cms_AL: 34

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
34 EASTVIEW REHABILITATION & HEALTHCARE CENTER 15014 7755 FOURTH AVENUE SOUTH BIRMINGHAM AL 35206 2018-01-25 689 D 0 1 I9JH11 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on medical record review, a review of a facility policy titled Resident Assessment Instrument the facility failed to ensure a resident admitted to the facility was assessed for falls and a fall prevention care plan was in place prior to the resident sustaining a fall on 12/20/17. This deficient practice affected Resident Identifier (RI) #285, one of one sampled resident investigated for falls. Findings Include: A review of a facility policy titled Resident Assessment Instrument with a revised date of 10/2013 documented . PURPOSE: Residents are assessed, using a comprehensive assessment process, in order to identify care needs and to develop a plan of care. STANDARD: According to federal regulations, the facility conducts initially . a comprehensive, accurate . assessment of each resident's functional capacity . RI #285 was admitted to the facility on [DATE] with [DIAGNOSES REDACTED]. A review of RI #285's 14 day assessment Minimum Data Set (MDS) with an Assessment Reference Date of 12/28/2017 revealed RI #285's Brief Interview for Mental Status score of 7, indicating severely impaired cognition. Section G of the MDS, documented RI #285 required two plus person physical assist with transfers. On 01/24/2018 at 06:00 PM, RI #285 told the surveyor he/she had a fall on 01/19/18 when going to the bathroom with one staff member assisting him/her. RI #285 said he/she hurt his right side and hit his/her upper right forehead. He/she said he/she had pain to the right side of his/her abdominal area. RI #285 said an X-ray was done. RI #285 said he/she had tennis shoes on and the nurse took him/her by wheelchair into the bathroom and when trying to get back into the wheelchair from the toilet he/she fell . RI #285 said he/she was told there were no fractures. RI #285 said usually with his/her transfers there was always two staff members, but this time there was only one staff member. On 01/25/2018 at 08:30 AM, RI #285's Fall Risk assessment dated [DATE] was reviewed on the computer and it was observed to be blank. The surveyor asked for a copy of the Fall Risk Assessment. Employee Identifier (EI) #1, Registered Nurse (RN) Director of Nursing (DON) and EI #2, RN, MDS Coordinator provided a filled out/completed Fall Risk Assessment which was hand signed and dated 01/25/2018 (no time was documented). On 01/25/2018 at 9:15 AM, EI #2 was asked when was the Fall Risk Assessment filled out. EI #2 said at 9:00 a.m., on 01/25/2018 and she had filled it out. EI #2 was asked if the Fall Risk Assessment had been completed on admission. EI #2 said, no and this was the first Fall Risk Assessment done on RI #285. EI #2 was asked if completed in the computer why was it not signed in the computer. EI #2 said because she wanted to talk to the person who initially did the assessment. EI #2 was asked why was it hand signed by herself and EI #1. EI #2 said because it was never done initially. EI #2 was asked who was responsible to fill the Fall Risk Assessment out. EI #2 said, the admitting nurse. EI #2 was asked if RI #285 had ever had any falls at the facility. EI #2 said, yes sometime last week with no injury. EI #2 was asked how did RI #285 fall. EI #2 said she did not know. EI #2 was asked what interventions were in place for falls upon admission. EI #2 said, she did not know. EI #2 was asked if there was a risk for falls care plan (CP) for RI #285. EI #2 said, no. EI #2 was asked what would have indicated to her that RI #285 needed a fall CP. EI #2 said, the fall risk assessment. EI #2 was asked how would she have known if RI #285 needed a fall CP if the fall assessment was not done. EI #2 said, we missed out on this one. The 12/28/2017 MDS RI #285 was a two person assist with transfers does the MDS address if RI #285 was at risk or not for falls. EI#2 said no it does not. EI #2 was asked was a fall CP put in place after the fall on 01/20/2018. EI #2 said no. EI #2 was asked should have RI #285 been CP for falls. EI #2 said, yes. 2020-09-01