cms_NH: 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 GREENBRIAR HEALTHCARE 305005 55 HARRIS ROAD NASHUA NH 3062 2019-10-28 697 D 0 1 TYS711 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview, it was determined that the facility has failed to ensure that proper pain management is provided to meet professional standards of care for 1 resident in a final survey sample of 35 residents. (Resident identifier is #47) Findings include: Interview on 10/24/19 at 9:47 a.m. with Resident #47 stated that they were not getting enough pain control. Review on 10/24/19 of the medial record shows Resident #47 is receiving scheduled pain medication along with PRN (as needed), these orders are written as follow: [MEDICATION NAME] Tablet 325 mg Give 2 tablet by mouth every 6 hours as needed for mild to moderate Pain NTE (Not to Exceed) 3 GM(grams)/24 hours . [MEDICATION NAME] HCI Tablet 5 MG (milligrams) Give 1 tablet by mouth as needed for for muscle pain Take one tablet once daily as needed. [MEDICATION NAME] HCI Tablet 50 MG Give 1 tablet by mouth every 6 hours as needed for moderate to severe pain. Pain Monitoring using Verbal/Non-Verbal 0-10 Scale every shift for Monitoring Level of Comfort Interview on 10/28/19 at 12:30 p.m. with Staff B (Director of Nurses) was asked if a resident is cognitively intact and what type of pain scale would be used. Staff B stated the numerical scale because Resident #47 is cognitively intact. Staff B was then shown the orders which are written above and asked if you are using the verbal pain scale and documenting using 1-10 but are administering PRN medication using mild-moderate or moderate to severe. Staff B was then asked what would the numerical pain scale in translation to mild-moderate or moderate to severe be. Staff B was not able to answer the question. Staff B then was asked if these levels are from the Wong backer assessment tool for pain, Staff B said yes. On review of this tool it is rated as 1-3 mild, 4-6 moderate, 7-10 severe. Review on 10/28/19 of the PRN orders for [MEDICATION NAME] 325 mg 2 tablets being given using numerical numbers from 7-10 which when using the mild-severe scale would be coded as sever meaning the wrong pain medication was given for the pain level told 6 times in a row. Review on 10/28/19 of the PRN orders for [MEDICATION NAME] tablet 50 mg given by mouth every 6 hours shows it being given 3 times a day almost every day for the month of (MONTH) with pain levels fluctuating from pain levels of 3-8. On review of the times and doses this medication was being given always at 8:00 a.m., 2:00 p.m., and 8:00 p.m. Review on 10/28/19 of the PRN order for [MEDICATION NAME] 5 mg for muscle pain revealed this medication is again being given every day around 11-12 p.m. Interview on 10/28/19 with Staff B was shown the clinical information regarding substance abuse and Staff B stated it was a long time ago and it was not pills but alcohol. Staff B also stated the resident and physician have agreed to administer medication on a PRN schedule making Resident #47 feel like they have control of their pain. 2020-09-01