cms_DE: 47

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
47	WILLOWBROOKE COURT AT COUNTRY HOUSE	85003	4830 KENNETT PIKE	WILMINGTON	DE	19807	2019-07-15	580	D	0	1	N66611	NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on clinical record review, interview and review of facility documentation as indicated, it was determined that for 1 out of 1 death record sampled, the facility failed to notify the resident's physician when R48 did not receive 2 doses of Lacosamide medication and R48 had a new [DIAGNOSES REDACTED]. The facility's policy entitled Physician Notification, last revised in 6/2014, stated, . Procedure: 1. The licensed nurse is responsible for notifying the resident's physician at a minimum when there is: . j. The inability to obtain or administer on a prompt and timely basis prescribed medications . 5. Record the following in the resident's health record: a. All attempts to notify the physician or on-call physician, method of attempted contact, time and individuals contacted . b. Reported assessment findings. c. Additional information provided. d. Physician's response. e. physician's orders [REDACTED]. Resident's status and response to the treatment ordered. g. Notification of family or legal representative provided and the family or legal representative response. Review of R48's clinical record revealed: 5/28/19 - The hospital's Medication Orders Upon Discharge stated to administer the next dose of Lacosamide to R48 at 10 PM tonight (5/28/19). 5/28/19 at approximately 12 Noon - R48 was admitted to the facility with a [DIAGNOSES REDACTED]. 5/28/19 - A physician's orders [REDACTED]. 5/28/19 - Review of R48's (MONTH) 2019 eMAR and corresponding Order-Administration Note at 10:33 PM revealed that R48 did not receive Lacosamide at 8 PM because they were waiting for the pharmacy to deliver the medication. Review of R48's clinical record lacked evidence that the physician was notified of the inability to obtain and administer the above medication to R48 on 5/28/19 at 8 PM. 5/29/19 at 1:27 AM - The pharmacy's Proof of Delivery report for R48 revealed that Lacosamide was delivered to the facility at this time. 5/29/19 at 8 AM - Review of R48's eMAR revealed that he/she received the 8 AM dose of Lacosamide. 5/29/19 at 8:45 PM - An Order-Administration Note, written by E24 (RN), for R48's Lacosamide stated, .Not delivered yet from (name) pharmacy. Despite having received the Lacosamide medication from pharmacy on 5/29/19 at 1:27 AM and R48 receiving the 8 AM dose, R48 was not administered the medication at 8 PM. Review of R48's clinical record lacked evidence that R48's physician was notified that R48's anti-[MEDICAL CONDITION] medication was not administered. 7/10/19 at 2:36 PM - During a combined interview with E2 (former DON) and E4 (ADON), E2 stated that when a physician was contacted, nurses should be documenting this information in the progress notes. 7/11/19 at 12:30 PM - Findings were reviewed during the Exit Conference with E1 (NHA), E2 (former DON), E3 (acting DON), E6 (NP) and E16 (ED). The facility failed to notify the physician when R48's Lacosamide medication was not available and/or administered.	2020-09-01