cms_HI: 84

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.

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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
84 MALUHIA 125009 1027 HALA DRIVE HONOLULU HI 96817 2017-06-02 280 D 0 1 HXLB11 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations and medical record review (MRR) the facility failed to utilize interdisciplinary expertise to improve range of motion (ROM) for 1 of 24 residents (R#129) on the Stage 2 survey sample resident list. Findings include: On 06/01/2017 at 12:13 PM observed R#129 with splint on the right (R) hand. On 06/01/2017 at 12:37 PM, the MRR on R#129 found that a ROM assessment was last done on 4/28/17. The interdisciplinary conference notes included the rehab report for U/E Range of Motion: No changes noted with _R#129's U/E ROM this screen .Resident received U/E ROM 2 x/week on unit since her return from acute hospital. Use of R handroll for contracture management and utensil with build-up handle for facilitating in feeding. The care plan (CP)#2, I am at risk for further decline in ROM d/t impaired mobility secondary to medical problems; with Goals: I will have no further decline in ROM; and interventions included: 6. encourage me to use utensil with build-up handle for feeding; 7. Use right handroll 2-3 hrs every am and pm shift for contracture management. Check for redness or skin breakdown. Discontinued use of handroll immediately if redness or skin breakdown, & notify CN or OT department; 8. maintenance OT/PT programs 2 x/week UE/LE exercises. Behind the CP#2 were instruction sheets for R handroll use with instructions to place handroll on right hand for 2-3 hours every a.m. and p.m. shift. On 06/01/2017 at 2:32 PM observed R#129 sleeping in bed and the handroll was not placed in R#129's hand, but around the wrist. The resident's family member was at the bedside visiting and stated that R#129 cannot stretch fingers & whenever they try to stretch the fingers R#129 complains, sore. The family member also tried to use a pressure ball in the hand but R#129 refused. Queried Staff#59 if the resident's handroll was properly placed and Staff#59 stated that R#129 moved the handroll and sometimes will throw it. On 06/02/2017 at 11:42 AM observed R#129's food tray with Staff#24 and Staff#88 in the dining/activity rm. There was a regular spoon on the resident's tray and not a built-up spoon as was ordered by the rehab therapist. According to Staff#24, the resident used the built-up spoon only when dining in-room because they didn't want to misplace the built-up spoon. Staff#88 further stated that R#129 didn't like to use the built-up spoon and would sometimes throw it. Staff#88 went to get the built-up spoon from R#129's rm and stated that she would try to make the resident use it. Discussed with Staff#24 that the use of the built-up spoon should be re-evaluated as resident observed to be using small disposable plastic cups to drink pureed food. The facility did not explore care alternatives through a thorough care planning process in which the resident was able to select from alternative treatments after staff observed that R#129 would throw the built-up spoon and the handroll. 2) On 06/01/2017 at 1:59 PM reviewed Resident (Res) #50 medical record. Care plan was reviewed and noted that there is a plan in place for risk for Diabetes Mellitus and [MEDICAL TREATMENT] (HD)-related complications. It was noted that the last review date was 04/17/2017 and next review to be done in July. The care plan stated that the resident will continue to maintain post HD weights within target weight goal of 105.6 lbs +/- 5 lbs. Reviewed note from the [MEDICAL TREATMENT] facility from 05/15/2017 which had the new DW (Dry Weight) 47 kg (103.4 lbs) per staff from Liberty [MEDICAL TREATMENT] Hawaii, LLC and this information was not on Res #50 care plan. On 06/01/2017 at 2:46 PM interviewed staff #24 and staff #124 to find out why the new dry weight 47 kg was not placed on Res #50 care plan and staff #24 stated that it would be updated in (MONTH) at the next care plan revision. It was explained to staff #24 and #124 the importance of this information that needs to be shared with all the staff who are taking care of this resident to avoid any injury that could result in harm to the resident. The facility failed to update 2 of 27 residents Care Plans from the Stage Two survey sample which may result in injury to the resident. 2020-09-01