cms_TN: 5955

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.

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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
5955 NHC HEALTHCARE, DICKSON 445004 812 CHARLOTTE ST DICKSON TN 37055 2015-06-25 323 D 0 1 M5UR11 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on policy review, medical record review, observation, and interview, the facility failed to implement falls interventions for 1 of 3 (Resident #144) sampled residents of 5 residents reviewed with falls. The findings included: The facility's FALLS policy documented, .PURPOSE . To reduce patient risk of falling . Post falls nursing assessment to be completed when patient incident occurs. Intervention to prevent further falls to be put in place at the time of the incident . Interventions will be added to the multidisciplinary (multidisciplinary) note and Care Plan Coordinator notified of intervention. Staff will be notified of intervention . Medical record review revealed Resident #144 was admitted to the facility on [DATE] with [DIAGNOSES REDACTED]. The annual Minimum Data Set ((MDS) dated [DATE] documented Resident #144 had a Brief Interview for Mental Status (BIMS) score of 6, indicating severe cognitive impairment, and that Resident #144 required extensive staff assistance for activities of daily living. The MDS documented the resident was not steady and required human assistance to stabilize when moving from a seated to a standing position, and with surface-to-surface transfers. The MDS documented no falls since the prior assessment. The care plan dated 6/5/15 documented, .PROBLEM . Safety risk . at high risk for falls . does not often recognize her limitations . APPROACHES . Keep Wheelchair out of patients (patient's) sight when she is in bed . A Post Falls Nursing assessment dated [DATE] documented, .6/19/2015 9:20 PM . PT (patient) WAS FOUND SITTING IN THE FLOOR NEXT TO HER BED. PT STATED THAT SHE WAS GETTING UP TO USE THE BATHROOM AND SLIPPED. PT WAS PLACED BACK INTO HER WC (wheelchair) . fell from bed to go bathroom . Observations on 6/22/15 at 4:43 PM, and 6/23/15 at 7:23 AM and 3:35 PM, in Resident #144's room revealed Resident #144 lying in the bed with the wheelchair at bedside within her sight. Interview with Licensed Practical Nurse (LPN) #2 on 6/23/15 at 3:27 PM, at the unit 4 nurses' station, LPN #2 was asked to explain the care plan intervention related to keeping the wheelchair out of Resident #144's sight while she is was in bed. LPN #2 stated, That is because when she sees it, she thinks she can get up and go by herself. But, she is not safe to go by herself. Interview with LPN #2 on 6/23/15 at 3:35 PM, in Resident #144's room, LPN #2 was asked if the wheelchair was in the resident's sight at this time while she is in bed. LPN #2 stated, Yes. Right now it is. Interview with the Director of Nursing (DON) on 6/24/15 at 5:30 PM, in the education room, the DON was asked whether she expected the staff to follow fall interventions. The DON confirmed that she did. 2018-10-01