cms_AK: 54

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
54 WRANGELL MEDICAL CENTER LTC 25015 P.O. BOX 1081 WRANGELL AK 99929 2018-04-30 554 D 0 1 O8F911 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review the facility failed to conduct appropriate interdisciplinary team (IDT) assessments on 1 resident (#7) out of 8 sampled residents to determine if resident was capable of appropriately administering his/her own medication. This failed practice places all residents at risk for improper self-administration; more specifically, the possibility of over medicating or omitting medications ordered by a physician. Findings: Record review on 4/23-27/18, revealed Resident #7 was admitted to the facility with [DIAGNOSES REDACTED]. Review of the most recent MDS (Minimum Data Set, a federally required nursing assessment) assessment, a quarterly assessment dated [DATE], revealed Resident #7 was coded as having a Brief Interview for Mental Status score of 15 (a score of 13-15 determines mental status is intact). Observation on 4/24/18 at 12:06 pm, revealed Resident #7 had an unsecured bottle of multivitamins with an easy-open lid on his/her bedside table. During an interview on 4/24/18 at 12:06 pm, Resident #7 stated he/she took the vitamins daily without notifying any staff and further stated he/she has not taken a vitamin for that day. During an interview on 4/27/18 10:00 am, Licensed Nurse (LN) #2 stated if a resident wanted to self-administer medication, the LN on duty would call the doctor, for an order. Next the nurse would complete a self-administration form and place in chart. During an interview on 4/24/18 at 11:19 am, LN #1 stated, If a Resident requests to self-administer medication, the RN completes the Self-Administration Assessment and puts it in the chart. When asked if the IDT is involved in any way to complete the assessment, LN #1 said, No, only the nurse does them. Review of Resident #7's Medication Administration Record [REDACTED]. Review of Resident #7's medical record did not reveal any self-administration assessment documentation for the ordered multivitamin. Further review of the medical record revealed self-administration assessment was not documented on any Interdisciplinary Team (IDT) notes since admission. Review of Wrangell Medical Center's Resident's Bill of Rights reads, To take your own (self-administer) prescribed medications provided the interdisciplinary team has determined this is a safe practice for you. Review of Wrangell Medical Center's policy for Resident Self Administering Medication reads: Purpose: Residents will be able to self-administer medications with a physician order [REDACTED]. There will be a physician order [REDACTED]. 2. Resident will agree and complete a medication administration competency. The resident must demonstrate to the registered nurse safe handling and administration of the medication. The resident will be able to state the medication, purpose, and prescription information to the staff. 3. The registered nurse will check in with the resident daily for proper medication usage and storage. 4. Physician will be notified of any concerns or failure of resident to follow manufacturer's recommendations. 2020-09-01