cms_NE: 12656

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
12656 HIGHLAND PARK CARE CENTER 285063 P O BOX 950, 1633 SWEETWATER ALLIANCE NE 69301 2011-04-11 333 D     8W6H11 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** LICENSURE REFERENCE NUMBER: 175 NAC 12-006.10D Based on observations, record reviews, and interviews, the facility failed to administer medications before meals as specified by the manufacturer for 2 sampled residents (Residents 34 and 52). Sample size was 27. Facility census was 45. Findings are: A. Observation of Resident 34 receiving medications delivered by LPN (Licensed Practical Nurse)-B on 4/7/11 at 7:44 a.m. revealed Resident 34 receiving [MEDICATION NAME] 20 mg (milligrams) during the breakfast meal. Further observation of Resident 34 at the time of the medication being delivered, revealed Resident 34 had consumed over half of the breakfast meal before taking the [MEDICATION NAME]. Review of Resident 34's "MAR (Medication Administration Record)" for April of 2011 revealed Resident 34's order "[MEDICATION NAME] ([MEDICATION NAME]) 20mg" was ordered originally on 12/24/09 for "[MEDICAL CONDITION] Reflux". Scheduled time of administration on the MAR indicated [REDACTED] Review of Resident 34's "Physician Orders" form, signed on 3/21/11 by the medical practitioner, revealed the order for "[MEDICATION NAME] 20 mg" twice daily had been recertified with an original order date of 12/24/09. The order form revealed a [DIAGNOSES REDACTED]. B. Observation of medication administration to Resident 52 on 4/7/11 at at 7:38 a.m. revealed LPN-A was administering medications to Resident 52 during the breakfast meal. The label instructions on the medication container included instructions to administer "30 minutes" before meals. Observation of the task revealed Resident 52 received [MEDICATION NAME] 20 mg. Further observation of the resident revealed Resident 52 had consumed one half of the breakfast meal at the time the [MEDICATION NAME] was administered. Review of Resident 52's "MAR for April of 2011 revealed Resident 34's order "[MEDICATION NAME] 20mg" was ordered originally on 4/28/10. Scheduled time of administration on the MAR indicated [REDACTED] Review of Resident 52's "Physician Orders" form, signed on 1/25/11 by the medical practitioner, revealed the order for "[MEDICATION NAME] 20 mg" daily had been recertified with an original order date of 4/28/10. The order form revealed a [DIAGNOSES REDACTED]. Review of Resident 52's "Admission/Readmission" order form signed on 4/28/10 by the medical practitioner revealed the [MEDICATION NAME] had been ordered for a [DIAGNOSES REDACTED]. C. An interview was conducted with the DON (Director of Nursing) on 4/7/11 at 10:30 a.m. The DON agreed that manufacturer recommendations for administering [MEDICATION NAME] included instructions to give these medications 30 minutes before meals. The DON stated the consultant pharmacist had a meeting with nursing staff and stressed the need for [MEDICATION NAME] to be administered at least 30-60 minutes prior to meal consumption. Source: "Nursing 2011 Drug Handbook" by LIppencott, Williams & Wilkens 31st edition. Available forms (Of [MEDICATION NAME]) are "delayed release". Directions for "Administration" include to "Give drug 30 minutes before meals". Nursing considerations indicate the "Drug is unstable in gastric acid; less drug is lost to hydrolysis because drug increases gastric pH." 2014-04-01