cms_AL: 65

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
65 MERRY WOOD LODGE 15019 P O BOX 130 ELMORE AL 36025 2020-03-03 580 D 1 1 LZCS11 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** > Based on interview, record review and review of a facility policy titled Change in Condition: Notification of the facility failed to contact Resident Identifier (RI) # 24's resident representative when his/her diet was changed to pureed in August 2019. This affected 1 of 20 sampled residents. Findings Include: A review of policy titled Change in Condition: Notification of, with an effective date of 11/28/16, documented: .A Center must immediately inform the patient's Health Care Decision Maker (HCDM) where there is:.A need to alter treatment significantly (that is, a need to discontinue or change an existing form of treatment due to adverse consequences, or to commence a new form of treatment. RI # 24 was admitted to the facility on [DATE] with [DIAGNOSES REDACTED]. RI # 24 also had a [DIAGNOSES REDACTED]. A review of RI # 24's diet orders documented the following: 8/13/19.Resident's diet downgraded to pureed due to coughing when eating. Resident appearing at times to have trouble swallowing regular tray. Speech Therapy (ST) was alerted and to see resident. On 03/02/20 at 2:53 p.m. the Surveyor reviewed RI # 24's medical record. A Speech Therapy Initial Evaluation for therapy dates 8/2/19 through 8/31/19 documented the following: . Patient/Caregiver Education = Family/caregiver expressed understanding of evaluation and agreement with goals and treatment plan; Does patient/family agree w/ (with) Diet Recommendation? = Yes. On 3/2/20 at 9:38 a.m. an interview was completed with Employee Identifier (EI) # 3, Speech Therapist. EI # 3 stated she had RI # 24 on her case load on and off in 2019 for swallowing and cognitive problems. EI # 3 was asked what type of diet she recommended for RI # 24. EI # 3 stated she recommended a pureed diet in August of 2019 and RI #24 received that diet after the recommendation. A follow-up telephone interview was completed with EI # 3, Speech Therapist, on 3/2/20 at 2:47 p.m. EI # 3 was asked if she contacted RI # 24's family when he/she went on pureed diet in August. EI # 3 stated no. EI # 3 further stated she had a conversation with RI # 24's daughter but did not call her about the diet change. EI # 3 was asked what the statement on the Speech Therapy Initial Evaluation for therapy dates 8/2/19 through 8/31/19 meant when it documented the Family/Caregiver expressed understanding of the evaluation and agreement with goals and treatment plan to include the diet recommendation. EI # 3 stated it meant she spoke with the facility about the resident's diet, not the family. EI # 3 was asked if she normally called family regarding a diet change. EI # 3 stated no. An interview was completed with EI # 4, Registered Nurse (RN), on 3/3/20 at 9:35 a.m. EI # 4 was asked if nursing staff called RI # 24's daughter when his/her diet was downgraded in August of 2019. EI # 4 stated there was a note about downgrading the diet on 8/13/19, but it was not documented the daughter was called and informed. EI # 4 further stated it should be documented. EI # 4 was asked what was the potential negative outcome of not notifying family of changes. EI # 4 stated the family not knowing about the change. 2020-09-01