cms_GU: 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.

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
14 GUAM MEMORIAL HOSPITAL AUTHORITY 655000 499 NORTH SABANA DRIVE BARRIGADA GU 96913 2017-08-24 157 D 0 1 10C511 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on clinical record review and staff interview, the facility failed to notify 1 resident's (R) R5, out of a survey sample of 8 residents, physician of an abnormal blood sugar before administering 2 packets of sugar. Findings include: Per clinical record review, R5 was admitted to the facility on [DATE], with a [DIAGNOSES REDACTED]. A physician's order dated 8/17/17 noted, for the clinical staff, to do accuchecks twice a day and to administer regular insulin according to the results of the sliding scale (SS) via subcutaneous (SQ) as follows: if the resident's blood sugar was greater than 400 units to administer 20 units of Regular Insulin; if the resident's blood sugar was between 301 and 400 to administer 16 units of Regular Insulin; if the resident's blood sugar was between 201 and 300 to administer 8 units of Regular Insulin; finally, if the resident's blood sugar was greater than 150 to administer 4 units of Regular Insulin. There was no physician ordered parameters for blood sugar levels less than 149. The Medication Administration Record [REDACTED]. The Nurse's Notes dated 8/19/17 documented the following .Head of bed elevated for aspiration. Blood sugar 74 mg/dl (Milligrams per Deciliter) GT (gastrostomy tube) feeding with 2 packets of sugar added. At around 1800 (6:00 p.m.) blood sugar rechecked 102 mg/dl . There was no nursing documentation to show the physician was notified of the resident's low blood sugar nor were there any notes, from the physician, that would have directed the clinical staff to administer the resident 2 packets of sugar. An interview was conducted with Staff Member 11 on 8/22/17 at 9:05 a.m. The staff member stated she would expect that a physician's order would be in place before giving 2 packets of sugar. Staff Member 11 stated that there were also no parameters, in the electronic medical records, for notifying the physician when the blood sugar was low. An interview was conducted with Staff Member 3 on 8/22/17 at 9:15 a.m. Staff Member 3 said there should be a physician's order when the blood sugar drops low and the nurse should have called the physician when there was an abnormal blood sugar. The facility policy entitled Critical Tests and Critical Results with a revision date of 2/16, noted, .To ensure that Critical test results and critical results are identified and reliably reported to the responsible caregiver in time to meet the needs of patient care .A test that suggests a serious medical condition that may require prompt treatment. A critical result can come from a non-critical test .Within five minutes thereafter, the tech, will phone the service unit and ask to speak to the ordering physician . 2020-09-01