cms_WV: 9763

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
9763	PINE LODGE	515001	405 STANAFORD ROAD	BECKLEY	WV	25801	2012-09-26	329	D	1	0	FJI611	NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY . Based on record review and staff interview, the facility failed to ensure residents who received antianxiety and/or hypnotic medications received the smallest effective dose for the shortest period of time. A resident received anti-anxiety medication for nearly a year, at a dose higher than that recommended for the elderly. Another resident received a hypnotic medication for sleep for a prolonged period of time. The medication used was one which was typically used only for short-term management of [MEDICAL CONDITION]. Additionally, there was no evidence of non-pharmacological interventions to alleviate the symptoms for either resident. Resident identifiers: #145 and #93. Facility census: 109. a) Resident #145 Review of the medical record revealed this [AGE] year old resident with dementia was admitted to the facility on [DATE]. She was ordered [MEDICATION NAME] (an anti-anxiety medication) one (1) milligram (mg.) twice daily for anxiety on 09/21/11. Approximately two (2) weeks later, the dosage was increased to one (1) mg. three (3) times daily, where it has since remained. Review of manufacturer's recommendations, found that the total daily dose threshold for anxiolytic medication, [MEDICATION NAME], is up to two (2) mg. daily in divided doses for geriatric patients. On 07/03/12 a gradual dose reduction (GDR) was recommended by the consultant pharmacist. The pharmacist recommended a reduction in the [MEDICATION NAME] dosage to 0.5 mg. three (3) times daily. The physician declined to decrease the dose, and gave no rationale for this decision on the pharmacy consultation report form. Review of a physician's progress note, dated 07/03/12, found the physician's assessment of tremor, nervous, and the plan to continue the [MEDICATION NAME] and observe. Review of the behavior monthly flow sheets for June, July, and August 2012, revealed [MEDICATION NAME] was used for the [DIAGNOSES REDACTED]. Further review revealed this form was only sporadically used in June and July, with recordings of only 39 out of a possible 93 shifts. The recorded information indicated the resident experienced few episodes of anxiety, and only on the night shift. Review of the August behavior monthly flow sheet also noted only rare episodes of anxiety. The number of non-pharmacological interventions employed was zero (0) for these three (3) months. Review of the behavior/intervention monthly flow record for September 2012 revealed the targeted behavior [MEDICATION NAME] was treating was that of being afraid. The number of behavioral episodes was zero (0) for each of the shifts through 09/26/12. The number of interventions employed was zero (0) for the same time period. Review of the recapitulation of active physician's orders [REDACTED]. The order date and start date of this medication, was 10/04/11. During an interview with the Director of Nursing, on 09/19/12, at approximately 4:00 p.m., she said she thought there had been two (2) attempts at reducing the [MEDICATION NAME] dose in the past year. No information was produced to verify this statement. . . b) Resident #93 Review of the medical record for Resident #93 identified the continued use of the hypnotic, Ambien, since 09/28/11. The medical record contained no evidence of attempts at non-pharmacological interventions to assist in the management of the resident's [MEDICAL CONDITION]. The pharmacist completed a consultation report related to the use [MEDICATION NAME] 01/04/12. The pharmacist recommended adding an antidepressant such as [MEDICATION NAME], and [MEDICATION NAME]. Further review found the family nurse practitioner documented only no changes at this time, on 02/08/12. No rationale was given for not attempting the pharmacist's recommendations for decreasing/discontinuing the use of Ambien. As of 09/27/12, the use [MEDICATION NAME]. On 09/27/12, at approximately 9:45 a.m., Employee #119 (regional director of clinical services) stated she could find no other documentation related to the denial of the pharmacist's recommendations. .	2015-09-01