cms_WY: 44

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

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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
44 GRANITE REHABILITATION AND WELLNESS 535013 3128 BOXELDER DRIVE CHEYENNE WY 82001 2018-10-12 880 D 0 1 P2JJ11 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, staff interview, medical record review, and policy and procedure review, the facility failed to ensure appropriate infection control practices were followed during 2 random observations of wound care which affected 2 sample residents (#70, #88). The findings were: 1. Review of an SBAR (Situation, Background, Assessment, Request) Communication Form showed resident #88 began showing signs and symptoms of abdominal pain and diarrhea on 9/29/18. Review of the Contact Isolation Care Plan showed it was initiated on 9/30/18. The plan showed the resident required contact isolation precautions related to a [DIAGNOSES REDACTED]. Approaches included Inservice direct staff on contact isolation techniques. The following concerns were identified: a. Observation of the wound care nurse on 10/11/18 at 9:09 AM showed the nurse finished wound care for the resident and exited the resident's room without performing hand hygiene, and while wearing a gown and mask. Further observation showed the wound nurse walked to the second floor dining area and removed the gown, using an ungloved hand, by grabbing the gown on the exterior surface and pulling the gown away from her body. The wound nurse discarded the PPE in a trash can on the medication cart, walked to a cart outside the isolation room, and handled items in and on the cart without performing hand hygiene. b. Interview with the staff development coordinator on 10/11/18 at 4:56 PM revealed donning of PPE should be performed prior to resident care and doffing PPE should be completed prior to leaving the resident's room. Further she revealed PPE used during treatment of [REDACTED]. c. Review of the policy titled Personal Protective Equipment (PPE) Work Practices dated 09/2017 showed .8. All PPE is removed prior to leaving the work area. a. Contaminated garments are removed immediately or as soon as feasible. b. Removed PPE are placed in a designated or (sic)container for storage, washing, decontamination, or disposal .Contact Precautions: .c. Gloves and Handwashing .iii. Remove gloves before leaving the room and perform hand hygiene .d. Gown i. wear a disposable gown upon entering Contact Precautions room or cubicle. ii. After removing the gown, do not allow clothing to contact potentially contaminated environmental surfaces . 2. Observation of the wound care nurse on 10//11/18 at 9:21 AM showed the nurse gathered supplies needed for wound care for resident #70, then moved the trash can close to the bed. The nurse donned gloves and removed the dressing on the resident's heel using both hands. Hand hygiene was not performed prior to donning gloves. The nurse gathered the dressing in her left hand and discarded it. She removed her left glove and replaced it. The dressing change was completed and the nurse removed both gloves. The nurse left the room without performing hand hygiene at 9:36 AM. The nurse returned to the room at 9:39 AM and donned gloves without performing hand hygiene. She performed wound care to the resident's buttock area, removed her gloves, and washed her hands. 3. Interview with the DON on 10/12/18 at 10:17 AM revealed it was the facilities expectation for staff to perform hand hygiene upon entry to a room and exit of a room. In addition hand hygiene should be performed after removal of dirty gloves and prior to applying new dressing. 4. Review of the Handwashing/Hand Hygiene policy and procedure included the following: .6.Wash hands with soap and water for the following situations: . b. After contact with a resident with known or suspected with infectious diarrhea including, but not limited to infections caused by norovisus, salmonella, shigella, and [DIAGNOSES REDACTED]icile .7. g. Before handling clean or soiled dressings, gauze pads, etc.; .k. After handling used dressings, contaminated equipment, etc. m. After removing gloves. n. Before and after entering isolation precaution settings. 2020-09-01