cms_WV: 3317

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

This data as json, copyable

rowid	facility_name	facility_id	address	city	state	zip	inspection_date	deficiency_tag	scope_severity	complaint	standard	eventid	inspection_text	filedate
3317	MAPLES NURSING HOME	515186	1600 BLAND STREET	BLUEFIELD	WV	24701	2019-04-11	656	E	0	1	KGJN11	NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on record review and staff interview the facility failed to implement and/or develop resident care plans. For Resident #12 and Resident #56 the facility failed to implement their Diabetes Mellitus (DM). For Resident #9 the facility failed to develop a care plan in area of behaviors. Finally, for Resident #54 the facility failed to implement the residents care plan in regards to a smoking cessation program. This was trued for four (4) of 21 care plans reviewed. Resident identifiers: #12, #56, #9 and #54. Facility census: 57. Findings included: a) Resident #12 A review of Resident #12's medical record at 8:00 a.m. on 04/09/19 found the following physician orders: --Order dated 10/08/18 [MEDICATION NAME] R Regular Insulin per sliding scale. 200 - 249 give 2 units, 250 - 299 give 4 units, 300 - 349 give 6 units, 350 - 400 give 8 units. BS (Blood Sugar) greater than 400 call physician. This ordered was an as needed order. --Order dated 10/24/18 Accu Check twice daily at 6:00 a.m. and 6:00 p.m. Further review of the record found on the following occasions when Resident #12's blood sugar was elevated and she should have received sliding scale coverage and she did not: --10/14/18 - 2:58 p.m. blood sugar was 398. --10/16/18 - 8:03 a.m. blood sugar was 337. --10/16/18 - 5:10 p.m. blood sugar was 282. --10/16/18 - 8:19 p.m. blood sugar was 318. --10/21/18 - 7:49 p.m. blood sugar was 365. --10/22/18 - 8:45 p.m. blood sugar was 311. --10/23/18 - 8:46 p.m. blood sugar was 392. --10/24/18 - 4:47 a.m. blood sugar was 226. --10/24/18 - 9:46 a.m. blood sugar was 372. --10/24/18 - 6:09 p.m. blood sugar was 331. --10/26/18 - 5:37 p.m. blood sugar was 203. --10/29/18 - 5:07 a.m. blood sugar was 230. --10/30/18 - 5:44 a.m. blood sugar was 223. --10/31/18 - 5:34 p.m. blood sugar was 379. --11/02/18 - 5:52 p.m. blood sugar was 324. --11/05/18 - 9:09 p.m. blood sugar was 232. --11/12/18 - 5:54 a.m. blood sugar was 230. --11/12/18 - 8:00 p.m. blood sugar was 286. --11/13/18 - 5:24 p.m. blood sugar was 313. --11/14/18 - 5:06 a.m. blood sugar was 233. --11/16/18 - 5:27 a.m. blood sugar was 342. --11/17/18 - 5:04 a.m. blood sugar was 226. --11/17/18 - 5:25 p.m. blood sugar was 222. --11/19/18 - 5:05 a.m. blood sugar was 203. --11/20/18 - 5:46 p.m. blood sugar was 270. --11/21/18 - 5:24 p.m. blood sugar was 360. --11/23/18 - 5:03 p.m. blood sugar was 284. --11/24/18 - 5:13 p.m. blood sugar was 240. --11/25/18 - 5:13 a.m. blood sugar was 221. --11/26/18 - 5:53 p.m. blood sugar was 290. --11/28/18 - 5:01 p.m. blood sugar was 266. --11/30/18 - 5:30 a.m. blood sugar was 268. --11/30/18 - 5:01 p.m. blood sugar was 232. --12/03/18 - 5:09 p.m. blood sugar was 400. --12/07/18 - 5:14 p.m. blood sugar was 261. --12/09/18 - 5:07 a.m. blood sugar was 279. --12/09/18 - 5:35 p.m. blood sugar was 262. --12/15/18 - 6:01 a.m. blood sugar was 238. --12/19/18 - 5:12 p.m. blood sugar was 331. --12/22/18 - 5:42 p.m. blood sugar was 284. --12/23/18 - 5:57 p.m. blood sugar was 252. --12/25/18 - 6:05 a.m. blood sugar was 213. --12/26/18 - 5:15 a.m. blood sugar was 239. --12/27/18 - 9:43 a.m. blood sugar was 240. --12/27/18 - 5:15 p.m. blood sugar was 214. --12/28/18 - 5:45 a.m. blood sugar was 208. --12/31/18 - 5:16 p.m. blood sugar was 271. --01/01/19 - 5:34 a.m. blood sugar was 214. --01/03/19 - 7:19 p.m. blood sugar was 244. --01/04/19 - 5:06 a.m. blood sugar was 234. --01/05/19 - 5:10 p.m. blood sugar was 232. --01/06/19 - 5:00 p.m. blood sugar was 208. --01/11/19 - 5:05 p.m. blood sugar was 219. --01/13/19 - 5:28 p.m. blood sugar was 217. --01/19/19 - 5:08 p.m. blood sugar was 245. --01/23/19 - 5:24 p.m. blood sugar was 250. --01/25/19 - 5:38 p.m. blood sugar was 245. --01/26/19 - 5:45 a.m. blood sugar was 226. --01/31/19 - 5:34 p.m. blood sugar was 236. --02/06/19 - 5:24 a.m. blood sugar was 205. --02/19/19 - 5:16 p.m. blood sugar was 200. --02/24/19 - 6:38 p.m. blood sugar was 200. --03/07/19 - 5:00 a.m. blood sugar was 274. --03/11/19 - 6:18 p.m. blood sugar was 210. --03/12/19 - 5:04 a.m. blood sugar was 209. --03/26/19 - 5:07 a.m. blood sugar was 244. --04/02/19 - 5:09 p.m. blood sugar was 