cms_GA: 126

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
126 AZALEA HEALTH AND REHABILITATION CENTER 115044 1600 ANTHONY ROAD AUGUSTA GA 30907 2017-10-26 315 D 0 1 8OVO11 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, record review, and staff interview, the facility failed to provide incontinence care in a timely manner on two observations for one resident (R) #101. The sample size was 46 residents. Findings include: Review of R #101's Quarterly Minimum Data Set ((MDS) dated [DATE] revealed that she had a Brief Interview for Mental Status (BIMS) score of 3 (a score of 0 to 7 indicates severe cognitive impairment). Further review of this MDS revealed that she needed extensive assistance for toilet use, was not on a toileting program, and was always incontinent of bowel and bladder. Review of R #101's potential/actual elimination deficit related to bladder and bowel incontinence care plan, initiated on 3/28/17, revealed an intervention to provide assistance as required for toileting and incontinent care. Review of her ADL (activity of daily living) self-care performance deficit related to activity intolerance, confusion, fatigue, and limited mobility care plan initiated on 3/28/17 revealed an intervention that the resident was totally dependent on one to two staff for toilet use and incontinent care. Review of her risk for skin breakdown related to incontinence and poor self mobility care plan initiated on 3/28/17 revealed an intervention to provide incontinence care after each incontinence episode, or per established toileting plan. Review of a Bowel and Bladder Evaluation dated 9/6/17 revealed that R #101 was incontinent of both bowel and bladder, and was not able to participate in a bowel and bladder program as she did not have cognitive skills for toileting retraining. Further review of this evaluation revealed that the resident would be kept clean and dry to prevent skin breakdown and UTIs (urinary tract infections). Observation on 10/23/17 at 2:09 p.m. revealed that R #101 was sitting in a wheelchair in her room, and a urine odor was noted. Further observation at this time revealed that her pants were wet in the perineal area. During interview with Resident Care Specialist (RCS) II on 10/26/17 at 2:48 p.m., she stated that she checked residents to see if they needed to be changed and/or if they needed to go to the bathroom every two hours. During further interview, she stated that R #101 did not know when she was wet nor ask to go to the bathroom, so staff just had to check her. She further stated that the last time R #101 was checked and placed on the bedpan was before lunch that day, around 11:00 a.m. Observation of R #101 on 10/26/17 at 3:00 p.m. revealed that she was sitting in her wheelchair in the hall across from the nurse's station, and a urine odor was noted. Observation on 10/26/17 at 3:05 p.m. of incontinence care by RCS II and assisted by RCS JJ revealed that the resident's incontinent brief contained a moderate to large amount of urine and stool. During interview with RCS II after the incontinent care was completed, she verified that she had last provided incontinence care for R #101 around 11:00 a.m. (what time did this occur? I know it wasn't done in the hall way! Please add a date and time. During interview with the Director of Nursing on 10/26/17 at 4:40 p.m., she stated that residents should be checked for incontinence at least every two hours. Review of the facility's Bowel and Bladder Management policy with a revision date of (MONTH) (YEAR) revealed to monitor wetness and dryness every two hours. 2020-09-01