cms_GU: 68

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
68 GUAM MEMORIAL HOSPITAL AUTHORITY 655000 499 NORTH SABANA DRIVE BARRIGADA GU 96913 2012-01-26 157 D 0 1 J2NN11 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interviews and record review, the facility failed to immediately inform/consult with the resident ' s physician when there is a significant change in the resident ' s physical status and when there is a need to alter treatment significantly for one sampled and one non-sampled residents. (4 and 11) Findings include: 1. Resident 4 was admitted to the facility on [DATE] with [DIAGNOSES REDACTED]. Review of initial assessment dated [DATE] identified the resident as totally dependent on staff with all activities of daily living except eating. The resident had surgery to repair the fractured left hip (open reduction internal fixation) on 12/18/11. The initial assessment identified the resident with frequent hip pain daily. The admission notes dated 12/21/12 at 22:41 revealed the resident had a surgical wound that measured 15 ? centimeters (cm) scar incision in the left hip/thigh and a sore in the left hand in between the second and third finger. The Braden scale for pressure sore identified the resident as moderate risk to develop pressure sores. Upon admission the resident did not have any pressure sores but the resident was bedfast and required moderate to maximum assistance. Review of the nurses ' progress notes revealed that on 12/25/11 at 21:30, the left inner buttock 3 small 1-0.5 cm next to the sacrum, about an inch below it, small 0.5 cmx0.6 cm and the larger one at the bottom 2.0 cm L(length) x 1.0 cm W(width). dry, no drainage. Duoderm applied. On 1/25/12 at 4:00 p.m. in an interview with the licensed nurse who documented the pressure sore discovery, she revealed that she reported the skin breakdown to the charge nurse and was verbally told to apply the Duoderm. However, she was not sure if the physician was notified on the same day. She indicated that only the registered nurses (RNs) notify the physicians if there is a need to initiate or change a treatment for [REDACTED]. [REDACTED]. Review of the physician's orders [REDACTED]. 2. Resident 11 was re-admitted to the facility on [DATE] with [DIAGNOSES REDACTED]. The initial assessment nursing notes revealed no skin breakdown. On 1/25/12 at 9 a.m. Resident 11 was observed during morning care rendered by a certified nursing assistant. During the bedbath, the resident's back had three areas of persistent redness: a raised reddened area in the mid-back, flat reddened area on the right side of the back and a blackish red abraded area on the sacrum. The licensed nurse indicated that A&D ointment is applied as a preventive measure, however, the CNA did not apply the ointment because it was unavailable. The nurses' notes dated 1/24/12 revealed that the certified nursing assistant notified the licensed nurse of redness on the buttocks, raised reddish patches on the sacral area. On 1/25/12 on 11 pm-7 am shift, a licensed nurse documented red raised area mid-upper back still present, hard to touch. Charge nurse (CN) made aware. On 1/25/12, the 7 am-3 pm shift nurses notes revealed a reddened tender area size-like a quarter still present at mid upper back. Notified CN. Review of the resident's medical record showed no documented evidence that the physician was notified of the reddened skin areas at the back. On 1/25/12 at 4 p.m. interview with the resident's husband revealed a concern of the reddened raised area on the resident's back if it was a growing cyst. He was also concerned about the resident's peeling skin in the hands and feet from the allergic reactions incurred from antibiotics infused in the hospital. On 1/25/12 after discussions with the licensed nurse of Resident 11's skin condition, the charge nurse notified the physician and obtained orders for warm compress to mid-upper back. The physician also held the [MEDICATION NAME] and [MEDICATION NAME] doses for that day. 2017-01-01