cms_HI: 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.

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 HALE MAKUA - KAHULUI 125007 472 KAULANA STREET KAHULUI HI 96732 2019-11-26 690 D 0 1 6SOG11 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interviews with facility staff, and record review, the facility failed to provide appropriate catheter care and monitoring of the catheter tubing for sediment build up/clotting for Resident (R)159. As a result of this deficiency, R159 is placed at an increased risk for further complications and infection related to the use of a foley catheter. Findings include: R159 was admitted on [DATE] with the [DIAGNOSES REDACTED]. On 11/19/19 at 11:20 AM, initially observed small clots and sediment in the resident's catheter tubing. Observed the catheter tubing on six (6) subsequent days (11/19/19 at 01:03 PM; 11/20/19 at 10:10 AM; 11/20/19 at 12:51 PM; 11/21/19 at 09:28 AM; 11/21/19 at 12:45 PM; and 11/22/19 at 09:45 AM). Each day there was an increase in number of visible small clots and in the size of the build-up of sediment in the tubing. On 11/22/19 at 10:10 AM, observed the catheter tubing with registered nurse (RN)17. RN17 confirmed the catheter tubing and bag should be changed due to the number of small clots, sediment visible in the catheter tubing, and the possible obstruction of urine flow. On 10/23/19, R159 was diagnosed with [REDACTED]. Subsequently, on 10/24/19 R159 was diagnosed with [REDACTED]. R159 returned to the facility on [DATE] with a [DIAGNOSES REDACTED]. A review of R159's Minimum Data Set (MDS), Assessment Reference Date (ARD) of 10/27/19, documents R159 is totally dependent on staff for all care including bed mobility, transferring (bed/wheelchair), personal hygiene, dressing, eating, and toilet use. On 11/22/19 at 09:11 AM, observed certified nurse aides (CNA)21 and CNA3 provide catheter care to R159 due to fecal incontinence. CNA21 wiped R159's perineal area (soiled with feces) with a disposable wipe then used the same disposable wipe to clean the right labia majoria. The disposable wipe was visibly soiled with feces. The facility's policy and procedure, Catheter Care, instructs staff to not contaminate area with feces and to clean the area from front to back. CNA21 used another single disposable wipe and cleaned the catheter tubing, starting approximately 3 inches away from the meatus (insertion site), with a back and forth motion which would reintroduce contaminants. R159's care plan documents to clean around the catheter with soap and water, not a disposable wipe. The facility's policy and procedure for catheter care, documents staff is to cleanse the area at the catheter insertion site, starting at the meatus and working away from the body. 2020-09-01