cms_SD: 80

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
80	ROLLING HILLS HEALTHCARE	435035	2200 13TH AVE	BELLE FOURCHE	SD	57717	2017-02-01	280	D	0	1	X0TZ11	Based on observation, record review, interview, and policy review, the provider failed to update and follow care plans for 2 of 13 sampled residents (3 and 13). Findings include: 1. Observation on 1/31/17 at 9:10 a.m. of resident 3 revealed she had been: In her room sitting half-way off the seat of her wheelchair. -Scooting around her room with her feet. Attempting to pick clothes up off the recliner and was leaning forward. Interview on 1/31/17 at 9:50 a.m. with the director of nursing (DON) regarding resident 3 revealed she used to use a walker. She had not used a walker since (MONTH) (YEAR). She currently got around in her wheelchair. Observation on 1/31/17 from 11:50 a.m. through 12:35 p.m. of resident 3 revealed: She had been served her food at 12:20 p.m. She was served turkey with gravy, round small white potatoes, a bun, and fruit in a separate bowl. Her neighbor cut up the turkey for her. Review of resident 3's current undated care plan revealed: She was supposed to have her meat cut-up. It stated she ambulated with a four wheeled walker. Resident often refuses to sit in a chair and wants to sit on her walker, she has been educated on safety with her walker, and staff will continue to encourage her to sit in a chair at the table. Interview on 2/1/17 at 2:30 p.m. with the DON, the administrator, and the nurse consultant regarding resident 3 revealed the care plan had not been updated to reflect she was no longer using the walker. They were not aware the dietary staff had not been cutting up her meat but agreed she would not have been able to do it herself. Review of the provider's (MONTH) (YEAR) care planning policy revealed: Care planning was constantly in process. Care plans should be updated between care conferences to reflect current care needs. Any information updated or discontinued in the resident's care plan will include the date of the changes. 2. Observation on 1/31/17 of resident 13 at the 12:00 noon and supper meals revealed he sat at a table by himself. Further observations revealed he had a room by himself. A confidential complaint on 1/31/17 from another resident revealed resident 13 had been very aggressive toward him. He was concerned that staff had not appropriately addressed his behaviors. Review of resident 13's 8/22/16 nursing progress notes revealed: Resident became aggressive towards roommate and threatened to hit. Approximately 5 to 10 minutes later resident did hit roommate, (resident's name) over a disagreement with the curtain and TV. Both residents were spoken to by nurse to confirm incident. Nurse then spoke to resident in regards to inappropriate behavior and encouraged resident to call for nurse in future so a future episode like this may be avoided. 10/10/16: Situation between resident number (facility number) and (resident room number) where words were exchanged and a bubble cup was thrown and resident (facility number) was ultimately hit in forehead with bubble cup. Background: Resident has hx (history) of aggression towards one another as well as other residents and staff. Interview on 2/1/17 at 9:15 a.m. of certified nursing assistant (CNA) A regarding resident 13 revealed: For the most part he was very pleasant. He had not required any assistance with care, so he did not have a lot to do with him. He had problems in the past with not getting along with other residents at the table, so that was why he sat alone at meals. Interview on 2/1/17 at 9:30 a.m. with bath aide B regarding resident 13 revealed: She had no problems with giving him a bath; he was cooperative. He could not have a roommate, because he had hit them in the past. Interview on 2/1/17 at 10:00 a.m. with the director of nursing regarding resident 13 revealed: They had problems with him in the past that had contributed to why he did not have a roommate. He did not like females. His behaviors were sneaky; he said things under his breath that were mean or aggressive towards other residents. -He would try not to do it if staff could hear him. Review of resident 13's printed 2/1/17 care plan revealed on 4/20/15 they had implemented: Focus: I show a need for mental stimulation, diversion, relaxation, and enjoy interaction with others as evidenced during interview. -Intervention: I enjoy socializing with other residents and staff during meals and activity events. --Staff invite/escort me to current events as scheduled. --Staff invite/escort me to special activity events as scheduled. Focus: I enjoy some specific activities in open court, activity room and off unit. -Intervention: I enjoy attending Catholic Mass/Communion as scheduled on Wednesday. -I enjoy attending Christian Life Services as scheduled on Sunday. -I enjoy being involved in poker runs that are planned by the activity department. -Staff invite/escort me to group musicals as scheduled. Focus: I have a hx (history) of resisting cares and do not like to have help. - Intervention: I prefer male caregivers over female caregivers if able, I accept help from males better than females. Focus: Behavior/Coping: I have behavior issues that can interfere with my day to day activities that include: I become aggressive with females, more than males, due to a poor relationship with my mother as indicated by my family. -Interventions: (mental health facility name) provide me with consultation as needed. I have a history of being verbally abusive towards other residents. Please monitor me when I am out of my room. The above care plan did not address: How to prevent the behaviors from happening. The potential for physical aggression. Updates of activities the resident was attending, and what was no longer available such as poker runs. How they met the resident's activity needs since he was not able to attend activities because of concern over his behaviors. The varying information regarding his preference males or females. The benefit of his eating at a table alone, and having a private room to manage behaviors. Interview on 2/1/17 at 1:00 p.m. with the activity director regarding resident 13 revealed: There was a reason he did not have a roommate or tablemate. -He had chased off every tablemate ever he had. --They had requested to be moved to another table. He had not come to activities because his behavior was unpredictable. He would come to Mass. -He liked church services and his family visits. He did not like males. He liked to go to Deadwood whenever that was scheduled. They had not gone on poker runs for over two years. She confirmed the care plan was not current. Review of the provider's undated activity care plan policy revealed: 1. An individualized activity care plan is maintained for each resident. 2. This plan contains activities that the resident enjoys, or may enjoy, and has been approved by the resident's attending physician. 3. Individualized activity plans are incorporated into the resident's total care plan. *4. Activity plans are reviewed and/or revised as necessary, but at least quarterly.	2020-09-01