cms_NH: 36

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
36 GREENBRIAR HEALTHCARE 305005 55 HARRIS ROAD NASHUA NH 3062 2019-10-28 880 D 0 1 TYS711 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview and policy review, it was determined that the facility failed to maintain infection control in regards to hand hygiene during medication administration for 2 out of 37 medication administration observed. (Resident identifiers are #46 and #136.) Findings include: Review on 10/24/19 of facility's policy titled, Handwashing/Hand Hygiene, revision dated 4/2018, revealed that .Use an alcohol-based hand rub .alternatively soap . and water for the following situations: .before and after direct contact with residents .before preparing or handling medications .before and after handling an invasive device (intravenous access sites) .before donning gloves . .Washing hands 1. Vigorously lather hands with soap and rub them together, creating friction to all surfaces, for a minimum of 20 seconds or longer, under a moderate stream of running water, at a comfortable temperature . 2. Rinse hands thoroughly under running water. Hold hands lower than wrist. Do not touch fingertips to inside of sink . 3. Dry hands thoroughly with paper towels and then turn off faucets with a clean, dry paper towel . .Using Alcohol-Based Hand Rub (ABHR) 1. Apply generous amount of product to palm of hand and rub hands together . 2. Cover all surfaces of hands and fingers until hands are dry . Resident #136 Observation on 10/23/19 at 1:30 p.m. with Staff C (Unit Manager) during Resident #136's medication administration of Klonopin (benzodiazapine) revealed that Staff C went into Resident #136 room then left the room with medication cup in hand and headed to the supply closet and obtained a unopened 60 ml (milliliter) syringe and 500 ml basin. Staff C went to Resident #136's bathroom, opened the 60 ml syringe package and washed the 500 ml basin and the 60 ml syringe. Staff C went to Resident #136 without performing hand hygiene and used Resident #136's side table, placed the 500 ml basin and 60 ml syringe on the table and the crushed Klonopin in a medication cup then Staff C donned gloves. Staff C removed gloves and left Resident #136's room with medication cup in hand and went to the nurse's station and answered a doctor's phone call. After the phone call Staff C went back to Resident #136's room with the medication cup, Staff C donned new gloves without performing hand hygiene, and used the 60 ml syringe to push air to the [DEVICE] to check placement then administered the medication the flushed the [DEVICE]. Interview on 10/24/19 at 9:20 a.m. with Staff C confirmed above observation. Staff C was unable to provide explanation for not performing hand hygiene prior to medication administration. Resident #46 Observation on 10/23/19 at 2:00 p.m. with Staff A (Unit Manager) during medication administration of Meropenem for Resident #46 revealed that Staff A went to Resident #46's room, washed their hands with soap and water, dried their hands with paper towel then donned gloves. Staff A then removed gloves went out of Resident #46's room and went to the 5-2 treatment cart and obtain alcohol wipes. Staff A went back to Resident #46's room, donned gloves without performing hand hygiene and continued to flush Resident #46's PICC line catheter, prime the administration set with the Meropenem medication and administered Resident #46's Meropenem. Interview on 10/24/19 at 9:10 a.m. with Staff A confirmed above findings. Staff A stated that they thought that they did hand hygiene prior to medication administration. 2020-09-01