cms_OR: 71

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
71 PROVIDENCE BENEDICTINE NURSING CENTER 385018 540 SOUTH MAIN STREET MOUNT ANGEL OR 97362 2018-12-19 684 D 0 1 NNTH11 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview and record review it was determined the facility failed to ensure interventions to prevent bruising to arms were implemented in a timely manner for 1 of 3 sampled residents (#20) reviewed for non-pressure skin conditions. This placed residents at risk for skin injury. Findings include: Resident 20 was admitted to the facility in (YEAR) with [DIAGNOSES REDACTED]. The 9/20/18 CAAs indicated the resident had kidney disease and diabetes, the conditions worsened and comfort was the goal of the resident's care. The resident was at risk for skin breakdown due to immobility, skin folds and multiple chronic diagnoses. The skin was intact but at risk for breakdown. Progress notes dated 10/7/18 indicated the resident had very dry, thin and almost translucent skin. The resident was assessed to have bilateral arm bruising which appeared to be related to the resident rubbing and scratching her/his arms. The bruising was diffuse, scattered and varied in color from purple to light purple. The staff tried to ensure long sleeves and sweaters were used but the resident continued to rub her/his arms. The 10/20/18 note indicated arm sleeves would be ordered for the resident. The Packing slip invoice revealed the resident's arm sleeves were ordered on [DATE] and received by the facility on 10/29/18. On 12/12/18 at 11:19 AM Staff 3 (Central Stores Manager) indicated he ordered Resident 20's arm sleeves on 10/22/18, received the sleeves on 10/29/18 and immediately provided the sleeves to the nurse or RNCM on Resident 20's unit. The Personalized Bedside Care Plan dated 10/21/18 indicated the resident was to choose her/his clothing. The resident had skin issues related to recent weight loss and had areas of loose skin and rashes. The staff were to keep the resident's skin moisturized. There were no interventions to indicate staff were to use the arm sleeves or to ensure the resident wore long sleeves. On 12/10/18 at 1:42 PM Resident 20 was observed with short sleeves and there was bruising to both lower arms. On 12/12/18 at 10:47 AM Staff 2 (RNCM) indicated the resident had fragile skin and often rubbed her/his arms which was likely the cause of the resident's arm bruises. Staff 2 indicated the protective sleeves took a while to obtain and when the order arrived the arm sleeves were too big but the next size smaller was too small. Staff 2 attempted to resize the sleeves and did not complete the correct fit until 12/12/18. Staff 2 acknowledged the care plan did not include the arm sleeves and/or direct the staff to ensure the resident wore long sleeves. On 12/12/18 at 12:12 PM Staff 5 (CNA) indicated she worked with the resident since 12/1/18 and she never saw the arm sleeves in the resident's room. This was the first day she saw the sleeves in the resident's room. On 12/12/18 at 12:23 PM and 1:30 PM Staff 1 (DNS) stated the arm sleeves for Resident 20 were not implemented in a timely manner. The sleeves were identified to be a possible intervention in (MONTH) and the sleeves were provided almost two months later. Staff 2 indicated the sleeve protectors and the use of long sleeves should have been placed on the care plan for the CNAs. 2020-09-01