cms_GA: 25

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.

Data source: Big Local News · About: big-local-datasette

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rowid facility_name facility_id address city state zip inspection_date deficiency_tag scope_severity complaint standard eventid inspection_text filedate
25 NORTH DECATUR HEALTH AND REHABILITATION CENTER 115012 2787 NORTH DECATUR ROAD DECATUR GA 30033 2017-02-09 278 D 0 1 OC5011 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, record review and staff interviews, the facility failed to accurately assess pressure ulcers for one resident (R) (R#5) and failed to accurately asssess the oral/dental status for one resident (R#90) who had missing and broken teeth. The sample was 27 residents. Findings include: 1. R#5 was admitted to the facility on [DATE]. Further review of the record revealed the resident did not have pressure ulcers present on admission to the facility. A significant change MDS assessment was conducted on 3/23/16 and the resident was coded as having no pressure sores. On a quarterly MDS dated [DATE], the resident was coded as having an unstageable pressure sore to both heels which were present upon admission and present on the prior assessment. Review of the clinical record revealed the resident had unstageable pressure sores on her bilateral heels which developed in the facility. In addition, a quarterly MDS assessment was conducted on 9/9/16 and again the resident was coded as having the pressure sores present on admission. Review of a quarterly MDS dated [DATE] indicated the resident had a Stage 3 pressure sore upon admission and present on prior assessment. During an interview on 2/9/17 at 6:40 p.m., the MDS Coordinator confirmed she completed the assessments and further stated the resident's pressure sores her on bilateral heals were acquired in-house and both MDS assessments dated 6/23/16 and 12/2/16 were not coded correctly. 2. Review of records revealed R#90 was admitted to the facility on [DATE]. Current [DIAGNOSES REDACTED]. Physician orders [REDACTED]. Observation of R#90 on 2/07/17 at 10:43 a.m. revealed the resident had several teeth missing in the upper and lower gums and several teeth, broken with caries. Review of a Clinical Health Status assessment completed for R#90 on 4/26/16 revealed under the section, Oral/Respiratory, that the resident had broken, loose, or carious teeth. Review of the latest Clinical Health Status assessment last completed for the resident on 10/24/16 also revealed the resident was documented as having broken, loose, or carious teeth. Review of the most recent Quarterly Minimum Data Set (MDS) assessment completed for R#90 on 12/9/16 revealed in Section C - Cognitive Patterns - a Brief Interview for Mental Status (BIMS) score of 10 which indicates a moderate cognitive impairment. Further review of the last comprehensive assessment completed for R#90, the Annual MDS assessment with reference date of 5/3/16, revealed in Section L - Oral/Dental Status - the resident was documented as having no dental issues such as caries or broken teeth. Interview on 2/9/17 at 1:55 p.m. with the current MDS Coordinator revealed she was not employed at the facility when the last comprehensive MDS assessment was completed for R#90 and, therefore, could not explain why that assessment, completed by the previous MDS coordinator, documented that the resident had no dental issues while current observations indicate, and the comprehensive Clinical Health Status assessments documents the resident has broken and carious teeth. 2020-09-01