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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.

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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
55 BELLA TERRA OF BILLINGS 275020 1807 24TH ST W BILLINGS MT 59102 2016-12-15 253 E 0 1 PSRD11 Based on observation, interview, and record review, the facility failed to consistently clean entry ways, floors, dining room tables, and window screens. The facility failed to consistently clean an electric wheel chair for one (#4); failed to thoroughly clean the resident room for one (#6); and failed to consistently clean a toilet for one (#7) of 19 sampled residents. Findings include: 1. During an observation on 12/13/16 at 11:10 a.m., resident #4 was in the Mountain View dining room. The resident was seated in an electric wheel chair. There was a right arm support connected to the wheel chair. Dried food, skin particles and a white colored stain, appearing to be the skin particles mixed with moisture from the resident's arm, were observed on the arm support, and beneath on the chair and right wheel. During an observation on 12/14/16 at 9:43 a.m., resident #4's wheel chair was against the outside wall of room 108. Dried food, skin particles, and the discolored white stain continued to be on the wheel chair arm support, on the chair, and the right wheel. During an observation on 12/14/16 at 2:21 p.m., resident #4 was assisted to bed. The resident's wheel chair was against the window in the room. Dried food and skin particles were on the wheel chair arm support, along with the discolored white stain. Skin particles and dried food were observed under the arm support, side of the chair, and wheel. During an observation on 12/14/16 at 4:25 p.m., resident #4 was in the Mountain View dining room. Skin particles and the white stain remained on the arm support of the wheelchair. Dried skin particles and dried food remained under the arm support, down the wheel chair wheel. Review of the Mountain View wheel chair washing schedule showed resident #4's wheel chair was to be washed on Tuesdays by night shift staff. During an interview on 12/13/16 at 3:30 p.m., staff member V stated that cleaning wheel chairs was up to the night shift. She stated she had observed some wheelchairs which looked like they had not been cleaned. 2. During an observation on 12/12/16 at 4:40 p.m., a resident #6's room had a dirty bed side table with circular stains from a glass that had been dried onto the table. The floor of the resident room had food stains and foot prints throughout the room. During an interview on 12/13/16 at 8:35 a.m., resident #7 stated she had been having diarrhea and her toilet was dirty with dried stool. The resident stated she had asked several times for her toilet to be cleaned but no one had cleaned the toilet for one week. During an observation of resident #7's bathroom on 12/13/16 at 3:25 p.m., the resident's toilet was soiled with dried feces around the entire inside of the toilet bowl. During an observation and interview on 12/14/16 at 2:55 p.m., resident #7 stated, and pointed out that her toilet had finally been cleaned that afternoon. During an interview on 12/13/16 at 9:15 a.m., staff member F stated that the following areas were to be cleaned daily: -garbage's -bathroom sinks -bed side tables The staff member also stated they would clean the toilets and floors twice a week. 3. During an observation on 12/12/16 at 3:21 p.m., the dining room tables in Copper East were soiled. Two of the tables had a red ketchup like substance on it. Another table had a Kleenex box, and when the box was moved it stuck to the table and some of the cardboard packaging was left stuck to the table. During an interview on 12/12/16 at 4:24 p.m., staff member W stated cleaning the dining room tables was a job typically completed by the housekeeper, but Mondays and Tuesdays were the housekeeper's day off. She stated the head housekeeper or another person was assigned to keep the Copper East wing clean. She also said the CNAs could help out and clean the tables after the CNAs finished situating the residents after meals. During observations on 12/13/16 at 8:00 a.m., at 9:00 a.m., and 10:30 a.m. an entry way in the Copper East dining room had dry, muddy foot prints continuing into the dining room. Water had begun to pool up on the floor, and was tracked into the resident dining room. Cobwebs were observed in the family dining room, and the windows of the resident dining room. During an observation on 12/13/16 at 3:30 p.m., three dining room tables, in the Copper East dining room, were not wiped down after the noon meal. The tables had a sticky substance all over the top of them, and on the sides of the table which looked like dried food. During an observation on 12/14/16 at 2:00 p.m., the Crest East dining room tables were soiled with food, wrappers, sugar, dirty tissues, empty saltine