cms_AK: 12

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
12 KETCHIKAN MED CTR NEW HORIZONS TRANSITIONAL CARE 25010 3100 TONGASS AVENUE KETCHIKAN AK 99901 2018-08-03 657 E 0 1 RHGS11 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** . Based on interview and record review the facility failed to update and revise the care plan to reflect the current level of care and services for 3 residents (#s 3, 14, 16) out of 14 sampled residents. Failure to assess and revise care plan problems, goals, and interventions placed the residents at risk for not receiving appropriate and/or necessary care and services. Findings: Resident #3 Record review on [DATE] - [DATE] revealed Resident #3 was admitted to the facility with [DIAGNOSES REDACTED]. Review of Resident #3's most recent care plan, undated, revealed 18 Multidisciplinary Problems (Active). The expected end date, or target date, for all of these identified problems expired on [DATE]. Review of the most recent MDS (Minimum Data Set - a federally required nursing assessment) assessment revealed a quarterly assessment was completed on [DATE] preceeding the expired dates on the careplan. Review of the Quarterly Team Conference, dated [DATE], revealed the team reviewed the current care plan for all identified problems and approaches. Resident #14 Record review on [DATE] - [DATE] revealed Resident #14 was admitted to the facility with [DIAGNOSES REDACTED]. Review of the most recent MDS assessment, an annual assessment dated [DATE], revealed Resident #14 required extensive assistance in bed mobility, locomotion on and off unit, toileting, and dressing. He/she was coded total dependence for transfers and personal hygiene. Review of Resident #14's care plan revealed a Problem: Impaired strength and/or mobility . dated [DATE] and a Description: Related to left side [MEDICAL CONDITION] and [MEDICAL CONDITION] post [MEDICAL CONDITION]. Interventions for this problem were documented as restorative aid, range of motion exercises, with the goal needs to maintain current flexibility and prevent contractures. Further review of Resident #14's medical record revealed Occupational Therapy (OT) added instructions for a palm protector with finger separators on [DATE] with the following interventions: - Please place palm shield on (Resident #14) when in bed (in place of previous palm protector). - If finger separators out of place, please fix them - Keeping left arm up on pillow for support will help keep it in place and provide comfort to left arm - If (Resident #14) is having any discomfort with palm shield, please remove and give a break. Attempt to replace in 30 (minutes) - 1 hour. Additional review of Resident #14's care plan Problem: Impaired strength and/or mobility . revealed no documentation of the palm protector recommended by OT. Resident #16 Record review on [DATE] - [DATE] revealed Resident #16 was admitted to the facility with [DIAGNOSES REDACTED]. Record review revealed a physician order [REDACTED]. Review of the most recent MDS (Minimum Data Set, a federally required nursing assessment) assessment, a quarterly assessment dated [DATE], revealed the Resident was coded for taking an anticoagulant medication during the last 7 days of the MDS assessment. Review of Resident #16's most recent care plan, undated, revealed the problem Potential for complication r/t bleeding (see description) Description: I am on [MEDICATION NAME] .review of INR and [MEDICATION NAME] dose adjustment. Review of MDS Nurse Note dated [DATE], revealed Care conference complete . There was no documentation regarding the change in Resident #16's medication change from [MEDICATION NAME] ([MEDICATION NAME], a blood thinning medication that requires diagnostic monitoring) to Eliquis. During an interview on [DATE] at 7:46 am, Licensed Nurses (LN) #s 2 & 5 stated they do not use the care plan binders at the nurse's station and they do not regularly incorporate the care plans into their daily care for residents. During an interview on [DATE] at 9:00 am, the interim MDS Nurse (MDSN) could not state why a revision to a care plan would not be done. She stated revisions are manually completed by the full-time MDSN, who was on vacation at the time of this survey. Review of the facility's policy Care Planning, dated [DATE], revealed: The Care Plan is to be considered a dynamic document. It is to be kept up-to-date on a continual basis, and based on the assessed needs of the individual resident. Further review of the policy revealed: The MDS RN-Coordinator is in charge of and responsible for completing, reevaluating and revision of the Resident Care Plan. And Each discipline is encouraged but not required to make changes on the care plan as necessary. These changes can be written on the paper copy of the care plan, in the care plan notebook, or this can be taken to the MDS RN-Coordinator . 2020-09-01