cms_NE: 364

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
364 PARK VIEW HAVEN NURSING HOME 285073 309 NORTH MADISON STREET COLERIDGE NE 68727 2017-09-28 325 G 1 1 XTJ511 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** > LICENSURE REFERENCE NUMBER 175 NAC 12-006.09D8b Based on record review and interview; the facility failed to revise current interventions or to develop new nutritional interventions to address ongoing significant weight loss for Resident 13. The facility census was 25 and the sample size was 27. Findings are: [NAME] Review of the facility policy Significant Weight Loss (undated) revealed a goal of identifying causes or factors contributing to significant unplanned weight loss and implementation of interventions as appropriate to stabilize weight. Review of the identified procedure revealed the following: -Review food intake records. -Interview the resident to identify possible causes and appropriate interventions. -Implement individualized nutritional interventions based on resident preferences. This may include but is not limited to; foods enhanced with extra calories or proteins. -High calorie or high protein supplements. -Possible use of an appetite stimulant if appropriate. B. Review of Resident 13's Minimum Data Set (MDS-a federally mandated comprehensive assessment tool used for care planning) dated 7/24/17 revealed [DIAGNOSES REDACTED]. The resident's weight was 143 lbs. (pounds) and the resident was not on a prescribed weight loss regime. Review of Resident 13's Weights and Vitals Summary Sheet (form used to document a resident's weight, blood pressure, respiration, temperature and pulse) revealed on 5/28/17 the resident's weight was 142 lbs. Review of Resident 13's current Care Plan revised on 5/30/17 revealed the resident had the potential for nutritional problems related to pain and loss of appetite. The following interventions were identified: -Offer snacks as requested by the resident. -Provide and serve diet as ordered. -Registered Dietician (RD) to evaluate and make recommendations as needed. Review of Resident 13's Weights and Vitals Summary sheet revealed the following record of weights: 6/26/17- 138 lbs. 7/24/17- 143 lbs. 8/21/17- 134 lbs. (down 9 lbs. or a 6.3 % (percent) loss in 1 month) Review of a Nutrition Progress Note by the RD dated 8/22/17 at 1:06 PM, revealed the resident's current body weight was 133.5 lbs. with a significant weight loss of 6.8 % in 30 days. The resident was on a regular diet and had poor intakes averaging 25 to 100% at meals. The RD made a recommendation for the resident to receive Ensure (drink with added calories) 240 cubic centimeters (cc) twice a day to deter further weight loss. Review of Resident 13's Medication Administration Record [REDACTED]. Review of Resident 13's MAR indicated [REDACTED] -8:00 AM from 9/1/17 through 9/25/17 the resident consumed less than 50% of the supplement on 9/1/17 through 9/7/17, 9/9/17, 9/11/17 through 9/15/17, 9/20/17, 9/22/17, and 9/24/17 ( 16 out of 25 days) and, -12:00 PM from 9/1/17 through 9/25/17 the resident consumed less than 50% of the supplement on 9/1/17 through 9/7/17, 9/10/17 through 9/12/17, 9/15/17, 9/18/17 and 9/20/17 through 9/24/17 (16 out of 25 days). Review of Resident 13's Weights and Vitals Summary revealed the resident's weight on 9/25/17 was 121 lbs. (down 13 lbs. or 9.7% in 1 month and down 17 lbs. or a 12% weight loss in 3 months). Review of Resident 13's medical record revealed no evidence the Dietary Manager (DM) or the RD had addressed the resident's ongoing significant weight loss since 8/22/17. During an interview on 9/27/17 from 9:30 AM to 10:05 AM, the RD confirmed the following: -Resident 13 received the Ensure 240 cc only once a day from 8/23/17 through 8/31/17. The resident's intakes continued to decline and the resident was not always accepting the supplement. -Staff did increase the Ensure supplement to twice a day when the error was identified on 9/1/17 even though acceptance continued to be poor at times. -Resident 13 had not been interviewed since admission on 5/27/17 to determine dietary preferences. -No further nutritional interventions were developed or implemented despite the residents continued significant weight loss. 2020-09-01