cms_ND: 18

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
18	THE MEADOWS ON UNIVERSITY	355024	1315 S UNIVERSITY DR	FARGO	ND	58103	2019-05-16	684	D	1	1	FA2L11	NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY > Based on observation, record review, and review of professional reference, the facility failed to provide care and services to ensure safe positioning for meals for 1 of 4 sampled residents (Resident #30) observed eating in bed. Failure to ensure proper mealtime positioning placed Resident #30 at risk for aspiration. Findings include: Swigert's The Source for Dysphagia, 3rd ed., Pro-Ed, Inc., Texas, 2007, pages 9, 10, 125, and educational handouts, identified, . Signs and Symptoms of Dysphagia . coughing . during a meal . Some patients cough and choke when they aspirate . During the oral intake of . food and/or liquids, it is optimal for a patient to be seated at a 90 degree angle, whether in bed or in a chair. Even a slightly reclined position while eating greatly increases the risk of premature loss of food over the back of the tongue. Review of Resident #30's medical record occurred on all days of survey. [DIAGNOSES REDACTED]. Nurses' notes identified the following: 03/10/19 at 7:26 p.m.: . ProMod Liquid (a protein supplement) . Patient unable to swallow medication without coughing . 03/10/19 at 7:30 p.m.: . Juven Packet (a nutritional supplement) . Patient choking on liquids will update NP (nurse practitioner) . *03/10/19 at 10:42 p.m.: . Writer went into residents (sic) room where he was sitting up eating in bed. Writer gave him his 3 o'clock medication and patient began to cough. Patient face dark red in color. Patient was able to stop coughing after couple min. (minutes) . On call was called and writer was instructed to leave progress note . for NP. Observation on 05/14/19 at 12:48 p.m. showed Resident #30 eating lunch in bed. The head of the bed was at a 45 degree angle. Observation showed the resident coughed while eating. At 1:00 p.m., observation showed Resident #30 coughed and choked on his food, expelling pieces from his mouth while his eyes watered. The surveyor entered the room and asked if he needed to sit up. The resident replied, Yes. The surveyor found a certified nursing assistant who then raised the head of the bed to an almost 90 degree angle. Observation showed a sign next to the bed which stated, Safe Swallow Strategies . Food . Sit Upright . Drinks . Sit Upright . The resident's care plan failed to identify interventions to ensure safe swallowing/positioning during meals. Failure to position Resident #30 (who has dysphagia) in an upright position during meals resulted in the resident choking on his food, and may have resulted in aspiration.	2020-09-01