cms_NE: 2839

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
2839 BELLE TERRACE 285237 1133 NORTH THIRD ST TECUMSEH NE 68450 2017-06-08 353 H 1 0 LUKH11 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** > Licensure reference: 175 NAC 12-006.04C Based on observation, interview, and record revie;, the facility failed to ensure sufficient staff to meet resident needs as evidenced by not providing assistance to transfer in a safe manner for one sampled resident (Resident 3), failure to provide assistance with toileting for one sampled resident (Resident 9), failure to provide medications at scheduled times for two sampled residents (Resident 3 and 17), and failure to answer call lights within facility parameters for three sampled residents (Resident 3, 8, and 9). The sample size was 17 and facility census was 56. Findings are: [NAME] Resident 3 was admitted to the facility on [DATE] with [DIAGNOSES REDACTED]. A review of Resident 3's care plan revealed a problem dated 2/22/17 of alteration in mobility with approach of Hoyer lift with 2 assist for transfer. A review of a facility investigative report dated 5/18/17 revealed on 5/14/17 at 4:50 PM Resident 3 was transferred from the wheelchair to bed by two nurse aides without using a Hoyer lift. The report stated that a popping sound was heard when the nurse aides tried to reposition the resident in to the center of the bed. Resident 3 had very limited range of motion in all joints due to severe contractures and arthritic changes according to the report. Resident 3 was diagnosed with [REDACTED]. Preventative measures put in place by the facility included staff education on safe transfers for all residents and resident education on importance of Hoyer lift due to resident condition. In an interview on 5/31/17 at 11:05 AM, Nurse Aide A reported Nurse Aide A had assisted Nurse Aide B in transferring Resident 3 without use of the Hoyer lift. When trying to reposition Resident 3 in bed a popping sound had been heard. Nurse Aide A reported that Nurse Aide A had not been trained on transferring Resident 3. Nurse Aide A confirmed Nurse Aide A was not 18 and could not operate the lift. In an interview on 5/31/17 at 1:38 PM, Nurse Aide B reported Nurse Aide B had been trained by a previous nurse aide to transfer Resident 3 utilizing a two person lift. Nurse Aide B reported hearing a pop after transferring Resident 3. Nurse Aide B confirmed Nurse Aide B was not 18 and could not operate the lift. A review of the staffing schedule as worked for 5/14/17 revealed Nurse Aide A and B were the only nurse aides working the floor between 2 PM and 6 PM along with a charge nurse and a medication aide. In an interview on 5/31/17 at 12:57 PM, the Assistant Director of Nursing confirmed Nurse Aide A and Nurse Aide B were the only aides in the building at the time of the incident and neither one of the aides were old enough to operate the Hoyer lift. The Assistant Director of Nursing reported education had been provided the nurse aides to get the charge nurse or medication aide to assist with using the lift. Census List dated 5/30/17 identified 12 residents utilizing a Hoyer lift. B. Observations on 5/30/17 at 9:31 PM revealed Resident 17 was administered [MEDICATION NAME] HCL (a medication for pain) 50 mg (milligrams) and [MEDICATION NAME]-HCTZ 10-12.5 1 tablet by Medication Aide F. A review of Resident 17's (MONTH) (YEAR) Medication Administration Record [REDACTED]. In an interview on 6/8/17 at 2:32 PM, the Assistant Director of Nursing reported the facility had a one hour window of time on either side of the scheduled time for medication administration. C. Observations on 5/30/17 at 9:36 PM revealed Resident 3 was administered [MEDICATION NAME] sodium 1 cap (a laxative), [MEDICATION NAME] 75 mg (a medication for nerve pain), Celecoxib 200 mg (a nonsteroidal anti-[MEDICAL CONDITION] medication), and [MEDICATION NAME] 150 mg (an antacid) by Medication Aide F. A review of Resident 3's (MONTH) (YEAR) Medication Administration Record [REDACTED]. In an interview on 6/8/17 at 2:32 PM, the Assistant Director of Nursing reported the facility had a one hour window of time on either side of the scheduled time for medication administration. D. In an interview on 5/30/17 at 7:38 PM, Medication Aide F reported that Medication Aide F had to pass medications to all residents of the facility. A review of the facility roster received on 5/30/17 revealed the facility had a census of 56 residents. E. In an interview on 5/30/17 at 9 PM, Medication Aide G reported having to pass medications to all residents of the facility when Medication Aide G first started but it was better now. A review of an employee list with start dates revealed Medication Aide G had started working at the facility on 5/1/17. F. Resident 9 was admitted to the facility on [DATE] with a [DIAGNOSES REDACTED]. A review of Resident 9's Resident Status Sheet revealed the resident was to be checked and changed every 2-4 hours. If Resident 9 refused to be changed notify charge nurse and reoffer regularly. Observations on 5/30/17 at 10:11 PM revealed Resident 9 transferred to bed with a Hoyer lift. Resident 9's pants were observed to be wet and a urine odor was noted. In an interview on 5/30/17 at 10:11 PM, Nurse Aide C confirmed this was the first time Resident 9 had been changed since shift started at 6 PM. In an interview on 6/8/17 at 10:25 PM, the Assistant Director of Nursing reported Resident 9 should be offered toileting every 2 hours. Interviews conducted with nurse aides on 5/30/17 between 7:44 PM and 8:26 PM revealed 4 nurse aides were working on the floor. In an interview on 6/13/17 at 11:05 AM, the Director of Nursing confirmed 4 aides were working on the floor after 7 PM. [NAME] In an interview on 5/3/17 at 10:05 AM, Resident 3 reported call lights were not always answered in a timely manner and it may to take up to an hour to get a call light answered at night. A review of the call light log for Resident 3 from 5/20/17 to 5/27/17 revealed 18 times in which call light response time was greater than 15 minutes and 8 times in which call light response time was greater than 30 minutes two of which were greater than one hour. H. In an interview on 6/7/17 at 9:58 AM, Resident 8 reported that at times Resident 8 had to wait to get the call light answered. A review of the call light log for Resident 8 from 5/20/17 to 5/27/17 revealed one time that a call light response time was greater than 30 minutes. I. A review of the call light log for Resident 9 from 5/20/17 to 5/27/17 revealed 18 times the call light response time was greater than 15 minutes and 10 times greater than 30 minutes with two response times greater than one hour. [NAME] In an interview on 6/13/17 at 8:55 AM, the Assistant Director of Nursing reported it was the facility goal to have call lights answered within 10 to 15 minutes. K. In an interview on 6/13/17 at 9:52 AM, Staff Coordinator H reported Staff Coordinator H tried to staff 6 AM to 6 PM shift with 5 to 6 aides, between 6 PM-10 PM staffed with 4-5 aides with 2-3 aides being over 18, and between 10 PM-6 AM staff with 3 aides with 2 aides being over 18. 2020-09-01