cms_DC: 90

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
90 SERENITY REHABILITATION AND HEALTH CENTER LLC 95015 1380 SOUTHERN AVE SE WASHINGTON DC 20032 2016-08-18 309 D 0 1 GZ9J11 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, record review and staff interview for two (2) of 35 Stage 2 sampled residents, it was determined that facility staff failed to clarify physician's orders [REDACTED]. for one (1) resident; and failed to follow through on an Infectious Disease (ID) appointment for one (1) resident. Residents' #109 and #160. The findings include: According to Glaxo[NAME]Kline Company-www.[MEDICATION NAME].com ; Revised (MONTH) (YEAR)- pp 33-35; stipulates: How to use your [MEDICATION NAME] HFA inhaler . Step 2. Hold the inhaler with the mouthpiece down (canister should be pointed upward) . Step 7. Rinse your mouth with water after breathing in the medicine. Spit out the water. Do not swallow it . 1a. Facility staff failed to clarify physician's orders [REDACTED].#109's mouth following an oral aerosol inhalation treatment. On (MONTH) 11, (YEAR) at approximately 10:10 AM, Employee #18 was observed administering an oral inhalation aerosol to Resident #109. Resident #109 had a physician's orders [REDACTED].) The employee administered Resident #109 one (1) puff from the [MEDICATION NAME] inhaler. After administering the inhaler, the employee did not instruct the resident to rinse his/her mouth with water. A face-to-face interview was conducted with Employee #18 at approximately 10:00 AM. He/she was queried regarding not having the resident rinse with water and spit after administering the [MEDICATION NAME]. He/she replied, that since the resident is on aspiration precautions, (she/he) is not instructed to rinse with water because of the possibility of the resident swallowing it. Facility staff failed to clarify physician's orders [REDACTED].#109's mouth following an oral aerosol inhalation treatment. The observation and record review were conducted on (MONTH) 11, (YEAR). 1b. Facility staff failed to administer an oral aerosol inhalation treatment per the manufacturer ' s specification. Resident #109 On (MONTH) 11, (YEAR) at approximately 10:10 AM, Employee #18 was observed administering an oral inhalation aerosol treatment to Resident #109. Resident #109 had a physician's orders [REDACTED]. Employee #18 instructed the resident to take a deep breath in and out. Proceeded to position the mouthpiece of the inhaler in the resident's mouth in an upward position (with the canister pointed downward). A face-to-face interview was conducted with Resident #109 after the medication was administered. A query was made, if he/se felt the effect of the medication? He/she responded, Yes, I felt it going down. A face-to-face interview was conducted with Employee #18. He/she was queried regarding the correct positioning of the mouthpiece of the inhaler in the resident's mouth. He/she stated, It should be positioned with the mouthpiece in the down position(with the canister in the upward position). That's the way I usually administer it. The observation and record review were conducted on (MONTH) 11, (YEAR). 2. Facility staff failed to follow through on an infectious disease appointment for Resident #160. A history and physical examination [REDACTED]. The physician's orders [REDACTED]. A review of the (MONTH) 8, (YEAR) pharmacy consultation report read: (Resident ' s name) receives [MEDICAL CONDITION] therapy, Abacavir, [MEDICATION NAME], Kaletra The following monitoring plan for [MEDICAL CONDITION] therapy is recommended (1) continuous therapy: CD4 count and [MEDICAL CONDITION] load . Physician ' s response: I accept the recommendations(s) with the following modifications: Patient with ID (Infectious Disease) (follow-up). Will (check) ID notes. Follow up ID on (MONTH) 22, (YEAR). An infectious disease consult dated: (MONTH) 8, (YEAR) revealed: Plan: RTC (Return to clinic) - 2 weeks . According to a nurse ' s note dated (MONTH) 28, (YEAR) -1446 (2:46 PM)- F/U with infectious disease on (MONTH) 28, (YEAR) with (MD named) . Appointment rescheduled . A review of the medical record lacked evidence that the facility followed through on the infectious disease recommendation to return in two (2) weeks. A face-to-face interview was conducted with Employee #3 regarding the resident ' s follow-up ID appointment. He/she acknowledged the findings. The clinical record was reviewed on (MONTH) 17, (YEAR). 2020-09-01