cms_NH: 55

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
55 GREENBRIAR HEALTHCARE 305005 55 HARRIS ROAD NASHUA NH 3062 2018-12-19 880 D 0 1 P2R411 **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 provide a safe and sanitary environment for infection control in regards to following transmission-based precautions and a unsanitary suction machine for 2 residents out of the facility census of 234 residents. (Resident identifiers are #84, and #118.) Findings include: Policy review Review on 12/14/18 of the facility's policy titled, Isolation- Categories of Transmission-Based Precaution, last revised date of 4/2018, revealed that .Droplet Precautions .when a private room is not available and cohorting is not achievable, use a curtain and maintain at least 3 feet of space between the infected resident and other residents and visitors .put on a mask when entering the room .the facility will implement a system to alert staff and visitors to the type of precaution the resident requires . Resident #84 Observation on 12/14/18 at approximately 8:10 a.m. in Resident #84's room revealed a mouth suction machine on the night stand next to Resident #84's bed. The suction machine canister was 1/2 filled with what appeared to be yellow/white remnants of mouth suctioning. The tubing connected to the canister had a film noted on the inside that was consistent with what was in the canister. Interview on 8/14/18 at approximately 8:15 a.m. with Staff B (Licensed Practical Nurse) confirmed that the canister was 1/2 filled with remnants of mouth suctioning and the tubing also. Staff B revealed that mouth suctioning had not been done on Staff B's shift, the night nurse may have done mouth suctioning on (pronoun omitted). Interview on 8/14/18 at approximately 8:20 a.m. with Staff D (Registered Nurse) who worked the night shift revealed that Staff D did not do any mouth suctioning with Resident #84. Review on 12/14/18 of Resident #84's physician orders [REDACTED]. Oral suctioning PRN (as needed) for increased secretions, start date 2/9/16. Review on 12/14/18 of Resident #84's Medication Administration Record [REDACTED]. Interview on 12/14/18 at approximately 2:30 p.m. with Staff [NAME] (Director of Nurses) revealed that Resident #84 had not been suctioned recently, and stated that It could be up to 3 months without cleaning the suctioning system. It is a closed system. Review on 12/17/18 of the facility policy and procedure titled, Suctioning the Upper Airway (Oral Pharyngeal Suctioning), Revision date 4/2018 revealed the following: . Steps in the Procedure . 22. Discard water or saline in commode. Dispose cup in designated receptacle. 23. Empty and rinse collection container if necessary or as indicated by facility policy. . Resident #118 Interview on 12/13/18 at approximately 9:30 a.m. with Staff J (Unit Manager) revealed that Resident #118 was on contact precautions for [MEDICAL CONDITION]. When asked what personal protective equipment needed to be worn when entering Resident #118's room, Staff J stated that gowns, gloves and masks needed to be worn. Observation on 12/14/18 at approximately 8:15 a.m. of Resident #118 being fed by Staff Q (Licensed Nursing Assistant) who was standing right next to Resident #118's bed while feeding them, revealed that Staff Q was wearing gloves, but was not wearing a gown. Interview on 12/14/18 at approximately 9:00 a.m. with Staff Q revealed that Staff Q stated that they only needed to wear a gown when washing Resident #118, not when they are feeding them. Interview on 12/19/18 at approximately 1:15 p.m. with Staff K (Infection Control Nurse) confirmed that, for residents on contact precautions, gowns and gloves are to be worn when in the room. Staff K also confirmed that masks did not have to be worn, that when feeding a resident in their room who is on contact precautions a gown was to be worn, and that the signs alerting visitors needed to be visible where they could be easily seen. 2020-09-01