cms_NE: 15

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
15 ST JANE DE CHANTAL 285004 2200 SOUTH 52ND STREET LINCOLN NE 68506 2019-06-04 759 D 0 1 GLUX11 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** LICENSURE REFERENCE NUMBER 175 NAC 12-006.10D The facility failed to maintain a medication error rate of less than 5 %, which affected 3 residents (Resident 9, 51 100). The medication error rate was 24.14%. The facility census was 115. FINDINGS ARE: [NAME] An Observation on 6/3/19 at 12:05PM of medication administration by LPN (Licensed Practical Nurse) J for Resident 100. LPN J performed hand hygiene, donned gloves, and prepared Guar Gum (fiber supplement) by mixing it with 60 mL (milliliters-a unit of volume) of water. LPN J measured [MEDICATION NAME] (a medication used for [MEDICATION NAME]) 10mL and mixed it with the Guar Gum. LPN J doffed gloves and donned new gloves. LPN J checked the residual (stomach contents) of the PEG tube (Percutaneous Endoscopic Gastrostomy- a tube passed into a residents stomach through the abdominal wall to provide a means for feeding and medication administration when oral intake is inadequate) tube it was zero. LPN J pushed 60cc of water for the flush prior to the medication administration. LPN J administered the commingled medications. LPN J changed gloves. LPN J administered a 15 cc flush. Gloves changed and the tubes were exchanged for enteral feeding. LPN J primed the tubing and administered 237Ml of Pedisure Peptide (a feeding) that was hung for gravity flow. Gloves were changed and LPN J added 30 mL water flush. Gloves were changed and the tubing was removed. Hand Hygiene was performed. B. An observation on 6/3/19 at 12:55PM of medication administration by RN (Registered Nurse) K for Resident 51 revealed RN K measured the medications [MEDICATION NAME] 30m. RN K donned gloves. RN K measured tap water 100mL. RN K checked residual and equaled 60MmL and this was replaced. RN K mixed approximately 30mL of water with the measured medication and drew it into the syringe. No flush was performed by RN K. RN K administered the medication/water mixture by push and the remainder of the water was administered via gravity flow. C. An observation on 6/4/19 at 12:00PM of medication administration by LPN H for Resident 9 revealed RN K did not perform hand hygiene upon entry to the room. LPN H donned gloves and prepared medications Medication [NAME]nochol 25mg (milligrams-a unit of measurement) and [MEDICATION NAME] (a medication given for high blood pressure) 20 mg was crushed, [MEDICATION NAME] was measured 10 mL and [MEDICATION NAME] was measured 30mL. Gloves were changed. No flush was given prior to the medication administration. LPN H checked residual of PEG tube and was 210mL and that was discarded. LPN H mixed the [MEDICATION NAME] 10mL with 30cc water drew it up in the syringe and pushed the medication in the PEG tube. No flush was administered. LPN H drew up [MEDICATION NAME] 30 mL and it was given push through syringe in the PEG tube. No flush was administered. The combination of the crushed medications [NAME]nochol 25mg and [MEDICATION NAME] 20mg was mixed with 20mL of water and administered by LPN H per push via PEG tube. LPN H administered 30mL water flush per push via PEG tube. Gloves were changed and eye drops were administered. LPN H doffed gloves and hand sanitizer was used. Record review of the Feeding tube management Policy dated 4/1/16 revealed that Daily use for Feeding and Medication Administration Procedure 1. Any time the tube is utilized intermittently or disconnected from a feeding pump it is vital to flush the tube with a minimum of 30 mL warm tap water. An interview on 06/04/19 at 04:43 PM with the DON (Director of Nurses) confirmed that the facility did not have a physician order [REDACTED]. The DON confirmed that prior to the use of a feeding tube the tube should be flushed. Record review of Resident 9 and Resident 100 Active Orders document dated 6/4/19 revealed that the residents did not have an order for [REDACTED].> 2020-09-01