cms_ND: 98

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
98 MINOT HEALTH AND REHAB, LLC 355031 600 S MAIN ST MINOT ND 58701 2019-10-21 677 D 0 1 6YYS11 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, record review, review of facility policy, and resident, family, and staff interviews, the facility failed to provide activities of daily living (ADL) assistance to 1 of 8 sampled residents (Resident #17) and 1 supplemental resident (Resident #51) who required staff assistance for toileting/check and change. Failure to provide assistance in a timely manner to residents who cannot independently carry out ADLs may result in poor grooming/hygiene and decreased self-esteem. Findings include: Review of the facility policy titled Incontinence Prevention Program occurred on 10/17/19. This undated policy stated, To provide the appropriate bowel and bladder continence interventions based upon individualized evaluation of residents. Routine toileting (ADL based) - A scheduled bladder management program will be designed to toilet an incontinent patient/resident when a voiding pattern cannot be established or for a patient/resident who is unable to communicate the need to void. Goal: Keep the resident dry. Example schedule in care plan: 'Toilet the resident every 2 hours, before and after meals, at bedtime and once during the night.'. Check and Change . residents using briefs will be checked frequently as needed for incontinent episodes and removal/replacement of soiled briefs. Perineal care will be provided after each incontinent episode. - Review of Resident #17's medical record occurred on all days of survey. The resident's current care plan stated, . ADL self-care deficit as evidenced by requires assistance related to: decreased physical function . Check and change at routine times such as before and after meals, at HS (hour of sleep) and routinely throughout the night. Transfer with full body mechanical lift, full body sling, two staff . Urinary incontinence r/t (related to) Disease process dementia . Incontinence care at routine times such as upon arising in AM, before/after meals, activities, naps, at bedtime and on scheduled rounds at night . Observations on 10/16/19 showed Resident #17 seated in the wheelchair at the following times: * 9:55 a.m. - located in the commons area (following the breakfast meal) * 11:00 a.m. - located in the commons area during an activity * 12:08 p.m. - located in the dining room for the noon meal The nursing staff failed to toilet/check and change Resident #17 after the breakfast meal, before/after an activity, or before the noon meal as stated in the resident's care plan. - Review of Resident #51's medical record occurred on 10/15/19. The quarterly minimum data set (MDS), dated [DATE], identified the resident required extensive assistance of two staff for toileting, and the resident was always incontinent of bowel. Observations on 10/15/19 showed Resident #51 seated in the wheelchair in the resident's room at the following times: * 9:48 a.m. - Odor of BM (bowel movement). The resident stated, I am not taken to a toilet. They just change me, and indicated last changed that morning. * 10:20 a.m. - Odor of BM. A certified nurse assistant (CNA) (#4) provided a snack and left the room. * 10:48 a.m. - Odor of BM * 11:18 a.m. - Odor of BM. During an interview on 10/15/19 at 10:06 a.m., a family member (AA) confirmed Resident #51 smelled like BM. The nursing staff failed to provide incontinence care in a timely manner for Resident #51. During an interview on 10/17/19 at 3:50 p.m., an administrative nurse (#13) stated she expected staff to follow each resident's toileting schedule and/or check and change at routine toileting times, and then defined routine toileting as, every two to three hours, before/after meals, and at bedtime. 2020-09-01