cms_SD: 9

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
9	PRAIRIE HEIGHTS HEALTHCARE	435004	400 8TH AVENUE NW	ABERDEEN	SD	57401	2019-06-26	758	D	0	1	9U2F11	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 four sampled residents (69) had appropriate documentation to support the rationale for adding and increasing [MEDICAL CONDITION] medications. Findings include: 1. Review of resident 69's medical record revealed: She was admitted on [DATE]. Her Brief Interview for Mental Status assessment score was a ten indicating her cognition was moderately impaired. Her [DIAGNOSES REDACTED].>-Shortness of breath. -[MEDICAL CONDITION]. -Major [MEDICAL CONDITION] recurrent. -Anxiety disorder unspecified. -Dementia in other disease classified elsewhere with behavioral disturbance. Observation and interview on 6/24/19 at 4:40 p.m. with resident 69 revealed: She liked the facility. The staff were nice to her. She did not display any signs or symptoms of anxiety during the interview. Random observations of resident 69 on 6/25/19 from 7:30 a.m. through 6:45 p.m. and on 6/26/19 from 7:30 a.m. through 4:00 p.m. revealed: She was sitting in her room in her wheelchair. Visitors were playing cards with her at times. Her essential oil diffuser was on at times. No yelling out was noted. Review of all of resident 69's nursing progress notes from (MONTH) (YEAR), (MONTH) 2019, and (MONTH) 2019 revealed: In (MONTH) (YEAR) she had eighteen of thirty-one days where yelling out behaviors were documented. -Of those eighteen days seven days indicated a non-pharmalogical intervention was attempted. In (MONTH) 2019 eighteen of thirty-one days there were yelling behaviors documented. -Of those eighteen days two days indicated a non-pharmalogical intervention was attempted. In (MONTH) 2019 she had one of twenty-five days with documentation of yelling out behaviors. -On that day a non-pharmalogical intervention was used and was successful. Review of resident 69's medication administration records revealed: On 12/26/19 [MEDICATION NAME] 2.5 milligrams (mg) was added at bed time for anxiety. On 6/13/19 the [MEDICATION NAME] was increased to 2.5 mg twice daily. She was also receiving scheduled and as needed [MEDICATION NAME]. Review of resident 69's 6/26/19 care plan revealed: Seven of eleven interventions for anxiety were implemented on 2/26/19. -Those were two months after the [MEDICATION NAME] had been started. Interventions included: -Administer medication per physician orders [REDACTED]. Try non-pharmacological interventions on her; offer the bathroom, offer something to eat and drink, monitor her health status/pain, try and redirect her to an activity in her room or in a group setting. She does like to watch TV sometimes. -Evaluate effectiveness and side effects of medications for possible decrease/elimination of [MEDICAL CONDITION] drugs PRN. -Identify and decrease environmental stressors. --Initiated 6/13/18. -Offer 1:1 conversation. -Offer snacks of her liking. -Offer talking books/headphones/MP3 player of her favorite music. -Offer to turn her air conditioner on when she states she is too warm or states she can't breath. -Psych consult and treatment. -Recruit and encourage attendance at activities. -Utilize essential oil diffuser in her room with oils when she requests. -Ensure that her hand held fan is within reach. --Initiated 2/26/19. Interview on 6/26/19 at 10:33 a.m. with registered nurse [NAME] and the administrator regarding resident 69 revealed: She had anxiety. She yelled out when people were not with her. She was typically okay when people were with her. Some of the interventions for her anxiety were implemented after she had started the [MEDICATION NAME]. She had an order for [REDACTED]. Her family knew she did better when people were with her, and they had hired two individuals to be with her in the afternoons. Interview on 6/26/19 at 2:40 p.m. with certified nursing assistants C and D regarding resident 69 revealed: She was used to having someone in her room with her. She got lonely in her room and called out. She typically did not know what she needed but wanted people to sit with her in her room. She liked when staff sat with her. She had two or three people who could come and sit with her during the day. They would explain to her she needed to use her call light and not yell out. *Sometimes they would turn on her music or TV. Review of the provider's (YEAR) Antipsychotic Medication Use policy revealed: Antipsychotic medications may be considered for residents with dementia but only after medial, physical, functional, psychological, emotional psychiatric, social and environmental causes of behavioral symptoms have been identified and addressed.	2020-09-01