cms_WV: 11216

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
11216 REYNOLDS MEMORIAL HOSPITAL, D/P 515112 800 WHEELING AVENUE GLEN DALE WV 26038 2009-03-27 329 G 1 0 1UMJ11 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on medical record review and staff interview, the facility failed, for one (1) of eight (8) sampled residents, to ensure medications were not given without adequate indications of use and at an excessive dosage. The facility also failed to ensure that alternative causes for behaviors were ruled out and non-pharmacologic interventions were attempted without success prior to the use of psychoactive medications. Resident #19 experienced harm as evidenced by oversedation and decreased respirations after administration psychoactive medications. Resident identifier: #19. Facility census: 18. Findings include: a) Resident #19 Medical record review, on 03/25/09, revealed Resident #19 was admitted to the facility on [DATE]. On 09/15/08, a physician order [REDACTED]. Review of the nursing progress notes failed to record any behaviors to indicate the need for [MEDICATION NAME]. On 09/16/08 at 13:49 (2:49 p.m.), nursing progress note indicated, ". . . had been resting in chair very drowsy arouse when name called tho very weak, color dusky O2 sat on 3 liters 96 %, apical rate 92 and regular, faint bowel sounds, abdomen firm and distended had small loose stool this am (morning)." On 09/18/08, the physician ordered [MEDICATION NAME] 0.5 mg by mouth now for agitation and then [MEDICATION NAME] 0.5 mg every six (6) hours as needed for constant position changes, along with [MEDICATION NAME] 12.5 mg by mouth at night for the [DIAGNOSES REDACTED]. A nursing progress note, dated 09/18/08 at 18:23 (6:23 p.m.), revealed, "Pt becoming more restless and confused, attempts to get out of bed unassisted, family members cannot reason with him, medicated for pain." A subsequent nursing progress note, dated 09/19/08 at 00:19 (12:19 a.m.), stated, "1915 Pt voice was heard loudly from room out at nurses station, wife was holding pt's hands. Pt was agitated was to leave, she was trying to calm and reported by daughter bent her fingers back, he was out one side of the bed then the other, up in a chair." A nursing progress note, dated 09/20/08 at 06:06 (6:06 a.m.), stated, "Pt rested at long intervals tho when awake is confused, bed alarm sounded several times when pt turned in bed, wanting to go home pt reassured that he will need to stay here for breakfast, to seemed satisfied with answers." Nursing progress note, dated 09/20/08 at 23:31 (11:31 p.m.), stated, "@22:45 notified Dr. (name) patient is disrobing, pulling at TLC, IV, and O2 tubing getting out of bed unassisted. Insisting on going home, wife is present and can not calm patient . Order received for [MEDICATION NAME] 0.5 mg IM X 1 dose now." A physician's orders [REDACTED]." A nursing progress note, dated 09/20/08 at 23:57 (11:57 p.m.), stated, "Pt very drowsy and lethargic, skin warm and dry, responded weakly when pt into bed from recliner chair by son and 2 staff members, O2 per nasal canula at 3 liters, sat 97 -100 %, after pt in bed, very sedated, Cheyne Stokes respirations." A nursing progress note, dated 09/20/08 at 23:57 (11:57 p.m.), stated, "periods of apnea [MEDICATION NAME] for 1 minute and more, when breathing 24 resp over 30 seconds wit exp wheezing, dr chin beeped X 1, apical rate 60 and irregular blood sugar 117." An entry, dated 09/21/08 at 00:05 (12:05 a.m.), stated, "Sa tx given by Rt resp regular, pt responds by opening eyes." Following this excessive sedation, the physician ordered, on 09/21/08, "(arrow up) [MEDICATION NAME] 25 mg at hs (hour of sleep) at pm (night)." A nursing progress note, dated 09/23/08 at 14:33 (2:33 p.m.), stated, "[MEDICATION NAME] for [MEDICAL CONDITION] AEB abusive behaviors. No adverse reactions noted at this time." On 09/28/08, Resident #19 was transported to the emergency room after the nurse was unable to find pedal pulses; he was subsequently admitted to the hospital for a blood clot. The facility failed to adequately identify behaviors, complete a thorough assessment to determine possible causes of the behaviors, and provide non-pharmacological interventions to help eliminate behaviors prior to administering psychoactive medications. The facility used pharmacologic interventions which sedated and depressed his respirations. On the evening of 03/25/09, the head nurse (Employee #7) revealed this resident was at the facility prior to her employment. Following review of the medical record, she did not produce any additional information to dispute these findings. . 2014-07-01