cms_GU: 3

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
3 GUAM MEMORIAL HOSPITAL AUTHORITY 655000 499 NORTH SABANA DRIVE BARRIGADA GU 96913 2019-01-30 585 D 0 1 IS8311 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview the facility failed to implement grievances as per policy and regulation for 1 out of 8 sampled residents (R # 301). Resident's grievances are not being investigated, tracked, no corrective action plans are implemented, no documentation of resolutions and no evidence of the grievance log available for review. This failure prevents proper resolutions to resident and family concerns. Findings include: During a record review on 1/29/2019 reveals that resident #301 was admitted to facility on 3/24/18 with the [DIAGNOSES REDACTED]. Minimum Data Set (MDS) 14 day assessment completed on 4/7/18 disclosed a Brief Interview for Mental Status (BIMS) score of 14. Resident #301 was also admitted to facility for intravenous (IV) antibiotic treatment for [REDACTED]. Additional record review revealed that resident #301 had several nursing notes with documentations of the IV infiltration occurrence during the [MEDICATION NAME] administration and resident IV site was red, swollen, warm to touch and tender. During an interview on 1/29/2019 at 10:00 a.m., with Administrative Staff #9 she indicated that resident #301 spouse was very out spoken with all her concerns and she frequently voiced her concerns. She further explained that the residents and spouse concerns were addressed to their satisfaction but was never documented. When asked if she was aware of the police coming into the facility to question Staff #12 she indicated No during that time she was out on leave and that the person that was providing coverage at the facility did not forward the information to the administration staff. She further explained that her expectation from all staff is to report all concerns to administration. Administrative Staff #9 was not able to provide any evidence that the patient and spouse concerns were ever investigated or resolved. During an interview on 1/29/2019 at 12:00 p.m., with the Staff #12 she indicated that the residents spouse complained that she was not changing her gloves and washing her hands when caring for resident # 301. She also indicated that she apologized to the resident and the spouse after they complained to management. In addition she confirmed that the police came into the facility to question her because the resident spouse also reported that she was trying to run her off the road in retaliation. During an interview on 1/29/2019 at 12:10 p.m., with Administrative Staff #2 she indicated that the residents spouse had multiple complaints and they were resolved immediately. Staff #2 further explained that the complaints had to do with dissatisfaction with care, staff and personal issues. When asked to provide evidence of the grievance/complaint process and log she verbalized that she does not maintain a grievance/complaint log on reported complaints and concerns'. When asked about the IV infiltration that was documented in the resident clinical record she indicated that no incident reports were filed. Administrative Staff #2 was not able to provide any evidence that the patient and spouse concerns were ever investigated or resolved. During an interview on 1/30/2019 at 2:00 p.m., with Administrative Staff #13, the patient safety person/guest relation coordinator she indicated that she visits residents quarterly and pass out patient satisfaction surveys. In addition she started the grievances/complaint process since (MONTH) (YEAR) and have not had any reported concerns about resident #301. The complaint for resident #301 was never reported to her staff 13 indicated, as a result she had no evidence of the reported concerns. Reviewed the facility policy on 1/30/2019 titled Patient Grievances /Complaints disclosed: 1). The purpose of this policy is to assure that all patient complaints and grievances are addressed and resolved in a timely manner, as well as improve the service provided to patients. 2). A patient has the right to submit a grievance and complaint either written or oral and may be brought to the attention of the staff present. 3). A patient may file or report a grievance, once received it will be investigated and a written response will be provided to the grievant within 7 days from the filling date. If resolution of the complaint will take longer than 7 days a letter must be sent informing the grievant that additional time is needed and the letter must give an estimated time frame for completion. 2020-09-01