cms_AL: 2984

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
2984 AHAVA HEALTHCARE OF ALABASTER 15144 850 9TH STREET, NORTHWEST ALABASTER AL 35007 2017-03-16 322 D 0 1 5MZK11 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations, staff interviews, medical record reviews, and the Facility's Policy titled, Enteral Nutritional Therapy - Tube Feeding, the facility failed to ensure the container of formula was labeled with the time the feeding was administered on one of three survey days. This affected RI (Resident Identifier) #2, one of two residents sampled for receiving tube feeding. RI #2 was also identified as one of five residents in the facility who received continuous tube feedings. Findings include: A review of a facility policy titled, Enteral Nutritional Therapy - Tube Feeding, with the last revision date of (MONTH) 30, 2014, revealed: . PURPOSE: To provide liquid nourishment, through a tube, into the stomach. PR[NAME]EDURE . 9. f. Change feeding container every 24 hours. D[NAME]UMENTATION: . 1. Document time, date, amount of feeding . A review of the medical record revealed RI #2 was admitted to the facility on [DATE], with [DIAGNOSES REDACTED]. A review of the Quarterly MDS (Minimum Data Set), with the Assessment Reference Date (ARD) of 01/23/2017, revealed RI #2 was in a comatose state. This assessment indicated RI #2 was totally dependent on staff for all activities of daily living. RI #2 was also identified as requiring a feeding tube. A review of RI #2's physician's orders [REDACTED]. .[MEDICATION NAME] 1.2 CAL Calorie LIQUID GIVE 60 ML (milliliter)/HR (hour) X (times) 23 HOURS . On 3/14/17 at 3:20 p.m., during the facility tour, an observation was made of RI #2's tube feeding system. The tube feeding container was dated 3/13/17. No time was documented on the container to indicate when the feeding was started. On 3/14/2017 at 6:02 p.m., a second observation was made of RI #2's tube feeding system. The tube feeding container was dated 3/14/17. There was no time documented on the container. On 3/16/17 at 12:20 p.m., an interview was conducted with EI (Employee Identifier) #1, an LPN (Licensed Practical Nurse), who worked on the unit RI #2 resided on. EI #1 was asked what documentation was required for labeling a tube feeding container for residents. EI #1 stated, Name, date, route, time, and initials on the container of enteral feeding. The surveyor asked EI #1 how did she know when to change a tube feeding container. EI #1 stated, Well if it is really close to the bottom of the container, or the pump will beep when it is getting close to being finished. The surveyor asked EI #1 what length of time could a formula be hung. EI #1 stated, I know not longer than 24 hours. Most of our formula goes for about 16 to 18 hours, at 60 ml per hour, on average. The surveyor asked EI #1 what the concern was when the time was not documented on a tube feeding container. EI #1 stated, You don't know when the feeding was hung. It cannot hang over 24 hours. On 3/16/17 at 12:35 p.m., an interview was conducted with EI #2, the facility's Director of Nursing. EI #2 was asked what documentation was required for labeling a tube feeding container for residents. EI #2 stated, Patient's name, room number, cc (cubic centimeter)/hour, date it is hung, and the time. The surveyor asked EI #2 how did she know when to change a tube feeding container. EI #2 stated, Well it usually hangs 24 hours and we change the formula and tubing. Some formula can hang longer, but the spike tubing has to be changed every 24 hours. The surveyor asked EI #2 what was the concern when the time was not documented on a tube feeding container. EI #2 stated, You don't know when to change the spike set. 2019-08-01