cms_NH: 57

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
57 HANOVER HILL HEALTH CARE CENTER 305009 700 HANOVER STREET MANCHESTER NH 3104 2020-01-31 658 D 0 1 0IIF11 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on medical record review and interview, it was determined the facility failed to follow physician orders [REDACTED]. (Resident identifier is #47.) Findings include: Review of [NAME] [NAME] Potter and Anne Griffin Perry, Fundamentals of Nursing. 7th ed. St. Louis, Missouri: Mosby Elsevier, 2009. Page 336-Physicians' Orders revealed the following: The physician is responsible for directing medical treatment. Nurses follow physicians' orders unless they believe the orders are in error or harm clients. Therefore you need to assess all orders, and if you find one to be erroneous or harmful, further clarification from the physician is necessary . Review on 1/31/2020 of Resident #47's medical record revealed a physician's orders [REDACTED].#47 would have weekly skin assessment. Review on 1/31/2020 of Resident #47's weekly skin condition record revealed that Resident #47 did not receive timely weekly skin assessment. Resident #47 received one on 1/4/2020, which stated wounds to buttocks treated as ordered in MAR (Medication Administration Record) No s/s (signs/symptoms) of infections; the following week 1/11/2020 it revealed that it Continues with multiple open areas to coccyx/buttocks. Dressing and ointments applied as ordered. No changes noted. No s/s infection. This was the last note/input to the skin condition record. Review on 1/31/2020 of Resident #47's care plan revealed that Resident #47 has an alteration in skin integrity r/t (related /to) the pressure of Deep Tissue Injury (DTI). The care plan inventions include dressings as ordered. assesses placement and integrity of the dressing every shift and change if compromised. Interview on 1/31/2020 at approximately 2:00 p.m. with Staff D (Unit Manager) confirmed that Resident #47 developed a DTI on the heel. Staff D confirmed the heels started to be offloaded at this time. Review on 1/31/2020 of physician orders [REDACTED]. Heel foam cups BL (bilateral) heels- change weekly off-loading boot while in bed at all times. Staff D confirmed this was started after the DTI was discovered. Review on 1/31/2020 of Resident #47's medical record revealed no documentation that the heels had been looked at prior to the DTI developing. 2020-09-01