cms_GA: 27

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

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
27	NORTH DECATUR HEALTH AND REHABILITATION CENTER	115012	2787 NORTH DECATUR ROAD	DECATUR	GA	30033	2017-02-09	282	D	0	1	OC5011	NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on record review, staff interview, and review of policy and procedures, the facility failed to routinely implement care plan interventions related to behavior monitoring for one resident (R) (R#90) being treated with an antipsychotic medication from a sample of 27 residents. Refer F329 Findings include: Review of records revealed R#90 was admitted to the facility on [DATE]. Current [DIAGNOSES REDACTED]. Physician orders [REDACTED]. Review of the Quarterly Minimum Data Set (MDS) assessment for R#90 with reference date of 12/19/16 revealed in Section C - Cognitive Patterns - a Brief Interview for Mental Status (BIMS) score of 10 which indicates the resident has a moderate cognitive impairment. Section I - Active [DIAGNOSES REDACTED]. Review of the resident's Annual MDS assessment with a reference date of 5/3/16 revealed that [MEDICAL CONDITION] drug use and behavioral symptoms triggered on Section V - Care Area Assessment (CAA) Summary - and the decision was made to complete a plan of care for these areas. Review of the policy titled Behavior Management Guideline dated 11/1/16 revealed that each resident's drug regiment will be free from unnecessary drugs, defined as a drug when used without adequate monitoring. A care plan is developed for residents exhibiting negative behaviors or those on an antipsychotic medication, and a monitoring system is established for targeted behaviors and medication side effects and effectiveness. Review of the Plan of Care for R#90, last revised 10/28/16 revealed a focus area related to the potential for drug-related complications associated with the use of antianxiety and antipsychotic medications, physical and verbal altercations with roommates and staff, and refusal of medications. The goal was for staff to monitor for psychiatric drug complications through the next review date. Interventions included: monitoring and reporting side effects to the attending physician; monitoring and documenting target behaviors such as symptoms of agitation, cursing, hitting at staff; and reporting behavioral changes to the physician. Review of the Medication Administration Records (MARs) for (MONTH) (YEAR), (MONTH) (YEAR), and (MONTH) (YEAR) revealed [MEDICATION NAME] 0.5 mg, [MEDICATION NAME] HCL 50 mg, [MEDICATION NAME] 20 mg, and [MEDICATION NAME] 0.5 mg were administered as ordered. Review of the records for R#90 revealed Behavior Monthly Flow Sheets on which staff were instructed to monitor and document the presence of behaviors such as agitation, [MEDICAL CONDITION], and uncooperativeness for the resident related to her use of anti-psychotic, antidepressant, and antianxiety medications. These monthly monitoring sheets were included in the resident's records for (MONTH) through November, (YEAR), and February, (YEAR). However, no behavior monitoring sheets were found for the months of December, (YEAR) and January, (YEAR). Interview conducted on 2/9/17 at 4:50 p.m. with Medical Records Staff AA revealed that the administrative staff pulls behavior monitoring sheets each month from the monitoring book kept on the medicine carts and delivers these to the medical records department for filing in residents' records. However, he was never given a sheet for R#90 for (MONTH) (YEAR) or (MONTH) (YEAR). To his knowledge, behavior monitoring flow sheets were not completed for R#90 for these two months. Interview on 2/9/17 at 5:00 p.m. with Licensed Practical Nurse (LPN) BB revealed that the nurses are not required to routinely chart side effects unless side effects are noted. However, they are required to complete the behavior monitoring sheets for all residents receiving antipsychotic medications on every shift. Observation done at the time of the interview revealed Behavior Log on the medicine cart which contained Behavior Monthly Flow Sheets for R#90 and other residents being monitored for behaviors for the month of February, (YEAR). Behavior monitoring sheets for no other months were available in this log.	2020-09-01