cms_TN: 14116

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
14116 KINDRED NURSING AND REHABILITATION-SMITH COUNTY 445172 112 HEALTH CARE DR CARTHAGE TN 37030 2010-06-23 332 D     RZXL11 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, medical record review, review of professional reference, and interview, the facility failed to appropriately administer medications in four of forty opportunities resulting in an error rate of ten percent. The findings included: Observation and interview of Licensed Practical Nurse (LPN #1) on hall 600 on June 22, at 8:45 a.m., 2010, revealed the nurse preparing medications at the medication cart. Observation included LPN #1 gathered the following oral medications for resident # 23: 1. [MEDICATION NAME] 20 mg (milligrams) (medication to decrease gastric acid secretion); 2. [MEDICATION NAME] 0.4 mg (to increase urination); 3. Multivitamin with Minerals (supplement); 4. [MEDICATION NAME] 100 mg (stool softener); 5. Potassium 20 millequivalents (replacement); 6. [MEDICATION NAME] 5 mg (steroid); 7. [MEDICATION NAME] 40 mg (diuretic); 8. [MEDICATION NAME] 25 mg (antihypertensive); and 9. [MEDICATION NAME] 40 mg (Anti-depressant). Continued observation revealed LPN #1 entered resident #23's room and placed the cup of medications on the table in front of the resident sitting in the chair. Continued observation and interview with resident #23 in the room on June 22, 2010, at 8:38 a.m., confirmed the breakfast meal had been served, consumed, and the tray had been removed from the room. Medical record review of the recapitulation of the Physician order [REDACTED]. Medical record review of the recapitulation of the Physician order [REDACTED]. Review of the medication book located at the nurses' station (2010 Pharmerica Specialized Long-term care nursing drug handbook) revealed the administration of [MEDICATION NAME] is "Best if administered before breakfast." Interview with LPN #1 at the nurses' station on June 22, 2010, at 9:00 a.m., verified the [MEDICATION NAME] was omitted and the [MEDICATION NAME] was administered after the meal. Observation on June 22, 2010, at 11:05 a.m., revealed Licensed Practical Nurse (LPN #2) preparing medications for administration to resident #22. Continued observation revealed the nurse prepared and gathered the medications and bolus feeding and entered the room. Continued observation revealed the nurse ascultated the abdomen via stethoscope; confirmed placement by positive "air bubbles;" and attached a syringe to the Gastrostomy tube to reveal no significant residual tube feeding. Continued observation revealed the nurse then administered the medications and bolus feeding via the [DEVICE]. Interview with LPN #2 in the hallway on June 22, 2010, at 11:20 a.m., confirmed the medications and bolus feeding were administered without flushing the [DEVICE] prior to administration. Review of the physician orders [REDACTED]. Interview with the Director of Nursing (DON) in the DON's office on June 23, 2010, at 9:30 a.m., confirmed the facility failed to follow the physician order [REDACTED]. Observation and interview of LPN #3 on hall 400 on June 22, at 4:45 p.m., 2010, revealed the nurse preparing medications at the medication cart. Continued observation revealed LPN #3 gathered the following oral medications for resident # 24: 1. [MEDICATION NAME] 325 mg (iron supplement); 2. [MEDICATION NAME] 20 mg (antihypertensive); 3. Requip 5 mg (antidepressant); and 4. [MEDICATION NAME] 40 mg (to treat ulcers). Continued observation revealed the medications were placed in a 30 cc (cubic centimeter) plastic medicine cup and two small spoonfuls of orange sherbet were placed on top of the medications. Continued observation revealed LPN #3 entered the room and administered the medications by two spoonfuls to the resident and then some water was consumed by the resident. Medical record review of the recapitulation of the Physician order [REDACTED]." Interview in the conference room with the facility's Registered Dietician (RD #1) on June 23, 2010, at 8:35 a.m., revealed an order from the physician specifying a medication to be administered "with food" would indicate "a protein and a carb (carbohydrate)" to be given with the medication. Interview with the Director of Nursing (DON) in the DON's office on June 23, 2010, at 9:30 a.m., confirmed the facility failed to ensure a medication pass was performed with a medication error of less than 5 percent. 2014-04-01