cms_RI: 26

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.

Data source: Big Local News · About: big-local-datasette

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
26 BRIARCLIFFE MANOR 415012 49 OLD POCASSET ROAD JOHNSTON RI 2919 2019-12-27 710 E 1 1 IFE111 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** > Based on record review and staff interview, it has been determined that the facility failed to ensure the medical care of each resident is supervised by a physician for 1 of 5 sampled resident (ID #1) relative to diabetic monitoring. Findings are as follows: Closed record review for Resident ID #1 revealed a [DIAGNOSES REDACTED]. Record review revealed a drug regimen review dated 8/22/2019 with the pharmacist recommendation to monitor an A1C (bloodwork that tests your average blood glucose levels over the past 3 months) on the next convenient lab day and every 6 months if meeting treatment goals, or every 3 months if therapy has changed or goals are not being met. An A1C level was obtained on 8/26/2019 with results of 5.6 (less than 5.7 decreased risk for diabetes and greater than 6.4 is consistent with diabetes, according to the results range from the laboratory used by the facility). There was no evidence of a subsequent order for an A1C level. Record review revealed a drug regimen review dated 9/26/2019 with the pharmacist recommendation to discontinue Glimepiride (medication that manages blood sugar levels), if appropriate. Glucose monitoring should continue following any change in diabetic therapy. A telephone order dated 9/26/2019 was given to D/C (discontinue) glimepiride 2 mg daily, obtain blood sugar via fingerstick twice daily x 7 days, (1 week), to start 9/27/2019, and then D/C. Record review revealed blood sugars via fingerstick were obtained from 9/27/2019-10/3/2019 with results ranging from 68-223mg/dl (normal range for blood glucose levels according to the laboratory used by the facility is 70-99 mg/dl). There was no evidence that the resident's blood sugar results were reviewed by the physician. Further review of the resident's medical record revealed [REDACTED]. The result of the blood sugar reading was documented as Hi. The on-call provider was contacted by the nurse regarding the resident's assessment and subsequent orders were given to send the resident to the Emergency Department for an evaluation. During a surveyor interview on 12/26/2019 at approximately 2:00 PM with the supervising registered nurse, Staff C, who documented the blood sugar reading as Hi on 12/22/2019, she revealed that a blood sugar result of Hi indicates a fingerstick of greater than 600 mg/dl. In review of the resident's hospital medical record, the resident presented to the emergency department with a glucose level of 686 and the resident was placed on an insulin sliding scale. Additionally, an A1C level was obtained at the hospital on [DATE] with results of 11.4. During a surveyor interview on 12/27/2019 at approximately 1:00 PM with the resident's primary care physician, he revealed that he would expect a fingerstick to be done at least weekly and could not explain why the order for blood sugar monitoring was discontinued. 2020-09-01