cms_GA: 9981

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
9981 PARK PLACE NURSING FACILITY 115005 1865 BOLD SPRINGS ROAD MONROE GA 30655 2010-08-12 314 G 0 1 55J411 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, record review and staff interview it was determined that the facility failed to ensure that residents who entered the facility without pressure sores did not develop pressure sores unless the individual's clinical condition demonstrates that they were unavoidable. This failure to monitor resident's at risk for skin breakdown affected one (1) resident (#21) on a sample of twenty-one (21) residents and resulted in actual harm. Findings include: Record review for resident #21 revealed all MDS assessments since her admitted on 2/05/09 revealed the resident had never been assessed as having had a pressure sore before. Review of the record revealed the resident had a [DIAGNOSES REDACTED]. Review of the MDS dated 7/18/10 assessed this resident as having one (1) Stage I and three (3) Stage IV pressure sores. Review of the Weekly [MEDICAL CONDITION] assessment dated [DATE] documented resident #21 had two (2) new Stage IV pressure sores on the right outer foot. One pressure sore was measured as being 1.0 by 1.0 centimeters, black in color and necrotic. The other pressure sore to the right foot was measured as being 1.2 by 1.2 cm, brown in color and necrotic. Review of a Nurses Note dated 7/13/10 documented the resident had a new skin problem with a three (3) cm pressure sore to the left lower buttock. Further review of the Weekly Skin Lesion assessment dated [DATE] documented the new Stage IV pressure sore that was found to the resident's left buttock measured as 2.0 by 3.0 cm, grey in color and necrotic. After the pressure sores were identified (7/13/10) a [MEDICATION NAME] level was done with a low result of 16.1 (normal range of 20-40). A [DIAGNOSES REDACTED]. Observation on 8/11/10 at 9:15 a.m. of the wound treatment to the resident's right foot revealed there were two (2) Stage IV pressure sores to the right foot one near the 5th digit and the other of the mid area of the outer foot. There was also a Stage IV pressure sore to the left buttocks. All the areas were treated individually using aseptic technique by cleaning the areas with normal saline then santyl ointment was applied to areas and covered with a dry dressing. The most current measurements on these Stage IV pressure sores were done on 8/04/10 with the 1st area to right outer foot measuring 0.8 cm by 1.0 cm by 0.3 cm. The 2nd area to the right outer foot measured 1.2 cm by 1.5 cm by 0.3 cm. The left buttock measured 1.8 cm by 2.8 cm x 0.3 cm. Interview with the Director of Nurses (DON) on 8/11/10 at 9:35 a.m. revealed that these Stage IV pressure sores were acquired at the facility on 7/12/10 and 7/13/10. She revealed that the Certified Nursing Assistants (CNA) who gave showers to this resident twice weekly and are to document and report any skin problems they see, however, she could find no evidence that they were reporting or documenting any of these pressure areas for this resident. She stated at the current time no routine skin assessments were being conducted by the nursing staff. She revealed that a nurse found the two (2) stage IV pressure sores on the resident's right outer foot on 7/12/10 and called the physician for treatment orders. She further stated the nurse did not do a head to toe skin assessment on the resident on 7/12/10. She stated that the staff discussed the pressure sores on the resident's right foot in the Patient at Risk (PAR) meeting on 7/13/10 and a policy was developed regarding skin assessments. When a head to toe assessment was conducted for resident #21 on 7/13/10 another Stage IV pressure sore to the resident's left buttock was discovered. Review of the last skin note dated 7/07/10 completed by a CNA, who bathed the resident, documented there were no bruises on the body old or new. However, interview with two (2) CNAs, "BB" and "CC" on 8/12/10 at 9:45 a.m. and 9:55 a.m. revealed they had both noticed a red open area to the resident's buttock and stated they had reported it to a nurse. In addition, a wound culture was collected on 7/14/10 that revealed there was a heavy growth of proteus mirabilis in the wound and the resident was started of antibiotic therapy to treat the infection. An arterial duplex doppler study conducted of both lower extremities on 7/26/10 documented no significant arterial occlusive disease. 2015-03-01