cms_PR: 9

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.

Data source: Big Local News · About: big-local-datasette

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
9	RYDER MEMORIAL HOSPITAL INC	405018	355 AVE FONT MARTELO	HUMACAO	PR	792	2017-05-04	271	D	0	1	ZOYB11	NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on a recertification extended survey, review of eight records and interview with the resident sister, resident #2, nursing supervisor (employee #4) and medical director (employee #17), it was determined that the facility failed to ensure that all admission orders [REDACTED]. Findings include: 1. Resident #2 is an [AGE] years old male who was admitted on [DATE] with a [DIAGNOSES REDACTED]. The resident was admitted to the SNF for antibiotic therapy and rehabilitation. He is bedridden since (MONTH) (YEAR) due to the Pneumonia. 2. During record review performed on 5/2/17 at 1:00 am the following was found: [NAME]On the drug reconciliation sheet (Hoja de reconciliacion de medicamento) written by the RN in the initial assessment dated [DATE] the patient use these medication in his home: [MEDICATION NAME] 2 mg 1 tab PO HS, Norvacs 10 mg 1 tab PO daily [MEDICATION NAME] 40 mg 1 tab PO HS, [MEDICATION NAME] 50 mg 1 tab PO daily, [MEDICATION NAME] 50 mg 1 tab PO twice a day, [MEDICATION NAME] 20mg 1 tab PO daily and [MEDICATION NAME] 5 mg 1 tab PO daily. b.The admission order perform on 4/29/17 by the physician wrote the following medications; [MEDICATION NAME] 1 tab PO daily, ).45 NSS at 20 ml per hour intravenous, Zozyn 3.375 mg intravenous every twelve hours per seven days, [MEDICATION NAME] 10mg 1 tab PO HS, Intestinex 1 tab PO every 8hrs, [MEDICATION NAME] 40 mg SQ daily, [MEDICATION NAME] 20 mg intravenous every 12 hour, [MEDICATION NAME] DM 15 ml PO every eight hour, [MEDICATION NAME] 2% apply in sacral [MEDICAL CONDITION] twice a day, [MEDICATION NAME] cream apply in sacral area and pubic area in each diaper change, [MEDICATION NAME] 1.25 mg by FFN every four hours, Preprotein 30 ml PO three times a day, Multivitamin 1 tab PO daily, Zinc 10 mg 1 tab PO twice a day and Incontinence Kit. During interview with resident #2 on 5/3/17 at 9:01 am indicates that in the night of yesterday he could not sleep well. The inspector asks if he takes medicine to sleep and resident says yes. During interview with the sister of resident #2 on 5/3/17 at 9:10 am she indicates that her brother always took the pills without fail. He had problem to sleep and he starts having problems of depression. The first day he was admitted here the RN told me that I need to bring all his medications and I brought it because the facility is going to give to him all the medication that he took in my house. c. The medications that the RN wrote in the Drug reconciliation are not the same of the initial admission order that the physician wrote. During the investigation it was found that the physician did not prescribe the [MEDICATION NAME] 5 mg, [MEDICATION NAME] 20 mg, [MEDICATION NAME] 2 mg and the [MEDICATION NAME] 50 mg. When the surveyor asked the employee #4 and to the employee #5 they indicates that they do not know why the physician did not order the medications that the resident uses in his house. However on 5/4/17 at 10:50 am it was found a clarifying note written by the medical director indicating the following: Dr. Solivan informed that the nephrologist during the resident hospitalization discontinue the medication. That the use of [MEDICATION NAME] is not indicated for optimal awareness during rehabilitation process; the [MEDICATION NAME] is especially contraindicated for risk of gastritis/GI bleeding while on anticoagulant and the determination of recommending [MEDICATION NAME] will be evaluated according to his clinical performances while at SNF. 3. The facility fails to ensure that all continuity medications used by the resident in the home are administered to the SNF during the resident's stay.	2020-09-01