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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
75 VALLE VISTA MANOR 275021 402 SUMMIT AVE LEWISTOWN MT 59457 2018-11-15 658 D 0 1 MIUW11 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the faciltiy staff failed to meet professional standards of quality by not wearing gloves when removing and replacing a narcotic patch, [MEDICATION NAME], for 1(# 31) of 14 sampled and supplemental residents; and staff failed to dispose of a [MEDICATION NAME] appropriately. Findings include: 1. No Glove Use During an observation and interview on [DATE] at 4:25 p.m., staff member A removed a narcotic patch from resident #31. Staff member A did not wear gloves to remove the existing patch and to apply a new patch. Staff member A stated she was not sure if, and why, she should be wearing gloves to remove and replace a [MEDICATION NAME]. During an interview on [DATE] at 8:45 a.m., staff member A stated she should have worn gloves during the patch change for resident #31 to prevent self-contamination from direct skin contact with the narcotic patch. Review of the facility's policy, Medication Administration and Ordering, read, .7. Never handle medications with bare hands. 2. [MEDICATION NAME] disposal During an observation and interview on [DATE] at 4:27 p.m., staff member A disposed a [MEDICATION NAME] removed from resident #31. Staff members A and B co-signed in the Controlled Substance Record Book indicating the used patch was disposed of. Staff member A stated the co-signature was not always obtained when disposing of the [MEDICATION NAME]es. During an interview on [DATE] at 4:31 p.m., staff member F stated two nurses should have witnessed the disposal of a [MEDICATION NAME], and co-signed the destruction of the patch. Staff member F stated the destruction of [MEDICATION NAME]es were not always witnessed and co-signed by a second staff member because, We sometimes get too busy. A review of the Controlled Substance Record Books #25 and #26, for the North corridor, showed the following for resident #31: - [DATE]; only one staff member signed on page 82 when then [MEDICATION NAME] was disposed of. - [DATE]; one staff member signed on page 11 when the [MEDICATION NAME] was disposed of. - [DATE]; one staff member signed on page 11 when the [MEDICATION NAME] was disposed of. During an interview on [DATE] at 12:54 p.m., staff member M stated two licensed staff members should always witness the destruction of a [MEDICATION NAME]. Staff member M stated two signatures were required to prevent medication diversion. During an interview on [DATE] at 1:22 p.m., staff member B stated she should have had a licensed staff member witness the disposal and destruction of a replaced [MEDICATION NAME] for resident #31. Staff member B could not recall why two signatures had not been obtained. During an interview on [DATE] at 1:56 p.m., staff member [NAME] stated staff did not always follow the policies and procedures with co-signing the destruction of [MEDICATION NAME]es, but staff should have. Review of the facility's policy, Disposal/Destruction of Expired or Discontinued Medications, read, .10. Facility should record destruction of controlled substances on: 10.1 Medication Disposition/Destruction Form; 10.2 Controlled Substance Count Form; or, 10.3 Medication Destruction Log Book .12.1 Facility should destroy (Scheduled II-IV) controlled substances in the presence of a registered nurse and a licensed professional in accordance with Facility policy or Applicable Law. 12.2 Destruction of controlled medications should be documented on the controlled medication count sheet and signed by the registered nurse and witnessing licensed professional who should record: 12.2.1- Quantity destroyed; 12.2.2- Date of destruction; and, 12.2.3- Signature of registered nurse and pharmacist. References: http://www.sahealth.sa.gov.au/wps/wcm/connect/eefc0c804dec81cab734ff6d722e1562/Circ+[MEDICATION NAME].pdf?MOD=AJPERES 4. Disposal process is recorded in the drug of dependence register, and countersigned by the witness. 2020-09-01