cms_ND: 45

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
45 THE MEADOWS ON UNIVERSITY 355024 1315 S UNIVERSITY DR FARGO ND 58103 2018-12-06 697 D 1 0 PNS511 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** > Based on information provided by the complainants, observation, record review, review of facility policy, and resident/staff interviews, the facility failed provide treatment and services in a manner that maintained the highest practicable physical well-being for 1 of 10 sampled residents (Resident #10) observed experiencing pain during cares. Failure to carry out physician's orders [REDACTED].#10 experiencing avoidable pain/discomfort. Findings include: Information provided by the complainants indicated residents contacted family members/representatives when they experienced pain/discomfort secondary to skin breakdown/being soiled. Review of the facility's policy titled medication orders [REDACTED]. This undated policy stated, . The prescriber is contacted for direction when delivery of a medication will be delayed or the medication is not or will not be available. - Review of Resident #10's medical record occurred on all days of survey. The record identified [DIAGNOSES REDACTED]. A physician's orders [REDACTED]. Apply to rectum topically BID. The progress notes identified the following: * 11/19/18, . Patient was admitted from (hospital) with a [DIAGNOSES REDACTED]. * 11/22/18, . Patient is incontinent of B/B (bowel/bladder) . * 11/25/18, Weekly skin assessment done, noted redness to her bottom and continuing with feces d/t (due/to) her illness. * 11/26/18, Patient returned from (cancer center) with new orders to discontinue ammonium [MEDICATION NAME]. Start [MEDICATION NAME] to apply to gluteal/perianal and the vulvar areas three times a day. monitor skin for breakdown every shift. * 11/27/18, . Her coccyx area is excoriated from frequent diarrhea. Lac-Hydrine cream is burning her, so it will be d/c (discontinued) and [MEDICATION NAME] started. * 11/28/18, . Receiving [MEDICAL CONDITION] therapy and continuous chemo infusion for [MEDICAL CONDITION]. * 11/29/18, . Incontinent of B/B (bowel/bladder) . * 12/02/18, . redness to the perirectal area do (sic) to stool, treatments and incontinences (sic) treatment to area bid and prn (as needed). Observation showed the following: * 12/06/18 at 7:50 a.m., Resident #10 lying in bed, squirming from side to side. When asked if she required assistance, she pointed towards her buttocks and stated, It itches. Then it hurts. It's irritated. It hurts so bad! A different med (medication) is coming from Pharmacy today. * 12/06/18 at 10:50 a.m., Resident #10 shifted her weight as she laid on the bed and stated, My butt is so sore! During an interview on 12/06/18 at 10:55 a.m., when asked questions pertaining to Resident #10's toileting needs, a certified nursing assistant (CNA) (#4) stated, When we provide toilet cares, (we) gently wipe (the) little sore on her buttocks. Just redness to her buttocks, but very painful! Put a little ointment on the rash. The CNA then showed the surveyor the tube of Peri-Guard ointment located in Resident #10's dresser drawer. Observation on 12/06/18 at 12:48 p.m., showed a CNA (#4) assisted Resident #10 into the bathroom and provided toileting cares. Resident #10's coccyx area appeared darkened, and her perineal/rectal area appeared reddened/raw-looking. Resident #10 voiced discomfort when the CNA (#4) applied Peri-Guard ointment to the reddened area. During an interview on 12/06/18 at 1:30 p.m., when asked questions pertaining to Resident #10's prescribed skin cream, an administrative nurse (#1) reported the facility received the physician's orders [REDACTED]. The nurse (#1) explained the pharmacy did not have that particular cream in stock and therefore contacted a second pharmacy to see if they had it in their inventory. The administrative nurse (#1) reported the Pharmacy delivered the cream on 12/05/18. Review of the Medication Administration Record [REDACTED]. When asked questions regarding the discrepancy, the administrative nurse (#1) stated, It (Lipovan rectal cream) may have hit the building late in the day. It should have been here (12/03/18). Staff should have called (her physician) that evening, and checked into another medication until it came in. The progress notes failed to reflect staff notified Resident #10's physician regarding the unavailable Lipovan rectal cream, the delayed delivery of the cream depending upon whether it was available through the second pharmacy, and/or that they had asked for direction/a replacement cream until it arrived. Failure to carry out the physician's orders [REDACTED].#10 experiencing avoidable pain/discomfort. 2020-09-01