cms_DE: 85

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
85 BRANDYWINE NURSING & REHABILITATION CENTER 85004 505 GREENBANK ROAD WILMINGTON DE 19808 2017-07-19 309 D 1 1 ZBS111 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** > Based on observation, clinical record reviews, interviews and review of facility documentation, it was determined that for 2 (R2, R143) out of 55 Stage 2 sampled residents, the facility failed to provide the necessary care and services to maintain the highest practicable physical, mental, and psychosocial well-being consistent with professional standards of practice and their comprehensive person-centered care plans. For R2, the facility failed to follow her plan of care when it was observed that R2's disposable underpad was pulled up tight between her legs two different times when the disposable underpads were to lay flat underneath her. For R143, the facility failed to follow the physician's orders [REDACTED]. Findings include: 1. Review of R2's clinical record revealed the following: Last reviewed on 5/3/17, R2 was care planned for: - semi-comatose state; - incontinent of bladder and bowel with interventions that included to provide incontinence care every 2 hours and as needed .use pads or briefs; - potential for alteration in skin integrity due to decreased mobility and bladder/bowel incontinence with an intervention that included to keep bed linens wrinkle free. Review of R2's Resident Care Profile for the CNAs to reference, last updated on 5/3/17, revealed the absence of special instructions for incontinence care to meet R2's needs. On 7/17/17 at 5:35 AM, E15 (CNA) with E19 (CNA orientee) were observed providing incontinence care to R2. R2 was observed with 2 disposable underpads under her with one disposable underpad pulled up tight between her legs covering her genital area. The disposable underpad was soiled with a bowel movement. E15 was observed cleaning R2 and then placing another clean disposable underpad under R2 and pulling the underpad up tight between R2's legs covering her genital area. During this time, the surveyor observed a sign on R2's wall above her bed that stated, No attends. No pads. Chuck (sic) (Chux) and draw sheet only!!!! During an interview on 7/17/17 at 7:30 AM, E18 (RNAC) and this surveyor discussed what was observed and reviewed R2's care plan. It was unclear why R2's incontinence care plan, last reviewed on 5/3/17, stated to use pads or briefs, which contradicted the sign posted on R2's wall. The facility failed to follow R2's care plan and her Resident Care Profile. During an interview on 7/17/17 at 8:28 AM, E20 (CNA) confirmed that R2 does not wear attends or pads. E20 demonstrated and stated that a disposable underpad is placed under R2 and must lay flat across the width of the bed to prevent skin breakdown. E20 confirmed that R2's disposable underpad should not be pulled up tight between her legs covering her genital area. Findings were reviewed with E2 (DON) and E3 (RN/Staff Ed) on 7/19/17 at 3 PM. The facility failed to provide treatment and care in accordance with R2's plan of care to meet her needs. 2 Review of R143's clinical record revealed the following: R143 was admitted to the facility on [DATE] with a [DIAGNOSES REDACTED]. 1/31/17 - A physician's orders [REDACTED]. Review of R143's (MONTH) (YEAR) eMAR revealed that two doses of [MEDICATION NAME] were administered on 7/1/17 at 2:52 PM and 7:11 PM, with approximately 4.25 hours between administrations. Findings were reviewed with E13 (RN/Unit Manager) on 7/19/17 at 1 PM. The facility failed to follow the physician's orders [REDACTED]. 2020-09-01