cms_SD: 29

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
29	AVERA ROSEBUD COUNTRY CARE CENTER	435029	300 PARK STREET POST OFFICE BOX 408	GREGORY	SD	57533	2020-01-29	880	D	0	1	BDC011	NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview, record review, and policy review, the provider failed to ensure proper infection control techniques were followed during nursing procedures for: One of one sampled resident (11) during one of three observed dressing changes performed by two of two registered nurses (RN) (D and E). Two of two randomly observed nebulizer (neb) cleanings for resident 33 cleaned by two of two RNs (B and F). Findings include: 1. Observation on 1/29/20 at 10:30 a.m. of RNs D and [NAME] during a dressing change for resident 11 revealed RN D: Applied hand gel then lifted a cloth covering from a wound kit that was placed on a cart outside resident 11's door. With ungloved hands she: -Opened a plastic bag, removed several unpackaged gauze sponges from the package, and placed them in her opposite ungloved hand. -Reached into the wound kit to remove a packaged dressing, packaged wound barrier wipes, and an unpackaged paper wound measuring tool. -Brought those wound supplies into the resident's room. -Placed them on the resident's bedside table directly on top of a pile of mail without placing a barrier between the wound supplies and the mail. Washed her hands and put on gloves. With those gloves on she: Removed the soiled dressing. Picked up the paper measuring tool and placed it on the wound to measure it. Cleansed the wound using the gauze pads. Opened the barrier cream and applied it to the wound area. Removed her gloves and applied hand gel. She then put on clean gloves and with those gloves she: Picked up the dressing package from on top of the mail. Opened the package and applied the dressing to the buttocks. Removed the gloves and washed her hands. Interview at that time with RNs D and [NAME] regarding the above dressing change confirmed: Gloves should have been worn to remove unpackaged supplies from the wound kit. A barrier should have been placed between the clean wound supplies and the mail on the table. Packaged dressing supplies should have been opened prior to putting on clean gloves to prevent cross-contamination of the clean wound supplies. RN [NAME] stated her expectation was that gloves were to have been changed between soiled items and clean items. Interview on 1/29/20 at 11:00 a.m. with the director of nursing (DON) C confirmed a barrier should have been used between clean and soiled items, and gloves should have been changed between clean and soiled areas. Review of the provider's (MONTH) 2019 Proper Wound Care Technique policy revealed:Hands were to have been washed and clean gloves were to have been applied before touching the wound or wound dressings. Sterile dressings will be used. Nonsterile gloves may be used, but care should be used to avoid touching the surface of the dressing that will contact the wound bed. 2a. Observation on 1/28/20 at 10:00 a.m. of RN B cleaning a neb mask and chamber after a neb treatment for [REDACTED]. Removed the mask and chamber from the tubing. Separated the mask from the chamber. Set the mask in the bottom of the sink as she rinsed out the chamber with water. Picked up the mask and rinsed it under the water spigot. Surveyor b. Observation on 1/28/20 at 10:35 a.m. of RN F cleaning a neb after completing a treatment for [REDACTED]. She took the nebulizer to the sink in the room and rinsed the pieces off under the running water. She turned off the faucet with her bare hands. She then obtained a paper towel from the dispenser above the sink and used it to dry off the neb device. She placed the pieces she had rinsed and dried off in a drawer with the neb machine. -She did not change the paper towel that was already in the drawer prior to putting the cleaned pieces on it. He was observed touching and moving items around in his drawer including the paper towel and machine. c. Interview on 1/28/20 at 5:30 p.m. with the director of nursing (DON) confirmed RN F did not follow the appropriate processes for cleaning the neb machine. Surveyor d Interview on 1/29/20 at 11:00 a.m. with DON C confirmed RN B should not have placed the mask in the sink while she rinsed the chamber. Review of the provider's (MONTH) 2014 Concentrator and Nebulizers policy revealed:Nebulizer components (mask, mouthpiece, and tubing) will be rinsed in clean water and allowed to air dry after each treatment. *Nebulizer masks, cups, and tubing were to have been discarded when discontinued, contaminated, defective, or as deemed by the nurse and after a respiratory infection.	2020-09-01