cms_ND: 17

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
17	THE MEADOWS ON UNIVERSITY	355024	1315 S UNIVERSITY DR	FARGO	ND	58103	2019-05-16	677	D	1	1	FA2L11	NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY > Based on observation, record review, review of facility policy, and staff interview, the facility failed to provide activities of daily living (ADL) assistance to 1 of 11 sampled residents (Resident #45) who required staff assistance for toileting. Failure to provide appropriate assistance to residents who cannot independently carry out ADLs may result in avoidable incontinence, poor grooming/hygiene, decreased self esteem, and an avoidable decline in ADL ability. Findings include: Review of the facility policy titled Activities of Daily Living (ADLs), Supporting occurred on 05/16/19. This undated policy stated, . Residents will (be) provided with care, treatment, and services as appropriate to maintain or improve their ability to carry out activities of daily living (ADLs). Residents who are unable to carry out activities of daily living independently will receive the services necessary to maintain good nutrition, grooming, and personal and oral hygiene. Appropriate care and services will be provided for residents who are unable to carry out ADLs independently, with the consent of the resident and in accordance with the plan of care, including appropriate support and assistance with: a. Hygiene (bathing, dressing, grooming, and oral care); b. Mobility (transfer and ambulation, including walking); c. Elimination (toileting) . Review of Resident #45's medical record occurred on all days of survey. [DIAGNOSES REDACTED]. Focus . ADL Self care deficit related to physical limitations . Interventions . hands on staff assist with bed mobility, transfers, w/c (wheelchair) locomotion on and off unit, dressing, toileting, personal hygiene, eating and bathing. Staff anticipate needs as ADL's do fluctuate . Transfer: extensive assistance of one with gait belt and pivot . Focus . At risk for falls due to impaired balance/poor coordination . Interventions . assist to bathroom after meals as needed . check on resident and offer toileting regularly . Don't leave patient unattended in bathroom . Observation on 05/14/19 at 9:20 a.m. showed a certified nursing assistant (CNA) (#8) transported Resident #45 in her wheelchair to her room. The CNA called for help from another CNA (#16). The CNA (#16) entered the room and asked the CNA (#8) if they were toileting the resident. The CNA (#8) stated, No, we are going to change her in bed. She's just so hard to transfer. The CNAs attempted to transfer Resident #45 to bed, but the resident became resistive. A nurse (#6) entered the room and instructed the CNAs to re-approach the resident. At 10:44 a.m., two CNAs (#8 and #13) transferred Resident #45 into bed (without offering toileting) and attempted to check and change her incontinence brief. The resident again refused. At 11:31 a.m., observation showed a nurse (#6) exited Resident #45's room. The nurse indicated she checked and changed Resident #45's brief. During an interview on 05/14/19 at 2:16 p.m. a CNA (#8) stated she checked and changed Resident #45's brief in bed and she was now asleep. Observation on 05/15/19 at 11:15 a.m. showed two CNAs (#8 and #9) transferred Resident #45 into bed (without offering toileting) and checked and changed her incontinence brief. When asked if Resident #45 uses the toilet, the CNA (#8) stated, Not much. She's so unsteady. During an interview on the morning of 05/16/19, a supervisory nurse (#1) agreed staff should follow resident's care plans regarding ADL assistance.	2020-09-01