cms_DE: 12

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
12 KENTMERE REHABILITATION AND HEALTHCARE CENTER 85001 1900 LOVERING AVENUE WILMINGTON DE 19806 2017-09-07 406 E 1 1 H3FV11 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** > Based on clinical record review and interviews, it was determined that for one (R142) out of 25 Stage 2 sampled residents, the facility failed to obtain and coordinate specialized rehabilitative services from an outside rehabilitation center per a 4/10/17 facility physician's orders [REDACTED]. Findings include: Review of R142's clinical record revealed the following: 12/12/16 - R142 was admitted to the facility for rehabilitation after a stroke resulting in right sided weakness. 12/13/17 through 2/2/17 - R142 received rehabilitative services from the facility's inhouse physical therapy (PT) department. 2/3/17 at 12:48 PM - The facility's inhouse PT discharge summary stated that R142 achieved his highest practical level and restorative nursing care was not appropriate at the time due to inconsistent abilities and tone changes on the right side of his body. 2/28/17 - R142 was seen by C1 (neurologist) who recommended a physiatry evaluation to discuss resuming therapy. 3/8/17 at 2:43 PM - The facility's inhouse PT assessed R142 at the request of C1. The facility's PT evaluation stated that R142's functional mobility skills remained unchanged since his inhouse therapy discharge on 2/3/17 and treatment was not recommended at this time. 3/28/17 at 10:14 AM - A progress note stated that R142's POA (unidentified #1 or #2) insisted on scheduling an appointment with C2 (physiatrist), which was arranged for 4/7/17 at 1 PM. 4/7/17 - R142 was seen by C2 and received a referral for physical therapy two times a week for six weeks. In addition, a follow-up appointment with C2 was scheduled on 6/6/17 at 12:30 PM, approximately eight weeks later. 4/10/17 at 3:23 PM - The facility's physician order [REDACTED]. 5/1/17 at 9:37 AM - The facility's physician order [REDACTED]. 5/31/17 - The facility's physician order [REDACTED]. 6/1/17 at 12:29 PM - A facility's progress note stated that R142 returned from the outside rehabilitation center with no new orders. 6/6/17 at 10:20 AM - The facility's physician order [REDACTED]. 6/6/17 at 5:23 PM - The facility's inhouse PT evaluation stated that another family member of R142 asked that he be re-evaluated for transfer and gait training in addition to educating the family on how to transfer him so they could take him to family functions. The evaluation stated that R142 continued to lack sufficient motor control needed to advance his functional mobility skills and treatment was not recommended. 6/6/17 at 5:34 PM - The facility's physician order [REDACTED]. 7/14/17 - The facility's Rehab Screening Form stated E8 (Rehab Director) spoke with F2 (POA #2) regarding R142's cognitive status and the need for 24 hour care because of safety concerns and his lack of insight regarding his abilities. E8 stated that R142 does not appear at the current time to have further potential to reach a greater independence of mobility . E8 stated that the family wishes to pursue a second opinion from outside therapy . 7/26/17 at 6:13 PM - The facility's physician order [REDACTED]. It was unclear why it took the facility approximately 4 months to obtain and coordinate outside therapy services for R142 when the facility's physician ordered the specialized services on 4/10/17. 8/30/17 at 10:57 AM - During an interview, F1 (POA #1) stated that the facility delayed in obtaining therapy services for R142 eventhough C2 referred him for additional therapy. F1 stated that it had been a very difficult situation trying to obtain outside therapy services. F1 stated that R142 was finally receiving therapy services now at an outside rehabilitation center. 9/6/17 at 3:14 PM - During an interview, E8 stated the following: - on 3/8/17, the facility's inhouse PT evaluated R142 per a neurologist consult and determined that R142 was at his baseline; - on 3/23/17, the facility's inhouse OT evaluated R142's right hand and ordered a splint; - on 6/6/17, R142's family member asked the facility's inhouse PT if they could help them with taking R142 home for family functions (transfers, toileting). The facility's inhouse PT evaluated R142 on 6/6/17 and then called F1 (POA #1) to discuss options. F1 declined the facility's inhouse PT services and told them he was looking at other outside rehabilitation options for R142; and - on 7/14/17, E8 attempted to contact F1 without success and then called F2 (POA #2). F2 stated that he was looking at other rehabilitation options. 9/6/17 at 4:39 PM - During an interview, E4 (ADON) stated that there were delays due to billing issues regarding therapy services between the facility's inhouse PT and the outside rehabilitation center in addition to delays in arranging for medical transportation to the outside rehabilitation center. E4 stated that the facility's former social worker was directly involved but was no longer employed there. It was unclear exactly how the facility's former social worker was involved as R177's clinical record lacked evidence of social services documentation. 9/6/17 at 4:45 PM - Findings were reviewed and confirmed with E2 (DON) and E4 (ADON). The facility failed to obtain and coordinate specialized rehabilitative services from an outside resource per a 4/10/17 facility physician's orders [REDACTED]. On 8/4/17, approximately 4 months later, R142 received specialized PT services at an outside rehabilitation center. 2020-09-01