cms_GU: 6

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

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rowid facility_name facility_id address city state zip inspection_date deficiency_tag scope_severity complaint standard eventid inspection_text filedate
6 GUAM MEMORIAL HOSPITAL AUTHORITY 655000 499 NORTH SABANA DRIVE BARRIGADA GU 96913 2019-01-30 690 D 0 1 IS8311 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, record review, and interview, the facility did not ensure that a resident who had an indwelling catheter was assessed for removal of the catheter as soon as possible and received treatment and services to prevent urinary tract infections. Findings include: 1. Resident 9 was admitted to the facility on [DATE] with several [DIAGNOSES REDACTED]. Review of the quarterly minimum data set ((MDS) dated [DATE] revealed that the resident had a BIMS (brief interview of mental status) score of 15 indicating that she had no cognitive impairments and that she was dependent on staff for most activities of daily living. The medical record also noted that the resident also had a [MEDICAL CONDITION] as well as an indwelling catheter. During the survey on 1/28/19, Resident 9 was observed with a urinary drainage bag at the bedside draining yellow urine. Review of the care area assessment dated [DATE] revealed that urinary incontinence was triggered because of the resident's use of an indwelling catheter due to restricted mobility and presence of healing stage 4 sacral pressure sore. The assessment noted that a care plan will be developed to ensure that the resident will maintain continuous drainage of her bladder while minimizing the risk of negative outcomes. Review of the medical record revealed that Resident 9 has had several urinary tract infections which were treated with antibiotics: On 6/27/18, a urine culture and sensitivity (C&S) test result revealed infection with Citrobacter koseri (100,000 org/ml). On 7/13/18, another urine C&S test result revealed the presence of Eschirichia coli (100,000 org/ml). On 7/27/18, a urine C&S result indicated continuing infection with Eschirichia coli (100,000 org/ml) and yeast (100,000 org/ml). On 10/04/18, a C&S obtained revealed the presence of infection with Eschirichia coli (100,000 org/ml) and proteus mirabilis (100,000) org/ml). On 11/19/18, another urine C&S revealed infection with [DIAGNOSES REDACTED] pneumoniae (100,000 org/ml). In spite of this, there was no indication that an assessment of the resident's continuing use of the indwelling catheter was conducted. While a physician's note dated 11/14/18 revealed that the resident had recurrent [MEDICAL CONDITION] and required an indwelling catheter, there was no documentation that the retention was evaluated or that a urology consult requested was conducted. The same note described that the sacral pressure sore was healing. In addition, there was no indication that the catheter care procedure in the care plan was reviewed for effectiveness in light of the resident's [MEDICAL CONDITION] and frequent infection with Eschirichia coli, a bacteria that normally lives in the intestines. During an interview on 1/29/19, a licensed staff (LS9) stated that Resident 9 did not always have an indwelling catheter, and that the catheter was inserted to help heal the stage 4 pressure sore she was admitted with. During wound care observation on 1/29/19, the resident's sacral pressure injury was noted to be about 2.5 cms long, intact, without drainage, and was granulating well. The wound was cleaned with saline solution and covered with a small piece of Duoderm, a moisture barrier dressing. The licensed nurse (LS8) nurse stated that the wound had significantly improved from when the resident was first admitted . 2. Resident 17 was initially admitted to the facility on [DATE] with several [DIAGNOSES REDACTED]. Review of the medical record indicated that the resident was transferred to an acute care hospital for pneumonia and readmitted back on 11/19/18. Review of the MDS 60-day assessment dated [DATE] revealed that the Resident 17 had moderately impaired cognitive skills and required extensive assistance with most activities of daily living. During the survey, Resident 17 was observed with a urinary drainage bag at the bedside. Review of the medical record revealed that the resident had an indwelling catheter related to: Stage 4 pressure ulcer on (there resident's) sacrum. Further record review revealed the lack of indication that an evaluation of the continuing use of the catheter was conducted. During wound care observation on 1/30/19, the resident's sacral pressure sore was noted to be about 3.5 cms long, was pinkish in color, with minimal drainage and without any redness or swelling. A licensed staff (LS7) stated that the pressure sore was much improved from when the resident was initially admitted on [DATE]. LS7 added that the resident had recently completed a course of antibiotics because of a urinary tract infection with multi-drug resistant organisms including Acinotobacter baumanni. Further review of the medical record revealed that a urine C&S test result dated 12/19/18 also revealed the presence of Acinobacter baumanni and Pseudomonas aeruginosa bacteria. 2020-09-01