cms_GA: 70

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
70	WILLIAM BREMAN JEWISH HOME, THE	115022	3150 HOWELL MILL ROAD N.W.	ATLANTA	GA	30327	2017-03-30	309	D	0	1	U5BR11	NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on record review, facility policy review, and staff interviews, the facility failed to follow physician's orders for the administration of insulin per sliding scale. Findings include: Record review for R#17 revealed that the resident was admitted to the facility on [DATE] with the following Diagnoses: [REDACTED]. Review of the Physician Orders dated 1/20/17 revealed an order for [REDACTED]. Review of the Medication Record (MR) for (MONTH) (YEAR) revealed one incorrect dose of insulin administered at bedtime (HS) on 1/21/17, which was documented at 212. During further review, the MR revealed that four u of insulin were given; however, two u ordered. Review of the Physician Orders for (MONTH) (YEAR) revealed order for [MEDICATION NAME] 100 u/ml per sliding scale for BG greater than 160 mg/dl; give via subcutaneous injection before meals and at bedtime at 7:00 a.m., 12:00 p.m., 5:00 p.m. and 9:00 p.m. Continued review revealed that the sliding scale is as follows: 161-200, give one u, 201-250, give three u, 251-300, give five u, 301-350, give seven u; greater than 351, give 10 u. Review of the MR for (MONTH) (YEAR) revealed a total of seven (7) occasions when insulin coverage had no evidence of documentation for the following dates: 7:00 a.m. administration: 2/6/17 BG=174, 2/12/17 BG=162; bedtime administration: 2/4/17 BG=198, 2/5/17 BG=176, 2/11/17 BG=213, 2/12/17 BG=189, and 2/18/17 BG=187. Review of the (MONTH) (YEAR) MR revealed four (4) incorrect doses given, which includes the following: on 3/2/17 at 5:00 p.m. the BG was 232, and the resident was given two u instead of five units. Then on 3/8/17 BG=380, five u given, not 10 u as ordered; and on 3/13/17 BG=262-three (3) u given, instead of five (5) units. Review of the (MONTH) (YEAR) Physician Orders continued the same sliding scale insulin orders as (MONTH) (YEAR). Interview with Licensed Practical Nurse (LPN) DD on 3/29/17 at 11:15 a.m., she stated that inservices are held for all new medications, including how to draw up, if applicable, and administer. Continued interview revealed that annual inservices are held related to general medication administration. The procedure for self-reported medication errors is to contact the nursing supervisor, monitor the resident for any adverse reactions, complete the appropriate medication error paperwork and contact the physician and/or family. During an interview with the Director of Nursing (DON) on 3/30/17 3:20 p.m., she confirmed the discrepanceies on the Medication Records from (MONTH) (YEAR) through (MONTH) (YEAR). Continued interview revealed that she was unable to give an explanation for the medication discrepancies. Review of the Facility Policy and procedures titled, Administering Medications Version 2.0, Accucheck Blood Sugar Testing and Insulin Administration revealed that all detail the steps for correct documentation of the testing and administration processes: 1.) Date, time, blood glucose level. 2.) Type and amount of insulin administered and the injection site. 3.) If blood glucose level is above or below normal range, document the time the physician was notified. 4.) Any results achieved and when those results were observed. 5.) Signature and file.	2020-09-01