cms_GU: 10

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
10 GUAM MEMORIAL HOSPITAL AUTHORITY 655000 499 NORTH SABANA DRIVE BARRIGADA GU 96913 2019-01-30 761 E 0 1 IS8311 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation and interview, the facility failed to ensure that all single use medical solutions without preservatives were used only once. Failure to use single use irrigation solutions per the manufacture recommendations could result in health care acquired infections. In addition the facility failed to store all drugs in a locked medication cart. This failure has the potential to have an unauthorized person with access to the residents medications. Findings include: 1. On 1/29/2019 a licensed nurse (LN6) was observed doing a dressing change for Resident 5 on the right buttock and sacral area pressure ulcers. Resident 5 is a [AGE] year old female who was admitted to the skilled nursing unit on 1/13/2019. Her admission [DIAGNOSES REDACTED]. The records also identified that she was totally dependent on the facility for all care. Her other [DIAGNOSES REDACTED]. Resident 5 also had a gastric tube and left heel wound. The left heel wound, the gastric tube site, the sacral pressure ulcer and the right buttock pressure ulcer were all to be cleaned initially with normal saline solution. During the sacral and right buttock pressure ulcers wound care observation, LN6 cleaned the wounds with normal saline solution then applied a wet dressing of 0.125% Dakin's solution. The wounds were then covered with a clean dry gauze and secured with paper tape. The Dakin's solution was labeled with an open date and a discard date. The 500-milliliter (ml) normal saline solution was marked with an open date of 1/28/2019. The normal saline solution was used and returned to its storage area. On 1/30/2019 another observation of Resident 5's normal saline solution occurred. The bottle of solution that had been opened on 1/28/2019 and was still being used for her all her wound or gastric tube site care. The manufactures label indicated the solution was a single use item, there was no reference stating the solution had any form of preservative or bacterial static or antibiotic nor did any label indicate that the solution could be used over multiple days. The consulting pharmacist was asked to read the label and to determine if the solution was stable and if it could be used more than one day. The consulting pharmacist validated that the solution was a single use solution and that the solution was not stable to be used over multiple days. 2. During an observation tour on the nursing unit on 1/29/2019 at 9:00 a.m., noticed an opened medication cart with the keys on top of the cart without the supervision of an authorized staff. During an interview on 1/29/2019 at 9:09 a.m., with Staff #5 she indicated that she went to answer the call light and forgot to lock the cart and take her cart keys. She also explained that usually she locks the cart and she has been in-serviced about the safety of drug storage. She validated that there were no current wondering residents on the unit. She also validated with me while the list of the twenty six medications were being recorded that there were no control drugs in the medication cart. During an interview on 1/29/2019 at 9:20 a.m., with the Staff #3 she indicated that the staff are aware of the safety of drug storage and she routinely in-service the staff. During an interview concurrent with the policy review on 1/29/2019 at 9:40 a.m., with Administrative Staff # 2 she confirmed that the staff have been in-serviced. She further explained that she will began another round of in-services on drug storage immediately. The policy titled Locking of medication Cart and Medication room Purpose is to ensure the proper method for safely locking the medication cart and medication room. 1). Medication carts shall be locked at all times when not in use. 2). Licensed staff shall carry the medication keys all times 2020-09-01