cms_SD: 67

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
67	AVERA MARYHOUSE LONG TERM CARE	435034	717 EAST DAKOTA	PIERRE	SD	57501	2017-05-24	284	D	0	1	43OZ11	NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview, record review, and policy review, the provider failed to implement discharge planning for one of one sampled resident (10) who was independent and wanted to move to an assisted living center. Findings include: 1. Observation and interview on 5/23/17 at 11:00 a.m. with resident 10 revealed: She walked without a walker or assistive device. She was well groomed. She stated she gave herself her own shower. She wanted to move into an assisted living center. She had a microwave in her room, and they had taken it away from her. -She wanted the microwave back. She liked to play cards. She liked to walk. Surveyor: Observation and interview on 5/23/17 at 11:24 a.m. with resident 10 revealed: Licensed practical nurse (LPN) F had taken her blood glucose and it had been 113. LPN F had asked her if she wanted her noon dose of insulin. Resident 10 replied she did not need her noon dose of insulin. LPN F explained that resident 10 makes her own decisions if she wants her insulin according to her blood sugars. Surveyor: Review of resident 10's 1/26/17 care plan revealed there were no goals or interventions for discharge planning. Review of resident 10's medical record revealed she was her own power of attorney and made her own decisions. She had been admitted on [DATE]. Review of resident 10's 9/28/16 and 1/6/17 social services notes revealed: She had stated her desire to move out of the facility and into the community. There had been no documentation regarding discharge planning that had occurred following those requests. On 1/6/17 Section Q she really wanted to return to the community but her family think it isn't feasible at this time due to meds and diabetes. Review of resident 10's 10/19/16 care conference note revealed she wanted to move out. She was interested in the independent living center in Chamberlain. It stated she and her daughter were looking into it. There had been no documentation in regards to what the staff were doing for her discharge planning. Review of resident 10's 7/20/16 care conference note revealed: There was no discharge planning occurring for her. They had Discussed her tendency to have low blood sugars and encouraged her to speak with her doctor when she asked about 'a pump' which she has heard other people have sometimes. There had been no documentation regarding what staff were assisting her with and if the pump would have helped her being able to move out of the facility. Review of resident 10's 4/18/17 care conference note revealed she wanted to move out of the facility. They were not doing discharge planning, because the family did not want it. Interview on 5/24/17 at 11:30 a.m. with the social worker associate (SWA) and the administrator regarding resident 10 revealed: The SWA had not been actively discharge planning for her. The resident had blood sugars that sometimes became very low. They had not contacted the physician regarding the possibility of a pump. The last documented attempt for discharge planning they located was on 4/8/16. The family had not agreed with her moving out. They both agreed she was capable of making her own decisions, but the family did not agree with them. They stated she wanted to live in Pierre, and the assisted living center would not take Medicaid. -That had contradicted the above information that she would move to Chamberlain. They had no other documentation the resident had not wanted to live in any other assisted living center. They had found an application completed by the SWA for Money Follows the Person, but it had not been dated. Review of the provider's (MONTH) (YEAR) Discharge Planning policy revealed: A discharge planning high risk screening, evaluation, and care plan should have been completed. The professional medical social services staff will initiate the assessment process for each identified patient (resident). An acceptable reason that Social Services cannot be provided after an identification of need is made is that the patient refuses. Exceptions to refusal include crisis room patients and suspected abuse cases. *Attempts made to reach a patient or family, determinations made that discharge planning is not clinically indicated yet, other clinical reasons that active discharge planning is not possible, must be stated in the documentation as it is a part of the assessment and treatment planning process.	2020-09-01