cms_SD: 32

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
32	AVERA ROSEBUD COUNTRY CARE CENTER	435029	300 PARK STREET POST OFFICE BOX 408	GREGORY	SD	57533	2018-12-19	758	D	0	1	ZMYV11	NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on record review, interview, and policy review, the provider failed to ensure appropriate stop orders and clinical needs were in place for the use of as needed (PRN) [MEDICAL CONDITION] medication for two of five sampled residents (21 and 26) receiving psychoactive medication. Findings include: 1. Review of resident 21's medical record revealed physician's orders [REDACTED].>[MEDICATION NAME] 100 milligram (mg) by mouth at HS (bedtime) for dementia. On 11/16/18 via fax for [MEDICATION NAME] 2.5 mg PO (by mouth) q (every) 8 hours prn agitation. There had not been: -A stop date for the 11/16/18 order. -Documentation by the physician indicating rationale for the PRN antipsychotic medication to be extended beyond fourteen days. Review of the (MONTH) (YEAR) Gradual Dose Reduction-Psychopharmacological Medication form regarding the [MEDICATION NAME] for resident 21 revealed: Pharmacy recommended a dose decrease. The physician response indicated no change. -That action required the physician to provide clinical contraindication or exempt condition. -No information had been provided. 2. Review of resident 26's medical record revealed physician's orders [REDACTED]. Signed and dated on 12/3/18 for [MEDICATION NAME] 0.5 mg p.o. PRN every six hours for agitation. There had not been: -A stop date for the order of 12/3/18. -Documentation by the physician that had rationale for the PRN antipsychotic medication to be extended beyond fourteen days. Interview on 12/19/18 at 8:50 a.m. with the director of nursing revealed she: Agreed there was not an effective procedure in place for management of PRN antipsychotic medication orders. Had educated the physicians on antipsychotic PRN orders but had not kept any documentation of that education. Had been trying to educate the nurses to enter a fourteen day stop date for all PRN antipsychotic medications ordered. Agreed the physicians should have been ordering the stop dates for the PRN antipsychotic medications not the nurses. Agreed the provider had not always been contacted to examine the residents and document the need for continued use of antipsychotic medications. Review of the provider's last reviewed (MONTH) (YEAR) Antipsychotic Medication policy revealed: Antipsychotic medications will be supervised by the physician for appropriateness of use. The physician was to have reviewed antipsychotic medications and make recommendations for continuation. *PRN antipsychotic medication orders, and PRN [MEDICAL CONDITION] medication orders, including [MEDICATION NAME], are limited to 14 days. At that time the provider will be contacted to physically examine the resident and document rationale for keeping the PRN order, or, the order will automatically discontinue per date entered in the EMAR (electronic medication administration record).	2020-09-01