cms_SD: 73

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
73	AVERA MARYHOUSE LONG TERM CARE	435034	717 EAST DAKOTA	PIERRE	SD	57501	2019-08-07	656	D	0	1	ILL611	NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, record review, and interview, the provider failed to develop and revise individual care plans to reflect the current needs for 2 of 14 sampled residents (3 and 31). Findings include: 1. Multiple random observations on 8/6/19 from 9:00 a.m. through 5:30 p.m. and again on 8/7/19 from 8:30 a.m. through 2:00 p.m. of resident 3 revealed he: Sat in his slightly reclined Broda chair. Had pink foam boots on both heels. While he sat with the pink foam heel protectors on his heels had been firmly pressed against his chair. That would have offered no pressure relief or off loading for his heels. Both of his legs were contracted. There had been no protection for his lower legs and knees for pressure relief. Review of resident 3's revised 8/2/19 care plan revealed: A problem area stated: Skin integrity. -The goal for the above focus area regarding the resident's heels and legs had been: Maintain. -Interventions for the above had been: --Heel protectors on while in bed and/or offload heels on pillows. --Place cushion/pillow between knees to provide protection from his knees pressing on each other. Interview on 8/7/19 at 4:00 p.m. with the administrator and director of nursing regarding resident 3 revealed they: Confirmed the resident had a right heel pressure ulcer. Agreed the pink foam boots did not offer pressure relief when they had been constantly pressed on the foot and leg area of the Broda chair. Agreed the resident was to have had a cushion and pillow between his knees for preventative pressure relief. Review of the provider's last revised (MONTH) (YEAR) Pressure Ulcer Prevention and Wound Treatment policy revealed its purpose had been: To improve resident safety by identifying individuals at risk for healthcare-acquired pressure ulcers; to systematically assess and document skin risk factors; to implement skin-protection components of care, and to provide appropriate treatment when indicated. Interventions will be implemented to reduce the risk of developing pressure ulcers by managing moisture, optimizing nutrition and hydration, and minimizing pressure. 2. Review of resident 31's medical record revealed: She was admitted on [DATE]. She had a Brief Interview for Mental Status assessment score of fifteen indicating she was cognitively intact. Her [DIAGNOSES REDACTED].>-Type two diabetes. -End stage [MEDICAL CONDITION]. -Dependence on [MEDICAL TREATMENT]. -[MEDICAL CONDITION]. -Heart failure. -[MEDICAL CONDITION]. She had been receiving [MEDICAL TREATMENT] three times per week. She was on a renal diet with a 1500 milliliter fluid allowance per day. Observation on 8/6/19 at 2:22 p.m. and at 4:30 p.m. of resident 31 revealed: She was sitting on her bed watching television. Her room had a foul odor. There was a moderate amount of feces on the floor next to her bed in front of the garbage can. Had witnessed her throw an empty paper package on top of the feces on the floor. Interview on 8/6/19 at 2:58 p.m. with registered nurse (RN) I regarding resident 31 revealed: She often had feces on the floor in her room. She would also throw garbage and paper on the floor in her room. Review of 6/10/19 the registered dietician's nutrition information note regarding resident 31 revealed: Her husband had brought food in to her including fluids. Both the resident and her husband had been educated on dietary recommendations. Husband just wants her to be happy, and she agrees with this. Review of the last reviewed 6/27/18 care plan for resident 31 revealed no behaviors and non-compliance with diet had not been identified. Review of a 7/18/19 nurses note regarding resident 31 revealed: The [MEDICAL TREATMENT] center had sent nutrition education with the resident after her [MEDICAL TREATMENT] treatment. The nurse had asked her husband if he wanted to review the education. -He had not reviewed the information. -He told the nurse that the resident was going to do what she wanted. Interview on 8/7/19 at 11:40 a.m. with RN A regarding resident 31's care plan revealed: She had agreed the non-compliance with diet and fluid allowance and the behaviors such as defecating on the floor should have been on the care plan. *She had not put the behaviors on the care plan, because she did not have interventions to add that would help decrease the behavior. A care plan policy was requested on 8/7/19 at 11:30 a.m from the administrator. A policy for Baseline Care plans was received but not for care plans. The administrator stated they did not have one.	2020-09-01