cms_TN: 8682

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

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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
8682	ADAMSPLACE, LLC	445392	1927 MEMORIAL BOULEVARD	MURFREESBORO	TN	37129	2013-11-20	281	D	0	1	GOZW11	NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, medical record review, review of the meal intake record, facility policy review, and interview, the facility failed to weigh a resident weekly after admission and failed to reweigh the resident after a weight discrepancy for one resident (#224), of twenty residents reviewed. The findings included: Resident #224 was admitted to the facility on [DATE], with [DIAGNOSES REDACTED]. Observation on November 19, 2013, at 12:30 p.m., and on November 20, 2013, at 8:30 a.m., revealed the resident in the resident's room self feeding the meals. Further observation revealed the resident consumed 75-100 percent of both meals observed. Medical record review of the Admission Minimum Data Set, dated dated dated [DATE], revealed the resident was moderately cognitively impaired and was independent with eating after set-up. Medical record review of the hospital data dated October 28, 2013, revealed the resident's initial weight was 64.5455 kilograms (142 pounds). Medical record review of the admission nursing assessment dated [DATE], revealed the resident's weight was 161 pounds, had bilateral lower extremity [MEDICAL CONDITION], and had complaints of difficulty/pain with swallowing. Medical record review of the Nursing Progress Notes dated November 2-10, 2013, revealed the resident had bilateral lower extremity [MEDICAL CONDITION], TED hose (compression device) worn, legs elevated on pillow, and/or bilateral heels off loaded. Medical record review of the Weight Record revealed the admission weight was 161 pounds and the usual body weight was 142 pounds at home. Further review of the Weight Record dated November 13, 2013, revealed the resident's weight was 140 pounds, a decrease of 21 pounds in fourteen days. Review of the meal intake record revealed the resident consumed 75-100 percent of every meal after November 11, 2013. Medical record review revealed the resident was ordered a speech therapy evaluation and treatment at admission and therapy remained ongoing with improvement. Review of an undated facility policy entitled Weighing Procedure revealed .The nursing assistant is responsible for weighing all residents .If a resident has a difference in weight of plus or minus five pounds at the time of weighing, the nursing assistant will reweigh the resident within twenty-four hours. The nursing assistant is to notify the charge nurse immediately. The charge nurse will assess the resident and initiate interventions as needed which may include notifying the physician or nurse practitioners the dietitian, family and care plan team. Weights and reweights are to be documented in the patients medical record . Review of a facility policy entitled Documentation Guidelines revealed .Weights: should be recorded on the appropriate form. 1) Time frames a) Weekly for 4 weeks following admission. b) At least monthly, unless ordered on a more frequent schedule by the physician, nurse, or dietitian .3) Any unusual variation in weights should be verified by re-weighing the patient. a) Document the results. b) If unusual variation still exists, report to licensed nurse, who reports to physician . Interview on November 20, 2013, at 10:14 a.m., with the resident in the resident's room, revealed the resident was aware of the admission weight of 161 pounds and had told the staff (resident) had not weighed that much in many years and .didn't believe it (the admission weight) was right . Further interview revealed the resident clothes fit the same from admission to the current date. Interview on November 20, 2013, at 10:20 a.m., with Certified Nurse Aide (CNA) #1, in the resident's room, confirmed CNA #1 admitted the resident and noticed no difference in the residents weight from admission to the current time. Further interview revealed the CNA noticed no difference in the way the clothes fit the resident. Interview on November 20, 2013, at 10:39 a.m., in the Registered Dietitian (RD) office, with the Director of Nursing and RD, confirmed the facility failed to weigh the resident weekly after admission and failed to reweigh the resident after the weight discrepancy per facility policy.	2017-05-01