cms_NH: 71

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
71 DOVER CENTER FOR HEALTH & REHABILITATION 305018 307 PLAZA DRIVE DOVER NH 3820 2018-04-13 842 B 0 1 WGWA11 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on review of Resident #76's medical record , and interview it was determined that the facility failed have a baseline assessment for a seat belt for 1 resident in a standard survey sample of 22 residents (Resident identifier is #76.) and it was determined that the facility failed to document the notification of the physician of drug warnings triggered for 2 residents in a standard survey sample of 22 residents. (Resident identifiers are #35 and #329.) Findings include: Resident #76 Interview on 4/11/18 at approximately 9:15 a.m. with Resident #76 revealed that Resident #76 used a seatbelt whenever they are in their wheelchair. Review on 4/13/18 of Resident #76's medical record revealed that on the 24 hour positioning plan there was a seat belt iniated on 3/2/18 for positioning. There was no baseline assessment done for the residents ability to self release the seat belt. Interview on 4/13/18 at approximately 11:45 a.m. with Staff A (Director of Nursing) revealed that there was no assessment for Resident #76's use of a seat belt while in wheelchair. Resident #329 Review on 4/13/18 of Resident #329's (MONTH) (YEAR) Medication Administration Record [REDACTED]. Review revealed that Resident #329 also had an order for [REDACTED]. Review revealed that Resident #329 also hadan order for [REDACTED].>Review on 4/13/18 of Resident #329's (MONTH) (YEAR) Medication Administration Record [REDACTED]. Review on 4/13/18 of Resident #329's Progress notes revealed an order note, dated 4/4/18, which was time stamped at 17:34 (5:34 p.m.) and read .The order you have entered [MEDICATION NAME] Tablet 200 mg Give 200 mg by mouth every 6 hours as needed for pain/fever Has (sic) triggered the following drug protocol alerts/warning(s): Drug to Drug Interaction. The system has identified a possible drug interaction with the following orders: [MEDICATION NAME] Sodium Solution 30 mg/0.3 ml Inject 30 mg subcutaneously one time a day for blood thinner Severity: Severe Interaction: The risk of bleeding induced by [MEDICATION NAME] Sodium Solution 30 mg/0.3 ml may be increased by coadministration of [MEDICATION NAME] Tablet 200 mg, including the development of procedure-related [MEDICATION NAME] or spinal hematomas . Aspirin Tablet 325 mg give 325 mg by mouth one time a day for heart Severity: Severe Interaction: Regular use of [MEDICATION NAME] Tablet 200 mg may decrease the antiplatelet effects of Aspirin Tablet 325 mg. Reduced antiplatelet efficacy in patients with underlying cardiovascular risk may occur. Additionally, the potential for gastrointestinal side effects, including bleeding, may be increased with regular use of full-dose or low-dose aspirin. Review on 4/13/18 of Resident #329's Progress notes revealed an order note, dated 4/4/18, which was time stamped at 18:58 (6:58 p.m.) and read .The order you have entered [MEDICATION NAME] Sodium Solution 30 mg/0.3 ml (milliliters) Inject 30 mg subcutaneously one time a day for blood thinner until 04/09/2018 23:59 (11:59 p.m.) Has (sic) triggered the following drug protocol alerts/warning(s): Drug to Drug Interaction. The system has identified a possible drug interaction with the following orders: Aspirin Tablet 325 mg give 325 mg by mouth one time a day for heart Severity: Severe Interaction: The risk of bleeding in [MEDICATION NAME] Sodium Solution 30 mg/0.3 ml treated patients may be increased by Aspirin Tablet 325 mg, including the development of procedure-related [MEDICATION NAME] or spinal hematomas. [MEDICATION NAME] Tablet 200 mg Give 20 mg by mouth every 6 hours as needed for pain/fever Severity: Severe Interaction: The risk of bleeding induced by [MEDICATION NAME] Sodium Solution 30 mg/0/3 ml may be increased by coadministration of [MEDICATION NAME] Tablet 200 mg , including the development of procedure-related [MEDICATION NAME] or spinal hematomas . Review on 4/13/18 of Resident #329's Progress notes revealed that there was no documented evidence that the facility notified Resident #329's physician of these warnings. Interview in 4/13/18 at approximately 1:20 p.m. with Staff F (Registered Nurse) confirmed that there was no documented evidence that Resident #329's physician was notified of the warnings, and that the physician should have been notified. Resident #35 Review of Resident #35's physician orders [REDACTED]. Review on 04/13/18 at 8:05 am of Resident #35's Medication Administration Record [REDACTED]. Review on 4/13/18 at 12:49 pm of Resident #35's progress notes revealed on 3/22/18 an order for [REDACTED]. Interview with Staff H (Registered Nurse, Unit Manager) on 4/13/18 at 11:03 am revealed when orders are entered into the computer, nurses immediately receive an alert if there are pharmacy irregularities. Staff H revealed that Staff H notifies the provider knows when Staff H recieves alerts of pharmacy irregularites but does not have the provider sign anything. Interview with Staff I (Licensed Practical Nurse) on 4/13/18 at 11:17 am revealed that when Staff I receives an alert of a pharmacy irregularity Staff I would call the provider and notify them of the interactions and document the notification in the electronic medical record but they do not have the provider sign anything. 2020-09-01