cms_NH: 2082

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
2082 KINDRED TRANSITIONAL CARE & REHABILITATION-GREENBR 305005 55 HARRIS ROAD NASHUA NH 3062 2011-01-06 157 D     CBQB11 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and staff interview the facility failed to consult with the physician and failed to notify the family after a change in resident condition for 1 resident in a standard survey sample of 30. (Resident identifier is #14.) Findings include: Resident #14 Medical record review on 1/4/11 - 1/6/11 revealed this resident had a fall on 8/29/10 in the dining room and sustained a laceration on the hand. Review of the nursing note dated 8/29/10 at 2200 revealed this witnessed fall of an ambulatory resident had occurred at 1900 when the resident "tripped over own feet." Per interview and documentation review with Staff B (RN/Unit Manager) on 1/6/11 in the morning, it was confirmed Staff D (LPN) who witnessed the fall and Staff E (RN) who was the supervisor on duty both appropriately assessed the resident at the time of the fall and found no further injury. A nursing note in Resident #14's record dated 8/29/10 at 2245 (45 minutes after the fall), documents "During ambulation resident grabbin (sic) left leg and crying in pain. Leg not swollen or discolored. PRN (as needed) Tylenol given. Spoke with supervisor and told to wait until the a.m. to notify MD to see if x-ray needed. Will monitor through the night." Per interview with Staff B on 1/6/11 in the morning, it was confirmed that from 2245 on 8/29/10 when the resident started to exhibit increased pain until 0045 on 8/30/10 the physician was not consulted and the family was not notified. No documented evidence of any further nursing assessments of the range of motion of the hip or assessment of the rotation or length of the legs was found at the 2245 "During ambulation resident grabbin (sic) left leg and crying in pain." Review of the MAR for 8/29/10 - 8/30/10 reveals the resident had an order for [REDACTED]. Another nursing note written 8/30/10 at 0045 reads "Resident appears to be in increased pain. ....11- 7 supervisor notified. On call MD paged. Gave order to send to ...hospital for evaluation. Son called... ." During the same interview with Staff B on 1/6/11 in the morning, it was confirmed that Staff D, at the recommendation of the supervisor, did not notify the family or physician on 8/29/10 at 2245 which was the time of the initial change in condition of Resident #14 with evidence of the "resident grabbin (sic) left leg and crying in pain" after experiencing a fall 3 hours and 45 minutes prior. Further review of the medical record and of the hospital admission, operative report and discharge paperwork dated 8/30/10 - 9/2/10 revealed that Resident #14 was diagnosed in the emergency room with a left femoral neck fracture and had a closed reduction and pinning procedure done. This was also confirmed by Staff B during interview on 1/6/11. 2014-04-01