cms_AK: 27

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.

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
27 KETCHIKAN MED CTR NEW HORIZONS TRANSITIONAL CARE 25010 3100 TONGASS AVENUE KETCHIKAN AK 99901 2019-08-23 684 D 0 1 0OWF11 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review, observation and interview, the facility failed to provide treatment in accordance with professional standards for 1 (#10) resident out of 14 sampled residents. Specifically, the resident was receiving oxygen without a physician's order. This failed practice placed the resident at risk for receiving less than optimal care and incorrect treatments. Findings: Record review from 8/19-23/19 revealed Resident #10 was admitted to the facility with [DIAGNOSES REDACTED]. Review of the admission MDS (Minimum Data Set, a federally required nursing assessment), assessment dated [DATE] revealed the Resident did not use oxygen therapy. Review of Resident #10's H&P (history and physical), dated 6/17/19, revealed Continue respiratory medications .oxygen as needed. An observation on 8/19/19 at 4:00 pm revealed the Resident lying in bed with his/her eyes closed and wearing oxygen via nasal cannula (oxygen delivery system tubing). During an interview on 8/20/19 at 9:45 am, Resident #10 stated he/she wore oxygen mostly while he/she slept. The oxygen in the Resident's room was turned on at 3 l/min (liter per minute of oxygen flow). The nasal cannula was positioned next to the Resident in the Resident's bed. During an interview on 8/22/19 at 8:40 am, Licensed Nurse (LN) # 4 stated Resident #10 used oxygen as needed. LN #4 further stated that the Resident would use the oxygen when the Resident had chest pain. During an interview on 8/22/19 at 12:40 pm, LN # 2 stated Resident #10 used oxygen as needed. He/she would check the Resident's oxygen saturation (a noninvasive test to see how much oxygen is in the blood stream) and would provide the Resident oxygen as needed. A review of Resident #10's most recent physician's orders with LN # 2 revealed no physician order for [REDACTED].# 2 further stated that he/she would call the physician for the oxygen order. During an interview on 8/22/19 at 1:44 pm, LN # 4 stated he/she did not know if a physician order was required for oxygen use of 2 l/min or less, that oxygen use may have been at the LN discretion. A copy of the facility's policy for oxygen was requested of LN #4 at this time and was not provided by the close of the survey. A review of Resident #10's care plan Multidisciplinary Problems (Active), not dated, revealed no interventions for oxygen therapy. During an interview on 8/22/19 at 1:50 pm, the MDS Coordinator stated that oxygen therapy should be documented on the Resident's care plan. The MDS Coordinator further stated that a physician's order for oxygen would have triggered him/her to add oxygen to the care plan. According to Nurses Service Organization, accessed 9/9/19 at https://www.nso.com/Learning/Artifacts/Articles/Administer-meds-without-a-doctor-s-order-Proceed> Registered nurses generally should administer medications only with a physician's order .Giving a patient medication .without a physician's or nurse practitioner's knowledge has many risks. Most important, the medication could be contraindicated, even if it seems innocuous. 2020-09-01