cms_SC: 94

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
94	ELLEN SAGAR NURSING CENTER	425012	1817 JONESVILLE HIGHWAY	UNION	SC	29379	2017-05-11	329	E	1	1	SD8911	NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY > Based on record review and interviews, the Registered Pharmacist (RPH) failed to identify irregularity for two consecutive months related to the approved gradual dose reduction (GDR) of antipsychotic medication for 2 of 5 residents reviewed for unnecessary medications. The findings included: The facility admitted Resident #120 2/3/17 with [DIAGNOSES REDACTED]. Record review on 5/10/17 at approximately 1:49 PM revealed a Pharmacist recommendation dated 2/23/17 for Physician to please re-evaluate the need for continued use of ziprasidone, perhaps considering a gradual dosage reduction to 20 milligrams (mg) by mouth daily for delusions associated with [MEDICAL CONDITION], with the end goal of discontinuation of therapy if possible. Physician approved this request by checking the response I accept the recommendation(s) above, please implement as written with a signature date of 3/2/17. Further review of physicians orders initiated on 3/2/17 reveal the order change [MEDICATION NAME] to 0.25 mg tabs-take 1 tab by mouth four times daily (QID) which was signed by the Nurse Practitioner on 3/6/17. Additional review of the monthly physician orders [REDACTED]. During interview with MD#1 and DON on 5/11/17 at 10:00 AM, MD#1 verified that s/he did approve the GDR for ziprasidone on 3/2/17 that was recommended by the RPH during February 2017 MMR. MD#1 and DON then reviewed Resident #120's medical record during interview after which both verified that the pharmacy recommendation for GDR of ziprasidone that was approved on 3/2/17 had not been initiated as ordered with 2 subsequent RPH monthly MMR's on 3/9/17 and 4/13/17 that did not identify the irregularity. DON and MD both verified that Resident #120 should have been receiving ziprasidone 20 mg capsule by mouth once daily since 3/2/2017. DON and MD #1 both verified that for 71 days, Resident #120 received a daily unnecessary dose of ziprasidone for a total of 71 doses. At the conclusion of the interview, MD #1 initiated an order to decrease the ziprasidone from 20 mg twice daily to 20 mg once daily to begin on 5/11/17. The facility admitted Resident #31 with [DIAGNOSES REDACTED]. Review of Resident #31's record on 5-10-17 at 4:07 p.m. revealed that a repeated pharmacy recommendation from 2-23-17 stated to add an appropriate [DIAGNOSES REDACTED]. The physician indicated to discontinue the medication and signed the pharmacy recommendation on 4-20-17. The order to discontinue the medication was not written until 4-25-17, as evidenced by the 'Physicians Order Form'. The initial pharmacy recommendation was signed by the physician on 3-1-17 but did not indicate a response from the physician regarding the recommendation. Review of the resident's Medication Administration Record [REDACTED]. The records were reviewed by the Director of Nursing DON on 5-11-17 at 12:28 p.m. and confirmed that an order should have been written and the ordered should have been discontinued prior to 4-25-17.	2020-09-01