cms_TN: 2898

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.

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
2898 ALAMO NURSING AND REHABILITATION CENTER 445467 580 W MAIN STREET ALAMO TN 38001 2017-07-19 323 D 0 1 NDN711 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on policy review, medical record review, and interview, the facility failed to reassess a resident for the use of siderails and ensure 1 of 1 (Resident #57) residents of the 20 residents on the Stage 2 sample were free from potential accident hazards. The findings included: 1. Review of the facility policy and procedure entitled Safety and Supervision of Residents revised 12/08 revealed .Our facility strives to make the environment as free from accident hazards as possible. Resident safety and supervision and assistance to minimize the risk of accidents are facility-wide priorities .When accident hazards are identified, the PI (Performance Improvement)/Safety Committee shall evaluate and analyze the cause(s) of the hazards and develop strategies to mitigate or remove the hazards to the extent possible .Employees shall be trained and in- serviced on potential accident hazards and how to identify and report accident hazards, and try to minimize risk of avoidable accidents . 2. Medical record review revealed Resident #57 was admitted to the facility on [DATE] with [DIAGNOSES REDACTED]. Review of the annual Minimum Data Set (MDS) assessment dated [DATE],documented the resident required total assistance of 2 staff members for bed mobility and transfers. Review o the Task Care Plan for the nursing assistants (NA) identified the resident was to have 2 side rails up when the resident was in bed. Review of a nursing care plan dated 4/3/17 identified the resident was a fall risk .related to cognitive, functional & medical factors as evidenced by impaired safety awareness, poor judgement, weakness, balance instability and fall history . The approaches included to .Re-assess fall risk quarterly & PRN (as needed) .Observe for attempts to get up unassisted . Review of the Departmental Notes dated 7/15/17 documented, the resident was found in bed, with his legs hanging over the side rails. There were no further entries made in the electronic medical records regarding this incident. 3. Interview with the Licensed Practical Nurse (LPN) #2 on 7/19/17 at 11:19 AM, LPN #2 stated it was her expectation that the resident be reassessed for the use of side rails. She confirmed that there was no assessment done for Resident #57 after the 7/15/17 incident. Interview with the Director of Nursing (DON) on 7/19/17 at 3:23 PM, the DON stated she was unaware of the 7/15/17 incident involving Resident #57. She stated it was her expectation that staff should have alerted her and the MDS Coordinator. The resident needed to be reassessed for the use of side rails after this incident. 2020-09-01