cms_NE: 610

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
610 TIFFANY SQUARE 285087 3119 WEST FAIDLEY AVENUE GRAND ISLAND NE 68803 2018-03-07 686 G 0 1 K8KC11 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** LICENSURE REFERENCE NUMBER 175 NAC 12-006.09D2b Based on observation, record review, and interview; the facility failed to have interventions in place to promote healing of a facility acquired Stage 2 (partial thickness loss of skin) pressure ulcer on the sacrum (fused bones found at the lower end of the spinal column) for 1 of 3 sampled residents (Resident # 61) and therefore the pressure ulcer worsened from a Stage 2 to a Stage 3 (full thickness loss of skin). The facility identified a census of 82 at the time of survey. Findings are: Record review of Resident 61's MDS (Minimum Data Set-a comprehensive assessment tool used to develop a resident's care plan) dated 2/09/18 revealed an admission date of [DATE]. Resident 61 had a BIMS (Brief Interview Mental Status) score of 7 which indicated Resident 61 had severe cognitive impairment. Resident 61 required extensive assistance of 2 staff with bed mobility and was dependent with two plus persons physical assist with transfers. Review of Resident 61's Pressure Ulcer Record dated 1/23/2018 revealed Resident 61 had a Stage 2 pressure ulcer on the sacrum with an onset date of 1/21/2018. Observation of Resident 61 on 3/1/2018 at lunch time (12:00 PM) revealed Resident 61 was sitting in their wheelchair. Observation of Resident 61 on 3/1/2018 at 1:30 PM revealed Resident 61 was sitting in their wheelchair. Observation of Resident 61 on 3/1/2018 at 3:00 PM revealed Resident 61 was sitting in their wheelchair. Observation of Resident 61 on 3/1/2018 at 3:10 PM revealed staff assisted Resident 61 to lay down in bed. The resident had not been out of the wheelchair since before 12PM. Observation on 3/06/18 at 1:14 PM revealed Resident 61 was sitting in a recliner with the sling from the lift still underneath the resident. Observation on 3/06/18 at 2:40 PM revealed Resident 61 was sitting in a wheelchair at an activity with the sling from the lift underneath the resident. Interview on 3/06/18 at 10:45 AM with NA-J (Nurse Aide) revealed that the resident was to be laid down and repositioned every 2 to 3 hours from side to side, to get resident off their bottom. Interview on 3/06/18 at 5:00 PM with LPN-A (Licensed Practical Nurse) revealed that the lift sling was not to be left underneath residents in the chair, unless care planned for that resident. Interview with OT-D (Occupational Therapist) on 3/6/2018 at 1:25 PM revealed that the mechanical lift slings were not be left under residents when they are sitting on a pressure reducing cushion in a chair because it defeated the purpose of the cushion. Review of Resident 61's Pressure Ulcer Record (V3) dated 1/23/18 revealed a Stage 2, 2.5 cm (centimeter) by 1.3 cm pressure ulcer on Resident 61's sacrum. The open area was a fluid filled blister but had erupted and was now open. Review of Resident 61's Pressure Ulcer Record (V3) dated 2/13/18 revealed the pressure ulcer worsened from Stage 2 to Stage 3. Review of Resident 61's Physician Visit/Communication form dated 2/20/18 revealed that Resident 61 had been evaluated at the would clinic for a Stage 3 pressure ulcer that measured 1.5 cm by 1.3 cm by 0.2 cm. Review of Resident 61's Pressure Ulcer Record (V3) dated 3/06/18 revealed a Stage 3 pressure ulcer on the sacrum that measured 2.0 cm by 1.7 cm which indicated the wound had gotten larger than last measurement. Observation of Resident 61 on 3/6/2018 at 10:15 AM revealed Resident 61 had a pressure ulcer present on their tailbone area. Interview with the ADON-G (Assistant Director of Nursing) on 3/6/2018 at 10:20 AM confirmed the pressure ulcer to Resident 61's tailbone area was facility acquired. Review of Resident 61's Care Plan dated 1/27/2018 revealed no documentation that Resident 61 was to be repositioned and whether or not the lift sling was to be left under the resident. 2020-09-01