cms_ID: 16

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
16 ST LUKE'S ELMORE LONG TERM CARE 135006 895 NORTH 6TH EAST MOUNTAIN HOME ID 83647 2018-10-12 684 D 0 1 SC7O11 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and staff interview, it was determined the facility failed to ensure physician orders [REDACTED].#3 and #7) whose records were reviewed. Resident #7's blood glucose physician orders [REDACTED].#3's aspiration precautions were not followed. These failed practices had the potential to adversely affect or harm residents whose care and services were not delivered according to accepted standards of clinical practices. Findings include: 1. Resident #7 was admitted to the facility on [DATE], with [DIAGNOSES REDACTED]. An H&P, dated 8/28/18, documented Resident #7 received [MEDICATION NAME] (long-acting insulin) injections each morning, [MEDICATION NAME] (an oral diabetic medication) 50 mg once daily, and Humalog (a short-acting insulin) injections according to a sliding scale with each meal and at bedtime. The American Diabetes Association, website accessed 10/17/18, defines sliding scale as a set of instructions for adjusting insulin based on blood glucose test results, meals, or activity levels. Resident #7's MAR indicated [REDACTED]. The order was to check Resident #7's blood glucose at bedtime and 3:00 AM. The order stated if Humalog was given at bedtime to correct a high blood sugar, according to the ordered sliding scale, Resident #7's blood glucose was to be checked again at 3:00 AM. This order was not followed. Examples include: - On 9/2/18 at 9:21 PM, Resident #7 did not receive a Humalog injection. Her blood glucose was rechecked at 12:30 AM on 9/3/18, when it should not have been done per the orders, and it was not at 3:00 AM. - On 9/11/18 at 8:08 PM, Resident #7 received and injection of 1 unit of Humalog. At 2:52 AM, her blood glucose was not checked per physician order. At 4:36 PM on 10/11/18, the DON reviewed Resident #7's record and confirmed the blood glucose and insulin orders and stated they were not followed. 2. Resident #3 was admitted to the facility on [DATE], with [DIAGNOSES REDACTED]. A Speech Evaluation, dated 6/13/18, documented Resident #3 was a high aspiration risk due to her progressive dementia and age. Aspiration is the risk of breathing foreign objects into the airway which can be food, saliva, or stomach contents when swallowing. Resident #3's care plan included Aspiration Precautions, initiated on 6/13/18. The care plan included interventions to keep her at a 90 degree angle for all oral intake and keeping the head of her bed greater than 30 degrees. On 10/9/18 at 11:10 AM and 1:52 PM, Resident #3 was observed laying in her bed and the head of her bed was flat. On 10/11/18 at 10:30 AM, Resident #3 was observed laying in her bed and the head of her bed was flat. On 10/11/18 at 4:36 PM, the DON confirmed Resident #3's care plan included elevating the head of her bed for aspiration precautions. She stated if the head of the bed was not elevated staff were not following the care plan. 2020-09-01