cms_AK: 68

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
68 WRANGELL MEDICAL CENTER LTC 25015 P.O. BOX 1081 WRANGELL AK 99929 2018-04-30 757 D 0 1 O8F911 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview the facility failed to ensure 1 resident's (#10), out of 8 sampled residents, drug regimen was free from unnecessary drugs. The failed practice exposed the resident to 2 drugs without adequate indications for their use or continued use. As a result, this placed the resident at risk for adverse reactions and tolerance to drug therapy. Findings: Record review on 4/23-27/18, revealed Resident #10 was admitted to facility with [DIAGNOSES REDACTED]. Medication: [MEDICATION NAME] Review of Resident #10's medical record revealed physician's orders [REDACTED]. Record review of physician notes, dated 10/7/17 to 1/5/18, revealed multiple notes indicating treatment with [MEDICATION NAME] ineffective: -10/7/17 - .continues (to) complain of (body) pain even though we started (Resident #10) on [MEDICATION NAME] to treat what seemed like active [MEDICATION NAME]. -10/31/17 - .continuing to complain of (pain) which is related to .shingles and is now being treated with [MEDICATION NAME]. -12/5/17 - .continues to have chronic pain related to the open shingles [MEDICAL CONDITION] . -12/19/17 - chronic shingles .with suboptimal response to [MEDICATION NAME] .complains of chronic pain .as well as pain over (Resident #10's) [MEDICAL CONDITION] for which we have not made much progress .increase (Resident's) dose of [MEDICATION NAME] to 1000mg (twice a day) . -1/5/18 - Patient still complaining of 10 out of 10 pain .today I cultured the open wound on (the Resident) .if this does not grow any [MEDICAL CONDITION] I will discontinue oral [MEDICAL CONDITION] medication . Review of Resident #10's lab work, since admission, revealed the Physician ordered a [MEDICAL CONDITION] culture on 1/5/18 which had negative results for [MEDICAL CONDITION] Simplex Virus (HSV). Further review of the resident's medical record revealed [REDACTED]. Review of Resident #10's monthly Drug Regimen Reveiws revealed no review in (MONTH) (YEAR). During an interview on 4/27/18 at 11:05 am, the Pharmacist agreed the consultant pharmacist failed to confirm the necessity of the [MEDICAL CONDITION] mediation and communicate with the physician the lack of [MEDICAL CONDITION] testing. In addition, the Pharmacist stated the continued use of [MEDICATION NAME] with no results should have been noted on the monthly DRR. Medication: [MEDICATION NAME] Review of Resident #10's medical records revealed admission orders [REDACTED]. [MEDICATION NAME] was started on 10/2/17 for 7 days after lab work indicated a urinary tract infection [MEDICAL CONDITION]. [MEDICATION NAME] was restarted for 7 days on 10/31/17, rationale UTI. Review of Resident #10's physician notes and nursing notes from 10/24/17 to 10/31/18 did not reveal symptoms of UTI. Additional review revealed no further diagnostic testing. Review of Resident #10's physician note, dated 10/31/17, revealed Functional incontinence with chronic Foley as well as recurrent colonization versus UTI again showing colonization or UTI and will treat with [MEDICATION NAME] 500mg twice a day x 7 days. During an interview on 4/27/18 at 11:00 am, Lab Director confirmed only 1 UA, dated 10/2/17, and 1 culture and sensitivity, dated 10/3/17, was performed. During an interview on 4/27/18 at 11:05 am, the Pharmacist stated that if a Resident is colonized and there are no symptoms, the Resident should not have been treated with antibiotics on 10/31/17. The Pharmacist further stated validation of a proper indication for use of an antibiotic should always be conducted to prevent unnecessary use resulting in potential resistance. 2020-09-01