| Health Violations: |
| Category: |
Date: |
Specific Violation: |
Scope: |
Level of Harm Caused: |
| Environmental Deficiencies |
07/10/2003 |
Keep safe, clean and homelike surroundings. |
Pattern |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
07/10/2003 |
Make sure that the nursing home area is free of dangers that cause accidents. |
Isolated |
Minimal harm or potential for actual harm |
| Pharmacy Service Deficiencies |
07/10/2003 |
Make sure that the pharmacist reports anything unusual to the doctor on duty and the director of nursing. |
Isolated |
Minimal harm or potential for actual harm |
| Pharmacy Service Deficiencies |
07/10/2003 |
Properly mark drugs and other similar products. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
07/10/2003 |
Give professional services that follow each resident's written care plan. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
07/10/2003 |
Make sure that residents who cannot care for themselves receive help with eating/drinking, grooming and hygiene. |
Pattern |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
07/10/2003 |
Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
07/10/2003 |
Give proper treatment to residents with feeding tubes to prevent problems (such as aspiration pneumonia, diarrhea, vomiting, dehydration, metabolic abnormalities, nasal-pharyngeal ulcers) and help restore eating skills, if possible. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Assessment Deficiencies |
07/10/2003 |
1) Develop a complete care plan within 7 days of each resident's admission; 2) prepare a care plan with the care team, including the primary nurse, doctor, resident or resident's family or representative; or 3) check and update the care plan. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
07/10/2003 |
Have a private telephone available for use. |
Widespread |
Potential for minimal harm |
| Resident Rights Deficiencies |
07/10/2003 |
Provide care in a way that keeps or builds each resident's dignity and self respect. |
Isolated |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
06/17/2004 |
Get rid of garbage properly. |
Pattern |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
06/17/2004 |
Store, cook, and give out food in a safe and clean way. |
Pattern |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
06/17/2004 |
Give professional services that meet a professional standard of quality. |
Pattern |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
06/17/2004 |
Give professional services that follow each resident's written care plan. |
Pattern |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
06/17/2004 |
Give each resident care and services to get or keep the highest quality of life possible. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
06/17/2004 |
Make sure each resident is being watched and has assistance devices when needed, to prevent accidents. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Assessment Deficiencies |
06/17/2004 |
Develop a complete care plan that meets all of a resident's needs, with timetables and actions that can be measured. |
Pattern |
Minimal harm or potential for actual harm |
| Resident Assessment Deficiencies |
06/17/2004 |
1) Develop a complete care plan within 7 days of each resident's admission; 2) prepare a care plan with the care team, including the primary nurse, doctor, resident or resident's family or representative; or 3) check and update the care plan. |
Pattern |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
06/17/2004 |
Tell each resident who can get Medicaid benefits about 1) which items and services Medicaid covers and which the resident must pay for; or 2) how to apply for Medicaid, along with the names and addresses of State groups that can help. |
Widespread |
Potential for minimal harm |
| Resident Rights Deficiencies |
06/17/2004 |
Provide care in a way that keeps or builds each resident's dignity and self respect. |
Pattern |
Potential for minimal harm |
| Environmental Deficiencies |
01/26/2006 |
Keep safe, clean and homelike surroundings. |
Isolated |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
01/26/2006 |
Provide needed housekeeping and maintenance. |
Widespread |
Potential for minimal harm |
| Environmental Deficiencies |
01/26/2006 |
Have a program to keep infection from spreading. |
Isolated |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
01/26/2006 |
Store, cook, and give out food in a safe and clean way. |
Widespread |
Potential for minimal harm |
| Pharmacy Service Deficiencies |
01/26/2006 |
Keep drugs and other similar products locked safely and properly stored. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
01/26/2006 |
Provide activities to meet the needs of each resident. |
Widespread |
Potential for minimal harm |
| Quality Care Deficiencies |
01/26/2006 |
Give professional services that meet a professional standard of quality. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
01/26/2006 |
Give professional services that follow each resident's written care plan. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
01/26/2006 |
Give each resident care and services to get or keep the highest quality of life possible. |
Isolated |
Actual harm |
| Quality Care Deficiencies |
01/26/2006 |
Make sure that residents who cannot care for themselves receive help with eating/drinking, grooming and hygiene. |
Isolated |
Minimal harm or potential for actual harm |
| Fire Safety Violations: |
| Category: |
Date: |
Specific Violation: |
Scope: |
Level of Harm Caused: |
| Automatic Sprinkler Systems Deficiencies |
02/01/2006 |
an approved automatic sprinkler system connected to the fire alarm system. |
Isolated |
Minimal harm or potential for actual harm |
| Automatic Sprinkler Systems Deficiencies |
02/01/2006 |
properly working alarms on sprinkler valves. |
Pattern |
Minimal harm or potential for actual harm |
| Automatic Sprinkler Systems Deficiencies |
02/01/2006 |
automatic sprinkler systems that have been maintained in working order. |
Pattern |
Minimal harm or potential for actual harm |
| Building Service Equipment Deficiencies |
02/01/2006 |
properly protected cooking facilities. |
Isolated |
Minimal harm or potential for actual harm |
| Corridor Walls and Doors Deficiencies |
02/01/2006 |
corridor and hallway doors that block smoke. |
Pattern |
Minimal harm or potential for actual harm |
| Electrical Deficiencies |
02/01/2006 |
properly installed electrical wiring and equipment. |
Isolated |
Minimal harm or potential for actual harm |
| Emergency Plans and Fire Drills Deficiencies |
02/01/2006 |
record of quarterly fire drills for each shift under varying conditions. |
Widespread |
Potential for minimal harm |
| Exits and Egress Deficiencies |
02/01/2006 |
exits that are accessible at all times. |
Isolated |
Minimal harm or potential for actual harm |
| Exits and Egress Deficiencies |
02/01/2006 |
proper exit design. |
Isolated |
Minimal harm or potential for actual harm |
| Fire Alarm Systems Deficiencies |
02/01/2006 |
an approved installation, maintenance and testing program for fire alarm systems. |
Pattern |
Minimal harm or potential for actual harm |
| Hazardous Area Deficiencies |
02/01/2006 |
construction that can resist fire for one hour or an approved fire extinguishing system. |
Pattern |
Minimal harm or potential for actual harm |
| Smoke Compartmentation and Control Deficiencies |
02/01/2006 |
walls or barriers that prevent smoke from passing through and would resist fire for at least one hour. |
Isolated |
Minimal harm or potential for actual harm |
| Smoke Compartmentation and Control Deficiencies |
02/01/2006 |
smoke barrier doors that can resist smoke for at least 20 minutes. |
Isolated |
Minimal harm or potential for actual harm |
| Vertical Openings Deficiencies |
02/01/2006 |
protected exits that allow the resident to escape the building. |
Isolated |
Minimal harm or potential for actual harm |