cms_GU: 30

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
30 GUAM MEMORIAL HOSPITAL AUTHORITY 655000 499 NORTH SABANA DRIVE BARRIGADA GU 96913 2016-09-29 315 D 0 1 H7FJ11 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on the resident's comprehensive assessment, the facility must ensure that a resident who entered the facility without an indwelling catheter was not catheterized unless the resident's clinical condition demonstrated that catheterization was necessary; and a resident who was incontinent of bladder received appropriate treatment and services to prevent urinary tract infections and to restore as much normal bladder function as possible. (Reference Residents 2 and 9) Finding includes: 1. Resident 9 was admitted to the facility on [DATE] with several [DIAGNOSES REDACTED]. The most current MDS dated [DATE] described the resident as having short or long-term memory problems, with severely impaired cognitive skills for daily decision making, and was dependent on staff for most activities of daily living (ADLs). The MDS indicated that the resident did not have an indwelling catheter. During the initial tour on 9/26/16, Resident 9 was observed in bed with a urinary tubing and drainage bag at the bedside. In an interview after the tour (on 9/26/16) a licensed staff (LN6) stated that Resident 9 had an indwelling catheter. Review of the medical record revealed a physician's orders [REDACTED]. Review of progress notes revealed that the resident had an episode of [MEDICAL CONDITION] prompting insertion of the catheter. Further record review however revealed the lack of indication that an evaluation of the use of the indwelling catheter was conducted or that a referral to appropriate health care professionals was considered to determine the cause of the retention and whether continued use of the device was warranted. A physician's progress note dated 5/25/16 revealed the lack of mention of the catheter or any other urinary problems. In addition, the MDS dated [DATE] revealed the lack of an active urinary problem (or diagnoses) that required use of the catheter. Review of the medical record further revealed that a care plan for the use of the indwelling catheter was not developed until 8/29/16. While one Outcome of the care care plan noted that the resident will tolerate discontinuation of the catheter with at least 250 ml. of output every shift, there was no indication that a trial removal was conducted. During an interview on 9/28/16, a licensed nurse (LN1) stated that an attempt to remove the catheter might have been conducted but was unsuccessful. When a request was made to provide documented evidence, LN1 responded that the information could not be located. 2. Resident 2 was admitted to the facility on [DATE] with several [DIAGNOSES REDACTED]. Review of the admission MDS assessment dated [DATE] revealed that the resident had severe cognitive impairment with a BIMS (brief interview of mental status) score of 3, and that she was dependent on staff for all activities of daily living. The same MDS noted that the resident was admitted with an indwelling urinary catheter. Review of the medical record revealed the lack of documentation of the indication for the use of the catheter. The was no mention of an active [DIAGNOSES REDACTED]. During an interview on 9/27/16, a licensed staff (LN8) stated that a pressure sore might have been the indication for the use of the catheter. Review of the medical record however revealed that while a pressure sore was described as healing in nurses progress notes on 8/26/16, there was no evidence that an evaluation of the continued use of the catheter was conducted. In the same interview on 9/27/16, LN8 stated that a trial to discontinue the catheter might have been conducted; but further review of the medical record revealed that lack of documentation of the attempt or of any outcome. 2020-09-01