cms_DE: 51

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
51 WILLOWBROOKE COURT AT COUNTRY HOUSE 85003 4830 KENNETT PIKE WILMINGTON DE 19807 2019-07-15 684 D 0 1 N66611 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview, it was determined that for two (R42 and R44) out of six (6) residents sampled for medication review, and for one (R48) out of one (1) resident sampled for death review, the facility failed to administer medications as ordered and/or transcribe physician's orders [REDACTED]. 1. Review of R42's clinical record revealed: 6/14/19 - A physician's orders [REDACTED]. 6/28/19 - A physician's orders [REDACTED]. Review of the eMAR revealed R42 received the [MEDICATION NAME] 2.5 mg on 6/28/19, 6/30/19, 7/2/19, and 7/4/19 for a total of four (4) doses. The facility failed to administer the fifth dose of [MEDICATION NAME] on 7/6/19 as per physician's orders [REDACTED]. 7/8/19 approximately 5:00 PM - Findings were reviewed with E2 (former DON). 7/15/19 approximately 12:30 PM - Findings were reviewed during the exit conference with E1 (NHA), E2 (former DON), E3 (acting DON), E6 (NP), and E16 (ED). 2. Review of R44's clinical record revealed the following: 6/5/19 - A physician's orders [REDACTED]. According to the (MONTH) 2019 MAR, the Eliquis was timed to be administered at 9:00 AM and 6:00 PM. 7/2/19 10:35 AM - A physician's orders [REDACTED]. Review of the eMAR revealed that the 7/2/19 9:00 AM Eliquis dose had already been given prior to the order being written. Review of the eMAR revealed that the Eliquis was held on: - 7/2/19 at 6:00 PM; - 7/3/19 at 9:00 AM and 6:00 PM; - 7/4/19 at 9:00 AM and 6:00 PM; - 7/5/19 at 9:00 AM. This was a total of three (3) days or six (6) doses held. According to the physician's orders [REDACTED]. 7/8/19 2:29 PM - During an interview with E6 (NP) regarding the order to hold Eliquis for 2 days, written on 7/2/19, E6 confirmed that he/she would have expected it to be resumed on 7/4/19 with the 6:00 PM dose. 7/15/19 approximately 12:30 PM - Findings were reviewed during the exit conference with E1 (NHA), E2 (former DON), E3 (acting DON), E6 (NP), and E16 (ED). 3. Review of R48's clinical record revealed: A facility policy and procedure entitled Physician order [REDACTED].To strive to ensure that physician orders [REDACTED]. Procedure: 1. The licensed nurse receiving a hand-written physician order [REDACTED]. b. Enter the physician order [REDACTED]. 2. In order to double check that orders were not overlooked and are accurate in the electronic application order entry process, within twenty-four (24) hours, a second licensed nurse shall review the hand-written transcribed and newly entered physician orders [REDACTED]. Notify the physician as to the physician order [REDACTED]. Transcribe the correct order on the electronic health record application. 5/28/19 - R48 was admitted to the facility. 5/30/19 - A handwritten physician's orders [REDACTED]. The facility failed to transcribe the 5/30/19 physician's orders [REDACTED]. 5/31/19 - Review of R48's 24 Hour Chart Check form, performed on the 11 PM to 7 AM shift, revealed a blank space in the Initials column on 5/31/19 where a nurse signs off that it was completed. The facility failed to perform a 24 hour chart check on 5/31/19. 6/1/19 - The handwritten 5/30/19 physician's orders [REDACTED]. Although the 24 Hour Chart Check wasn't completed on 5/31/19, a nurse documented under the written order that he/she reviewed it on 6/1/19, but still did not identify the omission. Review of R48's (MONTH) 2019 and (MONTH) 2019 eMARs and Physician order [REDACTED]. 7/15/19 at 12:30 PM - Findings were reviewed during the Exit Conference with E1 (NHA), E2 (former DON), E3 (acting DON), E6 (NP) and E16 (ED). The facility failed to transcribe the 5/30/19 physician's orders [REDACTED]. 2020-09-01