cms_NV: 25

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
25	LEFA SERAN SNF	295001	1ST AND A ST/ PO BOX 1510	HAWTHORNE	NV	89415	2019-01-10	610	D	0	1	0DP411	NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview, clinical record review, and document review, the facility failed to ensure allegations of verbal and physical abuse were investigated and reported for 1 of 12 sampled residents (Resident #3). Findings include: Resident #3 was admitted to the facility on [DATE] with [DIAGNOSES REDACTED]. On 01/08/19 at 11:06 AM, a Resident Council Interview was held with four members of the Resident Council. The residents expressed concerns with Resident #3. Resident #3 was not present at the interview. The residents in the meeting verbalized the following statements: -Everyone had to do what Resident #3 wanted and the residents felt the facility lets Resident #3 do what Resident #3 wanted. -Resident #3 swore at residents. One resident recalled Resident #3 had made the statement fxxx you bxxch to the resident and had also been called names. -One resident explained Resident #3 had stated drop dead to the resident. -The facility staff had explained other residents have the right to be foul mouthed. Resident #3's progress notes revealed the following: -12/22/18 Resident #3 engaged into a few arguments with a couple of residents, took phone from a resident and hung up on the conversation. -12/23/2018 Resident #3 was stopping visitors in the hallway and talking on the phone about another resident. Resident #3 kept going on about how this particular resident was dying. The staff told her to stop saying things like that and Resident #3 just turned away and ignored the staff acting like Resident #3 could not hear the staff. -01/01/2019 Resident #3 was bothering residents by yelling at them from the doorway. The resident who was being yelled at had complained to the staff. Resident #3 has been very demanding about the TV in the den room, even to the extent of yelling down the hall. On 01/08/19 at 5:25 PM, the Assistant Director of Nursing (ADON) verbalized the Resident #3 had been verbally abusive to other residents and staff. Resident #5 was admitted to the facility on [DATE] with [DIAGNOSES REDACTED]. On 01/09/19 at 4:15 PM, Resident #5 explained Resident #5 hit Resident #3 in front of staff because she wanted the staff to see Resident #5 hot Resident #3. Resident #5 explained Resident #3 had hit her several times before Resident #5 hit Resident #3. Resident #5 verbalized she had told the facility Resident #3 had hit her but had not heard anything else about the situation. Resident #5 verbalized she was happy since she hit Resident #3 because Resident #3 had not bothered her anymore. On 01/10/19 at 8:38 AM, a Certified Nursing Assistant (CNA) explained Resident #3 had yelled at almost everyone. The CNA verbalized Resident #3 has cussed and yelled at three other residents. The CNA verbalized the CNA had been made aware of the allegation Resident #3 had been hitting Resident #5 and was directed during a CNA meeting to keep an eye out for the behavior. The CNA confirmed this was her instruction about three weeks to a month ago. Resident #3's progress notes lacked documentation regarding allegations Resident #3 had been hitting Resident #5. Resident #3's progress notes revealed the following regarding a resident hitting Resident #3: -12/20/2018 A Licensed Nurse approached Resident #3 regarding an incident of another resident striking her. Resident #3 recalled this resident looked in her face and stated I'm sick of you and she hit me on the shoulder. On 01/10/19 at 8:42 AM, the Activity Director explained she had heard Resident #3 yell and cuss at other residents. The Activity Director verbalized Resident #3 was a shouter and a verbal abuser. The Activity Director recalled examples as follows: -Resident #3 and Resident #14 got into a disagreement. Resident #3 rolled away from Resident #14 calling her a profane descriptor and name. -Resident #3 shouted at other residents when Resident #3 wanted to change the channel. -Resident #3 told another resident, the resident's husband was dead. -Resident #3 told a resident her husband was dead and nephew was in jail. -Resident #3 has ripped the telephone from two residents' hands multiple times. On 01/10/19 at 8:57 AM, the Risk Manager verbalized she did not know if the facility had an Abuse Coordinator. Allegations of abuse in the Skilled Nursing Facility were reported to the Director of Nursing (DON). The DON was responsible for filling out the paperwork and reporting to outside entities. The Risk Manager verbalized the Chief Nursing Officer (CNO) oversaw the abuse process. The facility completed a Facility Reported Incident on 12/21/18. The report was submitted to the State and described Resident #5 as hitting Resident #3 on 12/20/18, during a disagreement over the television channel. The report lacked documented evidence of Resident #5's allegations Resident #3 had hit Resident #5 or an investigation occurred. The facility completed a Facility Reported Incident on 10/15/18. The report was submitted to the State for Resident #3 eloping. The report documented the resident was verbally abusive to residents. The report did not include an investigation into this allegation. On 01/10/19 at 9:02 AM, the CNO verbalized Resident #3 had behaviors. The CNO recalled the following examples: -Resident #3 had taken remotes from people or turn station on other residents and there would be a screaming match to follow. -Resident #3 used to yell at another resident who was no longer in the facility. Resident #3 would harass the other resident and not let her go to smoke break. -Resident #3 wanted the television remote from Resident #14. Resident #14 did not give it to Resident #3. Resident #3 yelled at Resident #14 and staff intervened. The CNO verbalized yelling, shouting and cussing was considered verbal abuse. Also, leaving the area of an altercation yelling profanity would be considered verbal abuse. The CNO verbalized snatching a remote from another resident would be physical abuse. The CNO confirmed herself or the DON would conduct investigations regarding allegations of abuse. The CNO verbalized she had not been made aware of an allegation Resident #3 hit Resident #5, Resident #5 had wrenched other residents' arms, Resident #3 cussed at other residents, or Resident #3 had snatched remotes. The CNO was unable to provide evidence of investigations into alleged physical or verbal abuse from Resident #3 for wrenching of arms, cussing, or snatching remotes. The CNO was unable to provide evidence the allegations were reported to the State. On 01/10/19 at 2:30 PM, the Administrator verbalized there was a fine line regarding verbal abuse. The Administrator verbalized the facility had been making attempts to not diminish the rights of Resident #3. The Administrator confirmed verbal abuse would include yelling and swearing from resident to resident. The facility policy titled Abuse; Suspected Abuse and Reporting Unwitnessed Injuries and Abuse Prevention, revised 10/11/17, documented residents of the facility were to be free from verbal and physical abuse. All above allegations were to be investigated by Nursing Administration, the Risk Manager or designee and the Administrator. Notifications were to be made to the State. Results of investigations were to be forwarded to the State, not more than five days after the incident.	2020-09-01