cms_ND: 69

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
69	MINOT HEALTH AND REHAB, LLC	355031	600 S MAIN ST	MINOT	ND	58701	2017-07-26	325	D	0	1	GH6U11	NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, record review, and staff interview, the facility failed to maintain acceptable nutritional status for 1 of 3 residents (Resident #2) identified with weight loss. Failure to consistently implement weight loss interventions may result in poor nutrition and avoidable weight loss. Findings include:Review of Resident #2's medical record occurred on all days of survey. [DIAGNOSES REDACTED]. The current Minimum Data Set (MDS), dated [DATE], identified extensive assistance from one person for eating. Resident #2's care plan stated, . At risk for nutritional status change r/t (related to) wt. (weight) loss. Intakes less than estimated need . Interventions . assist to consume foods and/or supplements and fluids offered . A dietary assessment, dated 05/09/17, stated, . Visited with (Resident #2) and spouse about preferences. Her UBW (usual body weight) 150#. She dislikes; all potato but French fries, all vegetables except green beans and corn . Dietary progress notes stated the following: 05/23/17 at 1:58 p.m.: . Fortified cereal daily and fortified soup at supper. Staff set up and assist her at meals. 06/04/17 at 10:49 a.m.: . receiving fortified items at meals for additional nutrition and finger foods offered as much as possible. Recent weight loss is noted. Review weight 140, will add high calorie snacks at 10 am and 3 pm. Will continue to provide a fruit cup at hs (bedtime) per her request. 07/11/17 at 10:01 a.m.: . Fortified pudding at 10 AM provides approx. (approximately) 250 calories and 6 gms (grams) pro. (protein) Ice cream at 3 PM and fruit cup at HS per her request. 07/11/17 at 3:03 p.m.: . Current wt. 133.6# 3% loss in 1 month. Continues to lose wt. Continue fortified items and supplements. Try fortified mashed potato. Resident #2's dietary assessment, dated 05/09/17, identified the resident did not like potatoes. *07/25/17 at 11:33 a.m.: . receiving fortified items at meals for additional nutrition and high calorie snacks between meals. Refused fortified potatoes tried last week. Refuses approximately 75% of snacks. Resident #2's weight records identified a weight of 156.4 pounds (lbs) on 05/02/17, and a current weight on 07/24/17 of 133 lbs. This represents a 23.4 lb (15%) weight loss over twelve weeks. Observation on 07/24/17 at 3:45 p.m. showed Resident #2 asleep in her bed. An unopened container of ice cream sat on her bedside table. At 4:55 p.m., observation showed the resident out of bed and in her wheelchair, and the container of ice cream in the garbage with the lid still on. Snack intake charting for the afternoon of 07/24/17 failed to show a snack offered to Resident #2. Observation of the evening meal on 07/24/17 showed Resident #2 received her tray at 6:10 p.m. Staff failed to assist the resident with the tray set up, including removing the lid from her bowl of soup or unwrapping her silverware. The resident made no attempt to feed herself and received no cuing from staff until 6:21 p.m. when a staff member sat by the resident and assisted her to eat. Observation during the noon meal on 07/25/17 showed staff served Resident #2 a piece of fish, mixed vegetables (containing vegetables the resident identified she did not like), diced peaches, and eight ounces of milk. The meal failed to contain any fortified items and was the same food served to other residents. Review of Resident #2's snack intake records showed from 06/05/17 through 07/25/17, staff failed to document the 10:00 a.m. snack nine times and the 3:00 p.m. snack 38 times. Failure to accurately record snack intakes/refusals may misrepresent the actual amounts consumed by Resident #2 and may delay further dietary intervention. During an interview on the morning of 07/26/17, a supervisory nurse (#10) agreed the snack intakes were not accurately recorded and that Resident #2 needed assistance with meals.	2020-09-01