cms_SD: 88

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
88	ROLLING HILLS HEALTHCARE	435035	2200 13TH AVE	BELLE FOURCHE	SD	57717	2018-03-01	657	D	0	1	2S8V11	NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview, record review, and policy review, the provider failed to ensure the care plan reflected physician's orders for one of one sampled resident (40) who used oxygen and a bilevel positive airway pressure ([MEDICAL CONDITION]) device. Findings include: 1. Review of resident 40's medical record revealed: Her Brief Interview for Mental Status score was fifteen indicating no cognitive impairment. She had an above the knee amputation of the left leg. Her [DIAGNOSES REDACTED].>-Type 2 diabetes mellitus. -Sleep apnea. -Heart failure. -Major [MEDICAL CONDITION]. -[MEDICAL CONDITION]. -[MEDICAL CONDITION]. -Gastro-[MEDICAL CONDITION] reflux. -Abnormal posture. -Muscle weakness. Physician's orders on 4/27/17 for oxygen (02) and [MEDICAL CONDITION]. -Oxygen at 4 liters per minute (lpm) continuous when [MEDICAL CONDITION] not in use. -Oxygen at 10 lpm via [MEDICAL CONDITION] at night and during naps. -[MEDICAL CONDITION] at 16/8 with a backup rate of 12. Physician's order on 2/2/18 for oxygen. -Oxygen at 2 lpm continuous. -Continue [MEDICAL CONDITION] when sleeping. Observation on 2/27/18 at 3:00 p.m. with resident 40 revealed she had: Been sitting up in her lift chair taking a nap. Been wearing oxygen at 2 lpm. A [MEDICAL CONDITION] machine on her bedside table. Interview on 2/27/18 at 3:00 p.m. with certified nursing assistant (CNA) R regarding resident 40 revealed she used: Oxygen at 2 lpm during the day. [MEDICAL CONDITION] at night. Interview on 2/27/18 at 3:15 p.m. with CNA S regarding resident 40 revealed: She stated I have never seen her wear her [MEDICAL CONDITION] when she takes a nap during the day. She used oxygen at 2 lpm during the day. Interview and observation on 2/27/18 at 3:30 p.m. with resident 40 revealed: She had been sitting up in her lift chair and using her oxygen per a nasal cannula. Oxygen concentrator had been set at 2 lpm. She stated I only use my oxygen at 2 lpm during the day and 6 lpm with my [MEDICAL CONDITION]. -I have lost weight and my breathing is getting much better. -I only use my [MEDICAL CONDITION] at night. She no longer took naps in her bed, as she was getting stronger. She used a stand aid for transfers. She took naps in her lift chair. Review of resident 40's (MONTH) (YEAR) and (MONTH) (YEAR) treatment administration records (TAR) revealed: 02 at 10 lpm via [MEDICAL CONDITION] at night and during naps. -Start date 4/27/17. 02 at 4 lpm per nasal cannula continuous when [MEDICAL CONDITION] not in use. -Start date 4/27/17. Documentation of oxygen and [MEDICAL CONDITION] checks from 6 a.m. to 2 a.m., 2 a.m. to 1 p.m., and 10 p.m. Review of resident 40's 2/21/18 revised care plan revealed I USE OXYGEN AT 10 lpm AT N[NAME] (night) with a Bi-Pap. 02 4 lpm DURING THE DAY. Interview on 2/28/18 at 2:55 p.m. with registered nurse (RN) I regarding resident 40 revealed she: Used [MEDICAL CONDITION] at night with oxygen at 6 lpm bled-in. Used oxygen at 2 lpm continuous during the day. Took naps during the day. -Had not used her [MEDICAL CONDITION] for naps. Interview on 3/1/18 at 12:27 p.m. with the director of nursing regarding resident 40 revealed: Her oxygen order had been changed on 2/2/18. -Oxygen at 2 lpm continuous. -Continue [MEDICAL CONDITION] when sleeping. The new order had not been changed on the TAR or care plan. -She agreed that should have been changed to reflect the resident's current oxygen orders. She had been unable to provide an order for [REDACTED]. -Unsure when or why that had been changed. She planned on calling the [MEDICAL CONDITION] physician for clarification of the following: -Oxygen liter flow for daytime and nighttime. -Oxygen usage for daytime and nighttime. -[MEDICAL CONDITION] usage with or without naps. Review of the provider's revised (MONTH) (YEAR) Physician Order Procedure policy revealed: To correctly and safely receive and transcribe physician's orders so correct order is followed/administered. A notation needs to be made in the resident's medical record as to the reason for the new order and a brief summary of what it was. All transcription of orders should be signed off by a nurse and double checked by a second nurse to assure that all steps have been carried out to avoid errors. The second nurse will run the Administration Record Report for the MAR/Tar to view for accuracy of the transcription. Review of the provider's revised (MONTH) 2014 Physician Services policy revealed: Physician orders and progress notes shall be maintained in accordance with current regulations and facility policy. Review of the provider's revised (MONTH) (YEAR) Care Planning policy revealed: The physician's orders were referenced in the resident's care plan. *The DON was responsible for updating the care plan.	2020-09-01