cms_NM: 89

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
89 RIO RANCHO CENTER 325033 4210 SABANA GRANDE SE RIO RANCHO NM 87124 2018-02-12 758 E 0 1 M2BO11 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Surveyor: Puccetti, Ulysses Based on record review and interview, the facility failed to ensure that consultant pharmacist recommendations regarding gradual dose reductions of [MEDICAL CONDITION] medication were forwarded to the physician for 1 (R #101) of 5 (R #s 26, 31, 55, 90 and 101) residents reviewed for unnecessary medications. If consultant pharmacist recommendations are not reviewed by the physician and implemented in a timely manner, residents are likely to be administered medications they do not need, experience potential unnecessary drug interactions and adverse side effects. The findings are: [NAME] Record review of R #101's pharmacist recommendation dated 03/31/17 stated, (R #101) receives [MEDICATION NAME] (Medication that treats [MEDICAL CONDITION] and [MEDICAL CONDITION] disorder) 125 mg (milligrams) TID (three times a day) for dementia with associated behaviors. Please consider a gradual dose reduction, perhaps decreasing to [MEDICATION NAME] 125 mg BID (twice a day) . The recommendation was signed by the Director of Nursing (DON) on 04/15/17. There was no response from the physician noted. B. Record review of R #101's pharmacist recommendation dated 09/30/17 stated REPEATED RECOMMENDATION from 3/31/17. Please respond promptly to assure facility compliance with Federal regulations. (R #101) receives [MEDICATION NAME] 125 mg TID for dementia with associate behaviors. Please consider a gradual dose reduction, perhaps decreasing to [MEDICATION NAME] 125 mg BID . The recommendation was signed by the DON on 04/15/17. The physician response was I accept the recommendation above with the following modifications: D/c (discontinue) [MEDICATION NAME]. Did this turn into a physician order? C. Record review of R #101's Medication Administration Record [REDACTED]. D. Record review of R #101's pharmacist recommendation dated 04/26/17 stated (R #101) receives [MEDICATION NAME] (an antipsychotic medication) 50 mg BID . Please consider a gradual dosage reduction to [MEDICATION NAME] 25 mg QAM (every morning) and 50 mg at HS (at bedtime), with the end goal of discontinuations of therapy. The recommendation was signed by the DON on 05/15/17. There was no response from the physician noted. E. Record review of R #101's pharmacist recommendation dated 08/28/17 stated (R #101) receives [MEDICATION NAME] 50 mg BID .Please consider a gradual dosage reduction to [MEDICATION NAME] 25 mg QAM and 50 mg at HS, with the end goal of discontinuations of therapy. The recommendation was signed by the DON on 10/09/17. The physician response was, I accept the recommendation above, please implement as written. F. Record review of R #101's MAR indicated [REDACTED]. On 9/14/17 a new order for [MEDICATION NAME] was entered and R #101 was administered the lower dose of [MEDICATION NAME] (25 mg in the morning and 50 mg at bedtime). [NAME] On 02/08/18 at 11:41 am, during an interview with the DON, she stated that when she signs the recommendation it indicates that she has received it from the pharmacist and reviewed it herself. She stated she usually reviews the recommendations with the physician in person. She stated that after looking for R #101's recommendation dated 03/31/17 and 04/26/17, she could not find anything that showed the physician was aware of them. She stated she does not know if the physician was made aware of the recommendation in another way. The DON verified the recommendations dated 09/30/17 and 08/28/17 were both repeat recommendations that were first suggested months prior. The DON stated she could not speak as to whether the physician would have discontinued R #101's [MEDICATION NAME] or agreed to the [MEDICATION NAME] dose reduction months prior since she cannot verify whether the physician received those recommendations. 2020-09-01