cms_TN: 737

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
737	GOOD SAMARITAN HEALTH AND REHAB CENTER	445170	500 HICKORY HOLLOW TERRACE	ANTIOCH	TN	37013	2019-05-02	803	F	0	1	SHOF11	Based on review of the resident council minutes, review of the 4 week cycle menu, Review of the POS [REDACTED]. The findings include: Review of the Resident Council Minutes dated 2/27/19 revealed 2 residents stating would like something other than chicken and goulash, meal ticket stated resident did not like pork and that was not true, would like more variety on the menu. Review of the facility 4 week menu cycle revealed the following: On Week 2 a chicken entree was listed for the Sunday evening meal, the Monday mid-day meal, the Tuesday evening meal and for the Saturday evening meal. On Week 3 a chicken entree was listed for the Sunday mid-day and evening meals, therefore chicken was served for 3 consecutive meals, excluding the breakfast meal. A pork entree was listed for the Monday mid-day meal and both the Tuesday mid-day and evening meals. On Week 4 a pasta entree was listed for the Sunday and Monday mid-day meals. A chicken entree was listed for the Tuesday evening meal and the Wednesday mid-day meal. Chicken Fried Steak was listed on the Thursday evening and the Saturday mid-day meals. Review of the POS [REDACTED]. Further observation revealed no therapeutic diet menu and no specific portion identified for each food item served on the menu. Review of the cooks menu for 4/29/19 revealed the mid-day meal matched the mid-day meal on the posted menu. Further observation of the evening meal revealed Pot Roast, Mashed Potatoes, Peas and Carrots were to be served. The cooks menu for the evening meal did not match the posted menu. Observation on 4/29/19 at 11:43 AM in the dietary department of the resident mid-day meal trayline, with the Dietary Supervisor present, revealed Pork in Gravy, Lima Beans, Mashed Potatoes and Carrots were to be served. Further observation revealed pureed foods on the trayline. Continued observation revealed regular textured diets were receiving the pork in gravy, mashed potatoes with gravy and carrots. Continued observation revealed the pureed textured diets received pureed meat with gravy, mashed potatoes with gravy, and pureed carrots. Interview with the cook/server on 4/29/19 at 11:57 AM at the dietary department trayline, with the Dietary Supervisor present, when asked what the meat was in the pureed meat stated .breaded chicken tenders with bread added . When the cook/server was asked why the pureed meat was not pork like the posted and cook menus listed, the cook/server stated .a lot of them (residents) don't like pork . When the cook/server was asked why are all the diets were receiving mashed potatoes when the posted and cooks menus listed lima beans, the cook/server stated .a lot of them don't like lima beans . Interview with the Dietary Supervisor on 4/29/19 at 11:59 AM at the dietary department trayline when asked if he was aware of the mashed potatoes being served in place of the lima beans, he stated he did know. When asked why the posted and cooks menu were not followed the Dietary Supervisor did not respond. Interview with the Dietary Supervisor on 4/29/19 at 4:12 PM in the dietary department revealed the Dietary Supervisor wrote the menu and obtained the Registered Dietitian's approval and signature. When asked for the therapeutic menu for the diets the Dietary Supervisor confirmed there was no therapeutic diet menu. When asked how the staff knew what portion to serve per menu item the Dietary Supervisor stated the meat and vegetable portions were 4 ounces each. Further interview confirmed the portion to be served per menu item was not specified on the menu. Further interview revealed any menu changes were documented on the cook's menu and filed. Further interview confirmed the cooks menu had not be changed to omit lima beans and adding mashed potatoes. Telephone interview with the part-time Registered Dietitian (RD) on 4/30/19 at 11:30 AM revealed the RD had worked full time at the facility until 6 weeks ago. The RD stated the Dietary Supervisor had written the menus and she had approved and signed the menus. When the consecutive and repetitive food items were discussed the RD stated she was not aware of that and felt the menu she approved may have been altered after she left the facility. The RD confirmed it sounded as if the menu lacked variety. The RD was not aware the menu failed to include therapeutic diet and portion specification. The RD's expectation was for at least 2 ounces meat/protein and 4 ounces of vegetables to be served.	2020-09-01