cms_AK: 49

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

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rowid facility_name facility_id address city state zip inspection_date deficiency_tag scope_severity complaint standard eventid inspection_text filedate
49 WRANGELL MEDICAL CENTER LTC 25015 P.O. BOX 1081 WRANGELL AK 99929 2019-04-24 790 D 0 1 FNNN11 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview the facility to obtain dental services for 1 resident (#4), out of 8 sampled residents. Specifically, the facility failed to provide service to fix loose dentures. This failed practice affected the resident's ability use his/her dentures effectively and maintain a general diet. Findings: Record review on 4/15-19/19 revealed Resident #4 was admitted to the facility with [DIAGNOSES REDACTED]. (MONTH) manifest as weight loss, decreased appetite, poor nutrition, and inactivity). Review of the most recent MDS (Minimum Data Set, a federally required nursing assessment) assessment, an admission assessment dated [DATE], revealed Resident #4 was coded as having broken or loosely fitting full or partial denture (chipped, cracked, uncleanable, or loose). Further review revealed the assessment indicated no altered or therapeutic diets were needed. Review of Care Area Assessment (CAA) Summary of the admission MDS assessment revealed dental care was a care area triggered within the MDS and would have been addressed in Resident #4's care plan. Review of Resident #4's care plan, start date 3/15/19, revealed dental/dentures were not an identified problem. There were no goals or interventions associated to dental/denture care. Review of the Physician Orders for Resident #4 revealed a diet order, dated 3/2/19, food consistency general. Review of (Wrangell Medical Center) Nutritional Assessment, dated 4/12/19 revealed Nutrition Related Assessment Comments: Dentures are apparently loose per MDS . The plan on the assessment indicated add (mechanical) soft to order for ease of chew. During an interview on 4/16/19 at 12:52 pm, the Dietician stated Resident #4 was placed on mechanical soft diet (ground meat) because his/her dentures were loose and it would ease Resident #4's ability to chew meat. During an interview on 4/16/19 at 1:32 pm, Resident #4's Daughter stated Resident #4's dentures were too big and they fell out of his/her mouth at times and this had affected his/her ability to chew. The Daughter stated the facility had not mentioned to her what they were going to do about Resident #4's dentures. During an interview on 4/16/19 at 3:42 pm, the Senior Office Specialist stated all appointments, to include dental appointments, for the Long Term Care Residents were logged in the appointment book kept at the front desk. He/she stated there had been no dental appointments made for Resident #4. During an interview on 4/17/19 at 9:15 am, the MDS Coordinator stated all care areas triggered in the MDS should have been added to Resident's care plan so a plan of care could be initiated. When Resident #4's care plan was reviewed, the MDS Coordinator stated Resident #4's denture issue was not on the care plan. During an interview on 4/18/19 at 8:10 am, the MDS Coordinator stated a dentist appointment was made for Resident #4 during the course of this survey for 4/22/19. Review of the facility policy Dental Services, revision date 5/2017, revealed: The facility will have an advisory dentist who proves consultation, recommends policies concerning oral hygiene, and is available in case of emergency. It shall be the responsibility of the facility, when necessary, to arrange for resident to be transported to the dentist's office. During an interview on 4/19/19 at 11:00, the Director of Nursing (DON) stated there was no facility policy for oral hygiene. Review of the facility policy Resident MDS Assessment and Care Planning, revision date 6/2018, revealed: CAA triggers are used as basis for care planning. Additional areas care planned as determined by (interdisciplinary team), additional assessment, diagnoses, facility policy or other concerns specific to resident. 2020-09-01