cms_WY: 6

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
6 GRANITE REHABILITATION AND WELLNESS 535013 3128 BOXELDER DRIVE CHEYENNE WY 82001 2019-04-11 684 E 1 1 TYBQ11 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** > Based on observation, medical record review, and resident and staff interview, the facility failed to ensure anti-embolism hose were applied as ordered for 3 of 4 sample residents (#8, #52, #108) with bilateral lower extremity (BLE) [MEDICAL CONDITION] (swelling). The findings were: 1. Review of the 1/17/19 significant change MDS assessment showed resident #8 was admitted to the facility on [DATE] with [DIAGNOSES REDACTED]. Further review showed s/he had severe cognitive impairment and required extensive to total assistance with all ADLs. Review of the physician's orders [REDACTED]. The following concerns were identified: a. Observations on 4/7/19 from 4:45 PM to 8:40 PM, on 4/8/19 from 8:50 AM to 2:30 PM, and on 4/9/19 at 10:58 AM showed the resident did not wear anti-embolism hose. Further observation showed the resident's legs appeared [MEDICAL CONDITION]. b. Interview on 4/9/19 at 10:58 AM with the DON revealed the hose should have been applied because they usually were provided for the resident within 2 or 3 days of the order. She further stated she did not know why the resident did not have the anti-embolism hose. 2. Review of the 2/19/19 annual MDS assessment showed resident #52 was admitted to the facility on [DATE] with [DIAGNOSES REDACTED]. Further review showed s/he had severe cognitive impairment and required extensive assistance with dressing. Review of the physician's orders [REDACTED]. The following concerns were identified: a. Observations on 4/7/19 from 4:45 PM to 8:40 PM, on 4/08/19 from 8:50 AM to 2:30 PM, and on 4/9/19 at 10:58 AM showed the resident sat in his/her wheelchair and did not wear anti-embolism hose. During the observations the resident's lower legs appeared [MEDICAL CONDITION]. b. Review of (MONTH) 2019 TAR showed the nurses documented the hose were removed at bedtime on 4/3, 4/6, 4/7, 4/8, and 4/9. Further review showed no evidence the anti-embolism hose were applied on the on 4/3, 4/6, 4/7 and 4/9. c. Interview on 4/10/19 at 3:50 PM with the DON revealed the staff should not document they were applying and removing the hose if they were not. She further stated staff needed to determine whether the resident did or did not need the hose, because if the resident needed them they should be applied as ordered. 3. Review of the 3/8/19 admission MDS assessment showed resident #108 was admitted to the facility on [DATE] with [DIAGNOSES REDACTED]. The resident had a BIMS score of 14/15 (cognitively intact). The following concerns were identified: a. Observation of the resident on 4/7/19 at 5:22 PM showed the resident was lying in bed and the resident's lower legs appeared [MEDICAL CONDITION]. The resident was not wearing compression stockings nor were they wrapped with ACE wraps (bandages used to control swelling). b. Observation of the resident on 4/8/19 at 2:24 PM showed the resident was sitting in his/her recliner. The resident's legs appeared swollen and s/he was not wearing compression stockings nor were the resident's legs wrapped with ACE wraps. c. Review of a physician communication form dated 3/24/19 showed the resident had bilateral lower extremity [MEDICAL CONDITION] (BLE) and the resident had reported when s/he was at home his/her legs were wrapped every day. The facility requested an order for [REDACTED]. d. Observation of the resident on 4/10/19 at 12:12 PM showed the resident's legs were wrapped with ACE wraps. Interview with the resident at that time revealed s/he had to belly-ache about the wraps and then staff had wrapped his/her legs yesterday afternoon and again this morning. e. Review of the (MONTH) 2019 TAR showed documentation the ACE wraps had been donned and doffed, as ordered, on 3/30 and 3/31. Review of the (MONTH) 2019 TAR showed documentation the ACE wraps were donned and doffed, as ordered, from 4/1 AM through 4/10 AM. f. Review of an (MONTH) 2019 clarification TAR showed the ACE wraps were not applied during the month of (MONTH) until the morning of 4/10/19. g. Interview with unit manager #1 on 4/10/19 at 12:17 PM revealed the resident's [MEDICAL CONDITION] was a chronic problem and was worse when s/he was up in a chair all day. In addition, she stated the resident was on medication for the [MEDICAL CONDITION], had orders for ACE wraps, and was encouraged to elevate his/her feet when sitting. h. Interview with the DON on 4/11/19 at 11:18 AM revealed she was unsure why there was a discrepancy between the TAR and surveyor observations. Further, she stated a new nurse was orienting on the first floor and she had attempted to contact the nurse for clarification. Interview with the DON on 4/11/19 at 4:28 PM revealed the orientating nurse had been contacted and verified the ACE wraps had not been applied as ordered. 2020-09-01