cms_NE: 73

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
73 HOMESTEAD REHABILITATION CENTER 285049 4735 SOUTH 54TH STREET LINCOLN NE 68516 2019-09-30 758 D 0 1 UZYC11 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Licensure Reference Number 175NAC 12-006.12B Based on record review and interview the facility failed to ensure that antipsychotic (a medication used to treat serious mental health conditions) gradual dose reduction (the periodic physician review of the amount of an antipsychotic medication to consider a decrease in the amount of the medication) (GDR) was addressed by the resident physician for 1 resident (Resident 17) of 3 residents reviewed. The facility census was 123. Findings are: Record review of the current Physician Orders for Resident 17 confirmed that the resident had an order to receive [MEDICATION NAME] (an antipsychotic medication used to treat [MEDICAL CONDITION]) 400 milligrams by mouth daily at bedtime that started on 11/14/16. Record review of the face sheet (a document that gives a resident's information at a quick glance that can include contact details, a brief medical history and the patient's level of functioning) confirmed that Resident 17 had a [DIAGNOSES REDACTED]. Record review of the facility policy titled Medication Management dated 9/10 revealed Guidelines for Psychotherapeutic Medication Monitoring of Antipsychotics step 1 g: Tapering of a medication dose/gradual dose reduction (GDR): Within the first year in which a resident is admitted on an antipsychotic medication or after the nursing care center has initiated an antipsychotic medication, the nursing care center must attempt a GDR in two separate quarters (a 3 month calendar period) (with at least one month between the attempts), unless clinically contraindicated. After the first year, a GDR must be attempted annually (yearly), unless clinically contraindicated. Record review of the health record for Resident 17 revealed a Note to Attending Physician/Prescriber dated 6/30/19 requesting that the physician evaluate the current dose and consider a dose reduction (GDR) for the [MEDICATION NAME] 400 milligrams. No documentation of the physician response to the GDR request was in the resident record. Interview on 9/30/19 at 1:53 PM with the Clinical Services Consultant (CSC) confirmed that Resident 17 had a current order for the antipsychotic [MEDICATION NAME] that was started on 11/14/16. The CSC confirmed that the gradual dose reduction request on 6/30/19 was not addressed and documented by the physician and that there was no documentation of a GDR attempt in the past year addressed by the physician. The CSC confirmed that a GDR must be attempted annually after the first year after starting an antipsychotic medication. 2020-09-01