cms_ND: 5

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
5 THE MEADOWS ON UNIVERSITY 355024 1315 S UNIVERSITY DR FARGO ND 58103 2017-05-10 322 D 1 1 ZMNB11 **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 the appropriate treatment and services for 1 of 1 supplemental resident (Resident #18) observed receiving medications through a gastrostomy tube. Failure to administer the appropriate amount of fluid with administration of medications into a gastric tube and clean the syringe after administration may result in harm to the resident. Findings include: Review of the facility policy titled Enteral Tubes: Medication Administration occurred on 05/10/17. The policy, dated (MONTH) 2012, stated, . Procedure . dissolve medication in medicine cup using 10 to 30 ml (milliliters) of water . (before medication) Flush tube with a minimum of 30 ml of water . flush between each medication with a minimum of 5-10 ml of water . flush tube at end of medication administration with a minimum of 30 ml water . rinse reusable syringe, allow to air dry . - Review of Resident #18's medical record occurred on 05/09/17. The current physician order stated, Flush (gastric) tube with at least 30 ml of water before and after an external feeding and/or medication administration Observation on 05/09/17 at 3:42 p.m. showed a licensed nurse (#6) entered Resident #18's room to administer the contents of the [MEDICATION NAME] (nerve pain) medication capsule. The nurse (#6) checked placement of the tube, checked the stomach residual with a syringe, and flushed the syringe with 5 ml of water. The nurse (#6) administered the [MEDICATION NAME] powder with 5 ml of water into the gastric tube, flushed with 20 ml of water, clamped the gastric tube, and placed the used syringe in a bag to air dry. The licensed nurse (#6) confirmed she flushed the gastric tube with 5 ml of water, then gave the medication with 5 ml of water, and did a final flush with 20 ml of water. The nurse (#6) failed to flush the tube with 30 ml of water before and after medication administration, dissolve the medication in 10 to 30 ml of water, and rinse the reusable syringe. Observation on 05/09/17 at 5:05 p.m. showed a licensed nurse (#6) entered Resident #18's room to administer a crushed pyridostigmine (muscle strength) medication. The nurse checked placement, checked the stomach residual, and gave the medication with water flushes. When completed the nurse failed to rinse the reusable syringe. During an interview on 05/10/17 at 2:15 p.m., a nurse manager (#1) confirmed nursing staff are to follow doctors orders and facility policy on water flushes and cleaning of syringes with each use. 2020-09-01