cms_GA: 856
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.
This data as json, copyable
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rowid
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facility_name
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facility_id
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address
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city
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state
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zip
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inspection_date
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deficiency_tag
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scope_severity
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complaint
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standard
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eventid
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inspection_text
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filedate
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| 856 |
CALHOUN HEALTH CARE CENTER |
115340 |
1387 HIGHWAY 41 NORTH |
CALHOUN |
GA |
30701 |
2017-08-31 |
156 |
D |
0 |
1 |
KULD11 |
Based on observation, staff interview, clinical record review and review of the facility's policy titled, Advance Beneficiary Notices dated (MONTH) (YEAR) revealed two of three residents (R#12 and R#17) notices were incorrectly issued denying the resident the ability to request an appeal or expedited appeal review. The sample was 27. Findings include: 1. R#12 was on a Medicare Part A stay when the facility issued the form Centers for Medicare and Medicaid Services (CMS) R-131. The form CMS-R-131 was used to indicate Part B therapy services were ending. R#12 was issued the notice indicating her physical therapy (PT) and occupational therapy (OT) were ending on 8/16/17. R#12 had reached the max (maximum) rehab potential met for the time frame. The notice was issued on 8/16/17 and signed on 8/16/17 by the responsible party. The form CMS R-131 did not provide the information and number needed to appeal to the Quality Improvement Organization (QIO) or request an expedited appeal review of the facility's decision. 2. R#17 was issued a Notice of Medicare Non-Coverage (NOMNC) form CMS- on 4/21/17. The NOMNC indicated PT/OT would end on 4/21/17. The form was signed by the responsible party on 4/21/17. The NOMNC should have been issued and signed 4/19/17. A Skilled Nursing Facility Advanced Beneficiary Notice (SNFABN) was issued to R#17 as well and did not indicate when it was given, the estimated cost of continued therapy and the information and number of the QIO was not given to request a demand bill. The SNFABN form was signed on 4/21/17 by the responsible party. Interview with the social worker on 8/30/17 at 10:12 a.m., revealed she had only been in the position about two months. She had issued the notice to R#12 and was unaware there was a separate form to notify Medicare Part A recipients. R#17 was issued a notice by the former social worker. Review of the facility's policy titled, Advance Beneficiary Notice dated (MONTH) (YEAR), revealed .4. A Notice of Medicare Non-Coverage (NOMNC) shall be issued to the resident/representative when Medicare covered service(s) are ending. This informs the resident on how to request an appeal or expedited determination from their Quality Improvement Organization (QIO). It also specified in .5. To ensure that the resident, or representative, has enough time to make a decision whether or not to receive the services in question, the notice shall be provided within two days of the last anticipated covered day. |
2020-09-01 |