cms_SD: 35

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

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rowid facility_name facility_id address city state zip inspection_date deficiency_tag scope_severity complaint standard eventid inspection_text filedate
35 MONUMENT HEALTH CUSTER CARE CENTER 435032 1065 MONTGOMERY ST CUSTER SD 57730 2019-03-13 677 D 0 1 0JC611 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, record review, interview, and policy review, the provider failed to provide oral care for two of two sampled residents (41 and 204). Findings include: 1. Observation of resident 41 on 3/12/19 from 7:50 a.m. through 8:50 a.m. during personal care revealed certified nursing assistant (CNA) G had not provided any oral care. Interview on 3/12/19 at 10:00 a.m. with resident 41 revealed: *She was unable to use her left arm due to a stroke. *She was able to do some of her own oral care after set-up. *Staff would have helped if she could not complete all of her oral care herself. *CNA G did not assist her to brush her teeth this morning. Interview on 3/13/19 at 10:49 a.m. with resident 41 revealed she had not been assisted with any oral care this morning. Observation on 03/13/19 at 10:50 a.m. of resident 41's toothbrush and basin revealed they were dry. Interview on 3/13/19 at 2:00 p.m. with the director of nursing revealed staff should have assisted resident 41 with her oral care. She stated that had been addressed before and signs had been placed in residents' rooms who required assistance. She agreed resident 41 did have one of those signs. Review of resident 41's 11/6/18 care plan for her activites of daily living revealed: *Focus: I have a history [MEDICAL CONDITION] and my left side is flaccid. I am not able to complete my daily care activities and I need your assistance. *Goal: I will complete my daily care activities by accepting your assistance through my next review date. *Interventions included: -PERSONAL HYGIENE/ORAL CARE: I need limited to extensive assist to perform hygiene activities. I have my own teeth and need you to assist me to clean them. 2. Observations and interviews on: *3/12/19 at 8:15 a.m., 11:00 a.m., 2:00 p.m., and 3:48 p.m. with resident 204 and his wife revealed: -They both stated he had not been assisted with or provided oral hygiene during the above times. -His wife stated: --She knew that, because she had been with him since 7:00 a.m. --She would help him with oral hygiene but had no supplies. --No one had offered supplies or offered to help him. --She preferred the caregivers assist him with oral hygiene. --He had not had oral hygiene provided or offered since he came to the nursing home on 3/6/19. -The resident's: --Lips appeared dry and cracked with a clear, sticky-like coating on them. --Mouth was dry with a build-up of white particles on his tongue and yellow substance on his teeth. *3/13/19 at 11:11 a.m., 1:55 p.m., and 3:00 p.m. with the resident and his wife revealed no oral hygiene had been provided or offered for the resident. -His wife stated again she had no supplies to help him. -She preferred the staff help him. Interview on 3/13/19 at 3:15 p.m. with CNA B revealed she:*Had been the caregiver on resident 204's hallway. *Provided personal care and scheduled baths for all residents on the 200 hall. *Had not provided oral hygiene for him on 3/13/19. *Assisted resident 204 with a bed bath twice a week. -She would only provide oral hygiene on those days. 3. Interview on 3/13/19 at 4:00 p.m. with the director of nurses confirmed oral hygiene was an expectation of activities of daily living. She expected oral hygiene to be done in the a.m. and p.m. with resident care. Agreed oral hygiene supplies should have been provided by the staff. Review of the provider's 1/1/10 Oral Hygiene: Cleaning Dentures policy had no mention of oral hygiene for permanent teeth. No policy had been received by the conclusion of the survey on 3/13/19 at 5:00 p.m. 2020-09-01