cms_MT: 59

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
59	BELLA TERRA OF BILLINGS	275020	1807 24TH ST W	BILLINGS	MT	59102	2016-12-15	333	D	0	1	PSRD11	NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview, and record review, the facility failed to ensure staff primed the prefilled insulin pen prior to the medication administration for 2 (#s 12 and 22) of 22 sampled and supplemental residents. Findings include: Resident #12 was admitted to the facility with a [DIAGNOSES REDACTED]. Resident #22 was admitted to the facility with a [DIAGNOSES REDACTED]. During an observation on 12/12/16 at 4:30 p.m., staff member L put the needle on resident #12's [MEDICATION NAME] pen. The staff member twisted the dial back on the [MEDICATION NAME] pen to show 2 units of insulin. He then administered the insulin to the resident in the subcutaneous tissue in the left upper tricep. Staff member L did not prime the [MEDICATION NAME] pen with the 2 units of insulin prior to the insulin administration. During an observation on 12/12/16 at 5:01 p.m., staff member L, after placing the needle, twisted the dial back on the [MEDICATION NAME] pen to show 3 units of insulin. The staff member administered the insulin to the resident in the subcutaneous tissue of the right upper tricep. Staff member L did not prime the [MEDICATION NAME] pen with 2 units of insulin prior of the medication administration. During an interview on 12/12/16 at 5:03 p.m., staff member L stated he was not aware of the need to prime the insulin pen prior to the administration of medication. The staff member stated he had never primed the insulin pens before and had not been trained otherwise. During an interview on 12/12/16 at 5:15 p.m., staff member D stated it was the expectation of the staff to prime the insulin pen with 2 units of insulin prior administration. The staff member stated the last education provided to staff on the priming the insulin pens was at the last annual training. A review of the facility's Insulin Pen Instructions, dated 2/10/16, showed, Please use the following instructions prior to administering insulin from a prefilled pen: 2. You must give an airshot before each injection. Turn the dose selector to 2 units. Hold the pen with needle pointing up. Tap the cartridge gently with your finger a few times to make any air bubbles collect at the top of the cartridge. Keep the needle pointing upwards and press the push-button all the way in. The dose selector returns back to 0. A drop of insulin should appear at the needle tip. If not, change the needle and repeat the procedure. A review of the patient information pamphlet, provided by [MEDICATION NAME], showed: Giving the airshot before each injection. Before each injection small amounts of air may collect in the cartridge during normal use. To avoid injecting air and to ensure proper dosing: E. Turn the dose selector to select 2 units. F. Hold your [MEDICATION NAME] with the needle pointing up. Tap the cartridge gently with your finger a few times to make any air bubbles collect at the top of the cartridge. [NAME] Keep the needle pointing upwards, press the push-button all the way in. The dose selector returns to 0. A drop of insulin should appear at the needle tip. If not, change the needle and repeat the procedure no more than 6 times.	2020-09-01