cms_SD: 74

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.

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
74	AVERA MARYHOUSE LONG TERM CARE	435034	717 EAST DAKOTA	PIERRE	SD	57501	2019-08-07	698	D	0	1	ILL611	NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interview and record review, the provider failed to ensure communication between a [MEDICAL TREATMENT] center and the provider was documented, that nursing staff were assessing the resident for change of condition, and they were following physician orders [REDACTED]. Findings include: 1. Review of resident 31's medical record revealed: She was admitted on [DATE]. She had a Brief Interview for Mental Status assessment score of fifteen indicating she was cognitively intact. Her [DIAGNOSES REDACTED].>-Type two diabetes. -End stage [MEDICAL CONDITION]. -Dependence on [MEDICAL TREATMENT]. -[MEDICAL CONDITION]. -Heart failure. -[MEDICAL CONDITION]. She had been receiving [MEDICAL TREATMENT] three times per week. She had an arteriovenous (AV) fistula place on 7/31/19. [MEDICAL TREATMENT] post-assessment had not been completed since 7/18/19. Review of resident 31's 7/31/19 nurses note revealed: She had returned from an appointment for the AV fistula placement. The dressing was to be removed after forty-eight hours. She was to do stress ball exercises twenty times every hour while awake. Review of resident 31's last reviewed 6/27/18 care plan revealed a [MEDICAL TREATMENT] post assessment was to be completed on [MEDICAL TREATMENT] days. Interview on 8/7/19 at 10:14 a.m. with registered nurse (RN) B regarding resident 31 revealed: An assessment was to be done in the electronic medical record when she returned from [MEDICAL TREATMENT]. -She did know how to find and complete assessment. -She did not know where the assessment was to review it after it had been completed. The resident had a fistula placed a couple days ago on 7/31/19. Interview on 8/7/19 at 10:23 a.m. with resident 31 and her husband revealed that they did not know if a post-[MEDICAL TREATMENT] assessment had been done after her [MEDICAL TREATMENT] treatments. Interview on 8/7/19 at 11:40 a.m. with RN A regarding resident 31 revealed the [MEDICAL TREATMENT] post-assessment should have been completed by a nurse after each [MEDICAL TREATMENT] procedure. Interview on 8/7/19 at 3:19 p.m., at 3:28 p.m., and at 4:19 p.m. with the assistant director of nursing regarding resident 31 revealed: She had went to an appointment on 7/31/19 for afistula and had returned with new physician orders [REDACTED]. -She could not find the physician orders [REDACTED]. -They would not have documented that stress ball exercises had been completed. When the resident returned from [MEDICAL TREATMENT] appointments the [MEDICAL TREATMENT] center would send a communication sheet back with her. -The communication sheet had before and after [MEDICAL TREATMENT] run weight and vital signs on it. It would have also contained any new orders. -The nurse reviewed the sheet upon return. -The weights were recorded in the electronic medical record, and then the sheet was shredded. The resident's treatment record was requested during the interview, but it had not been provided by the end of the survey. Requested the policy on [MEDICAL TREATMENT] and assessment post-[MEDICAL TREATMENT] treatment. -She stated the provider did not have a policy on that. She had done a training on [MEDICAL TREATMENT] with staff. -The training material was requested during the interview, but it had not been provided by the end of the survey. Interview on 8/7/19 at 3:43 p.m. with RN I regarding resident 31 revealed: When the resident returned from the [MEDICAL TREATMENT] center she looked at the dressing and did an assessment. She reviewed the communication sheet from the [MEDICAL TREATMENT] center. After she reviewed the sheet she put it in a file to be scanned into the medical record. She did not document her assessment. *She did not know about the [MEDICAL TREATMENT] post-assessment that was to be completed.	2020-09-01