| Health Violations: |
| Category: |
Date: |
Specific Violation: |
Scope: |
Level of Harm Caused: |
| Environmental Deficiencies |
09/12/2003 |
Make sure that the nursing home area is free of dangers that cause accidents. |
Pattern |
Minimal harm or potential for actual harm |
| Mistreatment Deficiencies |
09/12/2003 |
1) Hire only people who have no legal history of abusing, neglecting or mistreating residents; or 2) report and investigate any acts or reports of abuse, neglect or mistreatment of residents. |
Widespread |
Potential for minimal harm |
| Nutrition and Dietary Deficiencies |
09/12/2003 |
1) Provide 3 meals daily at regular times; or 2) serve breakfast within 14 hours after dinner; or 3) offer a snack at bedtime each day. |
Pattern |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
09/12/2003 |
Store, cook, and give out food in a safe and clean way. |
Widespread |
Minimal harm or potential for actual harm |
| Pharmacy Service Deficiencies |
09/12/2003 |
Provide drugs and related services needed by each resident. |
Pattern |
Minimal harm or potential for actual harm |
| Pharmacy Service Deficiencies |
09/12/2003 |
Act when the pharmacist reports something unusual. |
Isolated |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
09/12/2003 |
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 |
09/12/2003 |
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 Assessment Deficiencies |
09/12/2003 |
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. |
Pattern |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
09/12/2003 |
Honor all of the resident's rights as a resident of the nursing home and as a citizen or resident of the United States. |
Widespread |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
09/12/2003 |
Let residents give themselves their drugs if they are able. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
09/12/2003 |
Provide care in a way that keeps or builds each resident's dignity and self respect. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
09/12/2003 |
Provide services to meet the needs and preferences of each resident. |
Isolated |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
07/02/2004 |
Provide needed housekeeping and maintenance. |
Isolated |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
07/02/2004 |
Keep sound levels comfortable. |
Isolated |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
07/02/2004 |
Make sure that the nursing home area is free of dangers that cause accidents. |
Widespread |
Immediate jeopardy to resident health or safety |
| Environmental Deficiencies |
07/02/2004 |
Get rid of garbage properly. |
Isolated |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
07/02/2004 |
Have a program to keep infection from spreading. |
Isolated |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
07/02/2004 |
Make sure that a working call system is available in each resident's room or bathroom and bathing area. |
Isolated |
Minimal harm or potential for actual harm |
| Environmental Deficiencies |
07/02/2004 |
Make sure there is a program to prevent/deal with mice, insects, or other pests. |
Pattern |
Minimal harm or potential for actual harm |
| Nutrition and Dietary Deficiencies |
07/02/2004 |
Store, cook, and give out food in a safe and clean way. |
Widespread |
Minimal harm or potential for actual harm |
| Quality Care Deficiencies |
07/02/2004 |
Give professional services that meet a professional standard of quality. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Assessment Deficiencies |
07/02/2004 |
Make a complete assessment that covers all questions for areas that are listed in official regulations. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Assessment Deficiencies |
07/02/2004 |
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. |
Isolated |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
07/02/2004 |
Provide care in a way that keeps or builds each resident's dignity and self respect. |
Pattern |
Minimal harm or potential for actual harm |
| Resident Rights Deficiencies |
07/02/2004 |
Provide services to meet the needs and preferences of each resident. |
Isolated |
Minimal harm or potential for actual harm |
| Fire Safety Violations: |
| Category: |
Date: |
Specific Violation: |
Scope: |
Level of Harm Caused: |
| Building Service Equipment Deficiencies |
09/18/2003 |
properly protected cooking facilities. |
Isolated |
Minimal harm or potential for actual harm |
| Corridor Walls and Doors Deficiencies |
09/18/2003 |
corridor and hallway doors that block smoke. |
Pattern |
Potential for minimal harm |
| Emergency Plans and Fire Drills Deficiencies |
09/18/2003 |
record of quarterly fire drills for each shift under varying conditions. |
Pattern |
Potential for minimal harm |
| Fire Alarm Systems Deficiencies |
09/18/2003 |
a fire alarm system that can be heard throughout the facility. |
Isolated |
Minimal harm or potential for actual harm |
| Hazardous Area Deficiencies |
09/18/2003 |
construction that can resist fire for one hour or an approved fire extinguishing system. |
Isolated |
Minimal harm or potential for actual harm |
| Miscellaneous Deficiencies |
09/18/2003 |
fire safety features required by current fire safety codes. |
Pattern |
Minimal harm or potential for actual harm |
| Smoking Regulations Deficiencies |
09/18/2003 |
posted No-smoking signs in areas where smoking is not permitted or did not provide ashtrays where smoking was allowed. |
Pattern |
Potential for minimal harm |
| Vertical Openings Deficiencies |
09/18/2003 |
protected exits that allow the resident to escape the building. |
Pattern |
Minimal harm or potential for actual harm |
| Automatic Sprinkler Systems Deficiencies |
07/09/2004 |
automatic sprinkler systems that have been maintained in working order. |
Pattern |
Minimal harm or potential for actual harm |
| Building Contruction Deficiencies |
07/09/2004 |
approved construction type or materials. |
Pattern |
Potential for minimal harm |
| Fire Alarm Systems Deficiencies |
07/09/2004 |
an approved installation, maintenance and testing program for fire alarm systems. |
Widespread |
Potential for minimal harm |
| Illumination and Emergency Power Deficiencies |
07/09/2004 |
emergency lighting that can last at least 1 1/2 hours. |
Isolated |
Minimal harm or potential for actual harm |
| Medical Gases and Anesthetizing Areas Deficiencies |
07/09/2004 |
proper medical gas storage and administration areas. |
Isolated |
Minimal harm or potential for actual harm |
| Automatic Sprinkler Systems Deficiencies |
11/09/2005 |
automatic sprinkler systems that have been maintained in working order. |
Pattern |
Minimal harm or potential for actual harm |
| Fire Alarm Systems Deficiencies |
11/09/2005 |
an approved installation, maintenance and testing program for fire alarm systems. |
Isolated |
Minimal harm or potential for actual harm |
| Hazardous Area Deficiencies |
11/09/2005 |
construction that can resist fire for one hour or an approved fire extinguishing system. |
Isolated |
Minimal harm or potential for actual harm |