cms_TN: 2410

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
2410	ADAMSVILLE HEALTHCARE AND REHABILITATION CENTER	445397	409 PARK AVENUE	ADAMSVILLE	TN	38310	2018-12-12	697	D	0	1	38WC11	NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on policy review, medical record review, and interview, the facility failed to ensure pain assessments were completed according to the facility policy for 2 of 7 (Resident #40 and Resident#64) sampled residents reviewed for pain. The findings include: 1. The facility's Pain Assessment and Management policy with a revised date of (MONTH) (YEAR) documented, .The purpose of this procedure are to help the staff identify pain in the resident, and to develop interventions that are consistent with the resident's goals and needs and that address the underlying causes of pain .Assess pain using a consistent approach and a standardized pain assessment instrument appropriate to the resident's cognitive level .Document the resident's reported level of pain .Upon completion of the pain assessment, the person shall record the information obtained from the assessment in the resident's medical record . 2. Medical record review revealed Resident #40 was admitted to the facility under hospice care on 10/22/18 with the [DIAGNOSES REDACTED]. The admission Minimum Data Set ((MDS) dated [DATE] documented Resident #40 was severely cognitively impaired, required extensive to total staff assistance for activities of daily living, and received scheduled pain medication or was offered as needed (PRN) pain medications. The Care Plan dated 11/3/18 documented, .at risk for alteration in comfort r/t (related to) [MEDICAL CONDITION] and End Stage disease process .Resident will be kept comfortable while on hospice .Evaluate pain at least Q (every) shift and PRN. Administer pain medication as needed and evaluate effectiveness. The physician's orders [REDACTED].[MEDICATION NAME] HCL 50 MG (milligrams) TABLET GIVE 1/2 TABLET 25 MG BY MOUTH AS NEEDED EVERY 8 HOURS FOR PAIN .10/29/18 .[MEDICATION NAME] 300 MG CAPSULE BY MOUTH THREE TIMES DAILY . Interview with Licensed Practical Nurse (LPN) #1 on 12/12/18 at 11:15 AM at 100 hall's nurses station, LPN #1 was asked if the Pain Assessments were completed. LPN #1 stated, I couldn't find those pain assessments .We don't have them. Interview with the Director of Nursing (DON) on 12/12/18 at 2:45 PM in the conference room, the DON was asked if the pain assessment documentation was on the medication administration record. The DON stated, No. The DON was asked if the pain assessments were documented for Resident #40. The DON stated, No. There was no documentation on the electronic Medication Administration Record (MAR) that pain assessments were conducted after admission to the facility on [DATE]. 3. Medical record review revealed Resident #64 was admitted to the facility on [DATE] with [DIAGNOSES REDACTED]. The Care Plan dated 11/20/18 documented, .At risk for alteration in comfort r/t (related to) [MEDICAL CONDITION] Arthritis, RLS (Restless Leg Syndrome)/Leg cramps. Muscle spasms .Assess and establish level of pain using numeric scale .Asses (assess) pain every shift and document on pain assessment flow sheet located on medication administration record . Review of the (MONTH) and (MONTH) MAR revealed no documentation of pain assessments having been performed. Interview with LPN #2 on 12/11/18 at 2:10 PM at the 500 hall nurses station, LPN #2 was asked if she did pain assessments on her shift for each resident. LPN #2 stated, .If they are not on a pain medication I will not ask . LPN #2 confirmed Resident #64 did not have physician orders [REDACTED]. Interview with the DON on 12/12/18 at 2:12 PM in the dining room, the DON was asked if every resident received a pain assessment on each shift. The DON stated, .it is not on the MAR. The DON was asked if pain assessments should be documented on the MAR. The DON stated, Yes. The facility was unable to provide documentation that the pain assessments were completed for each resident each shift and as needed.	2020-09-01