cracker wrappers, and unopened packages of saltines. Also, observed on the various tables in the dining room, were plastic lids with salad dressings on them, a spilled milky white liquid, salt and/or sugar which had spilled, and crumpled napkins. During an interview on 12/14/16 at 2:15 p.m., staff member X stated she realized the tables were soiled. She stated the CNAs had already assisted the residents after their meals and the tables should have been cleaned. She agreed the dining room was messy, and stated she didn't want the guests of the facility seeing the dining room in that condition. She stated she was going to grab the CNAs and have them tidy up the dining area. During an observation on 12/14/16 at 2:50 p.m., the Copper East dining room tables were stained with cup rings that were dry and sticky. During an observation on 12/12/16 at 3:26 p.m., The dining room tables, located in the dining room on Rimview, were sticky to the touch from dried food debris. The dining room tables had a light brown rubber edging around the outside. The rubber edging on the tables had food particles and a black grime rubbed into the rubber edging. The surface of the tables were also sticky from dried food debris. The dining room tables had food debris and left over sauce on the tables. During an observation on 12/13/16 at 2:52 p.m., the tables in the dining room, on Rimview, had food and debris buildup around the edges of the table. Two dining room tables had a brown sauce smear on the surface of the tables. There were three residents sitting in the dining room. During an interview on 12/13/16 at 2:55 p.m., staff member S stated the tables were wiped down after each meal service by the CNAs. A disinfecting wipe would be used to remove any food debris and dried on sauces after the meal. Staff member S stated house keeping did not provide a deep cleaning or degreasing of the dining room tables. During an interview on 12/13/16 at 6:37 p.m., staff member D stated the tables were designed with the sticky rubber edging to prevent dining ware from sliding off the table. Staff member D stated the facility had attempted to clean the tables with the rubber edging and had not been successful. During an interview on 12/14/16 at 8:50 a.m., staff member D stated the dining room tables on Rimview were cleaned. The black, brown grease build up on the rubber edging of the tables, had improved. However, on other tables in the dining area, there was still dried on food debris around the edges and on the sides of the tables. This observation was made with the staff member D present. During an observation on 12/14/16 at 8:55 a.m., dining room tables on Rimview showed the black, brown grease build up was removed. On the other dining room table edges there was food debris and sauce build up on the outside of the table edge. During an observation on 12/14/16 at 3:26 p.m., the dining room tables in the Rimview dining room had food and dried dark brown sauce stain on three tables. There were three residents sitting in the dining room. During an observation on 12/14/16 at 3:39 p.m., a CNA brought a resident down to the Rimview dining room. The CNA seated the resident across from another resident. The table the resident's were sitting at had a dried dark brown thick stain on the table. The CNA retrieved a disinfecting wipe and cleaned the table after the resident was seated. The resident had to wait for the table to dry prior to being served his beverages. During the same observation, two tables still had a dried dark brown stain on the table. Residents were sitting at the dirty tables. During an observation on 12/15/16 at 4:37 p.m., a resident was seated at a dining room table in the Rimview dining hall. The table the resident was seated at had a dried, thick, brown stain on the surface of the table. The stain had been on the table since the lunch service. The table was not cleaned after the lunch meal service, or before the resident was seated at the dining table for dinner service. During an interview on 12/15/16 at 4:40 p.m., staff member D stated it was the expectation of staff to clean the dining room tables after each meal service and when visibly soiled. A review of the facility's user manual, titled, Urethane Edge Tables, showed, Edgemold's urethane edge tables feature. The urethane flows around the table, and shrinks as it cools resulting in a tightly sealed, durable edge with no seam between the edge and laminate top. An edgemold original table seamless edge totally eliminates a place for dirt, microbial growth or moisture to accumulate. Our proprietary formula includes an antimicrobial agent that helps keep the edges sanitary. Review of the facility's Daily General Cleaning Policy showed that the following areas were to be cleaned daily: -Common areas -Restrooms -Resident rooms -Dining areas -Hallways -Windows -Bathroom toilet and sink -Sweeping floor -Dusting -Fixtures -Spot cleaning. 2020-09-01