cms_SD: 20

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
20	AVANTARA HURON	435020	1345 MICHIGAN AVENUE SW	HURON	SD	57350	2019-05-09	550	D	0	1	L4FS11	NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview, record review and policy review, the provider failed to ensure: One of one sampled resident (61) was engaged in conversation during three of three meal services. Two of two sampled residents (61 and 78) were provided privacy during personal care. Finding include: 1. Review of resident 61's medical record revealed: She was admitted on [DATE]. Her [DIAGNOSES REDACTED].>-Unspecified dementia without (w/o) behavioral disturbances. -Age related [MEDICAL CONDITION] w/o current pathological fracture. -Hypertension. -Vitamin D deficiency. Review of resident 61's 4/2/19 Minimum Data Set assessment revealed: There was no Brief Interview for Mental Status assessment score due to significant cognitive impairment. The resident representative was not available for an interview for her daily activity preferences, and the resident was not able to be interviewed. She was totally dependent upon two staff for assistance with bed mobility, transfers, toilet use, and bathing. She was totally dependent upon one staff person for locomotion on and off the unit. She required the extensive assistance of two staff for dressing and personal hygiene. She required the extensive assistance of one staff person for eating. Observation on 5/7/19 from 7:50 a.m. through 8:27 a.m. in the [NAME] wing dining room revealed: Certified nursing assistant (CNA) F and CNA G were sitting at dinning room table four. -They were sitting on opposite corners of the table to assist residents with breakfast. There were four residents sitting at the table needing assistance including resident 61. CNA F and G were maintaining a conversation between themselves across the table. CNA G did tell resident 61 what was on her fork one time. There was no other verbal communication with the resident's by either CNA during that time. Observation on 5/7/19 from 12:18 p.m. through 12:25 p.m. in the [NAME] wing dining room revealed: CNA G and H were sitting at dining table four. They were sitting on opposite corners of the dining room table to assist residents with lunch There were four resident's sitting at the table needing assistance including resident 61. CNA G and H were maintaining a conversation between the themselves, from across the table. No observations were made of staff talking to the residents during that time. Interview on 5/9/19 at 9:14 a.m. with CNA F revealed: It was normal for her to talk to the residents about what they were eating when she was assisting them. She explained to them what they were eating and when she was giving them a bite. She did not typically engage in conversations with other staff members sitting at the tables. Interview on 5/9/19 at 9:47 a.m. with CNA G revealed: She told the residents what was on their plates when assisting them with eating. She would watch the resident's facial expressions to know likes and dislikes. She would offer fluids after two bites of food. She did not typically engage in conversation with with other staff while assisting residents to eat. Interview on 5/9/19 at 9:52 a.m. with the director of nursing (DON) revealed: The expectation was for the CNAs to interact with the residents when they were assisting them with their meals. It was not acceptable to have minimal interaction with residents and conduct a conversation among themselves. 2. Observation on 5/8/19 from 8:16 a.m. until 8:23 a.m. of resident 61 revealed: Licensed practical nurse (LPN) N entered her room after knocking on the door, and resident 61 was laying in bed. LPN N elevated head of her bed, and then swabbed out her mouth. LPN N had not provided privacy for her. The door was not closed, and the curtains were left open. CNA F entered the room with her breakfast tray. CNA F was standing next to her bed assisting her with eating breakfast. CNA F stood next to her bed until she left the room [ROOM NUMBER] minutes after entering the room. Interview on 5/9/19 at 10:22 a.m. with the DON regarding resident 61 revealed: LPN N should have provided privacy for the resident when she performed oral care. CNA F should not have stood over the resident to assist her with eating. Surveyor: 3. Observation on 5/07/19 at 8:54 a.m. of resident 78 revealed: The DON and CNA M assisted the resident to the restroom using the mechanical standing lift. The curtain had not been pulled around her roommate's bed, and the bathroom door had not been closed. Her roommate was resting in her bed. Her roommate could have watched her while: -Staff exposed her while in the standing lift. -Being transferred to the toilet. -Sitting on the toilet. -Staff had provided perineal care that would have been visible to the roommate or anyone else that could have entered the room. Surveyor Interview on 5/8/19 at 8:54 a.m. with the DON regarding the above observation of resident 78: The curtain should have been pulled or the bathroom door should have been closed. *She agreed the roommate could have seen someone using the restroom if the curtain was not pulled, or the door was not closed. Review of the provider's 3/31/17 Quality of Life - Dignity policy revealed: Staff shall promote, maintain and protect resident privacy, including bodily privacy during assistance with personal care and during treatment procedures.	2020-09-01