN AK 99901 2018-08-03 842 D 0 1 RHGS11 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview the facility failed to ensure resident information was accurately documented for 3 residents (#s 2, 3, 14) of 14 sampled residents. This failed practice placed the residents at risk for not receiving services needed to address medical conditions. Findings: Resident #2 Record review on 7/30/18 - 8/3/18 revealed Resident #2 was admitted to the facility with [DIAGNOSES REDACTED]. Review of Resident #2's most recent care plan, undated, revealed 13 Multidisciplinary Problems (Active). Additional review of the individual problems revealed the following omission and/or discrepancies: 1) Review of the Problem: Difficulty swallowing . revealed no start date to the problem or the 4 interventions. 2) Review of the Problem: Alterations in comfort . revealed a start date of 4/26/17. This problem describes a cervical fracture that occurred on 4/8/18 (start date is almost one year before incident occurred). All 8 interventions to this problem also have a start date of 4/26/17. Resident #3 Record review on 7/30/18 - 8/3/18 revealed Resident #3 was admitted to the facility with [DIAGNOSES REDACTED]. Review of Resident #3's care plan, undated, revealed 18 Multidisciplinary Problems (Active). Additional review of the individual problems revealed the following discrepancy: 1) Review of the Problem: Elevated A1C . (A blood test that reflects your average blood glucose levels over the past 3 months) revealed a start date of 5/10/16 and an expected end of 5/14/18. Two interventions to this problem are 1) Monitor resident's blood sugars as ordered and 2) Monitor A1c level as ordered. During an interview on 8/3/18 at 11:20 am, Licensed Nurse (LN) #4 stated there are no current orders for blood sugar or A1C monitoring. The last blood sugar on Resident #3 was 2/22/16. The last A1C drawn was 7/17/15. Resident #14 Record review on 7/30/18 - 8/3/18 revealed Resident #14 was admitted to the facility with [DIAGNOSES REDACTED]. Review of Resident #14's most recent care plan, undated, revealed 19 Multidisciplinary Problems (Active). Additional review of the individual problems revealed the following discrepancy: 1) Review of the Problem: Impaired strength and/or mobility . revealed a start date of 10/17/17 and a Description: Related to left side [MEDICAL CONDITION] and [MEDICAL CONDITION] post [MEDICAL CONDITION]. Interventions for this problem were documented as restorative aid, range of motion exercises, with the goal needs to maintain current flexibility and prevent contractures. Further review of Resident #14's medical record revealed Occupational Therapy (OT) added instructions for a palm protector with finger separators on 5/29/18 with the following interventions: - Please place palm shield on (Resident #14) when in bed (in place of previous palm protector). - If finger separators out of place, please fix them - Keeping left arm up on pillow for support will help keep it in place and provide comfort to left arm - If (Resident #14) is having any discomfort with palm shield, please remove and give a break. Attempt to replace in 30 (minutes) - 1 hour. Additional review of Resident #14's care plan Problem: Impaired strength and/or mobility . revealed no documentation of the palm protector as recommended by OT. During an interview on 8/2/18 at 7:46 am, Licensed Nurses (LN) #2 & #5 stated they do not use the care plan binders at the nurse's station and they do not regularly incorporate the care plans into their daily care for residents. They had no knowledge of how care plans were updated. During an interview on 8/2/18 at 9:00 am, the interim MDS Nurse (MDSN) could not state why a revision to a care plan would not be done. She stated revisions are manually completed by the full-time MDSN, who was on vacation at the time of this survey. Review of the facility's policy Care Planning, dated 7/20/16, revealed: The Care Plan is to be considered a dynamic document. It is to be kept up-to-date on a continual basis, and based on the assessed needs of the individual resident. Further review of the policy revealed: The MDS RN-Coordinator is in charge of and responsible for completing, reevaluating and revision of the Resident Care Plan. And Each discipline is encouraged but not required to make changes on the care plan as necessary. These changes can be written on the paper copy of the care plan, in the care plan notebook, or this can be taken to the MDS RN-Coordinator . 2020-09-01