cms_ND: 10

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
10	THE MEADOWS ON UNIVERSITY	355024	1315 S UNIVERSITY DR	FARGO	ND	58103	2019-05-16	580	D	1	1	FA2L11	NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY > Based on record review, review of facility policy, family interview, and staff interview, the facility failed to notify residents' representatives or physicians promptly of a change in condition for 2 of 20 sampled residents (Resident #31 and #49). Failure to update resident representatives promptly on injuries of unknown origin and new treatment orders (Resident #31 and #49) and failure to update the physician promptly on a deterioration in skin condition (Resident #31) may delay treatment and is a violation of residents' rights. Findings include: Review of the facility policy titled Change in a Resident's Condition or Status occurred on 05/16/19. This undated policy stated, . Our facility shall promptly notify the resident, his or her Attending Physician, and representative (sponsor) of changes in the resident's medical/mental condition and/or status (e.g., changes in level of care, billing/payments, resident rights, etc.). The nurse will notify the resident's Attending Physician or physician on call when there has been a(an): . discovery of injuries of an unknown source . need to alter the resident's medical treatment significantly . Unless otherwise noted by the resident, a nurse will notify the resident's representative when: . The resident is involved in any accident or incident that results in an injury including injuries of an unknown source . there is a significant change in the resident's physical, mental, or psychosocial status . - Review of Resident #31 medical record occurred on all days of survey. Progress notes stated the following: * 04/18/19 at 11:00 p.m. to 11:26 p.m.: . resident left dorsal foot area has open area, due to [MEDICAL CONDITION], skin cleaned and dressing applied . measurement on left dorsal foot 2 x 1.5 cm (centimeter) . resident left foot has pitted [MEDICAL CONDITION] +2, wear ACE wrap in AM and off at HS (hour of sleep) . has some redness around the wound . will continue to monitor. * 04/24/19 at 5:43 p.m.: . called physician to notify of ulceration and request new treatment. Cleanse ulceration to L (left) dorsal foot with NS (normal saline) once daily. Apply [MEDICATION NAME] to slough and cover with a dry gauze dressing daily. * 04/26/19 at 11:21 a.m.: Residents sister (name of person) called and notified of resident skin alteration. The medical record lacked evidence of wound monitoring from 04/19/19 to 04/24/19. During an interview the morning of 05/16/19, an administrative nurse (#7) confirmed the physician and resident representative were not notified promptly of a change in Resident #31's medical condition. - During an interview on the afternoon of 05/13/19, a family member stated the facility does not update her of changes to Resident #49's plan of care/health status. The family member stated, She could have skin issues, I'd never know. They don't tell me anything. The family member also stated Resident #49 started speech therapy and staff failed to update her. Review of Resident #49's medical record occurred on all days of survey. [DIAGNOSES REDACTED]. 02/10/19 at 10:46 p.m.: . 4th nail on right toe has come of (sic). No pain and no bleeding noted. Note left for NP (nurse practitioner) to visit. To covered (sic) with bandage . 02/11/19 at 11:19 a.m.: . New orders per (NP) to apply [MEDICATION NAME] ointment to left fourth toe and cover with bandaid - change BID (twice per day) and PRN (as needed). Notify provider/NP if no improvements/worsens on 2/15/19. 02/11/19 at 4:53 p.m. (NP note): . pt (patient) seen today for left toe nail that was removed likely due to trauma. Pt reports discomfort at nail injury site. Toe nails are over grown and nursing will trim. 03/27/19 at 1:21 p.m.: . New orders per (NP) for SLP (speech-language pathology) evaluate and treat for dysphagia and difficulties with self feeding. Resident #49's medical record lacked evidence of representative notification of the above injury and new order for speech therapy.	2020-09-01