cms_NE: 55

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.

Data source: Big Local News · About: big-local-datasette

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
55 HOMESTEAD REHABILITATION CENTER 285049 4735 SOUTH 54TH STREET LINCOLN NE 68516 2017-05-25 428 D 0 1 18U611 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview, the facility failed to identify potential medication irregularities related to use of psychotropic medications for 2 (Resident 106 and 163) of 5 sampled residents. The facility had a total census of 131 residents. Findings are: Resident 106 was admitted to the facility on [DATE] with [DIAGNOSES REDACTED]. A review of Resident 106's 5/2017 Medication Administration Record [REDACTED]. A review of Resident 106's care plan revealed a problem dated 3/28/17 related to Resident 106 being at risk for adverse consequences related to use of antipsychotic medications for treatment of [REDACTED]. A review of order history for Resident 106 revealed Resident 106 was started on Seroquel 25 mg daily on 12/23/2015. Resident 106's Seroquel was increased to 50 mg on 5/6/2015 according to order history. A review of progress note from nurse practitioner dated 9/2/16 revealed Resident 106's Seroquel was increased to 75 mg for [DIAGNOSES REDACTED]. A review of pharmacist monthly reviews for Resident 106 revealed no irregularities were noted during the following reviews: 9/22/16, 10/24/16, 11/16/16, 12/19/16, 1/23/17, 2/27/17, 3/21/17, and 4/25/17. In an interview on 5/25/17 at 10:50 AM, Pharmacist D reported progress notes are reviewed during monthly medication reviews. Pharmacist D reported that gradual dose reductions are not recommended for residents being seen by a mental health practitioner as Pharmacist D trusts the mental health practitioner's judgement. B. A review of the MAR (Medication Administration Record) dated (MONTH) 1-24, (YEAR) for Resident 163, revealed the resident was admitted to the Memory Care Area of the facility on 8/2/14. The resident's [DIAGNOSES REDACTED]. Current medication administration orders indicated the resident was taking medications including: Citalopram (an antidepressant) 40 mg (milligrams) daily, Neurontin (used to treat neuralgia (nerve pain) and seizures) 400 mg threes times a day given for dx of unspecified dementia without behavior disturbance-started on 11/16/16, Seroquel an antipsychotic medicine (changes the actions of chemicals in the brain-used to treat schizophrenia and bipolar disorder) 25 mg four times a day started on 3/24/17, and Trazodone (an antidepressant) 100 mg daily started on 8/26/16. A review of pharmacist monthly reviews for Resident 163 revealed documentation that no irregularities were noted during the following reviews: 9/22/16, 10/24/16, 11/16/16, 12/19/16, 1/23/17, 2/27/17, 3/21/17, and 4/25/17. Review of Resident #163's medical record revealed no documented evidence of AIMS Testing (Abnormal Involuntary Movement Scale which aids in the early detection of movement disorders related to the use of antipsychotic medications as well as providing a method for on-going surveillance). An interview on 05/25/2017 at 3:49 PM with RN (Registered Nurse)-L revealed no AIMS testing had been completed for Resident 163. A review of a Drug Interaction Report obtained from Drugs.com revealed taking Trazodone, Seroquel, and Citalopram had the potential for a major negative drug interaction. Use of the medications together have the potential to cause severe side effects. An interview on 05/25/2017 at 2:11 PM interview with Pharmacist-D revealed the medications prescribed for Resident 163 had not been reviewed for possible negative drug interactions. The Pharmacist reported the lack of AIMS testing for Resident 163 had not been identified as an irregularity. A review of a facility policy titled MEDICATION THERAPY, revised (MONTH) 2007, revealed all medication orders will be supported by appropriate care processes and practices. Resident medications will be reviewed, assisted by the Consultant Pharmacist, upon admission and periodically to identify whether postential or suspected side effects are present. 2020-09-01