cms_RI: 88

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

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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
88	OAK HILL HEALTH & REHABILITATION CENTER	415027	544 PLEASANT STREET	PAWTUCKET	RI	2860	2017-12-20	695	J	1	0	MUG111	NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY > Based on surveyor observation, staff interview and record review it has been determined that the facility failed to provide respiratory care consistent with professional standards of practice for 1 of 1 residents reviewed for respiratory care, ID # 84 who was observed to be in respiratory distress. Lippincott Manual of Nursing Practice, eighth edition, 2006, defines Respiratory Assessment as, Assessment of respiratory status when administering inhalation medications. It states in part . Auscultate (listen to) the chest after administration of aerosol [MEDICATION NAME][MEDICATION NAME] to assess improvement in aeration and reduction in adventitious (abnormal) breath sounds. Record review revealed that ID # 84 was admitted to the facility on [DATE] with [DIAGNOSES REDACTED]. Review of the resident's physician orders [REDACTED]. 1. An order dated 11/13/2017 for [MEDICATION NAME] Nebulizer Solution (a [MEDICATION NAME] for inhilation) 2.5 milligrams (mg) in 3 milliliters (ml) every 4 hours (4 AM, 8 AM, 12 PM, 4 PM, 8 PM and 12 AM). 2. An order dated 11/14/2017 which reads, Respiratory Assessment with nebulizer treatment. 3. An order dated 12/01/2017 for Oxygen 1-3 liters (L) via nasal cannula (NC) continuous 4. An order dated 12/04/2017 stating O2 (oxygen) sats (saturation) greater than or equal to 92%. Surveyor observation during medication pass with Staff Nurse A on 12/14/2017 at 6:40 AM revealed resident ID # 84, sitting on the edge of the bed, anxious, short of breath, gasping for air with abnormal audible breath sounds, in respiratory distress. The resident's respirations were shallow and were counted at 33 per minute (normal adult range is 12-22 per minute). The resident stated I need the bag, get me the bag, holding the nebulizer mask to his/her face attempting to get air from the mask. Surveyor observed oxygen infusing at 5 L via nasal cannula. Staff A placed the medication, [MEDICATION NAME], into the administration set up, then left the room to get a pulse oximetry monitor (a monitor to measure the oxygen level in the blood). The resident stated to the surveyor, please don't leave me. Staff A returned to the resident's room and obtained a pulse oximetry reading which was 88 % on 5 L of oxygen. The resident remained anxious and continued to be short of breath. The resident's pulse oximetry reached 90% on 5 L after the breathing treatment was complete. Staff A stated that he was satisfied with the pulse oximetry reading of 90%. No further respiratory assessment was performed at this time. The resident remained anxious and short of breath. The nurse proceeded to leave the room and he did not return. When interviewed immediately following the observations, Staff A could not explain why he did not administer the treatment at the time it was due or why he did not perform a respiratory assessment as ordered. An interview was conducted with the Administrator 12/14/2017 at 7:45 AM. She was made aware of the observations and acknowledged that a respiratory assessment should have been performed and that the nebulizer breathing treatment should have been administered at 4:00 AM as ordered.	2020-09-01