cms_DE: 59

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
59 WILLOWBROOKE COURT AT COUNTRY HOUSE 85003 4830 KENNETT PIKE WILMINGTON DE 19807 2019-07-15 881 D 0 1 N66611 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review, interview and review of facility policy, it was determined that the facility failed to ensure the appropriate use of an antibiotic for one (R42) out of six (6) residents sampled for medication review. Findings include: The facility policy titled Antibiotic Stewardship, last revised 10/2017, stated .Ensure nursing staff access, monitor and communicate changes in a resident's condition in accordance with a standardized criteria, such as McGreer for residents in long-term care .In collaboration with the medical director help ensure antibiotics are prescribed only when appropriate . The facility policy titled Antibiotic Usage, last revised 7/09, stated .1. The licensed nurses and Infection control coordinator/preventionist will review culture reports upon receipt from the laboratory. 2. The physician will be notified via phone and/or fax of all culture reports . Review of R44's clinical record revealed the following: 6/5/19 - R44 was admitted to the facility post hospitalization . 6/5/19 through 6/6/19 - Review of progress notes revealed that R44 did not have any complaints of pain or discomfort or any elevated temperatures. 6/6/19 - A physician's orders [REDACTED]. It is unclear what prompted the order to obtain the urine specimen, as there was no progress note regarding the issue. 6/7/19 - The UA results were reported stating that R44 had blood in the urine and some bacteria. 6/7/19 - A physician's orders [REDACTED]. 6/8/19 - The urine C&S was reported from the laboratory and revealed that there was no growth after 24 hours, otherwise stating that R44 did not have a urinary tract infection. There was no documented evidence that the physician was notified of the urine C&S results. 6/10/19 - Review of the urine C&S laboratory report sheet revealed it was noted as reviewed on 6/10/19, however, there were no additional orders written and no progress note written justifying continued use of the antibiotic in the presence of a negative culture. 6/27/19 8:35 AM - A progress note stated, .14 day MDS completed: resident was being treated for [REDACTED]. The facility failed to discontinue R44's [MEDICATION NAME] when the negative culture was reported on 6/8/19. R44 received [MEDICATION NAME] 100 mg twice daily from 6/7/19 through 6/17/19 without an indication for use and in the presence of a negative culture report. The facility failed to implement their antibiotic stewardship program. 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). 2020-09-01