cms_WY: 51

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
51 SUBLETTE CENTER 535017 333 N BRIDGER AVE PINEDALE WY 82941 2017-02-02 309 E 0 1 W1N011 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on review of the facility's elimination protocol, staff interview, and medical record review, the facility failed to ensure interventions were implemented for lack of bowel movements (BMs) in accordance with the elimination protocol for 6 of 10 sample residents (#3, #21, #25, #27, #30, #35) reviewed. The findings were: Review of the facility's Elimination Protocol showed .3rd Day (72 hours without a BM) 2 [MEDICATION NAME] (laxative) tabs along with walking and fluids. Document senna on MAR comment sheet. 4th Day-Day Shift: [MEDICATION NAME] (stool softener) with walking and fluids. Assess bowel sounds. Document [MEDICATION NAME] on MAR comment sheet and follow up on BM (yes/no). Document in chart. EVE (evening) shift: MOM (Milk of Magnesia - a laxative) with walking and fluids. Assess bowel sounds. Document MOM on MAR comment sheet and follow up on BM (yes/no). Document in chart. N[NAME] (night) Shift: Bisocodyl suppository. Assess bowel sounds. Document suppository on MAR comment sheet and follow up on BM (yes/no). Document in chart. 5th Day- Assess bowel sounds- Fleets Enema- Notify physician and document in chart. The following concerns were identified regarding failure to follow the protocol: 1. Review of the BM record and MARs for resident #3 revealed the following: a. According to the (MONTH) (YEAR) BM record, the resident did not have a BM from 1/12 through 1/16 (5 days), 1/18 through 1/22 (5 days), and 1/24 through 1/30 (7 days). Review of the MAR and nursing notes showed no PRN (as needed) interventions in accordance with the elimination protocol were administered. b. Review of the (MONTH) (YEAR) BM record showed the resident did not have a BM 11/28 through 12/3 (6 days), and 12/15 through 12/19 (5 days). According to the MAR and nursing notes, there were no interventions for constipation documented on those dates. 2. Review of the (MONTH) (YEAR) BM record showed resident #21 did not have a BM documented from 1/18 through 1/21 (4 days), or on 1/25 through 1/28 (4 days). Review of the MAR and nursing notes showed no interventions were documented during those time frames in accordance with the elimination protocol. 3. Review of the (MONTH) (YEAR) BM record revealed resident #35 did not have a BM documented from 1/13 through 1/16 (4 days), 1/19 through 1/22 (4 days), and 1/24 through 1/27 (4 days). Review of the MAR and nursing notes failed to show any interventions related to the elimination protocol. 4. Review of the (MONTH) (YEAR) BM record showed resident #27 did not have a BM documented 1/26 through 1/29 (4 days). Review of the MAR and nursing notes showed no interventions related to the elimination protocol were documented. 5. Review of the (MONTH) (YEAR) BM record showed resident #30 did not have a BM documented 1/3 through 1/7 (5 days), 1/9 through 1/13 (5 days), 1/16 through 1/19 (4 days). Review of the MAR and nursing notes showed no interventions for constipation were administered during those timeframes. 6. Review of the (MONTH) (YEAR) and (MONTH) (YEAR) BM records showed resident #25 did not have a BM documented 12/13 through 12/21 (9 days), or 1/8 through 1/12 (5 days). According to the MAR and nursing notes showed no interventions were documented during those time frames in accordance to the elimination protocol. 7. During an interview on 2/2/17 at 9:15 AM the DON stated nursing staff should follow the elimination protocol and document interventions on the MAR. She stated she had copies of the elimination protocol sheets that nurses used to track days without a BM and interventions given, which she kept in her office. The facility provided copies of the documentation for the above mentioned residents, but the documentation failed to show any constipation interventions for the applicable dates. 2020-09-01