cms_OR: 45

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.

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rowid facility_name facility_id address city state zip inspection_date deficiency_tag scope_severity complaint standard eventid inspection_text filedate
45 REGENCY GRESHAM NURSING & REHAB CENTER 385015 5905 SE POWELL VALLEY RD GRESHAM OR 97080 2017-09-26 431 D 1 0 5RH111 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** > Based on interview and record review it was determined the facility failed to ensure a medication was available for 1 of 3 sampled residents (#1) reviewed for ADL assistance. This placed residents at risk for depression. Findings include: Resident 1 was admitted to the facility in 2010 with [DIAGNOSES REDACTED]. The 7/12/17 Brief Interview for Mental Status form indicated Resident 1 was alert and oriented. The (MONTH) (YEAR) MARs indicated Resident 1 was administered Adderall (stimulates the nervous system) BID. The Adderall treatment was initiated 11/2016 and was to treat Resident 1's depression. The MAR indicated Resident 1 refused the medication 36 out of 60 opportunities. On 6/22/17 the MAR and associated notes indicated the medication was not given BID waiting on script. The 6/21/17 pharmacy Refill Order Form indicated the facility requested a refill of the Adderall. This was the same day the resident was administered the last dose. The physician progress notes [REDACTED]. The resident reported the provider refilled her/his prescription in the past without an office visit. The note also indicated the resident asked the staff to make an appointment for her/him to see the mental health provider but the staff did not make an appointment and the Adderall was not able to be refilled. The resident indicated she/he was NOT happy the Adderall was not filled because the resident did not want to go cold turkey. On 9/1/17 at 2:25 pm Witness 3 (Resident 1's Pharmacist) indicated the facility was to have a system in place to notify the pharmacy when resident medications were low and before the medication ran out. It was good practice to notify the pharmacy at least one week before the medication ran out in case the pharmacy had to communicate with the physician to refill the prescription. Witness 3 indicated the pharmacy was first notified the resident required a refill for the Adderall on 6/22/17. The resident's Adderall was last filled on 5/2/17, was a 30 day supply and did not have an order to refill the medication. The 7/5/17 Physician Assistant Progress Note indicated Resident 1 was on medications including Adderall for the treatment of [REDACTED]. The note indicated the resident reported she/he did not benefit from the Adderall and the resident was to discuss trialing off the medication. The 7/7/17 Progress Note indicated Resident 1 has been out of Adderall, last taken dose was 6-23-17. The note indicated Previously the prescribing provider would not refill the Adderall unless the resident was seen. The note indicated Resident 1 had a scheduled appointment on 7/12/17. This was 19 days after the medication was documented as not available. The note indicated staff called the mental health provider to try to refill the medication before the 7/12/17 appointment. On 9/7/17 at 5:00 pm Witness 4 (Mental Health Provider Staff) indicated the Adderall refill request was made on 7/7/17 and she did not see a request to refill the Adderall prior to 7/7/17. Witness 4 indicated the note did not indicate if the resident or facility made the request. Witness 4 indicated the medication was discontinued on 7/19/17. The 7/14/17 Progress Note indicated Resident 1's Adderall prescription was refilled but Resident 1 refused to take the medication. The resident reported she/he did not take the medication since mid to late June, felt it did not work and would discuss medications with Witness 3 at the scheduled appointment. On 8/29/17 at 2:20 pm Resident 1 indicated in (MONTH) or (MONTH) (YEAR), the Adderall ran out and staff did not administer the Adderall for 20 days. The Adderall was to assist with depression. Resident 1 indicated she/he had an appointment with Witness 3 (Mental Health Provider) in (MONTH) (YEAR) and Resident 1 reported Witness 3 was not aware the Adderall was not administered. Resident 1 indicated the Adderall was discontinued after the visit because the medication did not seem to change the way she/he felt. On 9/1/17 at 2:43 pm Staff 11 (RNCM) indicated staff were to communicate with the pharmacy when medications were low and before the medication ran out. Staff 11 indicated the facility and the pharmacy staff worked together to ensure the resident did not run out of medication. A request was made to Staff 11 for documentation to indicate the facility tried to refill Resident 1's Adderall before it ran out on 6/22/17. No additional information was provided. The 9/18/17 e-mail from Staff 2 (DNS) indicated staff requested a refill on 6/21/17. Staff 2 indicated the pharmacy did not send the refill request to the physician until 6/29/17. 2020-09-01