cms_AL: 26

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

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rowid facility_name facility_id address city state zip inspection_date deficiency_tag scope_severity complaint standard eventid inspection_text filedate
26 HIGHLANDS HEALTH AND REHAB 15012 380 WOODS COVE ROAD SCOTTSBORO AL 35768 2019-06-06 880 D 0 1 3PTZ11 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations, interviews, medical record reviews and review of facility policies titled, Universal Precautions and Hand Hygiene, the facility failed to ensure: 1) a licensed nurse washed her hands when removing gloves after obtaining Resident Identifier (RI) # 9's fingerstick blood sugar (FSBS) and before leaving RI #9's room to return to the medication cart. Further, the nurse failed to use a barrier when laying an insulin syringe with RI #9's insulin and alcohol wipe on the bathroom sink; and 2) a licensed nurse did not place a medication cup containing medication for RI #23 inside another medication cup containing the remainder of RI #23's medication. Further, the nurse did not use a barrier before placing RI #23's Salonpas patches and [MEDICATION NAME] on the top of the medication cart, computer and a shelf in RI #23's room. These deficient practices affected RI #9 and RI #23, two of four residents and two of three nurses observed during medication pass observations. Findings Include: 1) A review of a facility policy titled, Hand Hygiene, Last Revised: 02/2019, documented: .B. Indications for hand washing and hand antisepsis .3. Perform hand hygiene: a. before and after having direct contact with patients; b. after removing gloves; before handling an invasive device (regardless of whether or not gloves are used) for patient care; .f. after contact with inanimate objects (including medical equipment) in the immediate vicinity of the patient; . A review of a facility policy titled, Universal Precautions, Last Revised: 02/2019, revealed: .[NAME] Hand Washing .3. Hands should be sanitized immediately after gloves are removed. B. 1. Gloves should be worn for touching blood and body fluids, . 1.) RI #9 was readmitted to the facility on [DATE] with [DIAGNOSES REDACTED]. On 06/05/19 at 5:04 p.m., the surveyor observed Employee Identifier (EI) #7, Registered Nurse (RN), during medication pass for RI #9. The surveyor observed EI #7, RN, obtain RI #9's FSBS and remove her gloves without washing her hands and returned to the medication cart to prepare RI #9's insulin injection. EI #7 was then observed entering RI #9's bathroom and laying the syringe filled with insulin and the alcohol wipes beside the bathroom sink without a barrier. On 06/05/19 at 5:17 p.m., an interview was conducted with EI #7, RN. EI #7 was asked when should she wash her hands when wearing gloves. EI #7 said she should wash them when she takes them off. EI #7 was asked did she wash her hands after obtaining RI #9's FSBS and removing her gloves before returning to the medication cart. EI #7 stated no. EI #7 was asked what should she do before laying anything down on any surface. EI #7 replied she should put down a barrier. EI #7 was asked did she put down a barrier before she laid the insulin syringe and alcohol wipe beside the sink. EI #7 stated no she did not. EI #7 was asked what was the concern with laying things down on surfaces without a barrier. EI #7 answered, it could be dirty and there could be germs. 2.) RI #23 was readmitted to the facility on [DATE] with [DIAGNOSES REDACTED]. On 06/06/19 at 8:39 a.m., EI #3, RN, was observed during medication pass for RI #23. EI #3 was observed removing two of RI #23's Salonpas patches from the packet and laying them on top of the medication cart without a barrier to initial and date them. EI #3 removed the nitro dur patch from the packet and laid it on top of the computer on the medication cart to initial and date it. EI #3 was then observed placing a medication cup containing [MEDICATION NAME] and placing it inside another medication cup containing the remainder of RI #23's pills. EI #3 entered RI #23's room and placed the items on a shelf unit inside the room without placing a barrier. On 06/06/19 at 9:21 a.m., an interview was conducted with EI #3, RN. EI #3 was asked what was the concern with placing a medication cup inside another medication cup containing medications. EI #3 said dirty stuff could be on them, infection control. EI #3 was asked what was the concern with placing Salonpas and nitro patches on the computer and on top of the medication cart to date them. EI #3 replied again, getting them dirty. EI #3 was asked did she place the Salonpas and nitro patch on her computer, top of the medication cart and on the shelving unit in RI #23's room without a barrier. EI #3 said yes. On 06/06/19 at 3:47 p.m., an interview was conducted with EI #5, RN/Director of Nursing. EI #5 was asked, when should nurses wash their hands when wearing gloves. EI #5 said as soon as the gloves come off the hands should be washed. EI #5 was asked should a medication cup containing medications be placed inside another medication cup containing medications. EI #5 replied no. EI #5 was asked should patches be placed on a shelving unit without a barrier. EI #5 stated no. EI #5 was asked what was the concern with those things. EI #5 answered infection control and cross contamination. 2020-09-01