cms_NE: 1500

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
1500 AZRIA HEALTH ASHLAND 285140 1700 FURNAS STREET ASHLAND NE 68003 2019-03-19 880 D 1 0 YCLW11 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** > LICENSURE REFERENCE NUMBER175 NAC 12-006.17B. Based on observation, interview and record review; the facility failed to implement isolation precautions/procedures to prevent the spread of infection for one Resident 1, who was diagnosed with [REDACTED]. [MEDICAL CONDITION] is a contagious microorganism (spore) that has the potential to survive for 5 months on inanimate (not alive) surfaces and can be spread by person to person contact or by direct contact with contaminated objects and surfaces for example clothing, door handles, equipment, privacy curtains and faucets). This had the potential to effect 3 out of 5 residents sampled (Residents 2, 3, and 4). The facility also failed follow its Transmission Precaution: Contact Policy related to Cohorting residents with the same infectious microorganisms this had the potential to effect 2 residents (Resident 1 and 2). The facility census was 73. Findings are: [NAME] Observation with the DON (Director of Nursing) on 03/19/19 at 10:09 AM revealed; Resident 1 was lying in bed with red bag/boxes located at the foot of the bed with the privacy curtain rested against the red bag. Record review of Resident 1's Admission Record revealed; admitted d of 11/25/15 and [DIAGNOSES REDACTED]. introduction of food). Record review of Initiating Isolation Procedures Policy dated 10/01/09 revealed; the Purpose was to provide a safe environment, isolation precautions will be initiated when there is reason to believe that a resident has an infectious or communicable disease. To provide a physical, mechanical, or chemical barrier between resident and staff, other residents has an infectious or communicable disease. Record review of Transmission Precautions: Contact Policy dated 10/01/09 revealed; In addition to standard precautions, contact precautions are used for resident known or suspected to be infected or colonized with epidemiological important microorganisms that can be transmitted by direct contact with resident or indirect contact (touching) with environmental surfaces or resident care items. Procedure was to review the need for a private room. When a private room is not available cohort the resident in a room with a resident who has infection or is colonized with the same microorganism but not a different organism. Record review of [MEDICAL CONDITION] Policy dated 10/01/09 revealed; isolate if colonized. Place in private room when possible. Cohorting is allowed. Record review of MAR (Medication Administration Record) dated (MONTH) 2019 revealed; Resident 1 had an order for [REDACTED]. Record review of Care Plan with target date of 04/04/19 revealed; 1) Resident 1 had Impairment of the immunity system related to infection with an intervention of contact isolation. There was no other interventions related to specific infection. 2) Resident 1 had an alteration in bowel/bladder elimination and required 1-2 person assistance to meet needs related to disease process and immobility with interventions to provide care after each incontinent episode, and with morning and evening cares. 3) Resident 1 had an alteration in ADL (Activities of Daily Living included bed mobility, transfers, toileting and personal hygiene) the interventions were: Resident 1 was dependent and needed 2 person assist with toileting, and transferred with a Hoyer lift. Interview on 03/19/19 at 09: 30AM with Housekeeping staff member A revealed; the housekeeping staff had cleaned room [ROOM NUMBER] with verex. Housekeeper A reported that the bathroom between Resident 1 and 2's room was shared with Resident's 3 and 4. Interview on 03/19/19 at 10:09 AM with the DON confirmed; Resident 1 did have [MEDICAL CONDITION] and the direct care staff used the bathroom for hand washing after placing soiled PPE (Personal Protective Equipment- gown, gloves and masks to prevent the spread of infection) the red bag. The DON confirmed it could have been a potential for cross contamination for Resident 3 and 4 who had also used the bathroom for toileting/hygiene purposes. The DON confirmed; that the privacy curtain had touched the red bag and that was a potential for cross contamination for all who had come into contact with the privacy curtain. The DON confirmed that Resident 2 did not have [MEDICAL CONDITION]. Interview on 03/19/19 at 11:00 AM with the DON revealed; the facility would be attempting to call family for permission to move Resident 1 to a private room. B. Observation on 03/19/19 at 10:09 AM revealed; resident 2 was lying in bed in the same room as Resident 1, watching television privacy curtain partially pulled between resident areas. Record review of Resident 2's Admission Record with an admission date of [DATE] revealed; [DIAGNOSES REDACTED]. Record review of Resident 2's Care Plan with a target date of 3/7/19 revealed; 1) Resident 2 has a history [MEDICAL CONDITION] ([MEDICAL CONDITION] (a bacterium that causes infection in different parts of the body that is resistant to some commonly used antibiotics) with ulcerative [MEDICAL CONDITION] in 4/2013. The interventions were Cohort [MEDICAL CONDITION]. 2) Resident 2 had an alteration in ADL's (Activities of Daily Living- daily tasks as personal hygiene, toileting, bed mobility and transfers) with interventions of dependence with bed mobility, toilet use and transfers. 3) Resident 2 had an alteration in urinary output related to disease process with interventions of check for incontinence every morning, evening, before and after meals and as needed and incontinence care as needed. 4) Alteration in bowel elimination related to disease process with interventions of incontinence care as needed, extensive assistance to toilet before and after meals in the morning and evening and as needed. Interview on 03/19/19 at 10:09 AM with the DON confirmed that Resident 2 did not have [MEDICAL CONDITION] and that Resident 2 had not used the bathroom and was incontinent. C. Observation on 03/19/19 at 09:30 AM of Resident 3 resting on bed, had come to a sitting position on their own, when staff entered the room. Record review of Resident 3's Admission Record revealed; a [DIAGNOSES REDACTED]. Record review of Care Plan with target date of 05/09/19 revealed; 1) Resident 2 had an alteration in ADL's related to disease process and had an intervention of Independent for toileting and personal hygiene. Interview on 3/19/19 at 11: 40 AM with Housekeeping Manager revealed; Housekeeper A was confused and had come from Resident 3 and 4's room. Housekeeping Manager confirmed that Clorox disinfecting wipes and Clorox Bleach dilution for cleaning in isolation rooms. Interview on 03/19/19 at 10:09 AM with the DON confirmed; that Resident 3 had used the an adjoining bathroom that was used for hand washing post care for a resident with infectious microorganisms for toileting and hygiene and this could have been a potential for cross contamination. Resident 4 Record review of Admission Record for Resident 4 revealed; a [DIAGNOSES REDACTED]. Record review of Resident 4 Care Plan revealed that Resident 4 had been independent with transfers, toileting, ambulation, and personal hygiene. Interview on 03/19/19 at 10:09 AM with the DON confirmed; Resident 4 had used the an adjoining bathroom that was used for hand washing post care for a resident with infectious microorganisms for toileting and hygiene and this could have been a potential for cross contamination. 2020-09-01