cms_ID: 78

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

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
78 GATEWAY TRANSITIONAL CARE CENTER 135011 527 MEMORIAL DRIVE POCATELLO ID 83201 2018-04-12 726 D 1 0 0IO011 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** > Based on record review, review of the Idaho Board of Nursing rules, and staff interview, it was determined the facility failed to ensure residents' care plans were developed and revised by licensed nurses. This was true for 3 of 9 sample residents (#1, #3, & #6) whose care plans were reviewed. The failure created the potential for harm if the residents' needs and/or wishes were not competently and comprehensively addressed in their care plans. Findings include: The Idaho Board of Nursing rules at IDAPA (Idaho Administrative Procedures Act) 23.01.01.401, state one of the functions of a Registered Nurse is to develop and document a plan for nursing intervention based on assessment, analysis of data, identified nursing [DIAGNOSES REDACTED]. The Idaho Board of Nursing rules at IDAPA 23.01.01.460, state one function of a Licensed Practical Nurse is to participate in the development and modification of the plan of care. The Idaho Board of Nursing rules at IDAPA 23.01.01.490, Unlicensed Assistive Personnel, documented, The term unlicensed assistive personnel .is used to designate unlicensed personnel employed to perform nursing care services under the direction and supervision of licensed nurses . and, unlicensed assistive personnel may complement the licensed nurse in the performance of nursing functions, but may not substitute for the licensed nurse . The rules do not allow Unlicensed Assistive Personnel to develop and document nursing care plans or make modifications to the plans. 1. Resident #6 was admitted to the facility in (YEAR) and readmitted on [DATE] with multiple diagnoses, including metabolic [MEDICAL CONDITION], dementia, altered mental status, urinary tract infection, [MEDICAL CONDITIONS] bladder, right [MEDICAL CONDITION], diabetes mellitus, [MEDICAL CONDITION], kidney disease, right eye [MEDICAL CONDITION], and hypertension. All of Resident #6's care plan Focus areas, goals, and interventions/tasks dated 3/7/18, were documented as created, initiated, and revised by CNA #1. These care plans were for diabetes mellitus, oxygen therapy, hypertension, acute/chronic pain related to diabetic [MEDICAL CONDITION], alteration in neurological status, kidney disease, [MEDICAL CONDITION], the risk for [MEDICAL CONDITION] or confusion, the risk for impaired cognitive function or thought processes related to dementia, impaired visual function, ADL self care performance deficit, suprapubic catheter/[MEDICAL CONDITION] bladder, and the risk for falls. On 4/12/18 at 4:11 PM, LPN #3 identified herself as an MDS nurse and said that MDS assessments help staff develop care plans. The LPN said the IDT, including CNA #1, work on care plans. LPN #3 said a CNA cannot open and create care plans and that care plans should be created by licensed professionals. 2. Resident #3 was admitted to the facility on [DATE] with multiple diagnoses, including [MEDICAL CONDITIONS] and [MEDICAL CONDITION] following cerebral infarction (stroke), presence of a cerebrospinal fluid drainage device, and generalized muscle weakness. Resident #3's ADL self care performance deficit care plan, initiated 2/20/18, documented CNA #1 created and revised an intervention regarding the use a bedpan every 2 hours. The fall risk care plan, initiated 2/20/18, documented CNA #1 created 2 interventions and revised 1 intervention on the plan. On 4/12/18 at 6:25 PM, the DNS said CNA #1 transcribes during IDT care plan meetings and the nurse who signs the MDS is responsible for the care plan. 3. Resident #1 was admitted to the facility on [DATE] with multiple diagnoses, including [MEDICAL CONDITION] and muscle weakness related to [DIAGNOSES REDACTED]. Resident #1's ADL self care performance deficit care plan, initiated 10/1/8, documented CNA #1 created 4 nursing rehab interventions. On 4/12/18 at 7:50 PM, the Administrator said the IDT, including CNA #1, develop and revise care plans. The Administrator said CNA #1 might be scribing for the IDT, but the CNA did not create care plans in a vacuum. 2020-09-01