cms_GA: 3634

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
3634	NANCY HART CENTER FOR NURSING AND HEALING LLC	115686	2117 DOCTOR WARD ROAD	ELBERTON	GA	30635	2020-01-16	686	D	0	1	D2MI11	NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observations, record review, review of the facility policy titled Wound Care/Treatment Guidelines and staff interviews, the facility failed to prevent the development of further skin breakdown for one resident (R) (R#25) of 36 sampled residents. Findings include: Review of the facility's undated policy titled Wound Care/Treatment Guidelines the purpose is to provide excellent wound care to promote healing.[NAME]Numeral X. The dressing should be labeled with the nurse's initials, date and time.[NAME]Numeral XII. The must be a specific order for the treatment.[NAME]Numeral XIV. The care plan should reflect the current status of the wound and appropriate goals. A review of the clinical record for R#25 revealed resident was admitted to the facility on [DATE] with [DIAGNOSES REDACTED]. The resident's Annual Minimum Data Set (MDS), dated [DATE], revealed a Brief Interview for Mental Status (BIMS) was coded as 10, which indicated moderate cognitive impairment. Section G revealed that the resident was assessed for extensive assistance for bed mobility, transferring, locomotion on/off unit and toilet use. Section M revealed no skin breakdown. Review of Nurse's note dated 1/5/2020, indicated un-stageable pressure area noted to both heels/toes and Physician Orders received to clean with saline. There is no evidence documented that R#25 had additional breakdown on toes two through four on left foot, until 1/15/2020. Review of Physician Phone Order (PO) dated 1/5/2020 revealed order to clean unstaged pressure areas to left and right (Lt/Rt) heel and to tip of Lt/RT great toe with normal saline (NS), apply skin prep and dressing every day until resolved. Review of the Interim Care Plan for R#25, dated 3/1/19, revealed no evidence that R #25 had a care plan problem to include potential for alteration in skin breakdown or actual skin breakdown. An interview on 1/14/2020 at 3:12 p.m. with Licensed Practical Nurse (LPN) JJ, revealed that she did not use wound cleanser on the wounds because the wounds were not draining. She stated that she did not know the order had been changed to cleanse wounds with wound cleanser, before applying the skin prep. A telephone interview on 1/16/2020, at 9:12 a.m. with Medical Director and primary Physician for R#25, revealed that he was aware of the wounds on the heels and great toes on both feet, and had ordered for wound care to be done daily. During further interview, he stated that he was not aware that there was additional breakdown on the other toes of the left foot although he did not feel that further breakdown could be avoided due to vascular disease. An interiew on 1/15/2020 at 2:19 p.m. with Director of Nursing (DON), she verified that the Physician order dated 1/5/2020 for R#25 indicated to cleanse un-staged pressure areas to left/right heel and to tip of left/right great toe with Normal Saline, apply skin prep and dressing every day until resolved. She further stated that she expects staff to follow all Physician orders as written, for medications and for wound care.	2020-09-01