cms_GA: 344

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
344 SIGNATURE HEALTHCARE OF MARIETTA 115206 811 KENNESAW AVENUE MARIETTA GA 30060 2019-11-14 658 D 1 0 VEPN11 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** > Based on interviews, observations, record review, review of facility policy titled Medication Administration and review of the Georgia Nurse Practice Act (chapter 410-10), the facility failed to provide supervision with the administration of medications for one of five sampled residents (R) (#10). Findings include: The Practice of Nursing includes, but is not limited to, provision of nursing care; administration, supervision, evaluation, or any combination thereof, of nursing practice; teaching; counseling; the administration of medications and treatments as prescribed by a physician [MEDICATION NAME] medicine in accordance with Article 2 of Chapter 34 of this title. Guideline #20 of the facility's Administering Medications General Guidelines policy documented the resident is always observed after administration to ensure that the dose was completely ingested. Review of the clinical record revealed R#10 has [DIAGNOSES REDACTED]. R#10 is his own responsible party. Review of the Minimum Data Set (MDS) assessment dated [DATE] revealed R#10 with a Brief Interview for Mental Status (BIMS) score of 15, indicating cognition intact. A Physician's Note dated 10/15/19 revealed R#10 with intermittent confusion, staff documented that he gets belligerent and aggressive at times. He is a bit demanding about his medications. During an interview on 10/29/19 at 7:30 a.m., R#10 revealed Licensed Practical Nurse (LPN) QQ gave him all his morning medication at 6:00 a.m. He then opened the drawer to his bedside table and produced a clear dosage cup, containing 10 pills. R#10 stated LPN QQ left the pills for him to take later. During an interview on 10/29/19 at 7:42 a.m., LPN QQ stated R#10 is medication seeking and she did not leave any pills with him. LPN QQ went to R#10's room and R#10 stated he had taken the pills because he didn't want anyone to take them from him. He then reached underneath his bed covers and produced the cup of medication. He also reached into the cup, removed and ingested one white, round pill that he stated was Klonopin. During continued interview on 10/29/19 at 7:42 a.m., LPN QQ stated if you don't start with his medications immediately on your med pass, he will make you miserable. He can get all the medications he was given at once. I gave him his 6:00 a.m. meds about 5:00 a.m. because he was asking for them. He was right in front of me with the water. I thought he took it. I was supposed to watch the resident take the medicine, but I didn't. He was pressing me to give him his medication. I gave it to him and left. I should have waited for him to take it. I was busy with a [MEDICAL TREATMENT] patient; the transportation was rushing me. The Certified Nursing Assistant was helping me but, there was a lot going on. During an interview on 10/29/19 at 8:16 a.m., Unit Manager (UM) AA revealed R#10 is very meticulous about his medications. UM AA was unaware of any pills in his nightstand drawer. UM AA stated that residents are not allowed to keep medications in their rooms. The nurse has to make sure they take the medications before leaving the room. R#10 can safely have his morning medications all at once but, he has to take them. The nurse should not have just left them with him. No matter how alert a resident is, it's against facility policy. During further interview on 11/4/19 11:14 a.m., UM AA revealed that R#10 does not have physician orders [REDACTED]. During an observation on 10/29/19: 7:57 a.m., with LPN QQ, a comparison was made with the remaining medications in the dosage cup and R#10's ordered medications in the medication cart. The following medications were identified: [MEDICATION NAME] 30 milligram (mg) Losartan Potassium 100mg [MEDICATION NAME] 5mg [MEDICATION NAME] ER 30 [MEDICATION NAME] 7.5mg [MEDICATION NAME] 25mg Vitamin C OTC (over the counter) Aspirin 81 mg [MEDICATION NAME] tablet 75mg During further interview on 10/29/19 at 8:35 a.m., R#10 revealed that he took the [MEDICATION NAME] pill and pain meds at the cart along with the muscle relaxers. LPN QQ asked him if he wanted the rest of his morning pills. He said yes, she gave it to him, and he walked away with the cup. R#10 stated that he usually gets his pills, goes to his room, makes sure they are all there, and then takes them. Some of the nurses just set them down, turn around and walk out. During an interview on 10/30/19 at 4:07 p.m., the Medical Director (MD) revealed, it is not the facility's operation that a nurse leaves medication with a resident. 2020-09-01