cms_WV: 11454

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

This data as json, copyable

rowid	facility_name	facility_id	address	city	state	zip	inspection_date	deficiency_tag	scope_severity	complaint	standard	eventid	inspection_text	filedate
11454	EAGLE POINTE	515159	1600 27TH STREET	PARKERSBURG	WV	26101	2011-05-12	325	D			1I0H11	NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY . Based on record review and staff interview, the facility failed to provide a physician-ordered therapeutic to one (1) of thirty-nine (39) Stage II sample residents in an effort to maintain acceptable parameters of nutritional status such as protein levels. Resident identifier: #82. Facility census: 129. Findings include: a) Resident #82 1. Record review revealed Resident #82 was readmitted from the hospital on [DATE], and her active [DIAGNOSES REDACTED]. Review of lab work revealed Resident #82 had serum [MEDICATION NAME] levels (with the normal reference range between 3.6 - 4.8) as follows: - 3.7 on 12/21/10 - 3.2 on 12/24/10 - 3.5 on 12/25/10 - 3.7 on 02/21/11 - 2.5 on 04/26/11 - 2.8 on 05/05/11 Further review of lab work revealed Resident #82 had total protein levels (with the normal reference range between 6.2 - 8.0) as follows: - 12/21/10 - 7.6 - 12/24/10 - 6.5 - 12/25/10 - 7.0 - 04/26/11 - 5.4 - 05/05/11 - 6.1 -- 2. Her most current care plan, which was last reviewed by the interdisciplinary team on 03/30/11 (with additional handwritten entries added after that date), included the following problem statements related to nutrition (quoted as written): - "111 - therapeutic diet - wt (weight) fluctuates due to [MEDICAL CONDITION] - wt loss desired" (dated 01/12/11) - "Non-compliant /c (with) diet & fluid rest (restriction)" (dated 04/28/11) - "181 - Risk for skin breakdown related to diabetes, [MEDICAL CONDITION], and [MEDICAL CONDITION]" (dated 01/06/11) - "[MEDICAL CONDITION]" (dated 03/30/11) None of the above problems, nor any of the other problems on the comprehensive care plan, included an intervention to provide the resident with addition protein. -- 3. Review of interdisciplinary (IDT) progress notes and nurses' notes in Resident #82's medical record revealed documentation by the consultant dietitian on 12/30/10, noting, "... Diet is consistent carb (for DM) & NAS (no added salt), (arrow pointing down) K+ (potassium), (arrow pointing up) Protein (renal). ..." Subsequent entries, made by the dietary manager on 01/06/11, 01/21/11, 02/21/11, and 03/21/11, also noted the provision of 1-1/2 protein with the resident's diet. On 04/29/11, the dietitian noted, "... Labs reviewed - 4/26 Alb ([MEDICATION NAME]) 2.5 - moderately depleted visceral protein stores - likely r/t (related to) [MEDICAL CONDITION] / diuretic tx (treatment) ..." -- 4. Review of the March 2011 recapitulation of physician orders [REDACTED]." (The word "protein" was handwritten, while the rest of the order was typed.) Review of the May 2011 recapitulation of physician's orders [REDACTED]. -- 5. Interview with the dietary manager (Employee #21), on 05/05/11 at 9:56 a.m., revealed that "1-1/2 protein" meant the resident was to receive 1-1/2 sized portions of each protein served at each meal. However, the dietary manager stated Resident #82's order for extra protein was not carried over; therefore, this resident had not been receiving the extra protein diet as prescribed by the physician. When asked, Employee #21 stated the resident's diet was for regular consistency, consistent carbohydrate, no added salt, low potassium, with fluid restrictions of 2200 cc per day. She said there was nothing special about the protein for her diet, and Resident #82 "gets what everybody else gets" in the way of protein. -- 6. During an interview on 05/05/11 at 10:20 a.m., the dietician agreed that the "1-1/2 protein" ordered for Resident #82 meant that, with each protein item served at each meal, the resident was to receive a 1-1/2 portioned size. According to the dietician, the first carry-over of physician's orders [REDACTED]. The dietician said that, upon admission in December 2010, Resident #82 was on a regular diet, and she calculated Resident #82's daily protein needs of 44 - 55 grams per day based on her ideal body weight range of 86 - 106 pounds, and not on her admission weight of 194 pounds. The dietician said Resident #82 received about 90 grams of protein per day with the diet now ordered and the "1-1/2" portion size would equal 135 grams of protein per day. -- 7. During an interview with the administrator on 05/05/11 at approximately 1:30 p.m., these findings were discussed, and she agreed there was no pre-[MEDICATION NAME] in Resident #82's medical record. -- 8. Further record review revealed a physician's telephone order, dated 05/09/11 at 7:45 p.m., to discontinue the 1-1/2 protein portions. .	2014-03-01