cms_DC: 14

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
14 WASHINGTON CTR FOR AGING SVCS 95014 2601 18TH STREET NE WASHINGTON DC 20018 2019-07-30 690 G 0 1 BMNI11 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on policy review, medical record review, and staff interviews for one (1) of 56 sampled residents, the facility staff failed to provide appropriate and sufficient catheter care and assessments and reassessments to prevent Harm for Resident #58 who was admitted with an indwelling Foley catheter which resulted in penile erosion and laceration. Findings included . Wound, Ostomy and Continence Nurses Society. (2016). Care and management of patients with urinary catheters: A clinical resource guide. MT. Laurel: N[NAME] Author Securement Devices: .Indwelling catheters should be secured to avoid traction on the catheter, which causes irritation and trauma to the urethra(e.g., urethritis, necrosis, erosion, stricture) .monitor the urethra daily for irritation, erosion, or urine leakage and assess the skin integrity under the securement device. Resident #58 was readmitted to facility on 12/21/18, with [DIAGNOSES REDACTED]., Depression, [MEDICAL CONDITION]. A review of the Comprehensive MDS (Minimum Data Set) dated 4/16/19 showed, Section C (Cognitive) - BIMS score 05 indicating resident has severe cognitive impairment. Section G Functional Status the resident was coded as needing total assistance with one to two person support and care under toileting. Section H Bladder/Bowel - Appliances was coded to indicate resident has indwelling urinary draining device. A review of the care plan for Foley Catheter due to [MEDICAL CONDITION] showed it was initiated on 1/23/2019. Goal: resident will have catheter care managed appropriately .not exhibiting signs of urinary tract infection or urethral trauma. Approach: .report signs of UTI .manipulate tubing as little as possible during care .provide catheter care .use catheter strap .use leg bag as needed . A review of Medical Record Revealed: A physician's orders [REDACTED]. Urology consult for UR 12/10/2018. Urology Consult-1/3/2019, Diagnosis; [MEDICAL CONDITION] with chronic indwelling Foley catheter and urethral erosion. A review of NP (Nurse Practitioner) progress note dated 5/31/2019, revealed, .10:36 PM Pt with UR, observed during day, unable to pee, Foley reinserted able to drain urine. Penis lacerated from previous Foley catheter with ulcer at glans Pt states pain burning at penis. Purulent drainage from penis . Foley inserted attached to right leg to avoid further laceration at left side avoid diaper when patient has Foley (to lacerate penis). 5/31/2019 - Interim Order, Please avoid diaper when pt. has a Foley (cause Laceration of penis) Foley inserted routine Foley care q shift. A review of NP Progress note dated 6/4/2019, .Pt with Foley catheter with ulcer of glans purulent drainage from penis . 6/5/2019- Interim Order, D/C order to avoid diaper when pt. has a Foley Use diaper to make it loose to prevent laceration. Urology Consult for possible Suprapubic catheter (6/20/2019) .Progress note [MEDICAL CONDITION] UTI (Urinary .Penile erosion .plan for SP (Suprapubic) tube placement under local . Urology consultation for [MEDICAL CONDITION] at (Hospital Name) at 1:30 PM with (Physician name) (07/03/19). Change Foley catheter q 6 weeks obtain medical records or other history to determine if there are reasonable alternative to indwelling Foley catheter . 7/5/2019- Urology Consult findings: S/P tube inserted under u/s (ultrasound) guidance New Diagnosis: [REDACTED].urethral erosion. 7/9/ 2019- Interim Order urology F/U (follow up) for Suprapubic Cath . Upon review of the nursing progress notes dated (MONTH) 1, 2019 through (MONTH) 30, 2019 showed no evidence the facility staff assessed the resident's [MEDICAL CONDITION] status for complications (irritation and trauma to the penis or urethra) regarding indwelling Foley catheter prior to or after the penile laceration and erosion occurred and was documented by Nurse Practitioner resulting in the surgical insertion of the suprapubic catheter directly in to the Residents bladder for further care. Through record review, it was noted the resident was diagnosed with [REDACTED]. There was no evidence that facility staff conducted an initial and ongoing [MEDICAL CONDITION] assessment (size, discoloration of skin, odor, swelling, pain, drainage) and treatment plan to promote healing. On 5/31/19, the resident was noted with a laceration to his penis from previous Foley catheter with ulcer at glans, with pain burning and purulent drainage from penis. On 7/5/19, the resident had a suprapubic catheter inserted due to [MEDICAL CONDITION] and urethral erosion. The findings were acknowledged on (MONTH) 29, 2019, at 10:00 AM during a face-to-face interview with Employee # 3 who stated she did not know what erosion was and would look it up on the internet. 2020-09-01