cms_TN: 4011

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
4011 AGAPE NURSING AND REHABILIATION CENTER, LLC 445162 505 N ROAN STREET JOHNSON CITY TN 37604 2016-12-22 309 D 1 0 C3FJ11 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** > Based on medical record review and interview, it was determined the facility failed to provide sufficient discharge preparation for home health services and an antibiotic was not administered as ordered for one Resident (#1) of five Residents reviewed. The findings included: Medical record review of a Record of Admission and a Client [DIAGNOSES REDACTED].#1 was admitted to the facility on [DATE] with [DIAGNOSES REDACTED]. Medical record review of a Discharge Summary and Skilled-Long Term Care Orders dated 10/26/2016 revealed Resident #1 was admitted to the hospital on [DATE] with [MEDICAL CONDITION] secondary to her right lower extremity wounds. Intravenous (IV) antibiotics were started on 10/22/2016 and administered through a Midline IV Catheter. Infectious Disease (ID) was involved in Resident #1's care due to the resistant bacteria in her leg wound and recommended treatment with [MEDICATION NAME] for a period of two weeks. Continued review revealed, Resident #1 received the 10/26/2016 dose of [MEDICATION NAME] prior to discharge. Further review revealed, upon discharge from the hospital to the facility, Resident #1 needed an additional 10 days of [MEDICATION NAME]. Medical record review of a Discharge Minimum Data Set (MDS) assessment dated [DATE] revealed the discharge from the facility was planned. Medical record review of a Physician's Telephone Order dated 10/26/2016 revealed an order for [REDACTED]. Medical record review of an Interdisciplinary Progress Note dated 10/31/2016, at 10:54 AM, and completed by the Director of Social Services (DSS), revealed, .Resident is requesting to be discharged home today . Medical record review of a Physician's Telephone Order dated 10/31/2016, at 4:49 PM, revealed, Discharge home with home health .skilled nsg (nursing) . Continued review of the Interdisciplinary Progress Notes on 10/31/2016, at 4:50 PM, revealed, .Resident discharged home . Medical record review of an Interdisciplinary Progress Note dated 10/31/2016 at 4:50 PM, revealed, : .Resident discharged home with son . Medical record review of a prescription pad sheet with an order dated 11/1/2016 and signed by the facility's Nurse Practitioner revealed, .(Home Health Provider) (#2) to begin services 11/2/16 d/t (due to) change in provider services for HH (Home Health). Will need IV [MEDICATION NAME] 1 GM (gram) until 11/6/16 D/T (due to) missed dose today . Telephone interview with the Care Transition Coordinator with Home Health Provider (HHP) #1 on 12/14/2016 at 6:50 PM, revealed the HHP (#1) had provided services for Resident #1 in the past. Continued interview revealed HHP #1's business hours of operation are Monday through Friday from 8:00 AM, to 5:00 PM. Further interview confirmed the facility's DSS did not notify HHP #1 until 11/1/2016, which was the day after Resident #1 was discharged from the facility. Continued interview confirmed HHP #1 declined to provide home health services for Resident #1 and recommended the facility notify another HHP. Interview with the DSS on 12/14/2016 at 7:00 PM, in the Conference Room revealed the DSS stated, (HHP #1) had seen (Resident #1) in the past, I assumed they would again .so I called them (HHP #1) on 11/1/2016 .they refused to provide home health to (Resident #1) .recommended I call another home health (provider) . Continued interview revealed the DSS notified HHP #2 on 11/1/2016 and HHP #2's services were not initiated until the next day on 11/2/2016. Further interview confirmed the DSS was notified by Resident #1 on the morning of 10/31/2016 (at 10:54 AM), but the DSS failed to ensure home health services were arranged prior to Resident #1's discharge on 10/31/2016. Telephone interview with Registered Nurse #1 with HHP #2 on 12/14/2016 at 8:00 PM confirmed Resident #1's start of care date for home health services, including the IV [MEDICATION NAME], was 11/2/2016. Continued interview confirmed the Resident was discharged from home health services on 11/18/2016. Telephone interview with the facility's Nurse Practitioner on 12/14/2016 at 8:55 PM, confirmed the administration of the IV [MEDICATION NAME] was necessary to treat the Resident's infection and should not have been missed on 11/ . Continued interview confirmed the order for the [MEDICATION NAME] was extended from 11/5/2016 to 11/6/2016 due to the missed dose. Interview with the Administrator on 12/14/2016 at 9:27 PM, in the Conference Room, confirmed the facility failed to ensure timely arrangements for home health services prior to the Resident #1's discharge on 10/31/2016. Continued interview confirmed the facilities failure resulted in the [MEDICATION NAME] not being administered on 11/1/2016, as ordered. 2019-11-01