cms_AL: 92

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.

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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
92 SENIOR REHAB & RECOVERY AT LIMESTONE HEALTH FACILI 15024 1600 WEST HOBBS STREET ATHENS AL 35611 2018-02-15 554 D 0 1 EZGG11 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, record review, interviews, and review of a facility policy titled RESIDENT SELF ADMINISTRATION OF MEDICATION, the facility failed to ensure Resident #293 was assessed for self-administering nebulizer treatments. This affected one of one resident reviewed for self administration. Findings include: Review of the facility's policy titled RESIDENT SELF ADMINISTRATION OF MEDICATION, updated 10/31/2017, revealed the following: POLICY: Each resident who desires to self-administer medication may be permitted to do so if Facility Interdisciplinary Care-Plan Team has determined that the practice would be safe for the resident and other residents of the facility. 1. The medication self-administration assessment is conducted by the interdisciplinary team . 2. The results of the interdisciplinary team assessment are recorded on the Self-Administration Assessment Form, which is placed in the resident's medical record. Resident #293 was admitted to the facility on [DATE] with [DIAGNOSES REDACTED]. Review of Resident #293's (MONTH) (YEAR) physician's orders [REDACTED]. There were no orders listed indicating Resident #293 could self-administer medications or nebulizer treatments. Review of Resident #293's comprehensive care plans revealed no care plan or approaches addressing self-administration of medications. On 02/14/18 at 9:26 AM, Resident #293 was observed receiving a nebulizer treatment. No staff were present in the room at the time. Resident #293 reached over and turned the machine off while the surveyor was speaking with the spouse; visible nebulizer solution remained in the nebulizer cup. Employee Identifier (EI) #1, Registered Nurse, was interviewed on 02/15/18 at 05:26 PM. When asked which residents she had that could self-administer nebulizer treatments, EI #1 referred to a list she had, and said Resident #293 was one of the ones she had that was able to self-administer nebulizer treatments. EI #1 explained she put the medication in the nebulizer cup, turned on the machine, and placed it on the resident. EI #1 said she sometimes started the treatment then, but other times, if the resident was not ready, she would let them start it when they were ready. When asked what type of evaluation or assessment was done to determine if residents could safely administer their treatments, EI #1 said she was not sure. She was unaware of the facility's policy. EI #1 said there should usually be a note in the chart or an assessment of some kind. EI #1 said it was important to assess residents to determine they could safely self-administer medications to ensure they were competent to do it and do it properly. EI #2, the Director of Nursing, was interviewed on 02/15/18 at 05:49 PM. EI #2 said the facility had not completed a self-administration assessment on Resident #293. EI #2 further explained the nurse had started the nebulizer treatment, left the resident while it was going, then came back. When asked about the facility's policy on administration of nebulizer treatments, EI #2 said they did not have one. EI #2 stated if a resident was going to self-administer medications, it should be addressed in their care plans, and an evaluation should be completed quarterly or with a significant change in the resident's status. 2020-09-01