cms_SD: 31

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
31	AVERA ROSEBUD COUNTRY CARE CENTER	435029	300 PARK STREET POST OFFICE BOX 408	GREGORY	SD	57533	2018-12-19	690	D	0	1	ZMYV11	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 (37) had appropriate bowel management. Findings include: 1. Observation on 12/19/18 at 7:05 a.m. of certified nurse aide (CNA) A performing morning care with resident 37 revealed: She was able to answer yes and no questions related to her daily activities. She had been able to state no when asked if she needed to have a bowel movement. Review of resident 37's medical record revealed: She was admitted on [DATE]. She had [DIAGNOSES REDACTED]. and history of urinary tract infection [MEDICAL CONDITION]. Her 11/26/18 admission Minimum Data Set (MDS) assessment revealed: -A Brief Interview of Mental Status score had been three indicating severe cognitive impairment. -She --Was an extensive assistance of one staff member with toileting and personal hygiene needs. --Had been able to indicate toileting needs. --Had always been continent of bowel. She had a recent short stay hospitalization related to rule out [MEDICAL CONDITION], UTI, and constipation from 12/7/18 to 12/11/18. She had not had a bowel movement (BM) for seven days. Interview on 12/19/18 at 7:30 a.m. with CNA A regarding resident 37's toileting habits revealed: She was able to tell staff when she needed to have a BM. She preferred to use the toilet and not go in her brief. Interview on 12/19/18 at 9:01 a.m. with CNA B regarding bowel management revealed: Resident 37 was able to ask to use the toilet. Every morning in report CNAs were given a list of residents who had not had a BM in three days. -The night nurse printed the report for day shift. The nurse would inform the CNAs if a resident were to receive a suppository or medication to assist with a BM. -CNAs would be aware of who would need immediate assistance with toileting. When the resident had results the CNA charted in the computer under Bowel Record. Interview on 12/19/18 at 10:30 a.m. with the director of nursing regarding resident 37 and the bowel management program revealed: She was unclear why the resident did not flag on the BM report. There must have been a glitch in the computer system. They had started keeping the daily BM report to monitor patterns and chronic issues. -Hoped it would prevent a resident from going seven days or more without a BM. Was unclear what else could be done to prevent the issue from happening again. Interview on 12/19/18 at 11:56 a.m. with the MDS coordinator revealed: The physician had been contacted regarding resident 37's chronic constipation issue. The computer system only had one report for no BM in three days. -Had been saving the report. -Unsure of what other measures could have been taken to prevent that from happening again. When they had a new admission they would run a BM report to make sure the new resident flagged on the report. *Needed to develop a better plan to manage the bowel program. Review of the provider's (MONTH) (YEAR) Bowel and Bladder policy revealed it did not address a bowel management program or system for a resident with constipation.	2020-09-01