cms_ND: 82

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

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
82 MINOT HEALTH AND REHAB, LLC 355031 600 S MAIN ST MINOT ND 58701 2018-08-16 658 D 0 1 B0I611 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** PRIMING INSULIN PENS 1. Based on observation and manufacturer's guidelines, the facility failed to follow professional standards of practice in priming insulin pens for 2 of 3 residents observed receiving insulin (Resident #16 and #42). Failure to remove the needle shield prior to priming an insulin pen and inverting the pen during priming may result in the resident receiving an inaccurate amount of insulin. Findings include: Prescribing information for [MEDICATION NAME]found at www.nov-pi.com/novolgpdf, stated, . Before each injection small amounts of air may collect in the cartridge during normal use. To avoid injecting air and to ensure proper dosing: Turn the dose selector to select 2 units. Hold your [MEDICATION NAME] with the needle pointing up. Tap the cartridge gently with your finger a few times to make any air bubbles collect at the top of the cartridge. Keep the needle pointing upwards, press the push-button all the way in. The dose selector returns to 0. A drop of insulin should appear at the needle tip. If not, change the needle and repeat the procedure no more than 6 times. - Observation on 08/14/18 at 12:10 p.m. showed a licensed nurse (#1) prepared an insulin pen for injection for Resident #16. After placing the needle on the insulin pen, the nurse failed to remove the outer needle shield before priming the insulin pen. With the shield still in place, the nurse was unable to visualize a stream of insulin from the needle. - Observation on 08/15/18 7:47 a.m. showed a licensed nurse (#24) prepared an insulin pen for injection for Resident #42. The nurse placed the needle on the pen, removed the needle shield, and primed the pen with two units of insulin while holding it with the needle pointing downward. Priming the pen with the needle pointing downward does not ensure an adequate amount of insulin is expelled during the priming process. OBTAINING/FOLLOWING physician's orders [REDACTED].>2. Based on observation, record review, review of professional reference, and staff interview, the facility failed to obtain/follow physician's orders [REDACTED].#8, #65, and #71 ). Failure follow physician's orders [REDACTED]. Findings include: Berman, Snyder, and Frandsen's Kozier & Erb's Fundamentals of Nursing: Concepts, Process, and Practice, 10th ed., Pearson Education, Inc., Massachusetts, page 68, states, . Carrying Out a physician's orders [REDACTED]. Documentation . Nurses, therefore, need to provide accurate and complete documentation of the nursing care provided to clients. - Review of Resident #71's medical record occurred on all days of survey. The resident's Medication Administration Record [REDACTED]. The record further identified a physician's orders [REDACTED]. During an interview on the afternoon of 08/15/18, a licensed nurse (#6) stated he was unable to locate an order to discontinue Resident #71's insulin. - Review of Resident #65's medical record occurred on all days of survey. The current physician's orders [REDACTED]. The resident's record identified staff weighed Resident #65 on 13 of the 42 days since 06/20/18 and last weighed the resident on 08/06/18. During an interview on the morning of 08/16/18, an administrative staff member (#16) stated the physician had not discontinued Resident #65's daily weights. - Review of Resident #8's medical record occurred on all days of survey. The current physician's orders [REDACTED]. Observations showed the following: * 08/15/18 at 3:59 p.m., Resident #8 not wearing her TED hose. * 08/16/18 at 9:33 a.m., Resident #8 lying in bed not wearing her TED hose. During an interview on 08/16/18 at 9:38 a.m., a licensed nurse (#19) confirmed staff failed to apply Resident #8's TED hose per the physician's orders [REDACTED].> 2020-09-01