cms_SD: 5

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
5	PRAIRIE HEIGHTS HEALTHCARE	435004	400 8TH AVENUE NW	ABERDEEN	SD	57401	2019-06-26	561	D	0	1	9U2F11	NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview, record review, and admission packet review, the provider failed to ensure one of one sampled resident's (52) choices related to her therapy schedule had been followed. Findings include: 1. Review of resident 52's medical record revealed: She had been admitted on [DATE]. She was alert and oriented. Her 5/14/19 admission Minimum Data Set assessment regarding her daily preferences revealed: -It was very important for her to choose her own bedtime. --There was no question to specifically address how important her wake-up time would have been. Her 6/26/19 care plan revealed: -Involve (resident name) in IDT (interdisciplinary team) and care planning. -Allow patient to perform tasks at his or her own rate. Do not rush patient. Encourage independent activity as able and safe. Observation and interview on 6/24/19 at 4:56 p.m. with resident 52 in her room revealed: She was sitting in her bed reading a book.She had been admitted about five weeks ago following a fall at home when she broke her hip. She was working with therapy services and hoping to get back home soon. Her only complaint was having to get up so early in the morning for therapy sessions. She was not a morning person and did not feel well at that time of the day. -She further stated she used to have low blood pressure issues early in the morning. The white dry erase board in her room indicated she would have three therapy appointments the next day at the following times: -At 6:30 a.m. with occupational therapy (OT). -At 8:30 a.m. with physical therapy (PT). -At 12:00 noon with speech therapy (ST). She had told more than one therapy staff person that she did not like those early morning appointments, and they still scheduled her that way at times. Observation and interview on 6/25/19 at 9:05 a.m. with resident 52 in her room revealed:She had just returned from therapy and was sitting in her wheelchair. She had slept well the night before, and therapy had gone okay that morning. Her preference still would have been to not do therapy so early in the morning. Observation on 6/26/19 at 8:29 a.m. of the dry erase board in resident 52's room revealed her three therapy appointments for that day were at the following times: At 8:00 a.m. with OT. At 12:00 noon with PT. At 1:35 p.m. with ST. Interview on 6/26/19 at 8:45 a.m. with the social services designee regarding resident 52's concern with her therapy schedule revealed:She had not been aware of the resident not wanting her therapy appointments so early in the morning. If the resident had told staff she had not wanted therapy scheduled so early in the morning her preference for that should have been followed. Interview on 6/26/19 at 8:49 a.m. with the director of rehabilitation (rehab) services regarding resident 52 revealed:He had known her for awhile, since she had been a resident in the facility for a separate stay prior to this admission. He was aware she did not like her therapy appointments early in the morning. Sometimes OT was scheduled at 6:30 a.m. in order to work on specific exercises such as dressing in order to get it done before breakfast started at 7:30 a.m. He thought the resident only had one or two times when therapy had been scheduled for 6:30 a.m. since she had been admitted . Interview on 6/26/19 at 9:34 a.m. with the director of nursing regarding resident 52's therapy schedule revealed:She expected the resident's therapy schedule to be adjusted and meet the resident's preferences. Therapy staff could have accommodated the resident's preferences to not be scheduled early in the morning. Further interview and record review on 6/26/19 at 10:03 a.m. with the director of rehab regarding resident 52 revealed:He brought her 5/7/19 through 6/26/19 therapy scheduled appointments list for review. According to that list she had been scheduled for the 6:30 a.m. time on the following dates:-On 5/10/19 with PT. -On 5/24/19 with OT. -On 5/27/19 with PT. -On 6/14/19 with PT. -On 6/17/19 with PT. -On 6/25/19 with OT. He stated she was getting three different therapies five days a week, and it could be difficult to get them all fit in during the day. He confirmed they could have adjusted her therapy schedule to meet her preferences. They could have worked on dressing at the time of her shower or asked her when it worked best for her to work on those dressing exercises. Interview on 6/26/19 at 10:27 a.m. with registered nurse/unit manager A regarding the above for resident 52 revealed:She was the unit manager for the rehab unit. Therapy appointments were scheduled by the therapy staff. She confirmed therapy appointments should have been scheduled to accommodate the resident's preferences. Review of the provider's revised (MONTH) (YEAR) Resident Admission packet revealed: .The rehab gym and office hours of operation are Monday through Friday 6:40 AM to 4:30 PM and Weekends by appointment only. Our therapy sessions are conducted one on one with the resident . The inter-disciplinary team or IDT, consists of your individual case manager, therapist(s), social services, dietary, recreation and direct care supervisor. Resident and/or family participation in our IDT meetings is extremely important and highly encouraged . The resident had a right to choices including: -(2) 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, and -(3) Unless adjudged incompetent or otherwise found to be incapacitated under the laws of the State, participated in planning care and treatment or changes in care and treatment.	2020-09-01