cms_NH: 52

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.

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rowid	facility_name	facility_id	address	city	state	zip	inspection_date	deficiency_tag	scope_severity	complaint	standard	eventid	inspection_text	filedate
52	GREENBRIAR HEALTHCARE	305005	55 HARRIS ROAD	NASHUA	NH	3062	2018-12-19	802	C	0	1	P2R411	Based on observation, interview, and record review, it was determined that the facility failed to employ sufficient staff to effectively carry out food functions for 5 of 5 nursing units (Building 2, 5-2, 5-3). Findings include: Observation on 12/13/18 1:15 p.m. on unit 3 East revealed lunch meal trays being delivered to residents in their rooms. Review on 12/18/18 of meal delivery times revealed that 3 East is scheduled to have food delivered for lunch at 11:14 a.m. Observation on 12/13/18 approximately at 10:00 a.m. on Building 2 revealed Resident #191 eating breakfast in the bedroom. Resident #191 complained that the breakfast always has toast but today was different because it had peanut butter on the tray; usually the toast does not even have butter on it it is always burnt. Observation on 12/13/18 of Building 2 dining area at 12:56 p.m. revealed a white erasable board that stated that lunch would be at 12:00. Several residents were at various tables waiting for lunch to be delivered complaining to each other that lunch is always late and wondering how long today. Interview at 12:15 p.m. with Residents #87, #187 and #191 revealed that lunch is always late. Observation at 12:56 p.m. revealed that the lunch cart arrived and that lunch trays were being distributed to different tables by two staff members. At 1:03 p.m. Resident #87 did not like the meal served and pushed the tray away. The staff members did not stop and ask Resident #87 if Resident #87 wanted an alternate. At 1:14 p.m. this resident got up to leave the room and the staff asked if Resident #87 was done and which time an affirmative answer was stated. Further observations revealed that all meals stay on the trays whether in the dining area or in the rooms in Building 2. Interview with Resident #87 at 1:45 p.m. revealed that the lunch trays are always late and if you do not like the main meal you can ask for an alternate but it will take up to an hour to get it so why bother. It would be nice to have some music while we eat; it is so quiet it and so institutional on the lunch trays. Interview on 12/19/18 at 1:45 p.m. with Staff C, (Administrator) revealed that they have tried everything with dining. With trays and without trays but can not seem to keep boundaries from other residents; so it is easier with the trays. Interview on 12/13/18 with Staff T (Food service manager) revealed that Staff T's department is operating short staffed and in need of filling six dietary positions including a cook, two full-time dietary aides and three part-time dietary aides. This staffing shortage is causing tray carts containing the resident's meals to be delivered late to the facility units. Interview on 12/19/18 with Staff T revealed that on 12/19/18 the dietary department only had four of seven needed staff available to help prepare the food carts in the kitchen. As a result on 12/19/18 the food carts for every unit left the kitchen late and Staff T's documentation revealed that the food carts were late leaving the kitchen on all days of the survey. A test tray on 12/19/18 done by Staff P (Dietician) on unit 5-3 documented the meal temperatures at a unaccpetable low level temperatures according to the dieticians form with the entree temperature recorded at 107 degrees and the vegetables at 115 degrees. Interview on 12/14/18 at 9:44 AM with Staff C (Administrator) confirmed that they are short staffed in the kitchen by 5 dietary aide's and one cook. The Staff C states they are doing the best they can trying to hire staff for the department but it has been very difficult. Observation on 12/13/18 at approximately 9:20 a.m. of the dining room on Unit 5-2 revealed the food truck arrived to the unit at 9:20 a.m. Observation on 12/14/18 at approximately 9:15 a.m. of the dining room on Unit 5-2 revealed the food truck arrived to the unit at 9:15 a.m. Interview on 12/14/18 at approximately 9:15 a.m. with Resident #226 and Resident #5 revealed that Resident #226 had been waiting about an hour to an hour and a half for breakfast. It's ridiculous, we wait like this everyday for all of our meals. Resident #5 confirmed Resident #226's statement that meals are always about an hour to an hour and a half late. Review on 12/13/18 of the facilitys Cart delivery sheet revealed that breakfast leaves the kitchen at 8:23 a.m. Interview on 12/14/18 at approximately 10:00 a.m. with Resident #164 revealed that meals are always cold. I don't ask for it to be warmed up anymore because it takes so long. Observation on 12/19/18 at approximately 9:00 a.m. of the dining room on Unit 5-2 revealed the food truck arrived to the unit at 9:05 a.m. Interview on 12/13/18 at approximately 10:45 a.m. with Resident #15 revealed that the meals arriving from the kitchen were frequently late and were frequently cold. When asked if the facility staff would heat the food up, Resident #15 stated that they would heat it up, but that Resident #15 didn't ask because they felt that it would have taken staff away from their work and they were already short staffed. Observation on 12/13/18 of the dining room on Floor 5-3 revealed that the lunch food carts arrived on the unit from the kitchen at 1:35 p.m. Interview on 12/13/18 at approximately 1:15 p.m. with Staff J (Unit Manager) revealed that the lunch carts were late and that they should have arrived earlier. Observation on 12/14/18 of the dining room on Floor 5-3 revealed that the lunch food carts arrived on the unit from the kitchen at 1:15 p.m. Review on 12/19/18 of the facility form, titled Cart delivery . time . revised 12/11, revealed that the lunch carts that went to Floor 5-3 were supposed to leave the kitchen at 12:18 p.m. Interview on 12/13/18 at 11:00 a.m. with Staff J (Unit Manager) revealed that lunch is served at 12:30 p.m. Observation on 12/13/18 at 12:38 p.m. of the 5-3 unit revealed that there were no meal trays for lunch delivered on the unit. Interview on 12/13/18 at 12:38 p.m. with Staff J revealed that the meal trays for lunch will be delivered in 5-10 minutes. Interview on 12/13/18 at 1:00 p.m. with Resident #62 and Resident #18 revealed that their lunch was often served late around 1:30 p.m. Observation on 12/14/18 at 12:30 p.m. of the 5-3 unit revealed that the meal trays for lunch were not on the unit. Interview on 12/14/18 at 12:30 p.m. with Staff M (Licensed Nursing Assistant) confirmed that meal trays have not been delivered to the 5-3 unit. Observation on 12/14/18 at 1:00 p.m. of the 5-3 unit revealed that the meal trays for lunch were not on the unit. Interview on 12/14/18 at 1:00 p.m. with Staff M (Licensed Nursing Assistant) confirmed that meal trays have not been up in the 5-3 unit. Observation on 12/14/18 at 1:20 p.m. of the 5-3 unit revealed that meal trays for lunch were just delivered on the unit.	2020-09-01