203. --04/07/19 - 5:46 a.m. blood sugar was 302. --04/08/19 - 5:06 a.m. blood sugar was 221. Review of the Medication Administration Record (MAR) found Resident #12 did not receive any sliding scale insulin on the above mentioned dates. An interview with the Director of Nursing (DON) at 11:00 a.m. on 04/09/19 confirmed Resident #12's insulin was not administered in accordance with the sliding scale insulin order. She stated that it should be recorded on the MAR when it is administered and it was not documented that it was given so it appears it was not administered. Review of Resident #12's care plan found the following problem statement: Potential for hyper/[DIAGNOSES REDACTED] other complications Related to [DIAGNOSES REDACTED]. The goal associated with this problem statement read as follows: Will remain free of signs or symptoms or complications related to diabetes evidenced by labs and blood sugar checks will be in normal range through next review. The target date for this goal was 04/16/19. The was initiated on 01/18/19. The interventions associated with this problem and goal included: Administer medications as ordered and monitor for side effects and effectiveness. This goal was added on 10/24/18. An additional interview with the DON on 04/10/19 at 10:30 a.m. confirmed Resident #12's care plan was not implemented. b) Resident #56 A review of Resident #56's medical record at 10:00 a.m. on 04/09/19 found the following physician orders: -- Order Dated 04/28/18 which read Blood Sugar checks once a day at 7:00 p.m. This was an active order at the time of this review. -- Order dated 03/23/18 which read [MEDICATION NAME] R per sliding scale coverage if blood sugar is 201 - 250 give 4 units, 251 - 300 give 6 units, 301 - 350 give 8 units, 351 - 400 give 10 units, 401 - 450 give 14 units, 451 - 500 give 20 units, if blood sugar is greater than 500 call doctor. Further review of the record found on the following occasions when Resident #56's blood sugar was elevated and she should have received sliding scale coverage and she did not: --02/27/19 - 7:50 p.m. blood sugar was 278. --03/29/19 - 9:11 p.m. blood sugar was 235. --04/01/19 - 9:19 p.m. blood sugar was 236. --04/03/19 - 8:56 p.m. blood sugar was 231. An interview with the Director of Nursing (DON) at 11:00 a.m. on 04/09/19 confirmed Resident #56's insulin was not administered in accordance with the sliding scale insulin order. She stated that it should be recorded on the MAR when it is administered and it was not documented that it was given so it appears it was not administered. Review of Resident #56's care plan found the following problem statement: Potential for hyper/[DIAGNOSES REDACTED] other complications Related to [DIAGNOSES REDACTED]. The goal associated with this problem statement read as follows: Will remain free of signs or symptoms or complications related to diabetes evidenced by labs and blood sugar checks will be in normal range through next review. The target date for this goal was 07/18/19. The was initiated on 04/02/19. The interventions associated with this problem and goal included: Administer medications as ordered and monitor for side effects and effectiveness. Receives [MEDICATION NAME] R sliding scale. This goal was added on 02/07/17. An additional interview with the DON on 04/10/19 at 10:30 a.m. confirmed Resident #56's care plan was not implemented. c) R9 During a medical record review on 04/08/19 for R9 revealed the care plan had not been developed to provide any structured programs or activities of interest to minimize his wandering behaviors of entering other residents room and trying to open closed doors. In a interview with the E74 registered nurse (RN) on 04/09/19 at 11:15 AM, verified the care plan had not been developed to provide any redirection interventions for R9's wandering behaviors. d) R54 During a medical record review on 04/08/19 for R54 revealed the care plan had an approach to encourage resident to stop smoking and offer smoking-cessation assistance as desired, consult physician for nicotine patch/gum or other medication as needed. Further review of the Observation Book for the physician had a note on 01/02/19 for R54: Patient has agreed to try and quit smoking would like to start with low dose Nicotine Patch and decrease smoking gradually. In an interview with the director of nursing (DON) on 04/10/19 at 1:20 PM, was unable to locate any evidence that R54 had been offered any smoking-cessation assistance to help her to decrease smoking.	2020-09-01