cms_GA: 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.

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
85	GLENWOOD HEALTH AND REHABILITATION CENTER	115025	4115 GLENWOOD RD	DECATUR	GA	30032	2017-11-08	281	D	1	1	FY6A11	NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY > Based on observation, record review, review of the Georgia Practice Act for Registered Nurses (RN) and Licensed Practical Nurses (LPN), staff and family interviews the facility failed to ensure that resident vital signs were monitored per the Physician orders [REDACTED].#_), that Physician orders [REDACTED].#6) that received [MEDICATION NAME] injection, that nurses were conducting narcotic reconciliation per the facility's policy for one resident (R#201) reviewed for use of injectable [MEDICATION NAME] and that nurses were confirming that the pharmacy label for medications corresponded with the physician's orders [REDACTED].#201 and R#137). The resident sample was 35. Findings include: Review of the Georgia Practice Act for Registered Nurses 2.2.2: Standards Related to Registered Nurse Responsibility for Nursing Practice Implementation. [NAME] Implements treatments and therapy, including medication administration, delegated medicals and independent nursing functions. Review of the Georgia Practice Act for Licensed Practical Nurses 2.3.2: Responsibilities for Nursing Practice Implementation. [NAME] Implements appropriate aspects of client care in a timely manner. 1. Provides assigned and delegated aspects of client's health care plan. 2. Implements treatments and procedures. 2. Administers medications accurately. K. Documents care provided. 1. Review of the Controlled Substance Accountability Sheet for R#6 revealed a pharmacy medication label with an original date of 5/23/17 for [MEDICATION NAME] INJ 2MG/ML (2 milligrams per milliliter) [MEDICATION NAME]- Inject 0.5ML (0.25ML). Review of the Physician order [REDACTED]. Review of the MAR indicated [REDACTED]. Interview on 11/3/17 at 1:50 p.m. with the DON and the Consulting Pharmacist (CP) confirmed that R#6 does not have an order for [REDACTED].#6, they should have notified the nursing supervisor and an order for [REDACTED]. 2. Review of the policy titled Controlled Drugs dated (MONTH) 2005 and revised (MONTH) 2011 documented: To ensure that controlled drugs are inventoried and administered as required by State and Federal agencies: 1. Maintain a declining inventory record by resident by drug on all controlled drugs. Records must be accurate and include: Name of resident Prescription number and name of issuing pharmacy Drug name and strength Medication form Route of administration Strength and dose administered Date and time of administration Signature of the person administering the drug 2. Reconcile the declining inventory record at the beginning and the end of each shift. Reconciliation is performed by a physical count of the remaining medication by two persons who are legally authorized to administer medications. Observation on 11/2/17 at 1:50 p.m. with LPN CC and Unit Manager LPN DD of the West Wing storage medication refrigerator on 11/2/17 at 1:50 p.m. revealed a plastic package with four vials of [MEDICATION NAME]. The label read; 2MG/ML, Inject 1MG (0.25ML) intramuscularly every four hours as needed, prescribed to R#201. Review of the Controlled Substance Accountability Sheet with LPN CC revealed the last dated entry of dispense was 10/31/17 with a remaining quantity of five vials. LPN CC and the Unit Manager, LPN DD looked in the refrigerator and were unable to locate the fifth vial of [MEDICATION NAME]. Interview on 11/2/17 at 1:58 p.m. with LPN CC revealed she had not conducted a count of the [MEDICATION NAME] in the West Wing medication storage refrigerator because the night shift nurse had to leave early due to an emergency. LPN CC confirmed that she signed the Change of Shift Controlled Substances Count Sheet but that she had only counted the narcotics in her assigned medication cart, but not the narcotics in the medication storage refrigerator. Interview with the Director of Nursing (DON) on 11/2/17 at 3:55 p.m. revealed that after an investigation it was discovered that on 10/28/17, R#201 was having [MEDICAL CONDITION] and LPN CC administered [MEDICATION NAME] on the dayshift. The DON stated that the LPN CC never signed out the [MEDICATION NAME] on the Controlled Substance Accountability Sheet on 10/28/17. The DON stated that if the nurses had been properly conducting narcotic counts as they are supposed to each shift, the discrepancy would have been discovered on 10/28/17 during the 3:00 p.m. count. The DON confirmed that the nursing staff had been signing off with their signatures on the Change of Shift Controlled Substances Count Sheet, that narcotic counts had been conducted. Review of the Change of Shift Controlled Substances Count Sheet revealed signed signatures from the Nurse Departing from Duty and the Nurse Arriving on Duty indicating that all narcotics had been accounted for on the following dates and time: 10/28/17 at 3:00 p.m., 11:00 p.m., 10/29/17 at 7:00 a.m., 3:00 p.m., 11:00 p.m., 10/30/17 at 7:00 a.m., 3:00 p.m., 11:00 p.m., 10/31/17 at 7:00 a.m., 3:00 p.m., 11:00 p.m., 11/1/17 at 7:00 a.m., 3:00 p.m., 11:00 p.m. and 11/2/17 at 7:00 a.m. A total of 15 shift narcotic counts were documented by nurses indicating that five vials of [MEDICATION NAME] prescribed to R#201 was remaining. Cross refer to F431 3. Record Review for R#201 revealed a Physician order [REDACTED]. Review of the pharmacy label for [MEDICATION NAME] indicated Inject 1 MG (.25ml) every four hours as needed for [MEDICAL CONDITION]. Review of the Medication Administration Record [REDACTED]. Review of the Controlled Substance Accountability Sheet indicated the amount administered 1 on 9/3/17 and 9/9/17. Record review for R#137 revealed a Physician order [REDACTED]. Review of the pharmacy label for [MEDICATION NAME] with original date of 10/27/17 indicated Inject Intramuscularly 1 vial every eight hours. [MEDICATION NAME] INJ 2MG/ML. Review of the Controlled Substance Accountability Sheet indicated [MEDICATION NAME] was dispensed on 10/28/17 at 3:00 a.m., 11:00 a.m. and 1:00 p.m. with amount administered 1. Interview on 11/3/17 at 12:30 p.m. with the DON and the Consulting Pharmacist (CP) confirmed that the pharmacy label for [MEDICATION NAME] and the order for [MEDICATION NAME] on the facility's Physician order [REDACTED].	2020-09-01