cms_ND: 16

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

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
16	THE MEADOWS ON UNIVERSITY	355024	1315 S UNIVERSITY DR	FARGO	ND	58103	2019-05-16	658	E	1	1	FA2L11	NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY > Based on observations, record review, review of facility policy, review of professional reference, family and staff interview, the facility failed to follow professional standards of nursing practice for 5 of 20 sampled residents (Resident #30, #35, #43, #49, and #61). Failure to carry out a physician's order (Resident #35), failure to follow facility policy when priming insulin pens (Resident #43 and #61), and failure to ensure residents received follow up care as ordered (Resident #30 and #49) may result in adverse health effects. Findings include: PHYSICIAN'S ORDERS Kozier & Erb's Fundamentals of Nursing, Concepts, Process and Practice, 10th Edition, (YEAR), Pearson, Boston, Massachusetts, page 68, stated, . Carrying Out a Physician' Orders . If the order is neither ambiguous not apparently erroneous, the nurse is responsible for carrying it out. - Review of Resident #35's medical record occurred on all days of survey. [DIAGNOSES REDACTED]. A cardiology progress note, dated 04/08/19, identified an order for [REDACTED].#35 on 9 of the past 37 days. During an interview on the morning of 05/16/19, an administrative nurse (#1) confirmed she expects nurses to follow physician orders and that the weights were missed. - Review of Resident #30's medical record occurred on all days of survey. [DIAGNOSES REDACTED]. The record identified a hospital stay from (MONTH) 3-7, 2019 for a [DIAGNOSES REDACTED]. Discharge instructions identified a follow up appointment at the urology clinic on 03/18/19. The medical record lacked evidence the resident went to this appointment. During an interview on the afternoon of 05/16/19, an administrative nurse (#1) confirmed Resident #30 did not go to the urology appointment. - During an interview on the afternoon of 05/13/19, a family member stated she was upset because Resident #49 missed a neurology appointment in (MONTH) which was previously scheduled. The resident was then unable to see the neurologist until June. Review of Resident #49's medical record occurred on all days of survey and identified a [DIAGNOSES REDACTED]. Pt. (patient) returned from appointment with (medical doctor). Continue with exercise and ROM (range of motion) at least twice a day. Pt. to follow-up with (neurologist) on 3/18/19 at 1030. The record also contained an appointment reminder letter from the medical provider which listed a neurology appointment on 03/18/19. Resident #49's record lacked evidence the resident went to this appointment. During an interview on the morning of 05/16/19, a supervisory nurse (#7) confirmed Resident #49 missed the neurology appointment and is scheduled to go in June. Failure to ensure residents receive scheduled follow up care may result in inadequate medical management and adverse health outcomes. INSULIN PENS Review of the facility policy titled, Insulin Administration Instructions occurred on 05/16/19. This undated policy stated, . - Take off and keep the outer needle cap, then remove the inner needle cap and discard it - Select a dose of 2 units by turning the dosage selector - Hold the pen with the needle pointing upwards and tap the insulin reservoir so that any air bubbles rise up towards the needle - Press the injection button all the way in and check if insulin comes out, repeat the process until you see a drop of insulin, a max of six times . - Review of Resident #43's medical record occurred on all day of survey and identified a physician's order for Humalog (a rapid acting insulin). Observation of medication pass occurred on 05/13/19 at 5:08 p.m. A nurse (#5) selected two units on Resident #43's Humalog Pen and pressed the injection button without holding the pen upwards. The nurse (#5) failed to hold the pen upwards to properly prepare the pen for insulin administration to Resident #43. - Review of Resident #61's medical record occurred on 05/14/19 and identified physician order's for Tresiba (a long acting insulin) and [MEDICATION NAME] (a rapid acting insulin). Observation of medication pass occurred on 05/14/19 at 1:17 p.m. A nurse (#6) failed to remove the needle cap selected two units on Resident #61's Tresiba pen and pressed the injection button without holding the pen upwards. The nurse (#6) prepared Resident #61's [MEDICATION NAME] Pen without removing the needle cap, selected two units and pressed the injection button without holding the pen upwards. The nurse (#6) failed to remove the needle cap and to hold the pen upwards to prepare the pen for injection to Resident #61.	2020-09-01