| Health Violations: |
| Category: |
Date: |
Specific Violation: |
Scope: |
Level of Harm Caused: |
| Mistreatment Deficiencies |
10/18/2003 |
Write and use policies that forbid mistreatment, neglect and abuse of residents and theft of residents' property. |
Isolated |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
10/18/2003 |
Hire enough skilled workers to carry out dietary service. |
Widespread |
Potential for minimal harm |
| Nutrition and Dietary Deficiencies |
10/18/2003 |
Make sure that residents are well nourished. |
Isolated |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
10/18/2003 |
Provide food in a way that meets a resident's needs. |
Isolated |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
10/18/2003 |
Store, cook, and give out food in a safe and clean way. |
Widespread |
Potential for minimal harm |
| Quality Care Deficiencies |
10/18/2003 |
Make sure that each resident who enters the nursing home without a catheter is not given a catheter, unless it is necessary. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Assessment Deficiencies |
10/18/2003 |
Check and update (if needed) each resident's assessment every 3 months. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Assessment Deficiencies |
10/18/2003 |
Develop a complete care plan that meets all of a resident's needs, with timetables and actions that can be measured. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Assessment Deficiencies |
10/18/2003 |
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 Assessment Deficiencies |
10/18/2003 |
Provide a final summary of the resident's health status and a summary of the resident's stay, when the resident is ready to leave the nursing home. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
10/18/2003 |
Have a private telephone available for use. |
Widespread |
Potential for minimal harm |
| Administration Deficiencies |
09/30/2004 |
Make sure that nurse aides show they have the skills to be able to care for residents. |
Isolated |
Minimal harm or potential for actual harm |
| Administration Deficiencies |
09/30/2004 |
Keep accurate and appropriate medical records. |
Isolated |
Minimal harm or potential for actual harm |
| Administration Deficiencies |
09/30/2004 |
Set up or keep a group of people to review and ensure quality. |
Widespread |
Potential for minimal harm |
| Environmental Deficiencies |
09/30/2004 |
Keep safe, clean and homelike surroundings. |
Widespread |
Potential for minimal harm |
| Environmental Deficiencies |
09/30/2004 |
Have a program to keep infection from spreading. |
Isolated |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
09/30/2004 |
Provide special eating equipment and utensils for each resident who needs them. |
Isolated |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
09/30/2004 |
Store, cook, and give out food in a safe and clean way. |
Widespread |
Potential for minimal harm |
| Quality Care Deficiencies |
09/30/2004 |
Provide social services for related medical problems to help each resident achieve the highest possible quality of life. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
09/30/2004 |
Give professional services that follow each resident's written care plan. |
Pattern |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
09/30/2004 |
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 |
| Quality Care Deficiencies |
09/30/2004 |
Make sure that residents with reduced range of motion get proper treatment and services to increase range of motion. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
09/30/2004 |
Properly care for residents needing special services, including: injections, colostomy, ureostomy, ileostomy, tracheostomy care, tracheal suctioning, respiratory care, foot care, and prostheses. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
09/30/2004 |
Provide care in a way that keeps or builds each resident's dignity and self respect. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
09/30/2004 |
Provide services to meet the needs and preferences of each resident. |
Isolated |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
02/24/2006 |
Provide needed housekeeping and maintenance. |
Isolated |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
02/24/2006 |
Keep a resident apart from the others if the resident has an infection that can spread. |
Isolated |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
02/24/2006 |
Prepare food that is nutritional, appetizing, tasty, attractive, well-cooked, and at the right temperature. |
Widespread |
Potential for minimal harm |
| Nutrition and Dietary Deficiencies |
02/24/2006 |
Offer other nutritional food to each resident who will not eat the food served. |
Widespread |
Potential for minimal harm |
| Nutrition and Dietary Deficiencies |
02/24/2006 |
Store, cook, and give out food in a safe and clean way. |
Widespread |
Potential for minimal harm |
| Quality Care Deficiencies |
02/24/2006 |
Give professional services that follow each resident's written care plan. |
Pattern |
Minimal harm or potential for actual harm |
| Resident Assessment Deficiencies |
02/24/2006 |
Make sure all assessments are accurate, coordinated by an RN, done by the right professional, and are signed by the person completing them. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
02/24/2006 |
Provide care in a way that keeps or builds each resident's dignity and self respect. |
Isolated |
Minimal harm or potential for actual harm |
| Fire Safety Violations: |
| Category: |
Date: |
Specific Violation: |
Scope: |
Level of Harm Caused: |
| Emergency Plans and Fire Drills Deficiencies |
10/22/2003 |
record of quarterly fire drills for each shift under varying conditions. |
Pattern |
Potential for minimal harm |
| Hazardous Area Deficiencies |
10/22/2003 |
construction that can resist fire for one hour or an approved fire extinguishing system. |
Isolated |
Minimal harm or potential for actual harm |
| Miscellaneous Deficiencies |
10/22/2003 |
fire safety features required by current fire safety codes. |
Widespread |
Potential for minimal harm |
| Vertical Openings Deficiencies |
10/22/2003 |
protected exits that allow the resident to escape the building. |
Isolated |
Minimal harm or potential for actual harm |
| Automatic Sprinkler Systems Deficiencies |
10/05/2004 |
an approved automatic sprinkler system connected to the fire alarm system. |
Pattern |
Potential for minimal harm |
| Building Service Equipment Deficiencies |
10/05/2004 |
properly protected cooking facilities. |
Isolated |
Minimal harm or potential for actual harm |
| Electrical Deficiencies |
10/05/2004 |
weekly inspections and monthly testing of generators. |
Isolated |
Minimal harm or potential for actual harm |
| Electrical Deficiencies |
10/05/2004 |
properly installed electrical wiring and equipment. |
Pattern |
Potential for minimal harm |
| Corridor Walls and Doors Deficiencies |
03/07/2006 |
corridor and hallway doors that block smoke. |
Isolated |
Minimal harm or potential for actual harm |