cms_NE: 12427

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
12427 GOOD SHEPHERD LUTHERAN HOME 285148 2242 WRIGHT STREET BLAIR NE 68008 2010-06-10 319 G 0 1 P9FH11 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Licensure Reference: 175 NAC 12-006.09D5 Based on interviews, observations, and record review, the facility failed to evaluate psychosocial needs and implement interventions to promote social interaction for 1 (Resident 6) of 16 sampled and 10 non-sampled residents. The facility had a total census of 80 residents. Findings are: A. Resident 6 was admitted to the facility on [DATE] according to admission and discharge summary. The admission and discharge summary listed the following [DIAGNOSES REDACTED]. A review of Resident 6's quarterly MDS (Minimum Data Set; a comprehensive assessment used for care planning) dated 6/7/10 revealed Resident 6 exhibited an OK short and long term memory and was independent with cognitive skills for daily decision making. A review of Resident 6's Care Plan revealed a problem dated 5/12/10 of "resident displays a sad/anxious mood that is easily altered" and "resident exhibits persistent anger with self or others." Resident 6's Care Plan listed the following interventions: - " Provide 1:1 visits prn (as needed) " - " Attempt to identify and situational cause for sadness/anxiety; help to correct if possible " - " Encourage resident to ventilate feelings. Give realistic, positive feedback " - " Medicate as ordered with [MEDICATION NAME] " - " Discuss possible need for psychological consult with health care team prn " - " Encourage participation in activities of facility " - " Attempt to identify and resolve basis for voiced/demonstrated anger " - " Encourage family/friends to communicate frequently with resident via visits/phone calls " Observations on 6/8/10 at 7:45 AM, 8:30 AM, 10:05 AM, 11:30 AM and 5:16 PM and on 6/9/10 at 8:30 AM, 9:46 AM, and 11:55 AM, revealed Resident 6 resting in bed on back with head of bed elevated. Resident 6 was not observed to change out of Resident 6 ' s pajamas. Observations on 6/8/09 and 6/9/09 revealed Resident 6 did not attend any facility activities and ate breakfast and lunch in room. Nurse's Notes dated 6/9/10 at 10:30 AM stated " .5 cm (centimeter) round superficial open area noted while bath was being given " . Wound assessment and Care Tool with Braden Scale for Resident 6 dated 6/9/10 stated Resident 6 had a .5 cm x .5 cm x .2 cm, stage II pressure sore on left buttock. A review of Vital Sign and Weight Flow sheet revealed Resident 6 experienced an 11 lb (7.7%) weight loss between admission on 11/24/09 and 5/1/10. Geriatric Depression Scale for Resident 6 revealed a score of 7 on 12/8/09 and a score of 6 on 4/20/10. According to Geriatric Depression Scale, a score greater than 5 indicated probable depression. Activities Progress Note dated 3/17/10 stated "Spends time in bed little act (activities)." Dietary Progress note dated 3/17/10 stated resident refused to come out to dining room for meals. Fax Communication to the physician regarding Resident 6 dated 2/2/10 stated " Res (Resident) currently on [MEDICATION NAME] 60 mg (milligram) q d (every day) with occ (occasional) episodes of tearfulness. Can we increase or give additional antidepressant. " Physician orders [REDACTED]. Resident 6 was seen by the Nurse Practitioner for mental health on 2/25/10 with orders to continue current medications and a follow up appointment scheduled in 4 weeks. In an interview on 6/9/10 at 2:35 PM, the DON (Director of Nursing) reported Resident 6 refused to go to the follow up appointment with the mental health Nurse Practitioner. The DON reported the primary care physician was not notified of Resident 6's refusal. Social Services Progress Note for Resident 6 dated 2/11/10 reported Resident 6's POA (Power of Attorney) stated the following: " (POA) stated that (Resident 6) has been in 7 indep. (independent) living/AL (assisted living) in the last 7 yrs. (years). This is (Resident 6) first NH (Nursing Home) placement (with) hx (history) of depression. (Resident 6) really shuts (Resident 6) self in. (Resident 6) does not read or watch tv. SSD (Social Service Director) stated that (gender) would notify activities so they do more 1-on-1 (with) Res. Also, Res would enjoy more visits from facility pastor. . . " In an interview on 6/9/10 at 2:45 PM, the Activity Director reported 1-1 visits were made to Resident 6 to ask Resident 6 to go to activities. The Activity Director reported the staff member who did 1-1 visits was currently on leave. In an interview on 6/9/10 between 2:50-3 PM, the Social Service Director reported there was no formalized plan for Resident 6 to receive 1-1 visits. The Social Service Director reported the volunteer Ombudsman did a weekly visit to Resident 6 but there were no other interventions planned. 2014-07-01