cms_TN: 14294

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
14294 ISLAND HOME PARK HEALTH AND REHAB 445476 1758 HILLWOOD DRIVE KNOXVILLE TN 37920 2010-10-28 514 D     4S8L11 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on medical record review, observation, and interview, the facility failed to maintain accurate clinical records for two residents (#3, #5) of six residents reviewed. The findings included: Resident #5 was admitted to the facility September 5, 2007, with [DIAGNOSES REDACTED]. Medical record review of the Minimum Data Set (MDS) dated [DATE], revealed the resident had short and long term memory problems, was totally dependent for activities of daily living, had no indications of depression, anxiety, or sad mood, and had exhibited no behavior symptoms or psychosocial deficits. Medical record review of the social services notes dated August 28, 2008 through May 17, 2010, revealed " ...no mood or behavior problems ..." Medical record review of a psychiatric consultant Nurse Practitioner Progress notes dated January 10, 2010 through October 22, 2010, revealed "recent exac (exacerbation) of sexually inappropriate behaviors ...seen for E&M (evaluation and management) of DAT (dementia) c (with) [MEDICAL CONDITION] and beh (behavior) sxs (symptoms) including sexual inappropriateness & physical aggressive ..." Observation on October 27, 2010, at 9:30 a.m., in the dining room with the resident revealed the resident sitting in a wheelchair, smiling, alert, oriented to person and time, pleasant, and socially appropriate. Interview with the Administrator and Director of Nursing (DON) October 27, 2010, at 10:45 a.m., in the conference room, confirmed the resident had no current behavioral issues. Further interview with the Administrator and the DON confirmed the resident's medical record was inaccurately documented in describing the problem behaviors as "current" and/or "recent" rather than "history of." Resident #3 was admitted to the facility on [DATE], with [DIAGNOSES REDACTED]. Medical record review of a notorized document dated June 27, 2010, revealed " ...Appointment of Healthcare Agent ..." with one daughter listed as the Agent and no alternate listed. Medical record review of a Social Service Note dated June 28, 2010, revealed " ...New POA (Power of Attorney) papers on chart this date. HC (Healthcare) POA papers signed 6/27/10. Per POA, if (sibling) calls r/t (related to) (resident) ...we are not to provide info (information) & refer (sibling) to contact (health care agent) for information ..." Continued medical record review of a Social Service Note dated June 30, 2010, revealed " ...POA's (sister) in to see this worker ...apologized to this worker ...for giving the staff such a hard time because ...didn't realize ...wasn't on the recent POA papers ...showed this worker old POA papers and inquired if they were on chart. This worker informed ...that they were not and newer POA doct. (document) is on chart with ...(other sibling) named as POA ( this sibling) verbalized ...disagreement. This worker reported that it was not done at this facility and again advised (this sibling) to speak with (other sibling) ..." Interview with the Administrator, Director of Nursing, and Medical Records Director on October 25, 2010, at 3:45 p.m., at the Nurses Station revealed no POA papers on resident's current chart. Continued interview confirmed there was no new POA form and that the Appointment of Healthcare Agent form was not an alternate POA form. Further interview with the Medical Records Director on October 25, 2010, at 4:05 p.m., in the conference room, confirmed that the new POA referenced in the Social Service notes was the Appointment of Healthcare Agent, not an actual new POA. Review of a notarized POA dated September 4, 2003, found in the thinned record, and provided by the Medical Records Director revealed both siblings listed as POA's. Interview with the Medical Records Director confirmed both sister's were listed as POA's and the document dated September 4, 2003, is the only POA for the resident at this time. 2014-02-01