cms_TN: 94

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
94 NASHVILLE COMMUNITY CARE & REHABILITATION AT BORDE 445033 1414 COUNTY HOSPITAL RD NASHVILLE TN 37218 2018-07-25 880 D 0 1 565T11 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on medical record review, observation, and interview the facility failed to establish and maintain an infection prevention and control program designed to provide a safe, sanitary and comfortable environment and to help prevent the development and transmission of communicable diseases and infections for 2 of 23 residents (Resident #87 and Resident #1) reviewed related to dating of oxygen tubing for Resident #87 and Resident #1, and dating of humidified water canister for Resident #1, and storage and dating of a [MEDICATION NAME] (suctioning instrument) for Resident #1. Findings include: Medical record review revealed Resident #1 was admitted to the facility on [DATE] with [DIAGNOSES REDACTED]. Medical record review of the Quarterly Minimum Data Set ((MDS) dated [DATE] revealed a Brief Interview of Mental Status (BIMS) score of 3 indicating severe cognitive impairment. Medical record review of the physician's orders [REDACTED].oxygen at 5 liter / per minute via mask. As needed. Dx (diagnosis) lethargic, low blood pressure .3/16/18 Treatment/Procedure suction with [MEDICATION NAME] PRN (as needed) for increased secretions . Observation on 7/23/18 at 10:27 AM in Resident #1's room revealed the [MEDICATION NAME] connected to tubing hanging on the wall uncovered and undated. Further observation revealed nasal cannula uncovered and undated. Further observation revealed humdified water canister connected to oxygen port on wall dated 5/16/18. Interview and observation with Licensed Practical Nurse (LPN) #3 also known as the Unit Manager on 7/23/18 at 3:39 PM in Resident #1's room confirmed the the [MEDICATION NAME] with tubing and nasal cannula was uncovered and undated. Further observation and interview revealed the date on the humidified water canister was 5/16/18. Interview with LPN #3 on 7/25/18 at 1:23 PM at the nurse station confirmed the tubing was suppose to be dated and changed weekly by the nurses. Further interview confirmed the facility failed to date, and cover the respiratory equipment and replace the humidified water canister. Medical record review for Resident #87 revealed the resident was admitted to the facility on [DATE] and re-admitted on [DATE] with [DIAGNOSES REDACTED]. Review of Resident #87's Annual MDS dated [DATE] revealed the facility assessed the resident to have a BIMS score of 14 which indicated the resident was cognitively intact. Further review of the MDS section O revealed the resident was receiving oxygen therapy. Review of the (MONTH) (YEAR) physician's orders [REDACTED].change oxygen tubing weekly every Wednesday night . Review of the (MONTH) (YEAR) medication administration record (MAR) for Resident #87 revealed .change oxygen tubing weekly every Wednesday night . Observation of Resident #87 on 7/23/18 at 10:55 AM and 3:43 PM, and on 7/24/18 at 8:16 AM in the resident's room revealed the resident's oxygen tubing was not dated. Interview with RN #1 on 7/24/18 at 8:24 AM in Resident #87's room confirmed the oxygen tubing was not dated. RN #1 picked up the oxygen tubing and stated the tubing and canisters are changed and dated at the same time, there's usually a piece of tape on the tubing with a date on it but I don't see one on his. Further interview confirmed oxygen tubing was to be changed and dated every 7 days. Interview with the Assistant Director of Nursing (ADON) #1 on 7/24/18 at 8:30 AM in the 400 hall confirmed oxygen tubing and canisters were to be changed and dated weekly. Interview with the Director of Nursing (DON) on 7/25/18 at 8:45 AM in the conference room confirmed oxygen tubing should be dated. The DON stated there was no policy for dating oxygen tubing, it's documented on the MAR every Wednesday and the oxygen tubing should be dated. 2020-09-01