cms_SD: 63

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
63	AVERA MARYHOUSE LONG TERM CARE	435034	717 EAST DAKOTA	PIERRE	SD	57501	2018-05-16	710	D	0	1	4XMM11	NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY 2. Observation and interview on 5/15/18 at 9:27 a.m. of resident 33 revealed: She repeated I'm hurting terrible. It was heard by this surveyor all the way down the hallway. Certified nursing assisted (CNA) G was applying an ice pack on her left lower leg on an oval shaped bruise approximately five inches by four inches. CNA G hesitated to apply the ice pack because of her yelling. CNA G and H elevated her legs in the recliner. She continued to yell and grimace in pain. CNA G and H stated she had started yelling out more with movement this weekend after her leg had been bumped into the door. Interview on 5/15/18 at 9:47 a.m. with resident 33 revealed when the surveyor asked what happened to her leg she stated: I'm afraid that its broke. Some girls did it when they were getting me up. Hurts all over. Interview on 5/16/18 at 4:45 p.m. with the director of nursing (DON) revealed: Resident 33's injury had been reported immediately by CNA I to registered nurse (RN) F on 5/12/18. CNA I reported she had brushed resident 33's leg against the wall in the hallway. The DON stated she had not examined the injury. Interview on 5/16/18 at 6:30 p.m. with RN/MDS assessment coordinator and RN/MDS assistant revealed: There was no incident report and investigation completed after the injury had been reported by CNA I. The physician had not been notified of the incident and injury to the resident's left leg. Review of resident 33's complete medical record revealed: An admission date of [DATE]. Her [DIAGNOSES REDACTED]. She: -Had a Brief Interview Mental Status (BIMS) score of twelve indicating her memory recall was slightly impaired. -Had been capable of making her needs known. There was no documentation to support the physician had been notified of: -The incident and injury that had occurred to the resident's left leg on 5/12/18. -The resident's complaints of increased pain and discomfort -The ineffectiveness of the pain medications the staff had give her for those complaints of discomfort. Refer to F697, Finding 1. Based on observation, interview, and record review, the provider failed to ensure physician notification and involvement had occurred in a timely manner for: One of one sampled resident (44) with a facility acquired pressure injury. One of one sampled resident (33) with increased pain after a facility acquired injury. Findings include: 1. Review of resident 44's medical record revealed: An admission date of [DATE]. Her [DIAGNOSES REDACTED]. She was dependent upon the staff to: -Assist her with all of her mobility needs (transferring from place to place and moving in bed) and activities of daily living (ADL). -Implement any preventative interventions to ensure skin breakdown would not have occurred. Her 4/5/18 admission nursing physical assessment identified no skin concerns to her left heel. She had been admitted with no open wounds or pressure injuries to her left heel. On 4/23/18 a pressure injury had been identified to her left heel. -That pressure injury had been identified 18 days after her admission to the facility. No documentation to support the physician had been notified and involved with the wound care of the pressure injury until 5/10/18. -That had been 18 days after an area of concern had been identified on the resident's left heel. Refer to F686, finding 1. Surveyor: 2. Observation and interview on 5/15/18 at 9:27 a.m. of resident 33 revealed: She repeated I'm hurting terrible. It was heard by this surveyor all the way down the hallway. Certified nursing assisted (CNA) G was applying an ice pack on her left lower leg on an oval shaped bruise approximately five inches by four inches. CNA G hesitated to apply the ice pack because of her yelling. CNA G and H elevated her legs in the recliner. She continued to yell and grimace in pain. CNA G and H stated she had started yelling out more with movement this weekend after her leg had been bumped into the door. Interview on 5/15/18 at 9:47 a.m. with resident 33 revealed when the surveyor asked what happened to her leg she stated: I'm afraid that its broke. Some girls did it when they were getting me up. Hurts all over. Interview on 5/16/18 at 4:45 p.m. with the director of nursing (DON) revealed: Resident 33's injury had been reported immediately by CNA I to registered nurse (RN) F on 5/12/18. CNA I reported she had brushed resident 33's leg against the wall in the hallway. The DON stated she had not examined the injury. Interview on 5/16/18 at 6:30 p.m. with RN/MDS assessment coordinator and RN/MDS assistant revealed: There was no incident report and investigation completed after the injury had been reported by CNA I. The physician had not been notified of the incident and injury to the resident's left leg. Review of resident 33's complete medical record revealed: An admission date of [DATE]. Her [DIAGNOSES REDACTED]. She: -Had a Brief Interview Mental Status (BIMS) score of twelve indicating her memory recall was slightly impaired. -Had been capable of making her needs known. *There was no documentation to support the physician had been notified of: -The incident and injury that had occurred to the resident's left leg on 5/12/18. -The resident's complaints of increased pain and discomfort -The ineffectiveness of the pain medications the staff had give her for those complaints of discomfort. Refer to F697, finding 1.	2020-09-01