cms_SD: 85

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
85	ROLLING HILLS HEALTHCARE	435035	2200 13TH AVE	BELLE FOURCHE	SD	57717	2018-03-01	580	D	0	1	2S8V11	NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interview, record review, and policy review, the provider failed to ensure notification to the physician had occurred with a change in condition for one of two sampled residents (47) who had shortness of breath. Findings include: 1. Interview on 2/27/18 at 2:30 p.m. with resident 47 and her power of attorney (POA) during the resident council meeting revealed: She had felt short of breath last night (2/26/18) and thought she had an order to have her inhaler more then one time per day. She asked the nurse when she had gotten her inhaler last and told her she needed it again, but the nurse would not give it to her. The nurse had told her she did not have an order to have it more then one time per day. It had made her feel bad that she could not have her inhaler. The POA stated he had spoken with a staff member today, and they stated they were not able to find the order she could have the inhaler more then one time per day. Review of resident 47's 2/6/18 Minimum Data Set (MDS) assessment revealed: Her Brief Interview for Mental Status score was fourteen indicating she had no cognitive impairment. She had been independent with transfers, walking, and personal hygiene. Her [DIAGNOSES REDACTED].>-[MEDICAL CONDITION]. -[MEDICAL CONDITION]. -Heart failure. -Hypertension. -[MEDICAL CONDITION]. -Arthritis. -[MEDICAL CONDITION]. -Depression. -Asthma. Section J revealed her health conditions included shortness of breath with exertion. Phone interview on 3/01/18 at 10:30 a.m. with resident 47's POA revealed: He thought she had an order prior to entering the facility to get the inhaler more then one time per day. But when she had been admitted to the facility they had switched her physician, and he was not aware of what changes they had made to her medications. The staff member he had spoken to on 2/27/18 had been the director of nursing (DON). -She could not find the order for an inhaler for more then one time per day. -She had scheduled the resident to meet with the physician on 3/1/18. He had not been able to connect with the physician to discuss the resident's medical issues. Interview on 3/01/18 at 10:51 a.m. with resident 47 revealed: She could not remember the name of the nurse working the night she had felt short of breath. The nurse was not a new nurse to the facility. She stated the nurse could not find the inhaler order and had not done anything to assist her. Review of resident 47's medical record revealed: She had been admitted on [DATE]. There had been no: -Nursing progress notes regarding the situation described above. -Documentation of the assessment completed by the nurse regarding the resident's shortness of breath. -Documentation the physician had been notified regarding the resident's change in condition. Review of the nursing schedule revealed registered nurse (RN) K had been the nurse working 6:00 p.m. to 6:30 p.m. on 2/26/18. A phone interview had been attempted on 3/01/18 at 11:16 a.m. with RN K, but she had not answered. Interview on 3/01/18 at 2:37 p.m. with the DON regarding resident 47 revealed: She had spoken to the POA on 2/27/18 regarding the resident's inhaler order. She had not documented her discussion with the PO[NAME] She had not been aware of the incident with the resident having shortness of breath on 2/26/17. She had not been aware there was no documentation regarding the incident. She would have expected the nurse to contact the physician if the resident had been experiencing shortness of breath. Review of the provider's (MONTH) (YEAR) Resident, Physician, and Resident Representative(s) Notification policy revealed: The facility will immediately inform the resident; consult with the Physician/PA/NP; and inform the Resident Representative(s) when there is a change in condition such as but not limited to: -A significant change in the resident's physical, mental, or psychosocial status; deterioration in health, mental or psychosocial status in either life-threatening conditions or clinical complications. -A need to alter treatment significantly, such as discontinuing an existing treatment or commence a new treatment.	2020-09-01