cms_WV: 3893

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
3893 HARPER MILLS 515086 100 HEARTLAND DRIVE BECKLEY WV 25801 2016-09-23 154 D 0 1 0MB311 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review, staff interview, and resident interview, the facility failed to ensure Resident #170 was given information in advance sufficient enough for her to make a knowledgeable health care decision in regards to a fluid restriction which her attending physician at the hospital (who was also her attending physician at the facility) had recommended upon her discharge from the hospital on [DATE]. This was true for one (1) of four (4) residents reviewed for the care area of [MEDICAL TREATMENT]. Resident Identifier: #170. Facility Census: 178 Findings include: a) Resident #170 A review of Resident #170's medical record at 9:00 a.m. on 09/23/16, found a discharge summary completed by Resident #170's attending physician while she was at the hospital. The discharge summary completed on 08/22/16 included her attending physician recommended a fluid restriction due to her status as a [MEDICAL TREATMENT] patient and her [DIAGNOSES REDACTED]. The same physician was also her attending physician at the facility. During an interview with the corporation's Chief Medical Officer Medical Doctor (CMO-MD) #271 at 10:20 a.m. on 09/23/16, when asked why Resident #170, a [MEDICAL TREATMENT] patient, was not ordered a fluid restriction upon her return from the hospital on [DATE], he replied not every one on [MEDICAL TREATMENT] needed a fluid restriction. He indicated that people in the community very seldom ever restrict their fluid. He proceeded to state the risk and benefits related to not watching her fluid intake was explained to the resident, but she was alert and orientated and able to make her own decisions. Therefore, she had the right refuse the fluid restriction which is why she was not currently ordered a fluid restriction. CFO-MD #271 was then asked if the conversation explaining the risk and benefits related to her refusal of a physician recommended fluid restriction was documented in her medical record. He informed the surveyor that this information did not need to be in the medical record because she was alert and orientated and able to make her own decisions. Review of the State Operations Manual Appendix PP - Guidance to Surveyors for Long Term Care Facilities found the following, 483.10(d)(2) - The resident has the right to be fully informed in advance about care and treatment and of any changes in that care or treatment that may affect the resident's well-being; Interpretive Guidelines 483.10(d)(2) Informed in advance means that the resident receives information necessary to make a health care decision, including information about his/her medical condition and changes in medical condition, about the benefits and reasonable risks of the treatment, and about reasonable available alternatives. At 4:04 p.m. on 09/23/16 the NHA was asked to provide any information that showed Resident #170 was informed about the physician recommended fluid restriction. The Director of Nursing (DON) was also asked at 5:16 p.m. on 09/23/16 to provide the same information. The DON stated she would check with the NHA and let us know. At 5:30 p.m. on 09/23/16, the medical records director reported the DON had told her to let the surveyors know there was no documentation in the medical record related to Resident #170's recommended fluid restriction. During an interview at 4:15 p.m. on 09/23/16, when asked if anyone at the facility had ever talked to her about a fluid restriction Resident #170 said a doctor, who she described as CMO - MD #271, had just been in a little while ago and asked her about a fluid restriction. She stated, I told him that I would not mind being on a fluid restriction if it was what was best for me. She then stated, Then he (she was referring to CMO - MD #271) said not to worry about it because I really did not need one. She then stated, I just want to do what is best for me. When asked if anyone at the facility had ever spoken with her about a fluid restriction prior to that time she stated, No that was the first time they ever mentioned it. On 09/23/16 Resident #170's attending physician declined to be interviewed by the surveyor. The NHA indicated that he was going out of town and was too busy to talk to us. 2020-04-01