cms_ND: 6

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
6 THE MEADOWS ON UNIVERSITY 355024 1315 S UNIVERSITY DR FARGO ND 58103 2017-05-10 328 D 1 1 ZMNB11 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** > Based on observation, record review, review of professional reference, review of facility policy, and staff interview, the facility failed to provide the necessary care and services for 1 of 3 sampled residents (Resident #8) receiving oxygen therapy. Failure to follow the medical providers orders, and provide guidance to the facility staff on oxygen usage does not allow the facility or the health care provider to assess the effectiveness of the resident's oxygen therapy. Findings include: Berman and Snyder, S., Kozier & Erb's Fundamentals of Nursing Concepts, Process, and Practice, 10th ed., Pearson Education, Inc., New Jersey, page 1259 states, . Like any medication, oxygen is not completely harmless to the client. Clients can receive an inadequate amount or an excessive amount of oxygen and both can lead to a decline in the client's condition. Review of the facility policy titled Respiratory: Oxygen Administration occurred on 05/10/17. This policy, dated (MONTH) (YEAR), stated, . Procedure: 1. Verify Physician's order . Review of Resident #8's medical record occurred on all days of survey. [DIAGNOSES REDACTED]. Current physician's orders stated, OXYGEN AT 3L (liter) PER NASAL CANNULA AT BEDTIME AND AS NEEDED FOR SOB (short of breath)/WHEEZIN[NAME] Resident #8's care plan identified the following Focus: Resistive/noncompliant with oxygen therapy related to: [MEDICAL CONDITION], belief that treatment is not needed/working . The certified nurse aide (CNA) kardex identified OXYGEN 2L continuous, neb (nebulizer) prn (as needed), patient will remove O2 (oxygen) at times. Observations of Resident #8 showed the following: * 05/08/17 at 4:26 p.m. sitting in her room in her wheelchair wearing a nasal cannula connected to an oxygen tank set at 2 liters per minute (LPM). * 05/09/17 at 8:51 a.m., self propelling her wheelchair in the hallway wearing a nasal cannula connected to an oxygen tank set at 2 LPM. * 05/09/17 at 12:27 p.m. self propelling her wheelchair in the hallway wearing a nasal cannula connected to an oxygen tank set at 2 LPM. * 05/09/17 at 2:00 p.m. in her room lying on the bed wearing a nasal cannula connected to an oxygen tank set at 2 LPM. During an interview on the afternoon of 05/10/17, an administrative nurse (#1) confirmed information on the kardex failed to match the physician's order. The facility failed to ensure the consistency in the delivery of Resident #8's O2 per nasal cannula in regard to the liter flow rate and usage of O2. 2020-09-01